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

Nurses General Nursing

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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?

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?

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 :rolleyes:

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.

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.

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. :p

Which words cant you understand?:

THERE ALREADY IS LEGISLATION THAT SPECIFICALLY ADDRESSES NURSES WORKPLACE PROBLEMS AND RETENTION OF CURRENT NURSES & IT IS PRESENTLY GOING THRU THE LEGISLATIVE PROCESS IN WASHINGTON, D.C.

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.

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".

Specializes in Pediatric Rehabilitation.
Originally posted by -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.

jt,

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.

Tracy

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.

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?

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?

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.

Specializes in CV-ICU.

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). :cool: :o

There is no where in this current legislation that says they can't strike either.

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