August 2003

Inside… Single payer health care: The business community...... 2

Executive director’s column: Hospitals still fi ghting ratios ...... 3 THE NEWSLETTER OF THE MASSACHUSETTS NURSES ASSOCIATION ■ www.massnurses.org ■ VOL. 74 NO. 6 MNA on Beacon Hill: MNA Web site wins accolades from Union Web Services Budget victories...... 4 The Massachusetts Web Steward, a Political Pulse: Web portal from Union Web Services that Rep. Patricia Haddad...... 5 provides users with access to union news throughout the state, recently recognized Personal contact can help sway the MNA for its new and improved Web site legislators on safe staffi ng...... 5 (www.massnurses.org)and then sweetened the pot by naming it the best union site for Listing of legislators supporting the month of May. The honor came just months after the MNA quality care/safe staffi ng...... 6 expanded its public communications depart- ment to include an in-house webmaster, a Labor Relations news...... 7 position that has been seamlessly managed by Amy Weston. Since February, Weston has Collective bargaining updates .....7 added and edited dozens of pages and links in an effort to turn the site into the user- MNA Convention: friendly version that members had been Schedule & registration ...... 8-9 asking for. From its graphical redesign to its expanded job-postings page, the MNA Web Unit 7 Consent to Serve ...... 10 site has become a resource that members can depend on. Health & safety: Sensitivity to personal fragrances...... 10 The redesign According to Weston, navigating through Benefi ts Corner ...... 10 the MNA’s site once proved to be a bit of a challenge. “Just from a design perspective, communications department. “So designing are also consistently seen throughout the Web Diversity corner: the front page to look like a news center is site: larger headers help users identify exactly some of the information could be pretty hard Reaching out in Beijing ...... 11 to fi nd,” she said. “There was always excellent the perfect way to communicate the MNA’s where they are within the site, cleaner mar- breaking information.” gins add to the pages’ overall legibility and information posted on the site, but our links Proposed revisions to weren’t intuitiveso it was hard to fi nd what Also added to the site’s front page is an numerous photos of members create a sense MNA Bylaws...... 12-17 you needed.” As a result, Weston dug right area for a scrolling message that reminds visi- of comfortable familiarity. in and began to redesign the site. tors about important dates and deadlines; an The fi rst area of focus was the site’s front expanded and interactive navigation bar; and Post a job, fi nd a job Proposed revisions to page, which was redesigned to appear more access to a complete photo gallery. Weston With the redesign of its Web site, the NursePLAN Bylaws...... 18-20 like a news center. “The very nature of the also carefully and clearly archived older news MNA’s public communications department MNA’s business means that members need stories; made items easier to fi nd by remov- also expanded its pages that focus on career MNA Member Benefi ts ...... 21 easy access to timely and evolving informa- ing a considerable amount of “virtual clutter;” developmentincluding a page for posting tion, whether it’s about a bargaining unit’s and added a calendar with activists’ alerts and and reviewing job openings. Continuing Education ...... 22-23 negotiation efforts or a legislative initiative,” upcoming events. According to Schildmeier, MNA bargaining said David Schildmeier, director of the public The new look and feel of the front page See Web, Page 4 MNA Convention 2003 RN-to-patient ratios to be implemented in California The Unit 7 Business Meeting at the annual MNA convention will be a After efforts by the hospital industry in Department of Health Services, California tion to present scientifi c data along with California to water down and delay imple- offi cials made critical decisions on some hotly thousands of RN testimonials to make luncheon meeting on Thursday, Oct. mentation of RN-to-patient ratio regulations contested issues regarding implementation of the case for these reductions. 16, starting at 12:30. This year’s for the state’s hospitals, Gov. Gray Davis and the CNA-sponsored law, the fi rst such law in Assurances that hospitals must convention will be held Oct. 15, 16 the state’s Department of Health Services the nation and one that has been a model for adhere to scope of practice laws to & 17 in Worcester. For details and recently rejected the industry’s positions RNs in other statesincluding Massachu- protect patient safety. No RN may be registration information, see Pages and will push ahead with implementation setts. Key decisions in the plan include: assigned, or be responsible for more 8 and 9. of the ratios by January 1, 2004. The Cali- Proposals by the hospital industry to patients than the specifi ed ratios. The fornia Nurses Association (CNA) welcomed erode the ratios in emergency rooms, regulations clarify the respective roles the release of the fi nal regulations and said post-surgical recovery units, and for of RNs and LVNs, make it apparent that it was “a signifi cant step towards improving evening, night, and weekend shifts, RNs and LVNs are not interchangeable, For the latest patient-care conditions in California hospitals were all rejected. State offi cials also and require that additional nurses must developments and protecting patient safety.” rebuffed hospital efforts for further be assigned, as needed, by severity of “A new era is dawning in which all Cali- delays in implementation. patient illness. impacting nurses, fornia families should expect safer standards Phased-in, improved ratios (fewer Hospitals are required to document visit the in California hospitals,” said Kay McVay, RN, patients to nurses) in three hospital staffi ng assignments, including the MNA Web site, president of the 50,000-member CNA which areas. As of 2008, ratios will be lowered licensure of the direct caregiver for sponsored the safe staffi ng law and worked in step down units, typically housing every patient for every unit for every www.massnurses.org for 10 years to enact it. “The fi nish line is patients just transferred from critical shift, and keep the records for one fi nally near. Every patient should be able to or intensive care; telemetry, where yearsteps that will help the state demand and count on receiving the registered patients are on monitors; and other monitor and assure compliance with nursing care they need, when they need it.” specialty care units, such as oncology the law. In the package approved by Davis and the and rehab. CNA was the only organiza- See Ratios, Page 3 Page 2 Massachusetts Nurse August 2003

