I Don’t Hate America!

The Minnesota Nurses Association (MNA) is currently holding elections through September 8th, 2009 for many major positions within the union organization.  MNA members are given either a mailing packet with a paper ballot, or access to an online ballot.  I am running for three elected positions and hope that I can convey my message to a wide audience as the MNA represents 20,000 members.

All ballots should already have been received by the time of this posting.  This is an excellent opportunity to set in motion change by electing active members involved with current healthcare issues. I’ve been an active member in governmental affairs since being a nursing student at Winona State in 2007.  After graduation, I have furthered my interest as both an MNA bargaining unit representative for multiple units at Abbott Northwestern, served as a delegate to the annual House of Delegates, and have chosen the MNA organization as my clinical location for my Master’s degree practicum (MSN) in leadership & management.

One issue that I know many of us see in our daily workplace is the aging population of nurses. Many are nearing the retirement age, worried about pension problems that are extremely important to everyone including us, but also need to consider other issues important to the generation X and Y’ers who would like to be in the profession for many years to come. I understand that as younger nurses, we want flexibility in our job, regular hours, better pay, and tend to look at our job as second to our family and personal life. A study by Kovner et al. (2007) sent to nurses all across the country found that 41.5% of responding nurses would choose to go into another profession if they were given the chance, 24% “planned to leave their first job within two years of taking it,” and 37% plan to find a new job within one year (p. 68). Does any of this sound like you?

Have many of you faced issues with poor staffing ratios, were given severely ill patients, yet asked to take up to six or more of them on one night? Burnout and dissatisfaction in our jobs is commonplace, but it doesn’t have to be! Aiken, Clarke, Sloane, Sochalski, & Silber (2002) found that there was a high frequency of emotional exhaustion and job dissatisfaction “significantly associated with patient-to-nurse ratios” (p. 1990). MNA wants to change this by helping to pass legislation that would mandate a maximum nurse-to-patient ratio in MN. Furthermore, we would receive fewer patients depending on their acuity/intensity because we all know that sometimes the most difficult patients are not the ones that may be real sick, but can be the ones that need constant attention, or frequent assessments due to issues more than just their illness.

I’m a nurse with only two years of experience under my belt, but like many of you, I feel that we need a change in our healthcare system that works better for nurses, better for patients, and better for hospitals. Our jobs as nurses has always been considered a “line item,” or an expendable “cost” as patients are charged for our services simply through their room and board rate. How wrong is that when we do so much for our patients that simply one charge measures our work?

The nursing shortage has been discussed less as of late, but we can all agree that things have truly not become safer at the bedside. A survey by Anderson, Niebuhr, & Associates (2007) found that “90% [of] Minnesota citizens express concern that lack of adequate RN staffing negatively affects patient care” (p. 5). The study also highlighted the feelings of MN citizens during times of hospitalization as 30% “experienced a situation where too few registered nurses on duty affected the quality of care they received, or they know someone who experienced such a situation” (p. 5).

What we do as nurses is invaluable in healthcare. We cannot let anyone tell us that we need less nurses, or that we have to sacrifice lunch breaks, must stay for overtime, or do more non-nursing tasks just because hospitals do not want to hire ancillary staff. Registered nurses are there to assess and perform potentially life-saving nursing tasks, not stock gowns due to personnel issues! Soon, we may see hospitals try to increase our patient loads due to financial problems, but we know that patient mortality increases “7% for every additional patient in the average nurse’s workload” (Aiken, Clarke, Sloane, & Silber, 2002, p. 1991). If we let them do this to us, it is our license at risk and more notably, a patient’s life at risk.

If any of you have not seen the impromptu video of famed author Suzanne Gordon and me at Nurses Day on the Hill 2008, check it out on YouTube, it may be worth a look to raise awareness of the seriousness of this problem through an actual situation I had. I know for a fact I’m not the only one who has had experiences very similar to the one I presented, but we all need to speak up. I am reaching out to this group specifically because I know most of you are younger, just getting involved with your profession, and want to give the best care possible to your patients. I want to make sure that all of you are standing up for our profession, our rights as professional registered nurses, and are expressing to your colleagues any concerns you are facing. We also need more young nurses involved as the U.S. Department of Health and Human Services (2004) estimates the average age of our workforce is 46.8 years and increasing every year! We are the future and need to secure a better profession for ourselves!

