Sen. Erin Murphy, DFL-St. Paul, announces “The Keeping Nurses at the Bedside Act,” which would require hospitals to set minimum staffing levels based on input from direct care nurses, during a news conference on Feb. 13, 2023. Photo by Max Nesterak/Minnesota Reformer.
The Minnesota nurses’ union and their supporters at the state Capitol are taking aim at a shortage of hospital nurses across the state through legislation that would give rank-and-file nurses greater say over staffing levels.
The bill — dubbed “The Keeping Nurses at the Bedside Act” (SF1561) — would require hospitals to form staffing committees with at least half the members being nurses and other direct-care workers. The committees would set minimum staffing levels for each hospital unit, and the health commissioner would grade hospitals based on how well they meet their staffing plans.
The nurses’ union says chronic understaffing is driven by increasingly profit-driven hospital leaders, whose focus on cutting labor costs are causing nurses to burn out and take jobs in lower-stress clinics or leave the profession entirely.
“The problems in our hospitals are getting worse not better,” said Mary Turner, president of the Minnesota Nurses Association and an intensive care nurse. “The number one reason nurses give for why they’re leaving the bedside is short staffing by hospital executives.”
Union leaders pointed to a national survey of nurses from the fall of 2021, which found half of nurses were considering leaving the field in the next year, mainly because of “unsafe staffing levels.” Adverse events for patients such as bedsores and falls were up 33% last year, according to the Minnesota Department of Health, which nurses blame on short staffing.
Under the bill, nurses could not be disciplined for refusing to accept more patients if they believed it would endanger patients’ health or safety, although they may be required to accept more patients in an emergency.
The bill would also require hospitals to post emergency departments’ waiting times and inform patients of staffing levels when they arrive and throughout their stay. And hospitals would need to come up with violence prevention plans, as nurses complain of an uptick in unruly patients harming medical staff.
The Minnesota Hospital Association, which represents the state’s hospitals, blasted the proposal and warned it would hurt patient care.
“Introducing the unnecessary mandates called for in this bill on hospital operations will inevitably lead to unit closures, rising costs, longer wait times for patients, and the loss of vital services that communities rely on,” said a statement from the Minnesota Hospital Association.
The association said the proposal only focuses on one part of patients’ health care teams and limits their flexibility to make “real-time decisions” about patient care.
The hospital association did, however, say it supported additional state funding for student loan forgiveness and mental health support for health care workers.
The bill would provide $10 million in student loan forgiveness to hospital nurses over the next two years in an effort to entice more new nurses to work at hospitals. The state would also direct $20 million in funding over the next two years to hospitals to create programs aimed at improving the mental health of their workforce.
The push comes after a bruising, months-long fight between the Minnesota Nurses Association and seven of the state’s largest health systems over new labor contracts, which led to a three-day strike by some 15,000 hospital nurses, the largest private sector nurses strike in U.S. history.
The union gave up its demand for staffing committees with control over patient ratios to avoid a protracted strike, although the union did win some assurances from hospitals that staffing levels wouldn’t get worse.
The Keeping Nurses at the Bedside Act gives the nurses’ union a second bite at the apple to win the staffing provisions it couldn’t secure in its labor agreements. The bill would also apply to non-union hospitals, including the Mayo Clinic in Rochester and Regions Hospital in Saint Paul.
The bill has bipartisan authors, including DFL Sen. Erin Murphy of St. Paul, who is a registered nurse and former union leader; and Republican Sen. Jim Abeler of Anoka, whose wife is a nurse.
“We can no longer ignore the pleas of our professional registered nurses across the state,” Murphy said. “We can’t continue to build the pipeline, and have nurses coming into a system that burns them out.”
Even with Abeler’s support, the bill was unable to pass a Republican-led Senate last year. It faces better odds with Democrats in control of the Legislature and governorship.
Gov. Tim Walz made a public appearance on the picket lines in front of hospitals last year to show his support for union nurses.
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