I Don’t Hate America!

On March 5th, an agreement was made between Gov. Tim Pawlenty and DFL leaders to extend the GAMC program that was set to end on March 31st, 2010 and would have transitioned tens of thousands of low-income Minnesotans to a more expensive MinnesotaCare plan. Although the plan will continue coverage for many, the payments are slim from the state, instead shifting much of the costs to hospitals.  According to MPR and Sen. Linda Berglin (DFL), 77% of the program’s funding from the state is being cut.  Hospitals such as HCMC will still need to deal with picking up the cost to ensure all their patients receive the appropriate care.  From an RN that works at HCMC, staff have already been facing cuts that affect patient care.  Patient to nurse ratios have now increased on medical/surgical units up to 8:1 on nights.  With less reimbursement to hospitals and a shifting of costs such as this GAMC deal, patient care will still negatively be affected until legislators pass safe patient handling bills, or increase funding to programs for the uninsured.  This will be an interesting topic to continue following in the coming months.

From Minnesota Public Radio (MPR):

GAMC deal shifts costs to hospitals, health providers

by Madeleine Baran, Minnesota Public Radio, Tom Scheck, Minnesota Public Radio

March 5, 2010

St. Paul, Minn. — Gov. Tim Pawlenty and DFL legislators have reached a deal over funding for a health insurance program for the poor.

The deal will preserve coverage for most current General Assistance Medical Care recipients, but will shift costs onto medical providers.

GAMC provides health insurance for more than 30,000 of the state’s poorest residents. The program was scheduled to end on March 31, after Pawlenty cut its funding last year to balance the state budget.

The new plan will extend GAMC for two months. Starting June 1, a new system, funded with block grants, will replace it.

Instead of paying providers for each service provided, the new plan will provide hospital-based coordinated care systems with capped block grants to provide health care to eligible residents. Most former GAMC recipients will be eligible under the new plan.

“The hope will be this will be a more efficient, comprehensive, and continuous care,” Pawlenty said in a press conference this afternoon.

DFL legislators said they’re glad to have reached an agreement, but said the plan will hurt medical providers. Sen. Linda Berglin, DFL-Minneapolis, said the plan cuts the program’s funding by 77 percent.

“The health care providers are taking a huge cut,” said Rep. Thomas Huntley, DFL-Duluth. “That makes the state budget look good, but some hospitals may collapse, and other hospitals may just raise their rates to everybody else to make up for the loss of this money, and that will be put on your insurance bill.”

The state’s General Fund will provide $71 million in capped block grants to hospital-based Coordinating Care Organizations in the current 2010-2011 budget, and $131 million in 2012-2013.

The plan also establishes a separate method to reimburse CCOs for prescription drug costs. The deal caps drug reimbursements at $45 million from the General Fund in the 2010-2011 fiscal years, and $83 million in the 2012-2013 fiscal years.

GAMC recipient Robert Fischer expressed relief that he won’t lose his coverage. Fischer, who is 51, has sleep apnea, depression, and a degenerative back condition. His only income is $203 a month from the state’s General Assistance program.

“From what I’ve heard, I’m very, very happy,” Fischer said.

Negotiators have been working on a solution for GAMC for about nine months. The plan was set to expire later this month.

“We knew when we began this endeavor nine months ago that we were going to be putting together legislation that was going to be less than lovely,” said Rep. Erin Murphy, DFL-St. Paul. “We were working very hard to protect the safety net for those who get their care in GAMC, and we’ve protected that commitment.”

Murphy added, “I think the safety net is a little thinner. It may be a little bit more like a lifeboat.”

The state had planned to transfer many current GAMC enrollees into another state health insurance program, called MinnesotaCare, once the program ended.

But many recipients say they would not be able to afford MinnesotaCare’s monthly premiums and higher co-payments.

Issue background:

The General Assistance Medical Care (GAMC) fund is a MN healthcare program run by our Minnesota Department of Human Services (MDHS, 2009) that covers “low-income adults, ages 21-64, who have no dependent children under age 18 and who do not qualify for federal healthcare programs” (para. 1). The services offered include a comprehensive benefits package focused on preventative care and one for those who want coverage in case of an emergency hospital visit with a specific co-pay amount. A recent veto and line-item cut from MN’s budget by Gov. Tim Pawlenty took away $381 million from the GAMC (Perry, 2009). According to Share (2009), these “cuts to GAMC will leave 33,000 low-income Minnesotans without healthcare” as the labor review editor quoted the MNA.

One of the major hospitals in the Twin Cities, the Hennepin County Medical Center (HCMC) is one of the most affected by the line-item cut to GAMC as they will lose “$43 million in 2010 and $50 million in 2011” (Newmarker, 2009, para. 5). This has forced the one in only four Level 1 trauma center’s in the state to face many program cuts as they deal with a $550 million budget compared to a $600 million one in 2009 (Newmarker, 2009). Protesting nurses do not want to be a part of potential cuts, or see vulnerable patients turned away especially as we already face issues regarding safe staffing. HCMC’s major cuts highlight how payment increases to insurers must happen in order for healthcare organizations to stay afloat. Payment increases to insurers means payment increases to their customers, the ones who pay for health insurance. This is one element of the greater healthcare reform issue that needs to be addressed as the national debate continues.

Minnesota Department of Human Services. (2009). General assistance medical care. Retrieved
on October 15, 2009, from http://www.dhs.state.mn.us/main/idcplg?IdcService
=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_006257

Newmarker, C. (2009, September 25). HCMC lists programs facing cuts. American City
Business Journals, Inc. Retrieved on October 15, 2009, from http://twincities.bizjournals.com/twincities/stories/2009/09/28/story4.html?b=1254110400%5E2162231

Perry, S. (2009, October 1). Employment stimulus will dominate session, as well as bonding bill.
Finance & Commerce, Inc. Retrieved on October 15, 2009, from http://legal-ledger.com/item.cfm?recID=12318

Share, S. (2009, October 12). Nurses march on capitol, call on governor to restore general
assistance medical care. Workday Minnesota. Retrieved on October 15, 2009, from http://www.workdayminnesota.org/index.php?news_6_4205

The National Nurses United (NNU) updated their number of RN volunteers in the RN Response Network (RNRN) to 7,000 today.  These nurses are from all across the U.S. and are anxiously waiting for the go ahead to  to travel to Haiti for the relief effort.  The issue of course continues to be the need for funding to make this happen.  I am proud to say I am one of the 7,000 nurses waiting to go, but the NNU is still in the process of collaborating with multiple organizations while working on coming up with enough donations to start sending us.  When I eventually get to go (crossing my fingers), I promise to capture pictures, videos, and stories from the frontlines as I use my nursing skills to aid those who desperately need care.

