Minnesota lawmakers fell into partisan camps Thursday as a House panel advanced a bill seeking state regulations on the number of nurses working shifts in hospitals.
The Democratic-led House Labor, Workplace, and Regulated Industries Committee endorsed the nurse staffing bill on a 9-6 party-line vote after hearing charged testimony from both sides in a long-simmering dispute. Unionized nurses argued the standards are needed to ensure patient safety, and hospital industry professionals cast it as government intrusion in medical decision-making.
The concept of staffing ratios has been a hot topic for years at the bargaining table, but the Minnesota Nurses Association sees opportunity with a Democratic-dominated state government to gain advantage in law. A bill the union is promoting doesn't include explicit quotas but it would demand hospital-by-hospital staffing requirements that would be developed over the next year. The standards would differ by unit and by the severity of patient health woes.
"If hospitals won't listen to nurses that we're stretched too thin to properly change dressings, then perhaps they'll listen to you," said Joe Howard, a registered nurse in an intensive care burn unit at a Duluth hospital.
Lawrence Massa, president of the Minnesota Hospital Association, accused the nurses union of working to "undermine the collective bargaining process" by getting lawmakers to intervene on their behalf. He noted that the standards would apply to all hospitals even though a majority of the facilities in the state aren't unionized and most get high marks for quality care.
"The simple truth is, quotas do not equal quality," he said.
The plan would establish a system of record keeping for hospitals and potential punishments for those that fall short of the standards. Staffing levels, which would be determined by evidence-based protocols or a newly created government board, would have to be posted in waiting areas for staff, patients and the public. Annual reports from hospitals would include details on the hours-per-patient that nurses work.
The committee added an amendment that would prevent hospitals from laying off registered nurses, licensed practical nurses or certified nursing assistants to meet the standards. Opponents of the bill contend a similar law in California led to cuts in other employee ranks to pay for the hiring of new nurses.
Republicans complained all of it would put hospitals in an untenable situation and may lead to closures of smaller community hospitals.
"It intrudes on the management-labor relationship a great deal," said Rep. Mark Uglem, R-Champlin. "You need to have flexibility."
Rep. Joe Atkins, the bill's sponsor, said lawmakers need to look beyond the bottom line.
"Patient safety, patient's protection ought not to be decided at the bargaining table," said Atkins, DFL-Inver Grove Heights.
The bill has several more committee stops before reaching the House floor; a companion Senate bill awaits its initial hearing.
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