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Nurses once again ranked the most trusted and ethical profession in the U.S.

22 Dec

Nurse Talking To PatientOnce again, Americans say nurses are the most trusted profession in the country,  according to a Gallup poll released December 21.

Nurses have been first in the annual Honesty and Ethics Ranking every year since 2005.

“With an 85 percent honesty and ethics rating – tying their high point – nurses have no serious competition atop the Gallup ranking this year,” according to the national polling firm.

“Minnesota nurses are proud of the trust the public places in us,” said Minnesota Nurses Association President Linda Hamilton. “People know that we are dedicated professionals who fight to make sure all patients receive the quality care they deserve.”

Here are the top five most trusted professions:

  1. Nurses
  2. Pharmacists
  3. Medical doctors
  4. High school teachers
  5. Police officers.

Say ‘no’ to UAP charting requests

14 Dec

Mat Keller headshot

By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

In a cost-saving move, when certain units at a Minnesota hospital are short staffed, managers are asking nurses to allow Unlicensed Assistive Personnel (UAP) to chart under the RN’s license.  This allows UAPs to care for patients autonomously without supervision and oversight from RNs.

Needless to say, this practice is incredibly dangerous for many reasons, three of which we will highlight here.

  1. UAPs simply do not have the training or expertise to independently care for patients without proper RN supervision (and chart accordingly).
  2. Charts are legal documents, and when others chart using your name and login, it is legally the same as if you completed that charting and said that you did the work being documented.
  3. All electronic medical records track patient lookups and history; therefore, if the UAP utilizing your chart is looking at other patients, there is a strong possibility of HIPAA violations.

Far from a cost-saving practice, allowing UAPs to chart under someone else’s license is dangerous for the UAP, for the patient, for the nurse, and for the facility.

It cannot be emphasized enough how incredibly dangerous this practice is.  In fact, we have seen nurses in other facilities be disciplined for failing to log off their medical record properly, therefore resulting in someone else charting (inadvertently) using the nurse’s login.

Have you been asked to allow another to chart under your license?  We need to know.  Please contact your steward, your labor rep, and me — at Mathew.keller@mnnurses.org.

 

Laugh, cry, learn, and share at Ethics Book Club

24 Nov

 

By Sue Kreitz, Chair of MNA Ethics Committee

You’re invited to participate in a book club dedicated to reading and discussing the many ethical issues that RNs and other healthcare workers face every day.

MNA’s Ethics Committee Book Club meets five times a year to have some heartfelt conversations about ethics.

It gives you the chance to read some great books and occasionally even meet the authors who have joined our meetings in person or through Skype.

Our next book club is Dec.1.

We chose Critical Care: A New Nurse Faces Death, Life and Everything in Between.

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This book was written by a former English professor, Theresa Brown. In this memoir, Brown recounts experiences from her first year as an oncology nurse. She is a regular contributor to the New York Times blog, “Well,” and CNN.com. As a writer, she was looking for a change in her career to give her something more fulfilling in her life.  Her choice was bedside nursing.

  • “In her journey in the life of critical care, she has opened new doors of what it is like being a nurse. She describes how it feels to be delivering patient care, the frustration of giving bad news to a parent regarding a poor diagnosis of their child, learning to work with so many different medical personalities both nurses and doctors. Many frustrations of medicine in finding the right diagnosis and treatment for so many issues. With great compassion and her disarming sense of humor, she shares the trials and triumphs of her patients and comes to realize that caring for a patient means much more than simply treating a disease. Deeply moving and at times, sobering, Critical Care sheds light on the issues of mortality and meaning in our lives. This is a well written account of a nurse’s first year in medicine, a medical memoir that combines lyricism and compassion with honesty and well-timed laugh out laugh wit! This book offer a” palpable testimony that nurses are the first responders and primary healers in our times of crisis.” This is a quote from Dr. Mehmet Oz, Author of YOU: The Owner manual health series.

