What do you think a CEO or AHA think about pending legislation? - page 5

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   -jt
    <Do not push and insist on legislation to replace existing or recruit new nurses until all the problems are actually solved.>

    Which words cant you understand?:


    You just choose to ignore that it exists.

    Instead of ignoring it and crying about the working conditions of nurses and loss of experienced nurses, it would be much more effective if you and every other nurse in the country sent a note to your legislator telling him to pass the Nurse Retention bill into law so workplace conditions and nurse retention problems can be solved. (But if you and every other nurse wants to ignore that this workplace conditions/nurse retention legislation exists, dont be surprised if the legislators take a hint from you & do the very same thing.)

    In the meantime, while we are lobbying for this workplace/retention legislation, do we sit idly by, while waiting for it to go thru the process, and do we wait till every facility in the country has put it into effect, followed it perfectly to the letter, and are all now problem-free, before we tackle any other issue?

    According to you , I guess yes. But according to the rest of us, NO. Thats just wasted time sitting around waiting for the passage of one bill before we go after another. We'll use that time to lobby & push for the current Nurse Retention - Quality Care Act (which address the workplace problems) & at the same time, we'll work on getting legislation to address recruitment and education too, as well as other issues like banning Mandatory OT, thank you. Its a multi-faceted solution to the crisis - which some temp nurses dont want to see solved at all - for their own understandable reasons.

    Its your opinion that the legislation to fund a nursing education for new nursing students for the future, fund an advanced education for current experienced nurses to become educators for these new students, and fund grants to facilities to expand their nursing programs should not be done.

    And its your opinion that the nursing shortage should not be solved.

    Lots of others do not agree with you. You arent going to change their minds so why do you persist in trying to ram your opinions down their throats?

    Why not take some time out from beating up everybody who disagrees with you, and instead, write a letter to your legislator to support the Nurse Retention Act which will help solve the problems you are complaining about. If not, you really have no business complaining if the problems arent getting solved.
  2. by   wildtime88
    No JT, I would like to see all the basic problems resolved to the maximum benefit of all nurses who work at the bedside. I do not want to see the existing experienced nurses replaced when they say "hell no, I will not take it anymore".

    Time will tell. If this backfires like it has so many times in the past, then what?

    Try again next time there is a nursing shortage?

    Just take out the same old warn out manual "The way to Cure the Nursing Shortage".
    Last edit by wildtime88 on Dec 29, '01
  3. by   nurs4kids
    Originally posted 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.



    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.
    I'm not trying to argue here, but I'm not seeing this as clear as you. This STILL isn't measurable. Basically, it's saying MY employer can get a grant by having a few inservices every year(promotes nursing education) and offering SOME sort of education assistance(career development). OR because my employer just hired a "Nurse Retention Nurse", they will qualify in the #2 above? The nursing shortage made them do this, NOW the gov't is giving them money to do something they would have done anyway???????? Add an intranet and a hospital qualifies for #1, or hell..just put up a few bb's here and there. Another case of taxpayers money being sent to pad someone's pocket!!! What about those employers that do not depend on Medicare??? Peds isn't a big Medicare provider yanno, as well as many private institutions. Are those nurses just SOL??? I know you're going to argue that I'm trying NOT to see the picture, but I still don't think these things are truly measurable. Anyhow, thanks for trying to answer.
  4. by   december
    I wish I could find the article I had read about this legislation. Basically, the ANA said that it was a start and that it brings the problems of the nursing profession to Washington. The article said it wasn't an intention to cure any of the large problems-the problems are simply too great, and this was a tiny step in the right direction. I think that's how we should look at it.

    Our problems can't be cured in Washington, but I appreciate having an organization there to stick up for us. There is only so much the federal gov't. can do. They can't legislate morality and ethical behavior to the business leaders of healthcare.

    I think nurses are responsible for the cure to our working conditions. We got to this point because we are not organized and not because of any group's efforts along the way. We don't need to necessarily do it at a federal level, but we do need to at a local and state level. But mainly, we need to do it at our own community hospital level. If we're all united, as employees, we'd have strength.

