Led by nurses, coalition of MN unions to push ‘Healing Greed Agenda’ in 2024

February 9, 2024 by

John Welsh, a nurse at Unity Hospital, outlined the MNA’s 2024 legislative agenda.

Less than a year after hospital lobbyists stymied efforts to establish minimum staffing levels in Minnesota hospitals, union nurses will head back to the Capitol in 2024 with an agenda focused on safety, nurse retention and increased accountability for health systems and their highly paid executives.

The Minnesota Nurses Association calls it the “Healing Greed Agenda,” and the union has readied a broadly supported campaign to advance it when the 2024 legislative session begins Monday.

“Hospital executives think they run the show,” MNA President Chris Rubesch, a nurse at Essentia-Duluth, said during a Capitol press conference Feb. 5. “They have the money to pay more than sixty lobbyists to ensure the system stays exactly like it is. But we are here today to speak with one voice and demand change. Minnesota can do better, and we must do better!”

Leaders of several other labor organizations, including the Minnesota AFL-CIO and AFSCME Council 5, joined the press conference, pledging to work in coalition to support the campaign. And MNA leaders listed several DFL lawmakers who are working with the coalition to usher the proposed policy measures through the Legislature.

Those measures include:

• Increased protections for nurses who raise concerns about patient safety and inadequate staffing in their hospitals, and greater legal accountability for hospital executives when their staffing decisions lead to adverse events. MNA pointed to several examples of hospitals allegedly retaliating against nurses for calling out unsafe staffing in their units.

• An enhanced student-loan forgiveness program, with more funding and expanded eligibility, designed to recruit and retain hospital nurses, as well as new protections against violence in hospitals – another factor driving nurses away from the bedside. Nurses’ proposed violence prevention measures include trauma-informed care and de-escalation strategies.

• Increased regulation of nonprofit hospitals’ finances and operations, including a cap on executive pay and new requirements that hospitals give public notice of planned service cuts and consolidations. Nurses also want to see increased scrutiny of hospitals’ debt-collection tactics and how the non-profit institutions are meeting requirements that, in lieu of paying taxes, they invest in charity care and public health.

Nationwide polling results, released by Gallup in January, showed that nurses are the most trusted profession among Americans, with 77% of respondents agreeing that they are “honest and ethical.” It was the 22nd consecutive year in which nurses had the highest rating of any profession.

MNA President Chris Rubesch spoke during the Capitol press conference Feb. 5.

At the press conference. Sandra Feist (D-New Brighton) said lawmakers should have the same trust in nurses’ assessment of how corporate greed is impacting patient care in Minnesota hospitals.

“As lawmakers, we need to trust nurses when they tell us that they face retaliation for speaking up in defense of safe patient care,” Feist said. “We need to trust nurses when they tell us that violence is rising in their hospitals for patients and workers due to slashed staff levels and resources. And we need to trust nurses when they tell us that there is a crisis in our hospitals.”

But the “Healing Greed Agenda” is also notable for what isn’t included: the hospital staffing mandates that nurses hoped would become law a year ago.

The “Keeping Nurses at the Bedside Act” advanced through several legislative committees in 2023. The measure would have required hospitals to create labor-management committees to determine appropriate staffing in their wards, but support among lawmakers dwindled after Mayo Clinic threatened to withhold investments in its Rochester campus if the measure passed.

“Hospital CEOs have created a crisis in our hospitals that is driving nurses from the bedside and putting safe patient care at risk,” Shiori Konda-Muhammad, a vice president of MNA, said. “Now, they’re doing everything in their power to keep nurses from speaking up and taking action to demand better for patients and workers.”

Feist and many other DFL lawmakers continue to support the “Keeping Nurses at the Bedside Act,” but she said advocates decided to prioritize the anti-retaliation measure during this shortened legislative session because “it is pure policy,” while the staffing law would be more appropriately considered during a budget session.

Konda-Muhammad, meanwhile, said MNA members will continue to advocate for minimum staffing requirements in their bargaining units – and they shouldn’t fear retaliation from management when they do it.