Before each book club meeting, one of the Ethics Committee members shares some background on the book to help spark conversation about how the book fits in with ethical nursing concerns in our practice.  It’s not too late to grab our December book and read it before our book club on Dec. 1!

The meetings are at the MNA office at no charge for members. A light dinner is include in your registration. Non-MNA members pay a  $10 fee for the event.

We hope to see you at our book club! Please join us on Tuesday, Dec. 1, from 5-7 p.m. at the MNA office, 345 Randolph Ave. Suite 200, Saint Paul, MN 55102!

If you can’t make it Dec. 1, here’s the list of books for 2016:

Normal at Any Cost: Tall Girls, Short Boys, and the Medical Industry’s Quest to Manipulate Height by Susan Cohen and Christine Cosgrove (2009): Tuesday, Feb. 16

Hiding in the Open: A Holocaust Memoir by Sabina Zimering (2001): Tuesday, April 19

America’s Bitter Pill by Stephen Brill (2014): Tuesday, Aug. 16

Being Mortal: Medicine and What Matters in the End by Atul Gawande (2014): October 2016 (actual date, time, location TBD).

The Insanity Offense: How America’s Failure to Treat the Seriously Mentally Ill Endangers Its Citizens by E. Fuller Torrey (2008, 2012): Tuesday, Dec. 6

We look forward to exploring important ethical concerns that affect you and our profession in 2016!

Mandatory overtime: just say no

17 Aug

Mat Keller headshot

By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

 

“If you don’t stay and work extra, who will take the admission that’s coming?  There’s no one else.”

Sound familiar?

If you’ve been told by your nurse manager that you must work “mandatory” overtime, don’t buy it!  Under Minnesota state law, nurses cannot be disciplined for refusing overtime if, in the nurse’s judgment, it would be unsafe for the patient.

Study after study show that unplanned overtime assignments have a high potential to be unsafe. Working more than 10 hours in a given day, when unplanned, results in lower quality of care, higher RN burnout, decreased patient satisfaction, and increased errors.

Whether the overtime is planned or unplanned does make a difference: we plan to get extra sleep, bring an extra meal, and mentally prepare when we know overtime is coming; when it’s not, we’re caught between pleasing our supervisor and doing what’s best for the patient.

What happens if your nurse manager tells you that if you do not accept an overtime assignment, you are abandoning your patients?  Again, don’t buy it!

Generally speaking, patient abandonment occurs when a nurse leaves a patient without handing off that patient’s care to another nurse.  If you refuse mandatory overtime for the purposes of protecting your patients, you will need to hand off the care of your patients to another RN, which can include your nurse manager (i.e. give report).  Remember that under the language of the overtime law, healthcare facilities are forbidden from reporting nurses who refuse mandatory overtime to the Board of Nursing.

When employers ask for or “mandate” overtime, it means the hospital is desperately short of staff.  Accepting overtime assignments enables and perpetuates this unsafe staffing by allowing hospital administration to get away with not hiring enough nurses.  So, the next time you’re asked to take on mandatory overtime, just say no.

 

National Nurses United endorses Bernie Sanders for President

13 Aug

National Nurses United this week endorsed the U.S. Presidential candidate who agrees with nurses’ values and is an ardent advocate for issues important to the nursing profession, like expanding Medicare, the Robin Hood Tax to ensure Wall Street pays its fair share, and proper safety and protections from infectious diseases for nurses and patients.

National Nurses United announced on August 10 the endorsement of Vermont Senator Bernie Sanders for President at a “Conversation with Bernie” at NNU’s national offices in California.  Hundreds of RNs cheered Sanders on at the California event, and thousands more watched on live stream at 34 watch parties in 14 states, including Minnesota.

“I have spent my career fighting for something that I consider to be a human right,” Sanders told the crowd. “That human right is health care.”

He said it’s time for a Medicare for All single-payer health care program in the U.S.

