Nurses challenge hospital staffing cuts, administrative decisions

As the world confronts a major flu outbreak, Minnesota’s hospitals are attempting to reduce the ranks of personnel most skilled to address emergency health needs, the Minnesota Nurses Association says.

MNA, the union representing more than 20,000 Registered Nurses in 89 bargaining units across the state, has received demands from nine hospitals to reopen contracts regarding wages. In the metro area, more than 100 MNA members have been laid off from their jobs since December 2008. The economic situation sounds dire as employers raise concerns about rising uncompensated care, proposed state budget cuts and dips in census and investments, the union said.

“We’re not buying it,” said MNA President Linda Slattengren. “Yes, we are pushing back at a time when our family and friends have all suffered from layoffs in this economic downturn. Yes, we are saying no to these demands from our employers.”

Why? Call nurses cautious – skeptics perhaps. As 24/7 bedside providers, nurses know patient census fluctuates, sometimes wildly, as in the case of a pandemic. The hospital industry has not proven their case to MNA members, who express doubts because hospital administrative judgment has proven to be, all too often, less than stellar when it comes to the safety of patients in their care.

“North Memorial Hospital, where I work, enjoyed a nearly $179 million net profit over the last six years said Pam Scott, RN. “But due to decisions like purchasing NowCare for $3 million in 2008 and reporting a $4 million loss in the latest financial statement, we have our doubts about the wisdom of administrative choices. My question: Isn’t the purpose of reserves to accommodate more unexpected circumstances, such as economic pressures?”

The medical arms race is alive and well in Minnesota, as hospitals have rushed to compete with each other by providing the latest gadgetry or architecturally-inspired surroundings, MNA said.

“They’ve projected at least $300 million in construction costs for the next three years at Children’s Hospitals and Clinics,” said Melissa Hansing, RN, MNA Tri-Chair and staff nurse in Children’s emergency department. “My questions: Bricks and mortar may impress financiers, but what is going on behind the walls? Aren’t critically ill patients being attended to by overworked, fatigued nursing personnel who simply do not have enough colleagues on each shift? How do you justify cutting corners on skilled personnel at the bedside, when studies conclusively prove the increased risk to patients when staffing is not adequate?”

The claim that patient volume is down conceals the fact that nurses are working with a much sicker, more complex patient population, the union said. The Medicare Case-Mix Index (MCI) reflects the increased intensity (sometimes called severity) or hospital resource requirements of treating Medicare patients over time. Methodist Hospital’s recent financial disclosure, available at munifilings.com, reveals the disturbing evidence.

“In the last quarter, Methodist Hospital saw their MCI increase 5.3% over 2007’s 4th quarter,” said Margaret Gamble, RN. “My question: how do hospital accountants expect nurses to speed up healing time?”

Hospital schemes to wring wage concessions out of its workforce falsely depict an image that administrators are simply starting to ask for communal sacrifice. “When we all pitch in, we’ll make things better,” they claim.

Nurses have been pitching in for quite a while now, MNA members said.

“I’ve already reduced my salary by 3 percent because I’ve agreed to reduce my workdays – without pay – when patient volume was low in the past three months, “ said Juli Uzlik, RN of Fairview Southdale. The unspoken practice of nurses working off the clock over meal breaks or after they punch out also effectively donates time to the hospital bottom line.

“Four of my colleagues have opted for early retirement,” Uzlik said. “Over the last 90 days, Registered Nurses have agreed to a minimum value of $126,700 in salary hours. This doesn’t even account for mandatory low need days we’ve all taken, and other casual requests we’ve honored to work a shift here and there. Our question: what cuts in salary have the administrative staffs taken recently?”

On every shift, nurses witness waste and misuse of resources. “We have offered cost-saving suggestions time and time again, but it is the consultants who invariably capture the ear of decision-makers,” said MNA President Slattengren. “My question: When will they learn?”

Using the economic crisis as an excuse to reduce labor costs of the hospital’s core assets is a short-term temptation that will lead to higher costs and compromised care, MNA said. Members said they challenge hospital executives throughout Minnesota “to use clear-eyed, far-sighted courage to keep the interests of patients above the profit margin.”

For more information
Visit the MNA website, www.mnnurses.org