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

[wildtime88]

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 Association. The CEO's have to be drooling over these 2 pieces of legislation. If I were a CEO of a hospital, I would be encouraging everyone to write to his or her legislator. I would even provide the postage as well as pay them 5 or 10 dollars to send a postcard in support of the recruitment legislation. I would on the other hand be publicly against the legislation against mandatory OT, but privately I would be telling all my other counter parts to allow it to pass without major resistance.

Now why would I do such a thing. It is simple in the long run it will be beneficial to me in keeping costs down and ensure that my personal income to rise.

How exactly would that happen you ask. Simple, the recruitment legislation will provide me with brand new needed personnel that I can use to replace the nurses who are harassing me for more money and benefits. All I have to do is to continue to pay the same stagnated wages and benefits once it passes. As experienced nurses leave, I can put in my request for more nurses. I will be paying a fare wage when compared to the other hospitals even though it might be as much as 5 dollars less than the national average. In fact, me and my friends have already talked about again freezing salaries across the country as soon as this legislation passes. Many of us have been talking about how we will be able to use this same legislation to put the reigns on the unions we have to deal with. The legislation will provide a way to cut the bargaining power the unions and nurses in general have at this moment. We as employers only need to show that we are not blatantly abusing nurses. This way the government will pay for the replacements that we will need and put us on the needs list. As an extra bonus to us, they will even prioritize on the women who are on welfare or other forms of assistance. This will be a blessing. They will see the wages we offer as a blessing even if they are lower than today's current level, not to mention the low self esteem and other unresolved negative personality issues they will be coming to us with that will allow us to keep them in check.

The anti mandatory OT issue will benefit us in 2 different way. The first one will be that of making our needs greater. If we can not use mandatory OT anymore then we will have to increase the nurse to patient ratios to provide nursing care. By doing this we will benefit in fewer staff and less out of pocket costs for staffing thus better profits. This will surely result in loosing more of the nurses who are tired and have been harassing us for better pay and benefits. We can offer extra incentives for OT in the short term while we wait for replacement nurses to show up and we can continue to slowly increase nurse to patient ratios at the same time. By the time legislation is passed and goes into effect, if ever, The first group of replacement nurses will be ready to step in. I do not foresee a problem with bogging down any type of legislation or getting a time frame set that is in our favor for compliance to start.

The way this is all coming together is great. We could not have done a better job if we would have done it ourselves. We owe the ANA a big thank you for all they have done on our behalf. Just think all this plus the increased limits on foreign nurses that will pass, we will have control once again, as though we ever actually lost it. We will all have to meet with the genius from the Cleveland Clinic to get his input as well.

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I am not saying that one day recruitment legislation like this will not be needed and beneficial, I am just saying that it is going to undermine all the things we as nurses could improve today. In short, this legislation, if enacted, will help to defeat the real progress which nursing as a whole could benefit from. I hope that in a few years when someone asks what the ANA has done for you lately that you will remember this. This is going to take away yet again the chance that nurses can once and for all take control of our own professions and futures. Everyone is going to benefit from this legislation except the nurses who want to remain at the bedside.

If you have not taken the time to look over the legislation being pushed by the ANA, then I would encourage you to do so. It is easy to read. While you are reading it, keep in mind the climate that is going to exist in the minds of the public in general as each area chimes in declaring an emergency to get on the list of needs. What do you think will happen to any nurse opposition by saying no to their need for any reason? Please take the time to read through the entire bills, at first they start out a little different and become more. There are some parts that could be used today such as the advertisement/orientations to High Schools while focusing efforts on actually solving our problems first, but the way the way they are written, it is either all or nothing.

http://thomas.loc.gov/

Nurse Reinvestment Act (S. 1597, H.R. 1436) and the Nursing Employment and Education Development Act (S. 721)

If you are not familiar whit what happened at the Cleveland Clinic and surrounding area please take the time to familiarize yourself.

https://allnurses.com/forums/showthread.php?threadid=11674

To those who say that if you are not a ANA member you have no right to complain or get upset, if it directly affects your future then you do have a right. For the vast majority of us it is either the ANA or nothing, now as a nurse who wants to stay at the bedside why would I want to support an organization who is so intent on selling (not sailing) me down the river. Can anyone say who works at the bedside that this is good leadership?

