What do you think a CEO or AHA think about pending legislation? - page 4

Is this a possible CEO or AHA perspective on pending legislation? The nurse recruitment legislation and the legislation to abolish mandatory OT are dream come through for the American Hospital... Read More

  1. by   wildtime88
    "Previous shortages focus was mostly on gaining new students/nurses. Because of workplace environments today, a broader focus to include workplace issues and retention of current staff is being focused on.


    Once this legislation is passed, nurses can push their employers to go after these funds to improve their workplaces and retention of staff."

    ************************************************

    You just do not get it. Nurses were just beginning to make great strides with the reality and power of the nursing shortage to do this. The funds to do this were already available; they have just being going to everyone else in the form of salaries, bonuses, and perks. They are called revenue and profits. This legislation helps insure that those salaries, bonuses, and perks are protected.

    One more things, recommendations/suggestions are just that and no more. If they are acted on or followed is another thing entirely. Remember there are going to be other groups making their recommendations/suggestions too. We have seen the effects when the restructuring groups have come to the hospitals and made their individual recommendations/suggestions that were in total opposition to what the nurses have been recommending for years. In fact this is still going on today. Do you think this is suddenly going to stop. The only reason some facilities have chosen to try to back track on the things that they imposed was the nursing shortage and the power the nurses have begun to realize they have today. Now that is all going to be taken away by flooding the profession with new nurses who will have no choice to work due to the financial penalty they will have to incur if they refuse.

    So time will tell. And if this backfires, then what? The answer to that there will be nothing that can be done, because the power and position we have today will have been lost thanks to this legislation pushed and supported by the ANA.
  2. by   -jt
    <i dont care about any recruitment bills. i do care about proposed retention legislation.>

    Then you might want to contact your federal legislators & tell them to supprt THE NURSE RETENTION ACT which RNs - members of the ANA - helped develop (along with the Nurse Reinvestment Act and N.E.E.D). The Nurse Retention Act was recently introduced to Congress by Senators Hillary Clinton (NY) and Gordon Smith (OR).

    Recruitment is only one piece of the puzzle - and not the only nursing crisis legislation currently in Congress for passage into law. Retention and working conditions are a major focus. The Nurse Reinvestment Act addresses those as well as recruitment but the Nurse RETENTION Act addresses retention and working conditions even more specifically.

    <SHORT TITLE(S) AS INTRODUCED:

    Nurse Retention and Quality of Care Act of 2001

    <OFFICIAL TITLE AS INTRODUCED:

    A bill to amend the Public Health Service Act to provide programs to improve nurse retention, the nursing workplace, and the quality of care.

    ************************************************** **

    "ANA maintains that the current nursing shortage will remain and likely worsen if changes in the workplace are not immediately addressed.......

    The profession of nursing will be unable to compete with the myriad of other career opportunities available in today's economy unless we improve working conditions. Registered nurses, hospital administrators, other health care providers, health system planners, and consumers must come together in a meaningful way to create a system that supports quality patient care and all health care providers........

    We must begin by improving the working environment for nursing......."

    - from the US Senate Hearing Testimony June 27, 2001
    of Anne O'Sullivan, RN
    for the American Nurses Association

    Full text at: http://www.ana.org/gova/federal/leg...001/govaref.htm
    Last edit by -jt on Dec 28, '01
  3. by   nurs4kids
    <quote:
    --------------------------------------------------------------------------------
    1) Improve the quality of the health care facility work environment, including improving communication and collaboration among health care professionals.

    (2) Initiate or maintain aggressive nurse retention programs, including other initiatives as deemed appropriate by the nurse retention committee at the health care facility.

    (3) Reduce workplace injuries.

    (4) Reduce rates of nursing sensitive patient outcomes.

    (5) Provide high quality evaluations of the cost-effectiveness and patient-outcomes of best practices, to assist health care facility decision-makers in determining appropriate nurse retention strategies.

    (6) Promote continuing nursing education and career development.

