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It's the People, Stupid...

(Or, when will they ever learn, Part II)

Gary Schwitzer has called attention to this post by the Minnesota Nurses Association on his health news blog.

Hospital Staffing Cuts - Pragmatic or Planned?


Minnesota Nurses Association, 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.

"We’re not buying it," said MNA President Linda Slattengren.

"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.

"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.

[And the U of M/Fairview is putting up a new children's hospital at around $200 milion... That's for a hundred beds.]

"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 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?"

"When we all pitch in, we’ll make things better," they claim.

Our question: what cuts in salary have the administrative staffs taken recently?"

[A familiar question here at the U of M?]

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 Ms. 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. The members of MNA challenge hospital executives throughout Minnesota to use clear-eyed, far-sighted courage to keep the interests of patients above the profit margin.


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