    I had asked wildtime88 to provide examples of independent nurses making a positive political impact on nursing. He provided two examples-nurses quitting the field and agency nursing. The nurses quitting the field made their impact because it brought the shortage to a critical state and agency nurses because they can refuse assignments. Neither of those two choices would work for me. I think neither of those choices would work for many nurses. But the main reason is, I have a devotion to my community and to the hospital that I have worked in. The nurses that work there are my family. I just don't see any way to improve administration's treatment of nurses except to unionize.
  5. by   wildtime88
    December ,

    You talk with a little confusion. You want to use the power of nursing and the nursing shortage to effect change, yet you agree with this legislation to recruit a mass amount of new nurses. You want to use the bargaining power that nurses have to affect this change.

    Now how much bargaining power do you think you will have with new nurses knocking on the door to come in under a financial penalty to work and being sent to your hospital to resolve the shortage? You have to remember there has been no ruling about if these nurse refuse to work by striking if they will have to start paying back the cost of their education and all the extras they will receive. They will be under a financial contract to the government and if they refuse to work under the terms of that contract by participating in a strike, then what?

    They might have the right to join a union, but will they have the right to break their contract with the federal government by participating in a walk out?
  6. by   -jt
    <They might have the right to join a union, but will they have the right to break their contract with the federal government by participating in a walk out?>

    EVERY unionized worker has the right to strike unless they are a government employee. But accepting a government education grant does not make anyone a "government employee".

    Where in the legislation that provides for funding for students to go to nursing school does it say that they must give up their labor rights if they accept the grants?

    No where.

    So what are you talking about now?

    The federal funding is conditional, meaning the student pays it back not in cash but by working at a designated facility or area of the country for a period of time after graduation. Being on strike does not cancel her employment at that facility, therefore, she is not breaking her agreement with the government.

    The students who accept education grants do not have a contract with the federal government that will prevent them from striking at their RN job - unless they take a job in a government facility - like the VA - and thats because those government employees, even though they may be unionized, already are bound by a law that exempts them from striking - the same law that the air traffic controllers (who are also governement employees) broke when they went on an illegal strike years ago.

    If the new grad takes a job at a unionized facility, thats the labor contract she works under. The same one as all the other nurses there. If she doesnt work at one of the designated facilities or one of the designated areas (like a rural area), or she doesnt work for the specified time after graduation as re-payment for her funding, then she may have to pay back the cash to the government.

    But it has nothing to do with strikes. If she is working at one of the facilities that meets the criterion, she is still employed by that facility even when on strike and so is still keeping her end of the bargain with the federal government. I am not aware that this is even a question nor something that is awaiting a "decision". The grants for nursing education have nothing to do with labor activity.... just as they are not for minorities alone.

    The new nurse who went to school on a government grant has the same contract that the union of nurses at her facility have and if the union of nurses at her facility choose to strike, she is not obligated to cross the line just because she received a government grant to go to nursing school. Nor is she to start paying back money just because she is on strike & not at the bedside.

    Where do you come up with these ideas?
    Last edit by -jt on Dec 31, '01
  7. by   wildtime88
    Jt, If you show me what you have just posted in the legislation then I will agree totally. In that case the judgement would have already been made.

    But logic dictates that if you are educating and training nurses for the public's survival and for hospitals with needs due to understaffing and you have them under a financial contract to work, then they work. This legislation is more than just a regular grant.

    I have read though the legislation more than once directly through the links I have previous posted.

    Please give me a link to the laws and regulations you are talking about.
  8. by   Jenny P
    Wildtime, I had a federal grant for nursing school back in the 1960's that I would not have to pay back if I worked a certain number of years (I believe it was 12) in an underserved area. No where in my grant was there any rule saying I could not strike. I did work about 4 years in underserved areas, then moved to an area that wasn't underserved and ended up being on strike during that first 12 years I was out of nursing school. I'm more than sure that the US government would have come after my hide if it was illegal (I'm one of those people who always gets caught if I screw up).
    There is no where in this current legislation that says they can't strike either.
  9. by   Jenny P
    This thread is a prime example of why the nurses at the bedside can't organize independantly of any organization or union! Every single one of us reads the same piece of legislation and interprets it our own way. Should we each hire our own lawyer to walk us through the legalese so we can all be on the same wavelength? At least my state nursing organization has its own lawyer that we can talk to and get legal advice from.
  10. by   -jt
    <But logic dictates that if you are educating and training nurses for the public's survival and for hospitals with needs due to understaffing and you have them under a financial contract to work, then they work.>

    YOUR "logic" may dictate that to you but YOUR logic is not the reality of it. There is nothing anywhere in the legislation that says anyone accepting a grant to fund their nursing school education forfeits their labor rights or automatically becomes a government employee with no right to strike, so therefore, your "logic" is flawed.