“We have got to move toward a health care system which is based on providing quality care to all of our people rather than worrying about the profits of the insurance companies,” he said. “We have got to move toward a health care system which ends the absurdity of Americans paying, by far, the highest price for prescription drugs in the world.”

MNA President Linda Hamilton had the honor of being one of the NNU members introducing Senator Sanders. Hamilton said the members she represents are looking forward to issue-based discussions in the campaign. She said Senator Sanders will address the real problems that patients and the country face.

According to NNU Executive Director RoseAnn DeMoro,  NNU has adopted a call to Vote Nurses Values – Caring, Compassion, Community.

“Nurses take the pulse of America, and have to care for the fallout of every social and economic problem – malnutrition, homelessness, un-payable medical bills, the stress and mental disorders from joblessness, higher asthma rates, cancer, heart ailments and birth defects from environmental pollution and the climate crisis,” she said. “Bernie Sanders’s prescription best represents the humanity and the values nurses embrace.”

 

HCMC RNs stop ‘really awful’ situation

14 Jul

Filing Concern for Safe Staffing Forms and speaking out about unsafe staffing do make a difference. Just ask Surgical/Trauma/Neuro RNs at Hennepin County Medical Center in Minneapolis.

Nurses mobilized and forced the hospital to end a pilot program in the STN unit that increased the number of patients a nurse cared for at one time.

The pilot was implemented in January 2015 without Nurses’ input. They knew from day one the pilot was endangering patient safety and stretching each nurse too thin.

The increased number of patients was “overwhelming” to the nurses and other staff.

“You can’t keep track of that many people,” said RN Sue Oberg. “The push was to work at the top of our licenses, which was ridiculous. You need so many other people to take care of a patient. It was also pulling nursing assistants out of their areas of practice.” They were put in a position of taking over at the bedside because RNs had so many patients they couldn’t spend the proper amount of time in each room.

The situation was so bad that the RNs were worried about their licenses.

The pilot took its toll on nurses mentally and physically.

Some nurses were ready to look for another job.

Patients noticed a problem when they wouldn’t see a nurse for hours.

The nurses stood up and fought the pilot. They spoke loudly and strongly about the damage the pilot was causing. They talked to managers one-on-one and at meetings – and filled out the Concern for Safe Staffing forms. The forms showed that this issue was a concern on days, nights, and afternoon shifts. MNA received 45 forms from HCMC between January and the middle of February.

Nurses also shared their concerns with physicians, who saw what was happening and supported nurses by signing letters.

HCMC backed off the pilot under the pressure.

 

*This post was updated on July 31, 2015 to clarify some minor details.

Bemidji Clinic RNs say yes to new contract

11 Mar

 

RNs at Sanford Bemidji Clinic ratified their first contract in February after being officially recognized as part of MNA last October.

RNs say they’re happy to have a contract that protects patients and nurses alike.

“We’re excited about having a contract that protects our rights and ensures we’re all treated fairly,” said negotiating team member Christine Sheikholeslami.

“The new contract creates a wage scale, so raises are allocated fairly and consistently,” said member Tina Hawver.

Previously, managers gave raises arbitrarily.

The contract raises wages for all members, creates security in scheduling, and provides all other contract language to the Clinic RNs that hospital employees receive, such as more affordable health insurance and a cap on mandatory low-census days.

In 2017, the hospital and clinic nurses will bargain together for a new contract as one united group.

 

 

 

Community EMT proposal must protect public

6 Mar

3 some mat mac stacy2

Dealing with discharged patients continues to be one of the most confounding problems with hospital care. Nurses often don’t have the time to give patients all the education they need when they leave the hospital. The result: many go home confused, unable to care for themselves, and unsure how to get better.

 

Rep. Tara Mack (R- Apple Valley) Community EMT bill (HF261) enables EMTs to visit discharged patients the day after they get home, but the bill doesn’t actually specify what CEMTs can and can’t do.   The result could be agencies that allow CEMTs’ work to infringe on what nurses are specifically trained and prepared to do.