Today, the NNU set up a “Send A Nurse” Disaster Relief Fund.  Please go to their website and donate any amount so we can start sending nurses to Haiti as soon as possible.

The Star Tribune wrote an article today about how Minnesotan’s are ready to support the relief, but barriers are keeping the help from reaching Haiti:

Across Minnesota, as a large outpouring of volunteers and aid takes shape to help Haiti, Minnesotans are worrying that they are in a race against time.

Will emergency supplies arrive fast enough to save lives? Is there a place for volunteers to sleep? Is there food and water?

Feed My Starving Children, in the Twin Cities, is scrambling to get 1 million meals to Haiti in the weeks ahead. A White Bear Lake nonprofit is rushing its director there to check on the fate of its school and orphanages. A St. Cloud bank executive is writing a check for $50,000 to spur other donations to the tragedy.

But people — even doctors, nurses and engineers — need to wait for the right time.

Food, water, and housing are in such short supply that only skilled volunteers working with large international relief organizations are welcome at this moment.

“It’s going to be very unpredictable,” said Monte Achenbach, one of two staffers from the Minneapolis-based American Refugee Committee who flew to Haiti Thursday. “The first things that need to be done are to clear the roads, clear the people trapped in the buildings and offer food, water, sanitary services — the things people are literally dying for.”

In the same article, nursing colleague and close friend Cassandra Hamilton, RN was also interviewed:

In the Twin Cities, Cassandra Hamilton was among the Minnesota nurses who responded to a call by National Nurses United to help the injured in Haiti. Hamilton is a family care nurse who works with children at Mercy Hospital in Coon Rapids.

“I feel like nursing is a way to give back to people,” said Hamilton, who also has volunteered in Colombia. “I feel it’s my obligation.”

A University of Minnesota bioethicist outlined what needs to happen for the Haiti relief efforts to be successful:

As urgent as it feels now, Minnesotans should realize the crisis in Haiti will be with us for a long time, said Steve Miles, a University of Minnesota bioethicist who has participated in many medical relief missions.

“What’s really needed now is food, diggers, dogs and materials,” Miles said. “The best approach right now is to send money to large organizations … that can move on a swift and large scale.”

The next phase, he said, will include erecting “MASH-style” hospitals, clinics and feeding stations, as well as massive public health services.

The final phases include the rebuilding of roads, libraries, schools, and telecommunications systems, he said. This is where Minnesotans should consider lending a hand.

The NNU held an almost hour and a half long conference call yesterday led by executive director Rose Ann DeMoro with more than 1,800 RN’s and other national callers (including the press).  This was one of the largest, if not THE largest ever conference call held by NNU or CNA/NNOC, with the purpose of outlining the current plan for nurse deployment to Haiti.  From my notes, here is what I’ve gathered for those interested in where we are at.

Disclaimer:  Every effort was made to ensure the accuracy of what was said during the conference call.  Despite being an NNU member myself, the following is not meant to represent any official statement from the organization.  Please visit their website for the latest news and for all official statements.

• Nurses have historically been extremely valuable resources during relief efforts given their multiple skills & specialties, ability to assess situations in the environment and with the patient, carry out skilled treatments, and work under difficult conditions night and day.  Nurses organized through the RN Response Network were well recognized for their work during Katrina and in Sri Lanka.
• NNU is preparing a systematic process to roll-out nurses in waves.  Miami will act as the homebase for RN’s to travel to first, before they are transported to Haiti by either air, or potentially sea travel depending on what partnerships are made.
• The first priority is SAFETY for our nurses.  We will need security set in place at all times by groups such as the military, national guard, UN, or other security groups from other countries.  We will not put our nurses at risk by going if we can’t ensure constant protection.
• RN’s need to be prepared and properly oriented before deployment.  Vaccinations need to be up-to-date due to potential exposure to many infectious diseases.  Typical exposure includes food and water-borne disease, E. Coli, typhoid fever, HIV, AIDS, Hepatitis A and B, worms, tetanus, measles, malaria, malnutrition, and dehydration for example.  Sanitation is a problem in the country, as well as clean water and shelter (we will likely have to sleep in sleeping bags and potentially on the streets).  Aftershocks are still occurring which makes it dangerous to stay in unsteady buildings.  RN’s also need to be prepared mentally and emotionally as they will see a numerous amount of trauma patients, broken bones, dead children and adults laying in the street, kids without parents, and significant pain and suffering.
• NNU is hoping for cooperation from the health insurance industry and pharmaceutical companies to offer discounts, or even free vaccinations for RN’s going to Haiti.  Some of the vaccinations take up to 2-3 weeks before they are fully effective, thus delaying immediate deployment for some.  This is another top priority for NNU so we don’t have many more delays, however.
• RN’s will also need passports, but we are hoping that the White House may be able to waive certain travel requirements based on this being declared an emergency.  This would prevent more unnecessary delays holding qualified RN’s back because lives are at risk in Haiti!

From the NNU press release related to the conference call, Rose Ann DeMoro added:

“We are asking the hospitals to provide paid time off for the nurses who wish to join this effort. We are also asking the pharmaceutical companies and insurance companies to provide free vaccinations for the nurse volunteers, and others to donate medical supplies for the nurses to bring with them,” DeMoro said.

It will be very important for nurses to work with their healthcare organizations to arrange days off.  The deployment waves will likely last 7-10 days according to the conference call.  So far I’ve contacted the Allina Hospitals & Clinics, one of the largest healthcare organizations in MN and was directed to the following news post by them:

Haiti Earthquake Disaster Relief

Jan. 14, 2010

The devastation in Haiti caused by the recent earthquake has people around the world asking how they can help. Many Allina employees have asked if they can donate Paid Time Off (PTO) to disaster relief efforts, as was the case in the aftermath of Hurricane Katrina in 2005.  Current Internal Revenue Service (IRS) regulations require that PTO donations of this type be taxed — however, we are hopeful the IRS will suspend this requirement soon, which will enable employees to help in this way. We will communicate the process for donating PTO to Haitian relief efforts as soon as the IRS acts.

 Additionally, Allina representatives are coordinating with relief agencies to identify a process for deploying clinical personnel, supplies and/or equipment to Haiti. We will communicate additional detail on this as plans come together.

  We know that Allina employees are anxious to help, and we will provide additional information as soon as possible.

The American Red Cross and OxFam are accepting donations for Haiti relief efforts.

Hopefully they will recognize the “Send A Nurse” Disaster Relief Fund is in need of money to send our nation’s nurses.  Additionally, this and any other healthcare organization could be recognized internationally if they work with their nurses schedules to give them time off and use the donated PTO as charity pay to RN’s who take off from work to go to Haiti.  It would be a win-win situation for everyone, especially for the lives potentially saved in Haiti.