“We nurses will continue to fight for patients,” she said. “Now, we need lawmakers to have our backs and stand up to corporate bullies in our health care system so we can carry on that fight.”

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Quick fix for staffing crisis not enough, hospital nurses warn

January 21, 2022 by

One day after Minnesota Gov. Tim Walz announced a $40 million plan to bolster hospital staffing with temporary hires, long-serving nurses from many of the state’s hospitals met with state and federal lawmakers to make clear that the crisis demands more than a quick fix.

The virtual town hall Jan. 13 drew over 200 participants, with members of the Minnesota Nurses Association logging on to sound the alarm about dangerously low staffing levels in their hospitals.

Many pinned the blame on administrators for ignoring signs of trouble well before the COVID-19 pandemic began. “This problem was not created overnight,” Allina nurse Vanessa Soldo-Jones said.

Without meaningful action to change the way hospital systems conduct their business in Minnesota, nurses warned, staffing shortfalls will only worsen, threatening the state’s reputation for quality patient care.

“We are tired of delivering substandard care and putting patients at increased risk due to lean staffing,” United Hospital nurse Ali Marcanti said. “Hospital administration has been cutting back on staffing year after year, with staffing grid changes that take very little patient acuity into account.”

Marcanti, Soldo-Jones and other union members offered a series of dire reports from the front lines of a pandemic that has strained Minnesota’s health care system. They described treating patients in hallways, leaving patients’ hygiene needs unmet and being tasked with transporting bodies to trailers serving as makeshift morgues.

“There is very often a list in the double digits of patients who are waiting for a bed to open up,” Abbott Northwestern intensive care nurse Kelly Anaas said. “But we don’t have enough nurses to staff all the ICU beds.”

Sue Schroeder, a mental health nurse who works with adolescents at Abbott Northwestern, said violent incidents in her unit have increased since administrators altered staffing minimums for nurses and support staff last spring.

Nine of her colleagues, Schroeder said, have sustained injuries severe enough to require extended medical leave, but administrators have given no indication that they intend to reverse course on staffing levels. “This is unconscionable,” she said.

Nurses described a snowball effect to the staffing crisis; the worse it gets, the more likely others are to leave the profession. Doreen McIntyre, a nurse at Children’s in Minneapolis, said she doesn’t blame colleagues who, after a wage cut, furloughs and two rounds of layoffs, decided to walk.

“Every day I work, nurses are making plans for the future, and the future does not sometimes include being a nurse anymore,” she said. “I also have had many days where I have weighed my options also.”

Burnout, Marcanti added, doesn’t begin to describe how nurses are feeling. And they aren’t alone. Weeks earlier, members of SEIU Healthcare Minnesota who work in hospitals held a similar event to voice concerns about their short staffing in their ranks.

“Every day we go home after a full, 8- to 16-hour shift of providing substandard care, it takes a little piece of us,” Marcanti said. “Every day we walk out that door knowing we could have done so much more for you if we were adequately staffed.”

In addition to their exhaustion and frustration, hospital nurses on the call expressed a shared perception that administrators have been alarmingly out of touch with what’s happening in their units. And it’s not for nurses’ lack of speaking up.

Nurses at Children’s Hospital, McIntire said, filed over 3,000 reports of unsafe staffing in 2021. Abbott Northwestern nurse Adiam Midekssa said she was sent home from her shift and disciplined for refusing to take more patients than she felt she could safely manage.

“I requested that the assignment be modified so I could provide safe patient care, but I was denied that and sent home,” Midekssa said. “Our goal is to keep our patients and ourselves safe, and I feel like things need to change so we can do that.”

The town hall meeting came a day after Gov. Tim Walz announced the state would spend $40 million in federal relief funds to reinforce staffing – primarily among nurses – in Minnesota hospitals. The funding will stretch across 60-day period.

The move was accompanied by calls from some lawmakers to allow nurses with licenses from other states to practice in Minnesota – a move union nurses warned would undermine the high quality of care Minnesotans expect.