 

“Anybody can take vital signs but it’s what you do with that information that’s dependent on your training,” said Stacy Enger, an ER nurse at Methodist Hospital, “As a nurse, I’m trained and licensed to assess, intervene, and most importantly, re-assess patients.”

 

Enger testified at the House Health and Human Services Policy Committee hearing on the bill that she’s seen the effects of firefighters, EMTs, and paramedics who visit discharged patients already. Agencies in the west Metro, including Edina, St. Louis Park, and Eden Prairie have already begun the CEMT program with the help of Methodist.

 

“Edina and Burnsville use volunteer firefighters and there’s a clear difference in what we learn about a patient coming in with those departments versus one who comes in from a paramedic from North Memorial, Allina, or HCMC,” Enger said.

 

The Chief Nursing Officer at Methodist, who testified for the bill, confirmed that they still get many questions on the hospital nurse triage line even with the program.   The bill also has the support of the Professional Fire Fighters Association, which claims that 80 percent of their firefighters’ work is now healthcare.

 

MNA Nursing Policy Specialist, Mat Keller, pointed to the many problems that still exist in the legal language of the bill. He noted that the language allows CEMTs can do anything to intervene that prevents emergency department caring for the patient.   He said that could include anything from administering IVs to delivering a baby.

 

“It is important to remember that an EMT certification requires only 120 hours of training,” said Keller, a nurse and an attorney, “this equates to about half of one college semester. Furthermore, those 120 hours are dedicated to teaching EMTs the things they need to know in order to fulfill their role, which is to operate in emergency situations.”

 

Even proponents of the bill admit that CEMTs would probably only spend 15-20 minutes with a patient during their visit, which doesn’t allow for a proper assessment.

 

“Let’s say I’ve come to see you, and one thing I do is get you up and help you walk around,” Enger said, “one of the first things I’m looking for is if you are a fall risk. Can you get around? Are there things in your way that you might trip over or hit with a walker or crutches? We call it a “road test.” Sometimes, you road test somebody and you realize that the house needs to be de-cluttered or maybe rails or supports need to be installed somewhere. Sometimes, you road test somebody and they’re very quickly out of breath. We have to figure out if it’s because you are or have been a smoker. Or maybe it’s because you’ve gotten a hospital-acquired infection, which might turn into a fatal pneumonia?”

 

Rep. Erin Murphy (DFL-St. Paul), an RN, mentioned her time caring for patients at the bedside and in the home setting. Murphy urged “more work “ on the bill to delineate tasks and eliminate any infringement on the scope of practice.

 

Rep. Mack admitted that another issue to be worked on is which Minnesota board will oversee CEMTs. The bill names the Emergency Medical Services Board, but, as Keller noted, these actions would only be non-emergency situations.

 

HF261 was passed over for possible inclusion in the final Health and Human Services bill. MNA will continue to visit the Capitol with nurses to work with legislators on making the bill something that can truly benefit the patients of Minnesota.

Nurses bring ‘passionate commitment’ to 2015 Day on the Hill

12 Feb

 

MNA DOH at MNDH web (2)

Inspiring, empowering, and energizing. Those are some of the words MNA members used to describe Day on the Hill 2015.

About 150 RNs from throughout Minnesota stood up for their patients, their profession, and their communities at the February 9-10 event in St. Paul.

Members sat down with their legislators to share their experiences as bedside RNs to show why a Safe Patient Standard and workplace violence prevention legislation are needed. They told their personal stories of instances where patient safety was threatened because of understaffing; and times when they were subjected to workplace violence themselves.

They crowded into a room at the Minnesota Department of Health to deliver more than 2,000 ‘valentines’ – Concern for Safe Staffing Forms filed in 2014, documenting situations where patients were at risk due to low staffing levels.

Dozens of RNs lined up to share their stories at an emotional meeting with Health Commissioner Ed Ehlinger.