    -------------------------------------------------------------------------------->

    nrskaren,
    I'm confused over the above things. They are all vague and I see NO straight-forward approach to these problems. These all seem like wonderful GOALS, but not SOLUTIONS. What in the above holds an employer to these standards??
    These things are not measurable; not something an employer can be required to do.
  4. by   -jt
    <What in the above holds an employer to these standards??>


    you missed an important piece of that - under this legislation, they would be given additional reimbursements from the govt to put the "standards" into place & those retention/workplace improvements are the only things they can use this additional money for.

    ie....

    SEC. 861. DEVELOPING RETENTION STRATEGIES AND BEST PRACTICES IN NURSING STAFF MANAGEMENT

    Funding allocation: $10,000,000 for fiscal year 2003 and may be continued.

    g) USE OF FUNDS- An eligible entity that receives a grant under subsection (a) shall use such grant funds to:

    (1) Improve the quality of the health care facility work environment, including improving communication and collaboration among health care professionals.
    (2) Initiate or maintain aggressive nurse retention programs, including other initiatives as deemed appropriate by the nurse retention committee at the health care facility.
    (3) Reduce workplace injuries.
    (4) Reduce rates of nursing sensitive patient outcomes.
    (5) Provide high quality evaluations of the cost-effectiveness and patient-outcomes of best practices, to assist health care facility decision-makers in determining appropriate nurse retention strategies.
    (6) Promote continuing nursing education and career development.

    (thats just a sample of the legislation)

    They have to prove their efforts and show results. They'll risk losing government reimbursements (medicare money) if they dont comply, so that in itself is enough to "hold them to the standards".


    "legislation requiring health care providers to publically disclose and report the number and mix of nursing staff providing patient care on a shift-by-shift basis AS A CONDITION OF PARTICIPATION IN THE MEDICARE REIMBURSEMENT PROGRAM. The legislation would also require information on the staffing plan used by the facility and the incidence of nursing-sensitive patient outcomes to be reported and posted."


    If passed into law, either they really improve things so that nurses are attracted to that facility & want to work there and the employer proves it by disclosing the results & numbers among other things. Or they make no changes, do not retain staff & lose their govt funding.
    Last edit by -jt on Dec 28, '01
  5. by   thisnurse
    exactly what i was thinking nurskids
  6. by   wildtime88
    JT now you are saying that the government would actually take away medical services to a community in need if they do not comply.

    Do not try to change your wording on this or dance around it because that is what you have just said.

    Who's government are you talking about? Do you honestly believe this?
  7. by   -jt
    <now you are saying that the government would actually take away medical services to a community in need if they do not comply.>


    Change my words? Dance? Why? I wrote exactly what I meant to say.

    The legislation calls for a forfiture of medicare reimbursement if the employer does not comply with it. What better way to make the employers see the light & force them into action? Give them consequences to think about. With real risks when not doing anything about the conditions that are driving nurses away from the bedsides, they will finally have to make changes. Which hospital will refuse to do so, give up its govt reimbursements, take away services from a community, and revenue from its own pocket?

    That condition of medicare participation is one of the best parts of The Nurse Reinvestment Act and its supported by dozens of Congressional elected officials.

    There is an incentive for making the retention/workplace improvements - the improvements are funded with higher medicare reimbursement. And the increase is to be spent on making the improvements. They have to prove they used it for that & show results. So the improvements we need will not be costing the hospitals themselves all that much.

    The employers MUST comply if they want to be able to receive their government funding - medicare reimbursements. That is what is meant where it says complying with staffing, recruitment and retention efforts and proving it by disclosing their staffing mixes and numbers of nurses, among other things, is a "condition of participation in medicare reimbursement programs". NYSNA wrote a similar legislation which is going thru the process with the NY State legislature now.

    We need to speak a language the employers understand if we want them to move. There must be an incentive for them to follow these standards or what good is having any standards? Without any real incentive for them to comply, what would there be holding them to the letter of the law? Unless there are real consequences for not complying, what reason would they have to follow any of it? The Nurse Reinvestment Act makes sure there are real incentives with real consequences for not complying.