“There is no surplus of nurses in other states,” MNA President Mary Turner, an ICU nurse at North Memorial, said. “We are training more than enough nursing students to meet the need here in Minnesota, but CEO’s have made our hospitals into places that push our nurses away from the bedside to serve the bottom line.”

Instead of lowering standards, union members said, hospitals and lawmakers should be doing more to retain registered nurses and bring those who have left the profession back into the fold. Equitable compensation, more training opportunities and greater flexibility, nurses said, should be part of the solution.

“What I’d like to see from the hospital administrators is a little more recognition of our humanity and our limits,” Anaas said. “The stresses that every single person … is living through as a result of this pandemic are happening to nurses too – and then we go to work.”

The solution must also include taking nurses’ concerns about safe staffing and quality care to heart, said Sen. Erin Murphy, herself a registered nurse. Lawmakers and hospital administrators too often have tuned out those concerns, despite work stoppages, lobbying campaigns and thousands of reports documenting unsafe staffing, Murphy said.

“For more than a decade you have been telling us that staffing is inadequate in the hospitals in Minnesota,” the St. Paul DFLer said. “You have brought to bear countless, thousands of unsafe staffing forms. You have come and testified. You have asked for relief. Part of the reason we are experiencing what we are experiencing now is because the hospitals were never prepared for this level of crisis.”

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As hospital cuts loom in St. Paul, workers demand accountability, engagement from M Health Fairview

October 22, 2020 by

MNA member Melanie Timpano (L) and SEIU Healthcare Minnesota member Cleveland Donazal tape a list of demands to the Ramsey County Court House door, warning county board member to proceed with caution as they partner with M Health Fairview on using Bethesda Hospital as a temporary shelter for people experiencing homelessness.

With hundreds of jobs at stake, union nurses and health care workers are sounding the alarm on M Health Fairview’s plan to slash services at two St. Paul hospitals and close 16 clinics across the region.

The health system announced plans this month to close Bethesda Hospital, the only COVID-19 specialty hospital in the area, and reduce services at St. Joseph’s. Workers accused management of using the COVID-19 crisis as cover to justify eliminating services on which St. Paul community members rely.

“It is unthinkable that an urban center like St. Paul stands to lose so many patient services at once,” said Rose Roach, executive director of the Minnesota Nurses Association.

The announcement came just two weeks after Children’s Hospital announced plans to limit services on its St. Paul campus. Roach noted that, combined, the announcements threaten patients’ access to “operating rooms, pediatric ICUs, cardiac, epilepsy, chemical dependency, and diabetic services.”

“The loss of resources will again force patients, especially among communities of color, to have to travel to health care, instead of finding it available to them,” she added. “This is not health equity. This is tragic.”

Jamie Gulley, president of SEIU Healthcare Minnesota, with 200 members at Bethesda and St. Joseph’s, called the likely damage to health care access in St. Paul “insurmountable.”

“This move is incredibly shortsighted, and we know it will have long-lasting effects to both healthcare workers and patients,” he said. “Our state cannot afford to have this plan move forward without a much deeper analysis on the impact to our community.”

The unions planned to lobby state and local lawmakers, including Gov. Tim Walz, to put the rapidly approaching closures on ice until community members have an opportunity to provide more feedback.

M Health Fairview this week finalized an agreement to lease Bethesda to Ramsey County as a transitional shelter for people experiencing homelessness. But unions urged county officials to push for transparency and accountability in their agreement with the health care system.

“We support any real effort to provide housing for the homeless,” MNA member Melissa Kadrmas, a registered nurse at St. Joseph’s, said. “However, we don’t trust M Health Fairview, and we worry that their ill-thought-out plan is to provide them cover for closing a facility, laying-off nurses and eliminating key services. We are interested in seeing long term results, not just a bandage.”

The Ramsey County Board of Commissioners approved the Bethesda lease during a meeting Monday, after union members marched from the hospital to City Hall with a list of demands, many focused on meeting health care needs in the urban core.

Speaking during an outdoor press conference, Roach called for a statewide moratorium on health care cuts during the pandemic, and said pitting a health care crisis against a housing crisis creates a “false choice.”