IDHA! will continue to cover the Haiti situation and update everyone on the status of nurse deployment as well as my own hopefully soon.  Please keep checking back.

The recently formed National Nurses United (NNU) union which represents approximately 150,000 direct-care RN’s across the country has activated their volunteer RN Rapid Response Network (RNRN) in the hopes to immediately send the support of our nation’s RN’s to the disaster areas in Haiti.  The national organization, aptly named an RN “super union” became a major force when three major nursing organizations merged under the NNU umbrella in December of 2009 through a historical vote that took place in Phoenix, AZ.  These groups consisted of the 85,000 member California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), the 23,000 member Massachusetts Nurses Association (MNA), and the 45,000 member United American Nurses (AFL-CIO) with all their affiliates.  The NNU board consists of an elected co-president from each of the three major nursing organizations listed above, several elected vice-presidents from represented state nursing organizations, a Secretary Treasurer, and Rose Ann DeMoro who was elected executive director, a position she held while leading the CNA/NNOC since 1993.

The Minnesota Nurses Association (MNA) with its 20,000 members has a major stake within the national union.  A press release sent out by the NNU to their members was being circulated to all NNU affiliates yesterday including here in MN calling for volunteers to aid those in the devastation areas in Haiti.  The formal call to action press release is presented here:

Largest RN Union Issues Urgent Call for Nurse Volunteers

To Assist Earthquake Ravaged Haiti
Nurse Volunteer Group to Coordinate Emergency Nursing Mission

The nation’s largest organization of registered nurses tonight activated its nationwide disaster relief program to recruit nurse volunteers to provide assistance to residents of earthquake devastated Haiti, the National Nurses United announced Tuesday night.

Registered Nurse Response Network sent more than hundreds of nurse volunteers to the Gulf region following Hurricane Katrina. RNRN has also sent volunteers to Sri Lanka after the South Asia tsunami and to help following huge Southern California wildfires. RNRN is affiliated with National Nurses United, AFL-CIO, the national union and professional association for Registered Nurses.

Details are still being worked out, but nurses can sign up at the web form that follows for more details. http://www.calnurses.org/rnrn/rnrn-volunteer-form.html. NNU will also provide follow up information at www.twitter.com/nationalnu

rses <http://www.twitter.com/nationalnurses> for details and plans.
The 150,000-member NNU was formed last month through the unification of California Nurses Association/National Nurses Organizing Committee, United American Nurses, and Massachusetts Nurses Association.

Through RNRN, the organization hopes to send nurses to provide emergency short term and long term medical support, as it has in previous major disasters. Following Katrina, for example, RNRN volunteers worked with local healthcare and emergency agencies and officials in mobile clinics, area hospitals, and other healthcare settings in Louisiana, Mississippi, and Texas.

“We are calling on nurses throughout the U.S. to join us in this critical effort,” said NNU Co-Executive Director Rose Ann DeMoro.

“Nurses will be fundamental to the disaster relief process, to provide immediate healing and therapeutic support to the patients and families facing the devastation from this tragic earthquake,” DeMoro said.

If you are interested in donating to the National Nurses United (NNU) union of 150,000 direct-care RN’s, but more specifically to the fund for the RN Response Network (RNRN), please do so here.

According to the NNU, 1,500 RN’s have already responded in less than a day’s time to volunteer. The RNRN relief fund would help send these incredible nurses willing to to provide assistance in Haiti.  A new press release outlines information regarding a conference call for volunteering RN’s that will happen today:

National Conference Call Thursday For 1,500 RN Volunteers for Haiti Relief Effort
Press Can Dial-in or Visit Local Offices in TX, FL, MA, NV, IL, CA and DC

Nurses Issue Urgent Appeal to Public to Support Nurse Relief Efforts

More than 1,500 registered nurses from across the U.S. have responded in less than one day to the call by the nation’s largest organization of registered nurses for volunteers to provide assistance to residents of earthquake devastated Haiti —leading the RNs to now issue an urgent appeal for the public to support these efforts with donations of funds to support travel costs and medical supplies on their upcoming emergency nursing mission.

Press and nurses are invited to a conference call Thursday morning at 10:00 a.m. Pacific Time for an overview of the efforts and their logistics, including the details on the first teams of nurses traveling to the area.  Press can call in for the briefing at (866) 320-4709 using the access code 143135, or gather with local nurses and representatives in Boston, Chicago, Houston, Las Vegas, Oakland, Los Angeles, and Miami.

The relief efforts are being coordinated by the Registered Nurse Response Network (RNRN), a project of the 150,000-member National Nurses United (NNU), formed last month through the unification of the California Nurses Association/National Nurses Organizing Committee, United American Nurses and Massachusetts Nurses Association.  RNRN/NNU is hoping to have nurse volunteers on the ground in Haiti within the next few days and is coordinating with Haitian nurses on the effort.

Details are still being worked out, but those able to support the efforts of these nurses can get involved via:

• www.NationalNursesUnited.org to sign up to volunteer or donate
• @NationalNurses on twitter or by following: #haitiRN
• Call the RNRN hotline: 1-800-578-8225
• Support the RNRN/NNU disaster relief effort in Haiti by sending checks c/o California Nurses Foundation, 2000 Franklin St., Oakland, CA 94612. Charitable contributions will be used to pay for travel/related costs and medical supplies for volunteer RNs on their emergency nursing mission in Haiti.

RNRN sent hundreds of nurse volunteers to the Gulf region following Hurricane Katrina. RNRN has also sent volunteers to Sri Lanka after the South Asia tsunami and to help following huge Southern California wildfires. RNRN is affiliated with National Nurses United, AFL-CIO, the national union and professional association for registered nurses.

“The need for help has never been so acute.  We need financial support to transport them,” said NNU Executive Director Rose Ann DeMoro.  “Nurses will be fundamental to the disaster relief process, to provide immediate healing and therapeutic support to the patients and families facing the devastation from this tragic earthquake,” DeMoro said.

Follow the latest news related to NNU & RN involvement at:
http://www.twitter.com/nationalnurses
http://www.nationalnurses.united.org

Follow me as I attempt to go to Haiti:
http://idonthateamerica.com/category/jason-b/
http://twitter.com/Jason_RN
I will keep everyone updated here on I Don’t Hate America! as I am attempting to arrange to go to Haiti as part of the RNRN relief efforts.  My availability is dependent on my pleas to switch my hospital shifts which is still pending as of early Thursday, January 14th.  For those who do not know, I have a  Master’s in Nursing specializing in Leadership & Management (MSN), currently work in acute care, and am also a certified public health RN.  Please donate to the RNRN cause and/or volunteer if you are an RN able to go on such short notice.