Nurses’ Guide to Single-Payer Reform A single-payer system: what’s in it for the business community

By Alan Dieffenbach injured on the job would already be covered improvement in employee health status can the premiums of those who can paymainly Vermont Citizens Campaign for Health by the single-payer plan, workers compen- be anticipatedwith accompanying improve- employers. In a system in which everyone is Back in 1988, Lee Iacocca, then head of sation premiums would be substantially ment in morale. covered, this would no longer be the case. Chrysler Corp., testifi ed before a congressio- reduced. Greater freedom in deploying workforce: Reduced municipal and state taxes: We nal committee that his company paid more Reduced labor-management strife: Re- Under a single-payer system, employers all pay the health care costs of teachers and for employee health benefi ts than for steel. search indicates that health benefi ts are the would no longer be forced to hire part-time other municipal and state employees through The fi gure at the time was $700 per car, versus key issue in three out of four strikes. Quarrels employees or engage “independent contrac- tax payments. To the extent that single-payer $223 for the same car built in Canada. over health cost burden-sharing are common tors” as a way of reducing fringe benefi t reform reduces overall health care expendi- The situation has only gotten worse for in virtually every employment setting. costs. tures, we can expect our tax bills to shrink. American business in the decade and a half Reduction of health coverage costs for Improved competitiveness vis-à-vis the We need to recognize that while the vast since then. Companies willing to maintain retirees: The obligations that many compa- rest of the world: All other countries in the majority of employers stand to benefi t from their health benefi t commitments to workers nies have undertaken to meet health care costs industrialized world already offer universal single-payer health care reforms, some will have found their costs rising dramatically. of retirees would be considerably lightened or health care programs to their citizens. be asked to shoulder new expenses. This Others have fought morale-sapping battles eliminated altogether under single payer. Elimination of cost shifting: Under cur- group includes mainly small and marginal with unions to get workers to accept more of Improved employee health: Especially in rent arrangements, costs to the health care businesses that currently do no offer health the burden of paying for health care. Some employment settings where health benefi ts system which result from providing uncom- benefi ts to employees. The fi ne-tuning of a large fi rms have elected to self-insure, basi- are not currently being offered, a signifi cant pensated care to the uninsured are shifted to single-payer program will have to take this cally meting employee medical expenses out into account through some kind of sliding of company revenues at considerable admin- scale or subsidy arrangement. istrative cost. And a few have “solved” the problem by simply dropping health benefi ts altogether. It is surprising, then, that business has not been more active in seeking fundamen- tal reform of the nation’s health care system. In part, business has probably remained on the sidelines because of a long-standing bias toward private-sector, free-market solutions. This may, however, be an occasion on which a non-governmental solution is not the answer. Consider the following benefi ts to business of Mark your calendar a single-payer program: Public hearing on single-payer bill, Lower health costs: Under the recent S.686: Mass. Health Care Trust Fund Lewin Group analysis of the revenue needs of Mass. Statehouse a single-payer system in Vermont, employer contributions are estimated at 5.8 percent of payroll, far below current levels of spend- