Mayo Clinic Rochester Sidestepped Minn. State Staffing Bill

A proposed bill in Minnesota related to increasing nurse staffing was amended in order to pass the state legislature, after an exemption was granted to the Mayo Clinic, according to a statement from the Minnesota Nurses Association.

The proposed bill as originally described in the Minnesota Senate (SF1384) was also known as the Keeping Nurses at the Bedside Act.

If passed, the law would have required hospitals to create hospital nurse staffing committees, at least 35% of which would be direct care registered nurses. All committee participants would be paid their regular salaries for time spent participating in committee activities, which would be treated as scheduled work time.

On May 18, the Mayo Clinic facilities were granted an exemption from the proposed law.

At the end of the state’s legislative session, the bill as it stood no longer had enough votes to pass, according to a statement from the Minnesota Nurses Association (MNA).

Instead, the state legislation passed a Nurse and Patient Safety Act that included some elements of the original bill, notably a study on nurse staffing and retention, new protections against workplace violence, provisions for childcare assistance, and student loan forgiveness for nurses, according to the statement.

The Mayo Clinic was among the union-supported bill’s strongest opponents, and threatened in advance of the final voting to pull billions of investment dollars from the state if the bill passed in its previous form, according to the MNA. On May 18, lawmakers gave the Mayo Clinic facilities in the state of Minnesota an exemption, with language in an updated version of the bill stating that the terms did not apply to “a national referral center engaged in substantial programs of patient care, medical research, and medical education meeting state and national needs; that receives more than 40 percent of its patients from outside the state of Minnesota; and that is located outside the seven-county metropolitan area.” Only the Mayo Clinic met these criteria as of the time of the vote.

Unfortunate Trend

“The outcome in Minnesota is in line with other legislative efforts whereby a series of compromises result in an ineffective policy result for addressing the reasons that many hospitals do not provide patients with sufficient bedside nursing care,” said Matthew D. McHugh, PhD, JD, MPH, RN, professor of nursing and director of the Center for Outcomes and Policy Research at the University of Pennsylvania School of Nursing. “The elements of the legislation focused on workplace violence, student loans, and child care are certainly good progress, but they don’t fix the predominant reason nurses are burned out, dissatisfied, and leaving their employers: understaffing by design.”

McHugh said he was not surprised at all by the outcome in Minnesota. “Corporate interests of healthcare systems have always had an outsized role in undermining policy reforms aimed at ensuring minimum safe staffing standards and practices,” he said.

The clear clinical implication of the Minnesota vote is that “patients bear the consequences when hospitals choose to provide insufficient nurse staffing,” McHugh told Medscape. Research from his institution, as well as hundreds of other health services and policy researchers, has shown that “virtually every patient outcome including mortality, readmissions, adverse events, medication errors, infections, and sepsis would be better when patients are cared for in hospitals with better staffing levels.

“Our most recent studies show that the average hospital’s medical–surgical nurse workload can vary from four patients per nurse to as many as 10 patients per nurse; this effectively means that the same patient may receive nearly three times as much direct care time from their nurse in one hospital compared to another hospital,” he added. “This inequity is a function of budgetary decisions, not patient care needs.”

As for additional research, “The evidence clearly suggests, over and over again, that patients have better outcomes when their nurses have more manageable workloads,” said McHugh. “This evidence comes from decades of studies by different researchers, funded by the National Institutes of Health, and published in the most reputable peer-reviewed journals such as JAMA, NEJM, and The Lancet.”

McHugh said changes are sorely needed, but lamented that those improvements have been very slow to come to fruition.

“Translating that evidence into action is what is required; this could be achieved by hospitals themselves, but for decades it has not been resolved,” McHugh said. “There are public policy options, although the only one shown to be effective in improving staffing levels is establishing an enforceable minimum staffing standard to ensure every patient gets at least a minimum level of nursing care to meet their needs.”

McHugh is the author or co-author on several studies of nurse staffing issues, but had no relevant financial relationships to disclose.

Heidi Splete is a freelance medical journalist with 20 years of experience.

For more news, follow Medscape on Facebook, Twitter, Instagram, YouTube, and LinkedIn

Source: Read Full Article