——–

Barack Obama issued these remarks from a transcript released from The White House yesterday morning:

Remarks by the President on Rescue Efforts in Haiti
Diplomatic Reception Room

10:20 A.M. EST

THE PRESIDENT:  Good morning, everybody.  This morning I want to extend to the people of Haiti the deep condolences and unwavering support of the American people following yesterday’s terrible earthquake.

We are just now beginning to learn the extent of the devastation, but the reports and images that we’ve seen of collapsed hospitals, crumbled homes, and men and women carrying their injured neighbors through the streets are truly heart-wrenching.  Indeed, for a country and a people who are no strangers to hardship and suffering, this tragedy seems especially cruel and incomprehensible.  Our thoughts and prayers are also with the many Haitian Americans around our country who do not yet know the fate of their families and loved ones back home.

I have directed my administration to respond with a swift, coordinated, and aggressive effort to save lives.  The people of Haiti will have the full support of the United States in the urgent effort to rescue those trapped beneath the rubble, and to deliver the humanitarian relief — the food, water and medicine  — that Haitians will need in the coming days.  In that effort, our government, especially USAID and the Departments of State and Defense are working closely together and with our partners in Haiti, the region, and around the world.

Right now our efforts are focused on several urgent priorities.  First, we’re working quickly to account for U.S. embassy personnel and their families in Port-au-Prince, as well as the many American citizens who live and work in Haiti.  Americans trying to locate family members in Haiti are encouraged to contact the State Department at 888/407-4747.  I’m going to repeat that – 888/407-4747.

Second, we’ve mobilized resources to help rescue efforts.  Military overflights have assessed the damage, and by early afternoon our civilian disaster assistance team are beginning to arrive.  Search and rescue teams from Florida, Virginia and California will arrive throughout today and tomorrow, and more rescue and medical equipment and emergency personnel are being prepared.

Because in disasters such as this the first hours and days are absolutely critical to saving lives and avoiding even greater tragedy, I have directed my teams to be as forward-leaning as possible in getting the help on the ground and coordinating with our international partners as well.

Third, given the many different resources that are needed, we are taking steps to ensure that our government acts in a unified way.  My national security team has led an interagency effort overnight.  And to ensure that we coordinate our effort, going forward, I’ve designated the administrator of the U.S. Agency for International Development, Dr. Rajiv Shah, to be our government’s unified disaster coordinator.

Now, this rescue and recovery effort will be complex and challenging.  As we move resources into Haiti, we will be working closely with partners on the ground, including the many NGOs from Haiti and across Haiti, the United Nations Stabilization Mission, which appears to have suffered its own losses, and our partners in the region and around the world.  This must truly be an international effort.

Finally, let me just say that this is a time when we are reminded of the common humanity that we all share.  With just a few hundred miles of ocean between us and a long history that binds us together, Haitians are neighbors of the Americas and here at home.  So we have to be there for them in their hour of need.

Despite the fact that we are experiencing tough times here at home, I would encourage those Americans who want to support the urgent humanitarian efforts to go to whitehouse.gov where you can learn how to contribute.  We must be prepared for difficult hours and days ahead as we learn about the scope of the tragedy. We will keep the victims and their families in our prayers.  We will be resolute in our response, and I pledge to the people of Haiti that you will have a friend and partner in the United States of America today and going forward.

May God bless the people of Haiti and those working on their behalf.

Thank you very much.

The U.S government has set up a website located at The White House Blog, Help for Haiti, which should feature regular updates from Obama and the White House staff.

Americans looking for family members in Haiti are encouraged to contact the State Department at (888) 407-4747.

The Center for International Disaster Information also set up a site with more ways for people to donate to the “Haiti Earthquake Humanitarian Emergency.”

——–

Groups that are in Haiti already, or en route include the International Medical Corps, Red Cross, Doctors without Borders, UN Peacekeepers, U.S. Marines, U.S. Navy, University of Miami School of Medicine, Oxfam International, and so many more. Hopefully the NNU will be there within a few days. Keep following their site at http://www.nationalnursesunited.org/

The International Federation of Red Cross and Red Crescent Societies is there. According to CNN who quoted this group, “the most urgent needs at this time are search and rescue, field hospitals, emergency health, water purification, emergency shelter, logistics and telecommunications.”

According to WCCO local news in the Twin Cities, MN,
MN aid group’s that are assisting include Kids Against Hunger of New Hope, Haiti Outreach of Minnetonka, Feed My Starving Children of Coon Rapids, HealingHaiti.org of White Bear Lake, World Wide Village of St. Paul, and likely many other organizations that are sending food and other sorts of aid who deserve to be recognized.

——–

From the International Medical Corps, another great medical organization that could use donations as well sent out a mailing from the frontlines in Haiti:

Dear Jason,

We arrived in Port-au-Prince this afternoon. The airport is so full of people trying to evacuate that it is difficult to find transportation into the city.

We traveled about 35 minutes by car to a hotel called Villa Creole. It is complete devastation here. Most of the city does not have electricity. Crowds of people are standing in the streets, taking care not to get too close to shaky buildings. Many in the crowds are injured, and dead bodies are lined along the roadside. Injured people are sleeping next to people who are dead. The streets are littered with cables from downed power lines, as well as cars and buses that crashed or were abandoned when the earthquake and aftershocks hit.

The hotel here has been turned into a small makeshift hospital. About 90-100 people were standing in the hotel driveway, waiting for help. We instantly began conducting triage and treating patients alongside a Haitian doctor from Hope for Haiti. Medical supplies — such as IVs, pain medicines, and bandages — are extremely limited. Most patients that we have seen so far are suffering from broken bones, fractures, and ruptures. Some are in more critical condition, but there is no hospital we can refer them to. Our team will sleep outside tonight. Like everyone else, we are afraid to sleep inside a building. The aftershocks are still coming.

If you have already sent a donation to support our emergency response team, we thank you for your compassion. If not, we hope you will join us in responding to this devastating earthquake. Your donation will help us bring in the medical personnel, supplies and equipment we need to save as many lives as possible here. Donate now.

Thank you for your support,

Margaret Aguirre
Director of Global Communications
International Medical Corps

——–

More information to come as available.  I will update after the NNU conference call with the 1,500+ RN volunteers.  The press is invited to this call as well.  Again, the information to call in is as follows from the NNU press release:

Press and nurses are invited to a conference call Thursday morning at 10:00 a.m. Pacific Time [12:00 p.m. Central, 1:00 p.m. Eastern] for an overview of the efforts and their logistics, including the details on the first teams of nurses traveling to the area.  Press can call in for the briefing at (866) 320-4709 using the access code 143135, or gather with local nurses and representatives in Boston, Chicago, Houston, Las Vegas, Oakland, Los Angeles, and Miami.

