Fixed nurse-to-patient staffing ratios have been an increasingly contentious issue between nurses unions and hospitals.  Most recently the issue played out during negotiations between two Duluth, Minnesota hospitals and the Minnesota Nurses Association (MNA).  Ninety-six percent of  the 400 MNA nurses working at St. Luke’s Hospital voted on September 8, 2010 to ratify a three-year contract that included a more flexible strategy to address staffing and patient-safety issues.  Nine hundred nurses at another Duluth medical provider, SMDC/Essentia Health, voted on September 10 to ratify a contract with similar staffing provisions.

The St. Luke’s contract includes two key provisions the nurses claim will enhance patient safety.  First, the contract allows charge nurses to temporarily close a unit if they feel admitting additional patients could compromise safety.  Specifically, the contract requires charge nurses to evaluate the unit, patients’ illnesses, as well as the number and experience of the nurses in the unit.  Charge nurses must also work with their supervisors regarding whether the unit should temporarily redirect or delay additional patient admissions.  Second, nurses may refuse patient assignments if they believe that the assignment could compromise patient safety.  The contract also provides that nurses have the right to exercise these provisions without fear of retaliation. 

To implement these contract provisions, St. Luke’s administration will form a committee with MNA nurses to develop a staffing plan for the hospital.  By July 2011, the committee will recommend a staffing system at St. Luke's that involves analyzing the severity of patients' illnesses and the number of nurses scheduled to work.  As set forth in the new contract, St. Luke's administration is responsible for creating the timeline for implementing any such staffing system.

In addition, St. Luke's succeeded in securing what it believes are reasonable wage levels.  Specifically, St. Luke's will maintain the current level of nurse wages this year, but it will increase nurse wages by 1 percent on July 1, 2011, and by an additional 2 percent on July 1, 2012.  St. Luke's also will increase its contributions to employee health insurance plans and increase its reimbursements to nurses attending continuing education courses related to nursing.  The economics of the SMDC contract are essentially equivalent.

Labor experts predict that both contracts will serve as a blueprint for future contract negotiations between nurses and hospitals. 

This entry was written by Sarah Silvester.