I am running for three elected positions within the Minnesota Nurses Association so I can continue the fight for nurses and patients. If you have already received a ballot, there are many great candidates to choose from this year. I am likely one of the youngest on the ballot since I have only been in the profession since 2007. However, this means that all of you will have a voice for the younger generations in an organization mostly led by senior nurses. Please consider voting for me for the following positions if you have an MNA ballot:
- Commission on Governmental Affairs for congressional district 2
- Delegate to the MNA’s annual House of Delegates
- Delegate to the United American Nurses (UAN) national collective bargaining union

If you are interested in serving in the annual House of Delegates (HOD), there will likely be openings as alternatives! It is such an awesome event that teaches so much about our profession. Everything is paid for (except work hours), such as hotel, food, and mileage. Hotel is paid for based on dual occupancy and I’m more than willing to help a new member! This October 11-13th HOD will be located in the Crowne Plaza hotel in St. Paul, MN. CEU’s are available for those attending while you vote on items affecting MNA for the following year(s). More information is: here.

An alternate delegate form is available online. Fill this out and send it via e-mail to Kelli.Eisenschenk@mnnurses.org

Please consider being a delegate as I can’t stress how great of an experience this is: FORM.

My biography for the positions I am running for:

Jason Bauman, RN, BSN, PHN
- Winona State University graduate in 2007. Nursing major, Psychology minor.
- Walden University Master’s in Nursing (MSN) – Leadership & Management to be conferred in October, 2009.
Activities:
- Staff nurse at Abbott Northwestern
- MNA Steward
- Delegate to the MNA HOD
- League of Women Voters
- AFL-CIO: Working America
- Minnesota Public Health Association (MPHA)
- Creator/moderator of an international Nursing Student Community of 5,500+ members focused on healthcare issues.

Questions answered for the ballot (50 words or less):

- 1. How would you help fulfill MNA’s mission and strategic goals/priorities?
- We are a powerful union when using our collective strength. As a nurse part of Generation Y, I would promote the use of grassroots organizing, utilizing new technologies such as social networking and motivating members of all ages to participate. Education will especially be vital, particularly with negotiations approaching.
- 2. Health Care Reform and Safe Staffing legislation are priority issues of MNA. Please comment on one or both organizational priorities.
- MNA can have a real impact on these issues if we properly organized, mobilize and educate our members. RNs need to be patient advocates in the political area, though lobbying and sharing our stories as we focus on covering the uninsured and protecting our children.
- 3. How have you or would you represent the views of the membership?
- My political involvement prompted me to serve on the House of Delegates, become an MNA representative and choose MNA for my Master’s degree seminar. I am passionate about researching how other states are implementing nurse safe staffing to learn how we can improve our bill for next year.

My primary nursing issues:

- Nurse safe staffing. I would like to see state legislation pass next year that has a ceiling for how many patients a nurse can receive at any given time (e.g. mandated ratios), however this number can decrease if patients are more acute, have a greater need for nursing care, and/or ancillary staff is unable to help (i.e. with patients needing feeding, are fall risks, etc.). I feel we need this guaranteed in law, otherwise with the greater financial strain on our hospitals, we will be the first to feel cuts while given more tasks as nursing is technically considered a “line item” or “cost” that doesn’t generate revenue through what we do, unlike other parts and personnel in the hospital. We need change now to secure our future and keep nurses at the bedside!

- Healthcare reform. As of 2008, uncompensated care costs from those uninsured rose to 42.7 BILLION; money which will pass on to the consumer who is insured (Families USA, 2009). For families with private insurance, uninsured people are raising their insurance premiums approximately $1,017 annually (Families USA, 2009). These amounts are added up from many things such as uninsured people visiting the ED’s, patients unable to pay for the cost of their hospitalization (1/3rd of the uninsured pay out of pocket, 26% comes from the government or charities, but the rest is uncompensated), and many more reasons that add to the hospital’s debt. As a result, hospitals charge insurance companies more for services so they can get pay off their debts which again raises the premium of everyone else who has private health coverage. What we need is a comprehensive reform that targets a preventative approach to medicine (not a reactive one) that includes basic insurance coverage for all. If you think about it, a patient who comes into the ED with coverage will reduce uncompensated care costs since he or she will have money insuring them, physicians will receive payments rather than forced to do charity work, and nurses can provide optimal care as they are being reimbursed for what they do instead of increasing uncompensated care fees. Costs for hospital services will eventually decrease as the need for paying off uncompensated care, or debt isn’t going to be as major of an issue.  Why do we require car insurance for an “item” we use and aren’t requiring health insurance for our LIFE.