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/

Today, the 20,000 member strong Minnesota Nurses Association (MNA) voted to disband from the American Nurses Association (ANA).  I am proud to be a part of the elected delegation, representing one of the collective bargaining units, which made this major decision.  261 members were credentialed at the time of voting.  The vote ended up being 208 in favor and 49 against.  Discussions on the motion lasted well over an hour with both sides passionately emphasizing their points.  MNA nurses in favor of the motion cited increased risks to our bargaining units due to ANA’s recent decision attempting to eliminate any functions that defined itself as a labor organization.  The ANA’s June House of Delegates failed to completely eliminate all these functions, but voted to evaluate the situation over the next two years through a task force.  This move still puts our entire union at risk for future bargaining efforts with our employers because of MNA’s stance as a strong, united labor organization.  Also, there were discussions of a dues increase for Constituent Member Associations (CMA’s) of the ANA like ours who are also a part of the United American Nurses (UAN)/AFL-CIO, thus “penalizing” us for labor organization membership.

A nurse against the motion referred to the ANA website which still lists collective bargaining as a workplace issue.  While in the delegates meeting, I investigated this claim and also found ANA’s website to still list collective bargaining as an issue.  However, when clicking on the actual collective bargaining link on their website, you are automatically forwarded to the United American Nurses (UAN) website.  Was this a coincidence? It seems as though any question whether ANA was continuing any collective bargaining activities was answered by this interesting finding.

Though we disbanded from the ANA, MNA nurses are still encouraged to participate in individual memberships if interested.  I am proud of ANA’s long history of establishing nursing standards, policies, and Code of Ethics.  As a nurse currently in graduate study, I continue to utilize ANA resources to guide my research.  Their usefulness in this way is why I plan on paying for individual membership.  However, when it came to protecting union nurses in my state, the issue to force constituents to pay dues to a non-labor oriented organization would put all of us at risk.  MNA nurses will move forward together from this and I am confident we will be stronger than ever.

Via press release:

Minnesota Nurses Association Withdraws from American Nurses Association

ST. PAUL, MN — The 20,000 members of the Minnesota Nurses Association withdrew MNA’s constituent membership from the American Nurses Association, effective October 13, 2008. In a vote of MNA’s House of Delegates, the highest authoritative body of the organization, MNA affirmed its commitment to the comprehensive representational work that MNA has done for over 50 years, since it first started organizing nurses. MNA will continue its membership in the United American Nurses and the national AFL-CIO and Minnesota AFL-CIO.

ANA has chosen to explore initiatives that no longer include the programs and core functions of a labor organization for nurses, effectively creating an untenable relationship for 97% of MNA’s membership who are represented by union contracts.

“MNA respects the right and autonomy of ANA to guide their organization as they see fit,” said MNA President, Linda Slattengren, RN. “It is increasingly apparent however, that MNA and ANA share different visions of how best to represent the interests of our member nurses.”

MNA invested significant resources over many months in negotiations with ANA and examining a variety of consequences of maintaining or terminating its membership. MNA member leaders met in a Special House of Delegates in May to set in place protective actions to defend MNA’s status as a premiere collective bargaining agent for nurses.

The Minnesota Nurses Association has been the second-largest constituent member of ANA, and becomes the seventh state nurses organization to withdraw from ANA. California, Maine, Hawaii, Massachusetts, Pennsylvania and Michigan all left ANA previously.

“MNA’s priorities and direction in advancing the interests of registered nurses in Minnesota must be our primary concern.” said Ms. Slattengren. She emphasized the organization’s commitment to its stated priorities to focus on staffing for patient safety in acute care hospitals and to achieve health care reform.

ANA established policies several years ago that allow individual Registered Nurses to join and participate in ANA directly.

###

Uniting nurses in vision and voice since 1905. With 20,000 members, MNA is the leading organization for registered nurses in the Midwest and is among the oldest and largest representatives of RNs for collective bargaining in the nation. MNA is a multi-purpose union that fosters high standards for nursing education and practice, and works to advance the profession through legislative activity. MNA is affiliated with the United American Nurses and the Minnesota AFL-CIO.

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Via the MNA website, here is a picture of the 2008 MNA House of Delegates.

From MyFox 9:

MINNEAPOLIS — Former Vice President Al Gore thinks Al Franken would be “a fantastic senator,” according to a letter sent to Democratic delegates.

Gore’s endorsement of Franken’s bid for the U.S. Senate comes days before Franken squares off against opponent Jack Nelson-Pallmeyer for the DFL endorsement at the state party convention in Rochester, Minn.

One reason Gore endorses Franken is their shared goals of an effort to slow global warming.

The big day is this Saturday where Franken and Jack Nelson-Pallmeyer will fight for the DFL party nomination.  It should also be mentioned that the Minnesota Nurses Association (MNA) and AFL-CIO have endorsed Franken.  I do wish that JNP would voice his concerns for nursing more, like Franken has done on his website.  I have contacted JNP twice about it with no answer.  However, I cannot endorse Franken for his poor universal healthcare plan that requires each state to enact their own.

In response to the comments on my previous post, ANA endorses Hillary Clinton, I did some investigating into why Obama may not have been chosen over Clinton.

The ANA endorsement process involves four steps. Here is a brief outline of the steps found at the ANA site (some material quoted directly to ensure accuracy):

Step 1: The ANA chooses four members from the ANA-PAC board to serve on the Presidential Endorsement Task Force. This year, it was the following:
- Sara Jarrett, RN, MS, MA, EdD of Colorado (Chair)
- Barbara Crane, RN, CRRN of New York
- Elizabeth Dietz, EdD, RN, CS-NP, of California
- Representative Erin Murphy, BSN, RN of Minnesota

Step 2: The task force works with the ANA Government Affairs to:
- Review candidates voting records,
- Work on drafting a questionnaire,
- Polling of Constituent Member Associations (CMA) and ANA membership for their preferred candidates, and
- Conducting interviews with the candidates.

Step 3: The ANA’s Board of Directors are given the recommendation from the PAC board (which includes the task force and their work with the ANA Government Affairs) and an endorsement process decision is made. The three options are:
- No endorsement or support of a candidate,
- Support one or more candidates during the primary elections, or
- Support of a candidate following the party nominating conventions

Step 4: “The ANA Board of Directors will vote to ratify the PAC Board’s endorsement recommendation.” This information is then communicated to ANA members, CMA’s, the candidates, and appropriate media parties.

———-

Six questions were chosen for the candidate questionnaire. Here is an example of an unanswered one. Click the names below to read the candidate’s responses in their entirety.

Hillary Clinton

Barack Obama

———-

My investigation:

Finding 1

Representative Erin Murphy (DFL 64A) has been an excellent advocate for nurses. Just recently, I wrote Strib: Minnesotans could save 12.3 billion in healthcare costs in which I mentioned Rep. Murphy’s continuing support. Since finding who served on the Presidential Endorsement Task Force, I did some searches on any personal endorsements prior to the ANA decision. My concern was for any bias before serving on the Task Force.

