Our View: Heed hospitals' straight talk, legit and dire warnings
From the editorial: "To dismiss ... concerns as nothing more than corporate greed, as the nurses union and DFLers have done repeatedly for years, ... is irresponsible and ignores the realities of the current nursing-shortage crisis."
Echoing legitimate, longtime concerns, the Mayo Clinic last month sounded a serious alarm about legislative proposals to mandate nurse staffing levels, with the decisions made at a committee level rather than by the hardworking health care professionals in our hospitals and clinics who care directly for patients and who have the firsthand knowledge to make the best real-time health care calls.
More recently, this week, leaders from every Minnesota nonprofit hospital and health system similarly warned in a message to legislators that the proposed bill, as well as another to establish a board to take on rising health care costs, threatened patient care statewide.
The response from the Minnesota Nurses Association? The state nurses union, as vocal as anyone in pushing these measures into law this session — in spite of their repeatedly flagged shortcomings — accused Mayo of using “blackmail tactics.”
Seriously? Both pieces of legislation obviously are in real need of additional work, deeper discussions, respectful negotiations, and compromise. While “certain provisions” in them may be broadly acceptable, as Mayo representatives wrote to the Minnesota Senate Health and Human Services Committee in March, others are dogged by “significant concerns.”
To dismiss those concerns as nothing more than corporate greed, as the nurses union and DFLers have done repeatedly for years — public faith in our health care institutions be damned — is irresponsible and ignores the realities of the current nursing-shortage crisis and the ongoing bottom-line challenges created by the pandemic.
It’s even more close-minded when the concerns being dismissed are coming not only from every single nonprofit hospital and health system in the entire state but also from the state’s largest employer, Mayo, which provides jobs to more than 48,000 Minnesotans.
The concerns of many demand to be addressed, not brushed aside.
“If these bills pass as they are written, Minnesota's nonprofit hospitals are in trouble. This is not hyperbole. These proposals would negatively impact hospital care,” read the statement published Monday from Minnesota hospital and health system leaders. “These proposals will worsen an already unsustainable path for the future of hospitals in our state, endanger access to care, and may spell the beginning of the end of Minnesota's nonprofit hospital model. The reality is that our hospitals simply do not have sufficient resources.”
In spite of that, the legislation is frighteningly close to being rammed through in St. Paul. It ignores that there are currently more than 5,000 nurse openings in our state, an already alarming number that's expected to leap to 43,000 within seven years.
Meeting government-mandated nurse-to-patient ratios would be a challenge for hospitals and clinics, to put it mildly. Without enough staff, they would be forced to reduce beds and patient capacity instead.
The Minnesota Hospital Association has estimated that patient capacity would need to be reduced by 15% if the so-called Keeping Nurses at the Bedside Act becomes law this session. That would mean 70,000 Minnesotans a year unable to access the care they need, as the News Tribune has editorialized previously.
"How does it work right now? An ambulance comes in or an ambulance is about to come in. The nurse leader, the nurse manager, the charge nurse talks with her or his nurses in real time to say, 'What can we do to serve our patients?' We don't wait for committees," Dr. Rahul Koranne, a hospitalist and the CEO of the Minnesota Hospital Association, said in an interview in April with the News Tribune Editorial Board. "Patient care decisions are made on a minute-to-minute, hour-to- hour basis, not mandated by committees that may meet only a couple of times every couple of months.”
With straight talk and honest analysis, Mayo officials detailed what changing that process could mean in an email to the DFL-led Legislature and Gov. Tim Walz, also a DFLer. For Mayo, it could mean scrapping coming construction projects that promise to be “four times the size of the investment in U.S. Bank Stadium,” as the Rochester Post-Bulletin reported a week ago. The loss of that economic jolt would be devastating for all of Minnesota.
Mayo asked that the “extremely problematic” Health Care Affordability Board proposal be removed from the state’s Health and Human Services omnibus bill. It also asked to be exempted from the Keeping Nurses at the Bedside Act. Rather than offering any exemptions, in consideration of the very serious and even existential concerns raised by hospitals, clinics, and others, both measures can be removed from legislative consideration for additional work. It is clear neither is what’s best for the health care providers on which all Minnesotans depend.
Nurses, administrators, and others all working together to determine safe staffing levels and how best to provide high-quality care is a laudable goal. So is investing in health care education and in convincing high school and college students to pursue medical careers, which would help ensure Minnesota has enough nurses and other medical professionals.
Both can guide lawmakers, who can take seriously all concerns, including those being trumpeted now.