Some teared up telling their stories and as they identified with other nurses’ concerns.

“We are bringing these valentines from nurses on day shift, night shift, holiday shift, weekends, holidays,” said MNA President Linda Hamilton. “Here’s proof that we need more nurses. We want to do what’s best for our patients.”

Nurses document unsafe staffing in their hospitals by filling out Concern for Safe Staffing Forms and sharing them with their supervisors and the Minnesota Nurses Association.

“The hospitals aren’t giving you the information you need, so we will,” said oncology nurse Theresa Peterson, RN at North Memorial Hospital. “When (cancer) patients need medications, it’s an hourly thing. So if you have five other patients, they don’t get seen.”

Commissioner Ehlinger promised that he and his staff would read the forms and use them to inform their policy discussions.

Other highlights of Day on the Hill:

  •  National Nurses United Public Policy Director Michael Lighty brought the national perspective in his remarks during the February 9 kickoff. He urged MNA members to use their NNU Public Policy Director Michael Lighty “passionate commitment” for their patients when advocating for change at the state and national levels to “transform our country.”
  • St. John’s Hospital nurse Amy Schmidt spoke publicly for the first time about the patient attack on nurses on her unit last November. She described how the attack unfolded and how it changed the lives of everyone involved. St johns nurseSchmidt said every hospital should have a plan to deal with crises. “I urge all nurses to get involved and stop thinking that workplace violence is part of our jobs. It is not.”
  • Rep. Joe Atkins told members their voices do make a difference. “There’s not a legislator who doesn’t respect what you do. You have a case to make.”
    He promised to fight for safe patientjoe a staffing and workplace violence prevention legislation.

When RNs speak, policymakers listen

30 Jan

 

In response to recent attacks on nurses’ safety and their ability to provide safe, quality care for their patients, MNA members are speaking to legislators about safe patient staffing levels and workplace safety in 2015.

Nurses visited the Capitol January 28 to speak to legislators about the need for a Safe Patient Standard. They told lawmakers that patients are at risk when nurses have too many to care for at one time, and urged legislators to create a standard for nurse staffing that protects patient safety.

Nurses from North Memorial Medical Center “adopted” the day to talk specifically about the serious staffing issues facing the nurses and patients there. North Memorial management has unilaterally implemented new staffing grids hospital-wide, which add to the already large assignments of Registered Nurses as well as ancillary staff.

North Memorial RNs told legislators stories about how the new grids are limiting the care they’re able to provide patients and how concerned they are about their patients’ welfare.

“Are patients allowed water, turning, help to go to the bathroom only once a day?” asked one North Memorial RN. She said she’s gone through all the channels to alert management to the problem without success. “I can’t deliver a gold standard of care without support.”

Rep.  Joe Atkins (DFL-Inver Grove Heights) told the nurses how influential their advocacy is on legislators. Atkins said he and his fellow state representatives are lobbied on hundreds of issues, which makes it difficult to keep up, but they start to take notice when they see numerous emails about the same issue. What really breaks through the noise, he said, is when constituents visit them in person and they can put a real name and face to a story. Atkins encouraged nurses to continue coming to the Capitol to advocate for their patients and profession as often as possible.

MNA’s February 9-10 Nurses Day on the Hill is a great opportunity to learn about MNA’s legislative priorities and how to advocate for them. We’ll give you training on how to navigate the political process and will make appointments for you to meet your legislators. For more information or to sign up, visit the Day on the Hill page on MNA’s website.

We will continue taking small groups of nurses to the Capitol on Wednesdays during the legislative session. The next opportunities are Feb. 4 and 18. We will meet at 10 a.m. at the MNA office in St. Paul for a briefing and then head to the Capitol to talk to our state representatives and senators.

To sign up or to see if your hospital can “adopt” a day to meet legislators from your region, please contact Geri Katz at 651-414-2855 or email Geri.Katz@mnnurses.org.