Clinton’s webpage specifically mentions Representative Erin Murphy’s joining of Clinton’s Minnesota Steering Committee in a January 25th press release along with nearly 50 other Minnesota legislators and community leaders. Curiously enough, this came on the same day as the ANA endorsement of Hillary Clinton. The timing was appropriate, but I wanted to find out more. Mike from Blog4President.US made the announcement of Rep. Murphy joining Clinton’s campaign on January 24th, 2008. Again, timing is very important as a personal endorsement should not come before the association endorsement, especially since Rep. Murphy was bound to ANA endorsement rationale:

However, as a professional organization ANA will consider candidates based solely on who will best serve the interests of the nursing profession and their patients. Political parties or personal agendas will not matter in this process. No political support will be offered by ANA without thoughtful analysis of a candidate’s past record and views on nursing.

Turns out, John Edwards had already received an endorsement from Representative Erin Murphy following the launch of a “Women for Edwards” campaign on May 15th, 2007. If any of you remember, John Edwards was in the race until January 30th, 2008, just five days after Murphy’s joining of Clinton’s Steering Committee. Blog4President.US also announced Murphy’s support for Edwards.

I am very proud of Rep. Murphy’s accomplishments, but I bring up these issues since I worry about any bias when choosing the candidate for an association that represents 2.9 million nurses. This is especially important since she threw her early support toward John Edwards and now Clinton, with no mention of any support for Obama. I hate to pick on her, but I could not find any information on the others serving on the Task Force.

Finding 2

Step 2 of the endorsement process involves conducting interviews with the candidates. The ANA sent questionnaires to all candidates, but only received answers from Democrats Clinton, Obama, Biden, Dodd, Edwards, Kucinich, Richardson and Republican Ron Paul.

The only candidates that participated in the interview were Clinton, Kucinich, and Richardson. This makes Clinton the only candidate who participated in the interview who was still in the race at the time of selection. Because Obama did not participate in the interview, he consequently lost points throughout the endorsement process. This is despite his strong answers on the questionnaire.

Unfortunately, according to a letter sent back to nurses who were upset about the ANA endorsement, the following are the actual results of the member-base votes*:

Clinton - 42%
Obama - 21%
McCain - 8%
Edwards - 9%, Huckabee - 8%, Romney - 5%, Guliani - 3%, Thompson - 3%, Kucinich - 1%, Paul - 1%, Biden - 0.5%, Richardson - 0.12%, Dodd - 0%, Gravel - 0%, Hunter - 0%

*Despite my frequent activity working for nursing and political issues, I was not aware of this voting and consequently, my vote was not represented in the final tally. I am curious to know what the actual numbers are.

Finding 3

The California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) are vocal supporters of national single-payer coverage, which Clinton’s plan lacks. In advertisements that came out prior to the endorsement, the NNOC came out in full force challenging Clinton’s healthcare plan. Check out this YouTube video of one challenge:

It is only fair to say that Obama has been challenged as well because his plan does not include single-payer coverage either.

However, Obama has been consistent with the ideal that he supports a single-payer system. From Obama’s fact check:

Obama said, “Here’s the bottom line. If I were designing a system from scratch I would probably set up a single-payer system…But we’re not designing a system from scratch…And when we had a healthcare forum before I set up my healthcare plan here in Iowa there was a lot of resistance to a single-payer system. So what I believe is we should set up a series of choices….Over time it may be that we end up transitioning to such a system. For now, I just want to make sure every American is covered…I don’t want to wait for that perfect system…The one thing you should ask about the candidates though is who’s gonna have the capacity to actually deliver on the change?…I believe I’ve got a better capacity to break the gridlock and attract both Independents and Republicans to work together.”

Finding 4

The movie SiCKO pointed out the fact that many members of Congress receive contributions from the healthcare industry. Clinton is one who has, and still receives money from many of these insiders. The CNA/NNOC concluded an analysis on contributions and released a press release last summer. This was outlined on Fierce Healthcare:

The CNA/NNOC analysis concludes that healthcare industry players contributed $3.7 million to current candidates during the first quarter of 2007. It also notes that the industry–which it defines as including drug and insurance companies, doctors, hospitals, dentists and nursing homes–spent more than $2.2 billion on federal lobbying over the past decade. By CNA/NNOC calculations, Sen. Hillary Clinton (D) and Sen. John McCain (R) got the lion’s share of healthcare contributions of all presidential candidates, collecting 40 percent of the overall total.

Using data from the Center for Responsive Politics, Barack Obama receives 99% of his donations from individual contributors with a mere $25 received from PAC’s. Clinton receives 87% from individuals with over $1 million from PAC’s. She also recently donated $5 million from her own wallet to catch up with Obama’s advertising.

In an article entitled, “Deborah Burger and Maureen Caristi: Guaranteed healthcare, not just insurance,” the author’s look at the bigger problem of healthcare reform. Pieces quoted from the article:

“…simply adding more Americans into a flawed insurance system will not solve our national health care crisis. Especially when you let insurers continue to charge as much as they want, and do nothing to stop their callous, all too routine practice of denying medical treatment or blocking access to specialists or diagnostic tests because they don’t want to spend the money.

Mandating people to buy insurance is at the center of the debate on health care between Sens. Hillary Clinton and Barack Obama — she’s for it, he’s against it…”

“Obama has a point that the cost of insurance makes it a bad bargain for many Americans. Insurance policies now average over $12,000 per family just for the premiums, not including skyrocketing deductibles, co-pays and other costs that have made medical bills the leading cause of personal bankruptcy.”

“The individual mandate cheerleaders claim that if you don’t put everyone in the insurance pool, only the sick will buy health care and insurance companies will raise costs. Have any of them noticed that insurance premiums have gone up 87 percent nationally the past decade without a national individual mandate?

But individual mandates are popular with the insurance industry and those close to it. Insurers reap millions of new customers with minimal requirement to change their behavior. It further entrenches a broken system, expanding the reach of an industry that treats every dollar spent on care as a “medical loss ratio.”

It distorts the role of government, which should be to protect people, not act as an insurance agent.”

Finding 5

Many people across the internet are looking for the quote that Clinton apparently said about nurses being “overpaid and undereducated.” There are also rumors about her calling nurses “glorified waitresses” at one point. I scoured the net, including searching my graduate school databases with no evidence of these quotes. However, the website, Snopes, thinks they found the source for the “overpaid and undereducated” quote.