- I could list more of my opinions, but I am willing to discuss these on a one-on-one basis if anyone would like to contact me personally.

HOW TO VOTE:

If you work in an MNA facility (or are an MNA member) and did not receive a paper ballot, the online ballot is located here.

If you do not have your ID/password, go here and enter your registered MNA e-mail address.

If that doesn’t work (I had to go to this step as well… don’t worry!), go to the technical support information on the bottom and find the click “here” which brings you to a form located here.
- Fill the information out and you will receive your username ID/password within the next day or two so you can do the online ballot. Please do this and vote by September 8th!

Thank you everyone for reading and for your support. Don’t hesitate to comment, or write me directly as I would love to answer your questions. Thanks again.

References:

Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital
nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987-1993

Anderson, Niebuhr, & Associates. (2007). RN staffing and patient care in Minnesota:
Perspectives from nurses at the point of care and the citizens of Minnesota. Minnesota Nurses Association. Retrieved on August 15, 2009, from http://www.mnnurses.org/vertical/Sites/%7B41671038-B8D0-4277-90A9-50B10F730CBD%7D/uploads/%7B4F6264DC-088D-4B2B-9F1D-CD7FC2024FE8%7D.PDF

Families USA. (2009, June). Investing in health coverage: It just makes sense. Retrieved
on August 23, 2009, from http://www.familiesusa.org/assets/pdfs/health-reform/invest-in-coverage.pdf

Kovner, C. T., Brewer, C. S., Fairchild, S., Poornima, S., Kim, H., and Djukic, M. (2007).
Newly licensed RNs’ characteristics, work attitudes, and intentions to work: A better understanding of newly licensed RNs and their employment patterns is crucial to reducing turnover rates. American Journal of Nursing, 107(9), 58-70.

U.S. Department of Health and Human Services. (2004). The registered nurse population:
Findings from the 2004 national sample survey of registered nurses. Health Resources and Services Administration. Retrieved on June 29, 2009, from http://bhpr.hrsa.gov/healthworkforce/rnsurvey04/

(cross-posted at Bluestem Prairie)

In the midst of the media’s coverage of health care “town hall” style meetings and the hysteria from conservative activists over the reluctance (or in some cases, refusal) of some Members of Congress to participate in such forums, at least one Republican congressman’s refusal to hold one has, until recently, been virtually ignored.

Rep. John Kline, R-Minn., has largely gone under the radar despite not only failing to host a forum about health care so far during Congress’s summer recess, but hosting only one forum at all since his election to the House in 2002. Kline serves Minnesota’s Second Congressional District, which, while containing suburbs in Carver, Scott, Dakota and Washington counties, is largely rural.

This stubbornness has been an ongoing frustration for Kline’s constituents, but his emergence into the broader discussion about health care town halls only occurred when he turned down Rep. Tim Walz’s invitation to appear at a forum in Walz’s First District. In return, the invitation said, Walz would have appeared at a town hall with Kline in the Second District.

With a town hall even being held by DFL Seventh Congressional District Rep. Collin Peterson, who previously had a hands-off attitude toward such forums, a few of us from the Second District DFL thought was time to request that Kline hold one.

So, about a half-dozen of us went off to Kline’s district office in Burnsville yesterday. No video cameras. No ambushing. No hostility. No inflammatory rhetoric. Just a simple request that Congressman Kline hold a town hall forum on health care.

We were kindly greeted by congressional staff including District Director Mike Osskopp who invited us into a conference room to discuss our request. When Kline’s rejection of Walz’s invitation was brought up, Osskopp strongly reiterated that it was their opinion that the invitation was nothing more than a “publicity stunt.” Due to the relatively close relationship both congressmen share (he mentioned that they often travel together), if the invitation was in good faith Walz would have picked up the phone and called Kline as opposed to sending a letter, Osskopp said.

After some discussion of concerns with the current health care system, we were joined somewhat unexpectedly by Rep. Kline himself. After briefly mentioning his frustration with the road map to a health care reform bill used by President Obama, Speaker Pelosi, and Majority Leader Reid, Kline gave his reasoning for refusing to hold a town hall forum, with or without Walz.