    The incentive is that if they comply, their medicare reimbursement is increased to help offset some of the additional costs of their retention/workplace improvements.

    The consequence is that if they dont comply, they lose the reimbursements altogether.

    Do you really think any hospital is going to risk losing services and its medicare money over this? Or would it behoove them to make workplace improvements and real retention efforts to comply with the law & be reimbursed for their expenditure by the federal govt?

    Are you saying this wont pass into law because not enough nurses are willing to contact their officials to support it and arent willing to stand up & fight for it or lobby for it and some are, for some misguided reason, even writing their Congressmen to oppose it?
    Last edit by -jt on Dec 28, '01
  8. by   wildtime88
    What I am saying is that the Government will never take away needed medical services to a community. The CEO's in the American Hospital Association know this. Everyone else knows this. So in reality this is an empty threat.

    Do you not think that the CEO's and other board members of these hospitals do not know that all they have to do is just say no?
  9. by   -jt
    <What I am saying is that the Government will never take away needed medical services to a community.>

    The govt is not going to be taking away services from a community.

    The hospitals will just have to pay for it themselves if they choose not to comply. And what hospital is ever going to be willing to do that when the govt can instead? "The govt" is already on board to include the medicare conditions language in the legislation. What the hospitals choose to do is up to them but, as the legislation is, once passed into law with this language, either they comply with the retention stipulations or they will risk losing medicare reimbursements....


    "ANA representatives met with the offices of Rep. Maurice Hinchey (D-NY) and Sen. Harry Reid (D-NV) and secured their commitment to introduce legislation requiring health care providers to publically disclose and report the number and mix of nursing staff providing patient care on a shift-by-shift basis AS A CONDITION OF PARTICIPATION IN THE MEDICARE REIMBURSEMENT PROGRAM."
    Last edit by -jt on Dec 28, '01
  10. by   wildtime88
    Jt, you come across as though that everything that the ANA wants will go through without any resistance from anyone. You come across as though everything the ANA want will be introduced automatically into law.

    What planet and what country are you actually living in.

    If this would have been the case there would have been a to more significant changes a long time ago and many nurses would have never left.

    What is it exactly that is giving nurses more power and leverage to change things today?

    What one piece of legislation will take that away?
  11. by   -jt
    <you come across as though that everything that the ANA wants will go through without any resistance from anyone. You come across as though everything the ANA want will be introduced automatically into law.>


    Why do you assume such a ridiculous thing? Because Im not running around like you, predicting that doom is inevitable so why bother trying? And Im not throwing my hands up, shrugging my shoulders and saying "we cant compete with the AMA & the AHA and their mega bucks for lobbying against laws we want, so why even try?" And Im not saying "Im getting out of the profession because its hopeless"? If we all had that attitude of yours, we'd all be out of work already, having long ago been replaced by the licensed, medical REGISTERED Care Technicians the AMA tried to create to replace the nursing profession in the last shortage & spent its megabucks lobbying for.

    Except that nurses like me didnt say we cant compete with AMA or AHA so lets just forget it & give up. We said "No way in hell is this going to happen!" And it didnt. Because nurses didnt let it.
    Because of the political work that nurses did (especially ANA & its members) to prevent it, there is still no such thing as medical Registered Care Technicians replacing the nursing profession - despite all the money the AMA had - much more than the ANA - to fight for it. Thats just one example of why we cant just give up when standing in front of a Goliath.

    I know how laws get made & I know what the fight entails. I know there is a total of about 2.7 million nurses in this country who could move mountains if they let themselves - but too many will instead be like you & say "it cant be done - it will never happen, so why bother".

    I know there are 1.5 million of those nurses working out there in these conditions right now & who could make the fight a lot easier - without even spending a dime - just by making a phone call or writing a letter to their legislator. But I know the majority of them wont. They wont get involved even to that small extent to help themselves and it has nothing to do with joining any organization.

