Are we not talking about the largest nursing strike in US history happening right now?

[klone, MSN, RN]

Right now, 15,000 nurses in Minnesota, part of MNA, spanning 16 (?) hospitals, are on a 3-day strike. It's the largest nursing strike in US history. 

Staffing plans for this strike include utilizing nursing leaders as "helpers" and paying exorbitant amounts to travel nurses to fill in (on a FB L&D nursing group I'm in, I saw one agency offering $10,000 for five 12-hour shifts at one hospital in a northern suburb of Minneapolis).

As a nursing leader, it was requested that I sign up for a shift at one of the hospitals that is affiliated with the clinic where I work. I opted not to sign up, as I do not want to cross the picket line, and I am in solidarity with the nurses who are striking.

Ironically, my son came down with appendicitis yesterday morning, and I had to cross the picket line anyway, as we brought him in to the local ED and he had emergency surgery yesterday afternoon (they had to transport him to the children's hospital in the neighboring city because the children's hospital in the city where we originally brought him was closed except the ED, due to the strike). He got great care and is now home resting. Quite the ethical dilemma and moral crisis, depending on, and grateful to, the "scab" nurses (can I say that here?) that I disdained a week ago!

In case anyone was wondering, the major requests of the nurses is a 30% pay increase over the next 3 years, and having direct say and a vote in individual units' staffing plans.  As in, 51% of the nurses in a unit must approve the staffing ratios of that unit. I think that is VERY reasonable.

The first picture was taken from the cafeteria at the Children's hospital in Minneapolis. The second picture was taken from the lobby at Regions in St. Paul, just because I've never seen such healthy dracaena before and I thought they were beautiful. ?

[xigris1, BSN]

A 30% pay increase is reasonable? To me it sounds tone deaf. Nurses in large metro areas like Minneapolis can easily make six figures; whereas the average annual salary for a person with a bachelor degree is about $55k. We're privileged as nurses to work in a profession that provides an actual path to the middle class, and a large majority of Americans would scoff at the idea that nurses are "underpaid".  Hospital budgets are largely dictated by their payer contracts, which definitely will not be increasing at a rate of 30% over three years.  The budget is a pie, so if you're taking a bigger slice then be prepared to have less support staff.  How much do you value housekeeping, security, unit clerks, nursing assistants, etc.? 

Also I'm all for safe patient to nurse ratios, but opening it up to a voting system is ripe for abuse.  Setup a committee with representation from nursing, medicine, and administration to determine appropriate ratios and reevaluate on a regular basis. This isn't rocket science.  

Finally I'm glad that your son was able to get great care from those big, bad, "scab" nurses.  Hopefully both sides can quickly find a middle ground and get back to taking care of the patients. 

[klone, MSN, RN]

No, I was referring to the second part - wanting to be a part of the staffing ratio conversation/approval process. I absolutely think that the best people to determine safe staffing are the nurses caring for the patients. Ripe for abuse - as if staffing ratios determined by the C-suite ISN'T abused?? When I was a unit manager, the CEO of the hospital once made me tell him how dilated each of the labor patients were before he would approve me bringing in another nurse at premium pay. How the *** is that right?

 

I would have to see current pay ladders to have an opinion on whether the 30% increase over 3 years is reasonable. It may be; it may be not.

[xigris1, BSN]

I never suggested the c-suite should be the only decision maker in staffing ratios. But if floor nursing were allowed to vote by a simple majority, what's stopping units from voting for a 1:1 ratio when it clearly isn't warranted?  Maybe the folks you work with are more reasonable, but I could easily see this happening in my institution.  Healthcare is multidisciplinary, and there's no reason that a multidisciplinary approach couldn't be used to establish safe and fair staffing ratios.

[JKL33]

2 hours ago, xigris1 said:

But if floor nursing were allowed to vote by a simple majority, what's stopping units from voting for a 1:1 ratio when it clearly isn't warranted? 

Lots of fear-mongering for a first post. Okay, second post.

2 hours ago, xigris1 said:

Maybe the folks you work with are more reasonable, but I could easily see this happening in my institution. 