“They are a circus,” the congressman said. “They have been a circus for our side, and a nightmare for my Democrat friends, as you’ve seen.”

This position is in stark contrast with that of other Repbulican activists who were outraged at Peterson’s previous lack of town halls. Among them is Minnesota GOP Deputy Chair Michael Brodkorb, who said “If you don’t want to meet with people, then don’t run for Congress.”

While he refuses to hold a traditional town hall forum, Kline did express willingness to meet with a smaller group, 50 to 100, from the DFL side to discuss health care.

He explained that he felt the current “auditorium style” town halls have “gotten so far away from their original purpose” and only enable “each side to shout over each other.”

“It shouldn’t be about looking to get on YouTube; it shouldn’t be about getting on Channel 9,” Osskopp added.

Soon, the subject was changed to Kline’s use of “tele-town halls,” which Kline characterized as “successful” and led Osskopp to mention that “even Tim Walz is having one.”

I pointed out that the Walz telephone town hall, held last night, would feature a pre-announced dial-in number enabling all constituents and the media to “attend.” I added my position that this method enables greater constituent participation and transparency, as opposed to the method used by Kline and other members, like Michele Bachmann, which “auto dial” 40,000 constituents at random with no advance notice of the “event.”

Osskopp explained that since Kline usually hosts the telephone town halls from Washington, and the voting schedule changes “by the hour,” it would be difficult to offer advance notice. He went on to express willingness to email a couple of members of our group in advance when he becomes aware of the forums, however

Another DFLer at the table expressed greater concerns about the “auto dial” method of telephone town halls, particularly the potential for participants to be cherry picked based on party identification and for only friendly softball questions to be taken. Kline, Osskopp and Communications Director Troy Young (in the room taking photos) all explained that there are strict laws which would prohibit such behavior and that the House Ethics Committee has strict oversight over telephone town halls which would prevent it. Kline further explained that he indiscriminately goes “down the sheet one by one” taking questions during a forum. Young further explained that if a constituent opts-in to participate in the telephone town halls on Kline’s official website, the office is “required” to call the constituent when one occurs. We were all encouraged to take such a step.

Soon after, with his scheduler hovering in the hallway, it was time for Kline to move on to the next task on his schedule. He closed by mentioning that the subject of town hall meetings was one about which he agrees with his “friends Collin Peterson and Jim Oberstar.” Before his exit I quickly mentioned how Peterson recently had a town hall in Willmar which was widely reported as civil and productive. The congressman’s response: “Well, that’s great. Thanks guys.”

Kline mentioned a couple of times during the conversation that he is “not afraid of Democrats.” Since he spent time meeting with our small group, along with his willingness to meet with a larger group of us and his district director’s willingness to try giving advanced notice for telephone town halls, I would like to take him at his word. Considering the collegiality of our meeting yesterday (for which Kline, Osskopp and other staff should be commended) I see no reason for such a fear.

Hopefully there can be follow-through on both sides so we can continue our dialog about not just the process surrounding Kline’s constituent outreach but the subject on so many of our minds: health care.

After his refusal to stop lying about Rep. Tim Walz’s representation of the congressman’s own military record, Steele County GOP Chair Dave Thul is being less than truthful once again.

From his blog today:

So Congressman Walz tried to tie his sinking ship to Congressman Kline by publicly inviting him to a town hall meeting. It was actually a lose-lose situation for Walz. If Kline showed up, he would have had the crowd on his side (assuming the crowd isn’t packed by the unions) and Kline could have taken shots at Walz directly in a public forum. If Kline turns down the request (which he did), he can simply point out that Walz asked for help talking to his district but didn’t offer any such help in Kline’s district.

Didn’t offer any help in Kline’s district? Reeealllllllly?

From Rep. Walz’s invitation to Rep. Kline:

I would like to invite you to participate in a town hall with me here in Minnesota’s 1st Congressional District on Thursday August 20th at 6:00 pm.  In return, I would be happy to join you at a town hall in your district next week or in September. [emphasis mine]

Not only is it important to dispel myths, half-truths and lies concerning the current health care reform proposals, it’s important to dispel lies concerning the process of planning these town halls as well.

I’ll have more on the latter subject later.