If you are not up to date on ANA's stance on importing foreign nurses then take the time to look at this:

https://allnurses.com/forums/showthread.php?threadid=12321

I am just a nurse who works at the bedside who would like to remain there and who is looking for a brighter future with real progress being made. How can I argue with the intelligence or logic of the ANA in this mater. They see a 7 to 8% membership ratio as a majority approval of how good of a job they are doing? This is probably close to the same percentage of members of the Taliban in Afghanistan who actually controlled the country. We need a new national organization with leadership who will attract nurses and change the direction and focus on the needs and wants of the majority of nurses without selling anyone down the river.

Someone said to me in another post to either lead, follow, or get out of the way. I refuse to get out of the way because this is my possible future and existence that is at stake here. I refuse blindly follow a group that is going to sell me down the river due to their lack of logic. Unfortunately I am a man in a female dominated profession and would not be seen as a good leader without fostering feelings of resentment in the long run as too the leadership style that is needed. A woman would be the best candidate even though she would probably get resentment in a different form, she by just the fact of her gender would be easier to accept and follow under the existing climate.

If you agree that the direction that the current legislation if passed will then take nursing away from actual change by undermining the position we have now, then let everyone know that you do not support the ANA as a nurse and /or the pending legislation. This is your future especially if you plan or want to stay at the bedside. It is your future do not let it go down the drain.

http://www.pueblo.gsa.gov/call/e-mail.htm

http://www.senate.gov/contacting/index.cfm

http://www.house.gov/writerep/

Please remember that I stated a while back that legislation like this would zoom through congress because it would basically go unopposed. I also stated that any legislation that went to heart of our problems in nursing would drag on and be opposed at every turn. The ANA has found a way to appease the powers that be while at the same time setting up the nurses at the bedside for a hard reality of things to come. With leadership, and I use that term loosely, like this, is it any wonder we are in the shape we are in today?

[wildtime88]

The only thing I need to say is that time will tell.

If all this backfires then what? If the other legislation is not seen as a priority because nursing school enrollment is way up and there are many new nurses ready to enter the profession then what?

Maybe you should check nursing history as far as shortages are concerned.

Every nursing shortage has resulted in modest improvements. Just as these improvements started to take place there was legislation in one form of another that brought in a mass of new nurses, then the improvement basically slowed to a halt.

Time will tell.

[thisnurse]

its only logical that if we work on imporving our working conditions, focusing on retention, then recruitment will fall into place.

it seems to me that from looking at the past there is a pattern here.

there is a shortage...wages go up, conditions improve and enrollment in schools goes up. the shortage is gone and in fact the last one gave us a surplus of new nurses. when i graduated in 1996 it was hard for any of us to get a job.

this in itself caused some of the new nurses to change professions and it dried up the enrollment in the schools. who wants to go to school for a job you cant get?

so now here we are nearly 2002.

this shortage seems to be worse than the rest but wild is right, time will tell.

we just might see the yoyo effect again.

i am not pro ANA, nor am I anti ANA, although i often wonder if they are actively representing us or their own agendas.

i have not SEEN much in the way of retention, the focus seems to be on recruitment. in my opinion this is NOT going to help us,its going to help the hospitals.

the nursing schools will fill up again and there will be a surplus of nurses. the hospitals will tell us that if we dont like the working conditions we can quit (causing another shortage).

new grads will replace us. when they find out what the working conditions are like, many of them will quit as well. enrollment will decline and the cycle will begin again.

i dont care about any recruitment bills. i do care about proposed retention legislation. maybe im missing the mark here. please educate me on the pending legislation regarding retention.

ill be the first one to shout it off the rooftops if its legitimate. but like ive said before, i have no faith in the government helping anyone other than the hospitals.

please show me i am wrong.

[NRSKarenRN, BSN, RN]

this nurse and colleagues:

i've highlighted in blue the major initiatives of the nurse reinvestment act in the senate bill which is more comprehensive than the house bill (senate bills usually are).

in red, i've highlighted under part j initiatives to strengthen the nurse workforce those aspects of the bill that focus on retention, including formation of a commission to make recomendations.

under sec. 861. developing retention strategies and best practices in nursing staff management.

funding of 10 million dollars is available 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.

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.

[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."

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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.

[-jt]

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.

Nurse Retention and Quality of Care Act of 2001

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

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"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

[nurs4kids]

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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.

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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.

[-jt]

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.

[thisnurse]

exactly what i was thinking nurskids

[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?

[-jt]

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?

[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?

[-jt]

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."