In remarks by Hillary Clinton for the United Nations Fourth World Conference on Women (Sept. 5th, 1995 in Beijing, China), Clinton said the following,

As long as discrimination and inequities remain so commonplace around the world - - as long as girls and women are valued less, fed less, fed last, overworked, underpaid, not schooled and subjected to violence in and out of their homes - - the potential of the human family to create a peaceful, prosperous world will not be realized.

Full text and video can be found here. There were multiple statements made about nurses which could have caused this to be misinterpreted. However, many people still swear that they heard Clinton make the rumored comments.

Finding 6

Here are excerpts from the letter sent by ANA president, Rebecca Patton, in response to those against the ANA endorsement of Clinton,

In making this endorsement, the ANA Board recognized Senator Clinton’s longstanding commitment to nursing and health care. During her time in the Senate, Clinton has been an advocate for nursing issues. Clinton was in support of the Title VIII Nurse Reinvestment Act programs which provide much needed funding for nurse education. She recognizes the need for more nurse practitioners and supports increased authority for and utilization of nurse practitioners as a means of improving access to health care. She has a long history of advocacy for health care reform, and her current plan emphasizes the need to reduce costs, improve quality and ensure affordable health care for all Americans. She was a co-sponsor of the Mental Health Parity Act of 2007 which would improve mental health services.
From its inception in 1896 to the present day, ANA has recognized that individuals can shape health care policy consistent with the goals of registered nurses and in the best interest of their patients.

Obama’s Views:
- Regarding the Title VIII Nurse Reinvestment Act, Obama not only supports it, but he calls for greater funding in this statement:

I support reauthorization of Title VIII training programs with greater financial incentives for students and nurse faculty, including scholarships and loan repayment. Given the dire shortage of nurses, no less than $200 million should be allocated for Title VIII programs and the Nurse Reinvestment Act.

- Regarding APRN’s, Obama endorses this idea heavily in his statement,

I will support inclusion and expanded reimbursement for APRN services through federal health programs, my new public plan, and private plans offered through my plan’s National Health Insurance Exchange.

- S.558 - Obama is also a co-sponsor of the Mental Health Parity Act of 2007.

- From Advance for Nurses, Kate Hartner sums up Obama’s responses,

Obama proposes: supporting minimum staffing ratios, limiting overtime, reauthorizing Title VIII training programs with scholarships and loan reimbursement, health system reform, paperless systems, supporting nursing unions and expanding APRN practice.

I think it is only fair that a rationale letter would address how Obama and Clinton differ in their views, rather than explain most of the same things the candidates agree on.

———-

Summary

Needless to say from my week of exhausting investigation, I am disappointed in the American Nurses Association. I feel they prematurely endorsed a candidate that has a history of supporting nurses, but lacks the necessary ideas for a new direction for healthcare in this country. Obama’s healthcare plan, though not single-payer, works better in this country that seems entirely focused on their wallets. Clinton has gone as far as to say she’s willing to garnish wages as an enforcement mechanism. How can we force people to purchase coverage from insurance companies, feeding into our already broken healthcare system more, then go on to say we will punish our own citizens by taking away their hard-earned money if they don’t buy? And that dubious statistic that Clinton throws out that Obama’s plan will leave out 15 million people? That was already proven false at FactCheck.org. Blueollie has another excellent analysis on this topic.

I will say that I am slightly disappointed in both candidates as they do not provide true single-payer universal healthcare. However, Obama’s plan will best address the cost control issue currently plaguing our system. Mandating insurance will frustrate consumers while limiting options for those with low incomes. The question here is… is it better to have stripped down insurance (to satisfy a mandate to have coverage), or to buy into affordable, full coverage, which includes subsidies if you do not qualify for SCHIP or Medicaid?

As a registered nurse, I wait for the day when I don’t have to tell my patient that the life-saving drug they are prescribed costs $4 a day, since I worry they will have to choose between taking the drug, or eating a meal. As a registered nurse, I wait for the day that I can treat my patients out in the community, before they end up in the hospital bed, since preventing a disease will cost much less for everyone. As a registered nurse, I wait for the day that a patient of mine can see any doctor or APRN of their choosing, without having to get prior-approval from their insurance company. As a registered nurse, I can’t wait for the day that Barack Obama becomes our next president.

In a surprising move that should upset many nurses, the American Nurses Association endorsed Hillary Clinton for president on January 25th, 2008.  Needless to say, I am still holding my belief that Barack Obama will best serve the interests of our nation when it comes to healthcare.  More criticism to come.

Via press release:

THE AMERICAN NURSES ASSOCIATION ENDORSES
SENATOR HILLARY RODHAM CLINTON (D-NY)

SILVER SPRING, MD –The Clinton Campaign today announced the endorsement of the American Nurses Association (ANA). The ANA represents the interests of the nation’s 2.9 million registered nurses.

“Too many Americans must do without high quality health care, and this country deserves a president that will make health system reform a priority,” said ANA President Rebecca M. Patton, MSN, RN, CNOR. “Senator Clinton has shown a commitment to implementing real change in our health care system to ensure high quality, affordable and accessible care. She has also recognized the importance of educating, recruiting and retaining, RNs, and the need to improve the nurse’s work environment which includes addressing safe and appropriate staffing. America’s 2.9 million registered nurses represent the largest group of health care professionals. We have long advocated for the critically needed reforms vital to the improvement of health care and will use our power in the voting booth to make health care a priority.”

“I am honored to have the support of the American Nurses Association,” said Clinton. “We owe nurses a great debt of gratitude for the critical role they play every day in providing quality care. As President, I will continue to support efforts to attract and retain qualified nurses, especially in rural and urban areas, and to improve working conditions. I look forward to working with America’s nurses to deliver affordable, quality health care to every American.”

Hillary has a history of working for America’s nurses. In the Senate, Hillary introduced the Nursing Education and Quality of Care Act, which would expand the number of programs that address nursing faculty shortages and increase the supply of nurses in rural areas. As part of the Nurse Reinvestment Act, she helped create grants that expanded nurse Magnet hospitals. Hillary also supported increased funding for both Title VII and Title VIII, which help to address the higher education needs of nurses and nursing faculty. Finally, she has supported programs to attract nurses to the field, including efforts to improve the quality of the working environment for nurses.

Hillary’s American Health Choices Plan will cover all Americans and improve health care by providing consumers new choices, lowering costs and improving quality. Under Hillary’s plan, Americans who like the insurance they have can keep it and stay with their doctor. But Americans who don’t like the coverage they have will be able to pick from the same set of plans Members of Congress choose for themselves. Under Hillary’s plan, insurance companies won’t be able to deny people coverage for a pre-existing condition and tax credits will ensure that working families never have to pay more than a limited percentage of their income for quality health care. People who change jobs will be able to keep their health care.