    You do not need to be a member of any organization to write a letter or make a phone call to your elected official. Still the majority of nurses wont do even that much. Agency, temp, and travel nurses take those very positions to "get away from the politics" but unless all nurses start paying more attention to & getting involved in the politics, instead of running away from it, things are going to remain a difficult fight for us as a profession. (but that still doesnt mean we cant win - we have been winning).

    Yes, I know all about the resistance any legislation that benefits nurses will face. Resistance that can only exist because the majority of nurses in this country wont make themselves heard. Some will not even write a letter to their representative or contribute in any other way to strengthen or even fund the fight to help themselves - but they will complain that nurses interests can be defeated because of all the power and money the American Medical Assoc and American Hospital Assoc has to fight against nurses. (the classic "duhhh....."). The majority wont lift a finger to help themselves & wont do anything to help in the fight, but will instantly blame the only nurses who were out there doing the fighting, if they are defeated by more power and money. Go figure

    So yes, I am familiar with the legislative process, and a few other things that affect it too. I have hands-on experience with it, am involved, informed, and aware. I am no starry-eyed naive neophyte in this business. I know what bills must go thru to become laws and I know it doesnt happen easily. I know because Ive been in there lobbying for nurses bills that HAVE become laws. I know exactly what we are up against.

    Once again, your assumptions are way off the mark.
    Last edit by -jt on Dec 29, '01
  12. by   wildtime88
    JT, I am just being realistic and logical. This is something that you and your organization has failed at yet once again.

    The next time there is a nursing shortage and a chance for real change and a chance at nurses actually taking control of the profession, I hope that do not take out the century old book titled "How to Cure the Nursing Shortage" and follow it step by step again.

    Maybe someone will have enough sense this time to rewrite it.

    This would be a good revision.

    Do not push and insist on legislation to replace existing or recruit new nurses until all the problems are actually solved.
    Last edit by wildtime88 on Dec 29, '01
  13. by   -jt
    <What one piece of legislation will take that away?


    That is your opinion. I happen to disagree with your opinion and all your speculation, & interpretations. I think you are so against any legislation to solve the nursing shortage - for the sole reason that the legislations will actually be successful in helping to solve the shortage & subsequently may diminish the need for agency, temp and travel nurses, and you might be forced to lower your demands when negotiating an assignment or may have to take a staff position instead - when the crisis is alleviated & agency supplement is not needed so much.

    As youve said, as someone who works/worked agency/temp/travel, you want to keep the nursing shortage and this crisis going for the benefit of your own personal pocketbook but to do so, are fighting AGAINST efforts that would improve things for ALL nurses.

    Its not so surprising that some supplemental-staffing nurses would try to prevent passage of nursing shortage solution bills - and would try to keep the nursing shortage going in order to maintain the availability of their temp, agency, and travel supplemental staffing jobs.

    Youve said so yourself and promoted this misguided attempt TO PREVENT SUPPLEMENTAL STAFFING OPPORTUNITIES FROM DRYING UP BY FIGHTING EFFORTS TO RECRUIT NEW NURSES to the profession and fighting against solving the nursing crisis. So, who do you think youre fooling?

    The nursing crisis should not go on just so agency and travel nurses can have open positions to choose from. Its ludicrous but thats your whole campaign against ours.

    We may have a hard fight to win with these legislations for nurses, but that doesnt mean we're going to lay down, give up, & die. Where I come from, RNs have been winning fights for 100 yrs. In fact, both the profession of nursing and REGISTERED nurses exist because of the fights nurses in my state won. (source: "Honoring Our Past - Building Our Future").

    I have every confidence that there is hope for the future & that we nurses will make that future. And I know what we have to go thru to do it.

    You can criticize me from now till your doomsday, But Im just not as negative a person as you are.

    However, feel free to perceive me in whichever way you wish.

    After all, it IS cyber space.

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