Workers also had a warning for county commissioners: M Health Fairview “has not been a responsible employer or a trustworthy community partner,” Roach said. Cleveland Donazal, a lead storekeeper at Bethesda and SEIU member, added: “We want M Health Fairview to be held accountable.”

Health care workers from St. Joseph’s at the press conference called for deeper analysis of what M Health Fairview’s cuts will mean for people seeking care in St. Paul. That means doing more that just paying “lip service” to community engagement, St. Joseph’s nurse Melanie Timpano said.

“These closures will have an impact metro wide at a time when we already don’t have enough beds, when we already don’t have enough staff and at a time when nurses are exhausted,” she said.

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Council members push back against hospital cuts

February 11, 2020 by

Council Member Rebecca Noecker, whose ward includes St. Joseph’s Hospital, called Fairview’s proposal to close the hospital “heartbreaking” during a City Hall press conference yesterday.

Standing alongside nurses from Bethesda and St. Joseph’s yesterday, three St. Paul City Council members called on Fairview to reconsider steep cuts at the downtown hospitals and, instead, partner with the community in preserving care for St. Paul’s urban core.

“The services, the jobs and what it means for our community – we cannot do without them in downtown,” said Rebecca Noecker, whose second ward includes St. Joseph’s.

Fairview confirmed in December it is weighing several proposals to cut costs, and permanently closing St. Joe’s, the state’s oldest hospital, is among them.

At nearby Bethesda, Fairview already has moved to cut the facility’s admissions capacity from 90 to 50 beds.

Together, the proposed cuts amount to an “abandonment of the central city,” Council Member Jane Prince said, adding that Fairview executives “have to answer” for “a very serious decision that they are making to walk away from downtown St. Paul.”

To that end, Prince, Noecker and Dai Thao, whose first ward includes Bethesda, plan to introduce a resolution at the council meeting tomorrow opposing the hospital cuts, and demanding Fairview be more transparent and inclusive of community leaders in whatever service reductions play out at the facilities.

At a press conference inside City Hall yesterday, council members did not mask their frustration with Fairview’s failure to engage community leaders before announcing the proposed cuts. Thao said he learned what was happening from media reports in December.

“This is not acceptable,” Thao said. “When health care corporations make decisions without the community being a part of it, we know it’s not about delivering care. We know it’s about delivering profits.”

Antoinette Fiagbedzi, a nurse at Bethesda, calls out Fairview for putting profits before patients.

Noecker acknowledged “systemic issues” facing Fairview, like limited access to quality health insurance and mental-health treatment, but said Fairview executives have so far ignored offers to work collaboratively toward solutions that benefit the provider and the community.

“We are all standing around holding this safety net together, and we cannot have one of our critical partners unilaterally drop their side of the safety net and walk away from that conversation,” Noecker said. “We all need to stay in it together to solve these issues.”

The Minnesota Nurses Association, which represents nurses at both Bethesda and St. Joseph’s, has begun negotiations with Fairview to ensure layoffs are handled according to the union contract, MNA President Mary Turner said.

But Turner warned the cuts at Bethesda, one of only two long-term rehabilitation hospitals in Minnesota, won’t just be felt by hospital staff. Closing St. Joseph’s, which devotes 100 of its beds to inpatient mental-health care and serves the city’s high-poverty neighborhoods, would expand the ripple effect even further.

“There is no way we can do without Bethesda and no way we can do without those 100 phychiatric beds in St. Joe’s,” Turner said.

Nurses at the press conference questioned Fairview’s decision to put care for the most vulnerable members of the community on the chopping block when the nonprofit health system sits on hundreds of millions of dollars in hedge fund and other financial investments – and recently raised CEO James Hereford’s pay to $913 an hour.

“Health care is not about if you have income or not,” Bethesda nurse Antoinette Fiagbedzi said. “When you care about people, you don’t think about their income. You don’t think of whether they have insurance or not. You do it out of love.

“That’s what we stand for, that’s what my colleagues stand for.”

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