ANA has been making presidential endorsements since 1984. The endorsement process includes sending a questionnaire on nursing and health care issues to all of the Democratic and Republican candidates, an invitation to all of the democratic and republican candidates for a personal interview and an online survey of ANA’s membership regarding which candidate is most supportive of nursing’s agenda.

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The ANA is the only full-service professional organization representing the interests of the nation’s 2.9 million registered nurses through its 54 constituent member nurses associations. The ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Congress and regulatory agencies on health care issues affecting nurses and the public.

Last weekend was MNA’s 102nd annual House of Delegates convention.  I had the opportunity to be a delegate among 200+ Registered Nurses (RN’s) to represent MNA’s membership of almost 20,000 RN’s.  Like many union organizations, we voted on everything from financial issues to legislative priorities.  As this was my first convention, I did not expect that legislators and senate candidates would be so willing to come and listen with us.  The goal of the MNA PC (our political action committee) was to get a legislator (representative or senator) from every district to sit with their corresponding MNA member’s district.  It was quite successful with over thirty who came. 

I had the opportunity to meet Ron Erhardt (R) 41A, who isn’t my actual representative since I moved last week.  He is the only republican pro-choice candidate in the house.  The MNA believes that 2008 will be a big year for healthcare reform and safe staffing.  Ron wasn’t as optimistic about this as his last statement before leaving was, “I don’t believe in government-run healthcare.”  He was very willing to listen to what we had to say, but hopefully he will continue engaging in conversation with us as we discuss the difference between government-run and government-funded healthcare.  I will write more about that at a later time.

Betty McCollum also addressed us regarding our nursing safe staffing initiatives.  Here is the YouTube video of her statement:

The current U.S senate candidates were all invited to participate in speaking to the delegation.  The DFL candidates Al Franken, Mike Ciresi, Jim Cohen, and Jack Nelson-Pallmeyer accepted our invitation.  The GOP candidate, Norm Coleman ignored our invitation by not even responding to the MNA request.  All spoke about nursing issues and wanting to move toward universal healthcare, but their plans for implementation differ greatly.  Here’s a quick position statement from each candidate’s webpage:

Al Franken - “I would require every state to cover every one of its citizens, and the federal government to provide funding to fulfill that requirement. Each individual state would be free to offer a variety of options, as long as they add up to universal coverage, giving us 51 laboratories (if you count DC) to figure out which system works best. “

Mike Ciresi -  “Provide universal coverage.  Keep people healthy through preventative health care and early detection and cure of diseases – before they become chronic problems .  Keep people affordably insured for their lifetime – from job to job, and through retirement, and forever eliminate the term “pre-existing condition”

Jim Cohen - “A pragmatic progressive dares speak the truth that the most practical and economical way for all our citizens, including children, to have access to quality and affordable health care is a publicly funded single payer system modeled after Medicare. This is not socialized medicine. It is simple common sense and a moral dictate.” 

Jack Nelson-Pallmeyer - “We need a universal, single-payer comprehensive health care system with a focus on prevention. It will provide security to our families and improve the competitive position of U.S. companies.”

Norm Coleman - “Senator Coleman is deeply committed to the goal of giving all Americans access to quality, and affordable healthcare. With that in mind, he’s fought to pass common sense legislation to drive healthcare costs down.”Before IDHA! endorses any candidate, we will make sure to send out interview questions regarding important issues affecting the nation.  It will be up to the candidate to address our specific issues of importance, such as student financial aid, healthcare costs, and transportation… to name a few. 

You’re suffering from chest pain. You know you don’t have health insurance and can’t afford to get it checked out. It’s difficult to tell if the pain is severe enough to visit the ED or if it will go away on its own. Your wife forces you to go to the ED, worried that you might be having a heart attack. Reluctantly, you get a ride from her and go to the hospital. As soon as you get there, you’re hooked up to monitors, given a couple meds, and talking treatment options with the healthcare team. They decide you must go in for an angiogram, a common procedure done to see if any coronary vessels are occluded. Throughout the entire event, you keep thinking, “do we have to?” They rush you into the cath lab knowing there’s not much time before your heart will lose all circulation. They found you were having a heart attack and a vessel is 100% occluded. The MD, much like an artist creating their masterpiece, inserts a catheter through your femoral artery to access your heart, and swiftly inserts a stent in the occluded vessel. The team sighs in relief that they were able to prevent more damage from happening. Further tests will confirm the extent of the damage, but for now, you survived. Thank God. Oh wait, you don’t have health insurance.

I tell this real-life story because of an experience I had this week with a patient. He was your typical middle-aged family man holding two jobs. His concern interested me since… what DO you do? How do you tell someone that we saved their life while at the same time, handing them an invoice? With the stent he received, he needs to be on a medication called Plavix. This drug is extremely important to take daily for two years. Numerous studies have shown that not taking Plavix after insertion of a drug eluting stent (DES) can result in an increased risk for heart attack, stroke, re-stenosis, and death. The typical cost for Plavix is ~$4 a day. $4 A DAY! That equates to roughly $1,460 a year, or $2,920 for the total two years he NEEDS to be on it. In his case, that is approximately 10% of his yearly income that needs to be spent to literally stay alive.

A generic equivalent of clopidogrel bisulfate (Plavix) has been created, but Bristol-Myers Squibb has been fighting legal battles to make sure their name-brand drug is the only one available to patients. From AARP:

In the case of Bristol-Myers Squibb’s Plavix, an antiplatelet, what began as a dispute with the generic manufacturer over patent infringement has become a proposed settlement that will keep the generic version off the market until 2011. Plavix racked up huge sales in 2005—$3.8 billion in the U.S. alone, with worldwide sales of nearly $6 billion.

Thankfully, many of us have health insurance to cover these costs. Just think though, how many patients like mine have been paying 10% of their annual income on the drug Plavix for Bristol-Myers Squibb to rack up $6 billion?

At my hospital, a social worker and financial advisor will work with patients in situations like these. However, I strongly believe in a healthcare system that will allow anyone that needs life-saving drugs such as Plavix to get them at little to no-cost. I am hoping that when Tim Walz is re-elected and Steve Sarvi kicks John Kline out, they will continue believing in the mission of universal healthcare. I am predicting that in 2008, there will be a DFL controlled Senate, House, and President. If so, we will see dramatic changes in our healthcare system.

Maybe if the above story happens to you, there will be no need to ask, “do we have to?”

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I am starting my Master’s program at the end of the month. My plan is to receive my Master’s in Science of Nursing (M.S.N) with an education focus. Eventually, I would like to be a professor at a local community college. If anyone has some connections with a college that needs adjunct nursing professors, please forward any information along.

Also, continuing with my belief that everyone should have access to free healthcare, I just accepted a position at Planned Parenthood as a volunteer clinic nurse. If you are looking at donating to a great organization, look no further than Planned Parenthood. Here’s a link to their donation page.