    The legislation does not make any requirement for or mention of repaying the money in the event the nurse goes on strike, therefore what you suggest does not exist. If something is not written in the legislation, it doesnt happen.

    The "contract with the government" is ONLY for the nurse to repay the grant with her time & skills at her choice of places where they are most needed - it has nothing to do with her employment contract or giving up her rights to labor union activity, including striking. Her rights as an employee remain intact & what she does at work or whether she goes on strike or not has no bearing on repayment of her loan.

    All she is required to do to hold up her end of the bargain with the government is to be employed for a certain time period in an underserved area. Nurses on strike are outside on the sidewalk but STILL employed at their facility.

    While this is just the first time it is being considered to be national law for nurses, conditional education grants & student loans such as those the legislation addresses are nothing new and they are found in many places, including my city. The nurse receives a grant to go to school and in return is employed for a few yrs in an underserved area or pays the money back. Period.

    Teachers do it. Lawyers do it. Doctors do it. Nurses do it.

    NOTHING in the legislation obligates any nurse to relinquish her right to strike. And if its not in there, it doesnt happen.

    Now.....off to the party..... happy new year!
    Last edit by -jt on Dec 31, '01
  11. by   wildtime88
    To anyone who still thinks that proposing legislation and seeing it enacted is a simple process. Please go to the following thread and read the reality.

  12. by   Peeps Mcarthur
    The California situation looks like a good proving ground for the ANA leadership.
    It's not that I want to disprove thier efficacy. Actually, it's just the opposite. It just seems quite a coincidence that tha ANA was kicked out of California and BadaBoomBadaBing, in the interest of California nurses(whether they were thinking of them or not) the Gov gets a safe staffing bill passed.
    I think that the reason staffing levels, as found by the comission, have not been implemented is because they (the comission) can't face the reality of telling millionares (top hospital administrators) that they need to cut the fat. Imagine politicians faced with telling Big business "Thanks for the soft money, but we've got to help the nurses and patients at risk here". I don't think they had any idea when they formed this comission, the piss poor conditions and the reality of how understaffed the hospitals were in relation to humane and ethical tretment of both nuses and patients. I imagine they never pictured the shortage to be this imbalanced towards the little people.
    They're just sitting with hands folded across thier laps waiting for the Hot potato to cool down. Yep, they just left this nursing shortage potato in the microwave a little too long and it just needs to cool off a bit so they can dump it while nobody's looking.
    I don't think there's an oversight comittee to make sure they follow the guidelines of the bill. At least not one that isn't influenced by a few corporations somewhere in the gene pool.
    They have the results, it's just that nobody but nurses and patients want to believe the data is valid.
    Can't wait to see how this plays out.
    It's what is called a precedent.
    Last edit by Peeps Mcarthur on Jan 2, '02
  13. by   -jt
    No one ever said that getting legislation passed into law is easy. But its easier to do when there is a strong, collective voter voice pushing for it. Are the majority of the over 1 million nurses working in pt care standing up & saying NO MORE - making their voices heard by their legislators re: safe staffing or anything else? No...... its just a % of all nurses who are doing that...... so getting federal legislation passed on nurse staffing is going to be that much harder. But not impossible. Getting ANA-supported legislations for nurses/pts passed has been done many times before.
    Never say die.

    Re: the California staffing law:

    It did not happen overnight. It was a long fight & though they have had it since 1999 & it was supposed to be implemented last yr, putting it into effect had to be delayed a year because no one can agree on what the ratios should be. These are just ratios for only acute care hospitals and look at how difficult it has been.

    Direct-care nurses groups dont even agree with EACH OTHER on what the hospital ratios should be.

    So today is the day that law was to take effect but its being delayed again while they continue to hammer out what the ratios should be. Its not an easy process by any means.

    California is not the only state where nurse staffing ratios legislation has been introduced. It is the 2nd worst state as far as numbers of nurses per pt population and it is a state whose Director of Dept of Health is not a doctor or businessman but an RN (from NY) who understands about nurses & patients and lobbied for the law. All of the direct-care nurse groups were involved in lobbying for it too - including the SEIU. And all of that helped in CA becoming the first state where legislation to set hospital staffing ratios was passed.

    Nurse Staffing Legislations have been introduced in several states:
    Last edit by -jt on Jan 2, '02