?

Right.

Well, anyway, I'll bite, I do have a question for you. Let's pretend that could actually happen. Is it your opinion that THAT iteration of ridiculousness is somehow more ridiculous than blatantly unsafe nursing assignments?

[mmc51264, BSN, MSN, RN]

4 hours ago, klone said:

No, I was referring to the second part - wanting to be a part of the staffing ratio conversation/approval process. I absolutely think that the best people to determine safe staffing are the nurses caring for the patients.

I am in NC and there has been some talk about nurses wanting to unionize. I got very frustrated because the system I work for has been bending over backwards to take care of us. 

The points I was told: staffing. ICU is 1-2:1, Stepdown 2-3:1, mix of SD and int,. at the  very most 4-5:1 (and the 5:1 is very rare). Other hospitals in the area might have 6-8:1 ratios. Governance. "nursing doesn't have a say" I personally am on 3 committees and 2 practice councils. I don't understand nurses that have practiced roughly a year demanding things that they don't even know about. Nursing is not ever going to be 3:1 ratios for an intermediate floor. There are issues, but the ones demanding change, are unrealistic. We already have amazing benefits, good pay, and great opportunities for growth or change; vertically and laterally. 

I am a floor nurse that makes 6 figures. In the south. I grew up in the Chicago are and around the teamsters. Unions are not what they used to be. They are not always in our best interest. 

I was also a teacher for a few years. That is an area that needs help. I made 2x as much $ with a 2 year nursing degree as I did with a masters in teaching. It is so wrong. 

[xigris1, BSN]

25 minutes ago, JKL33 said:

Well, anyway, I'll bite, I do have a question for you. Let's pretend that could actually happen. Is it your opinion that THAT iteration of ridiculousness is somehow more ridiculous than blatantly unsafe nursing assignments?

Both are ridiculous.  Work with your leadership to find the right ratio, but putting a clause in the contract that floor nurses have the only voice in the matter is not a realistic solution.  

[klone, MSN, RN]

The clause is not that the have the only voice. The clause is That they have A voice, period. Right now they have nothing. 

[chare]

2 minutes ago, klone said:

The clause is not that the have the only voice. The clause is That they have A voice, period. Right now they have nothing. 

Having a voice is one thing, however that is not what would happen here.  How is requiring approval from 51% of the unit's staff to approve the staffing ratio not make their's "the only voice."

6 hours ago, klone said:

In case anyone was wondering, the major requests of the nurses is a 30% pay increase over the next 3 years, and having direct say and a vote in individual units' staffing plans.  As in, 51% of the nurses in a unit must approve the staffing ratios of that unit. I think that is VERY reasonable.

 

[klone, MSN, RN]

Same as any proposal that is made that people vote on. That doesn’t mean that the people voting have all the power. It’s supposed to be a collaborative effort. Leadership has a say, too. They just wouldn’t have the only say. It also has to be approved by a majority of the nursing staff. I can’t believe that there are nurses who would actually oppose that. 

[chare]

47 minutes ago, klone said:

Same as any proposal that is made that people vote on. That doesn’t mean that the people voting have all the power. ...

People voting on a proposal, in my mind at least, means that all involved parties vote.  What they are doing here is giving the staff the authority to kill any staffing plan that doesn't get 51% of the staff vote.  This would give the unit staff the unilateral ability to kill any staffing ratio they don't approve of.

[JKL33]

4 hours ago, xigris1 said:

Both are ridiculous.  Work with your leadership to find the right ratio [...] 

I have no dog in this except to be perplexed that "work with your leadership" is still a suggestion that could largely be taken seriously.

I really struggle to recall any nursing problem-solving-related discussion I have been involved in with leadership that didn't start (and thus end) with ground rules which precluded discussion of staffing.

I certainly thought that was a common experience. "We can't have more staffing, so what are we going to do instead?" And many permutations of that.

I feel like you're trying to....you know....and tell me it's raining.

If "work with your leadership" actually led to better staffing it's unlikely we would be having this discussion.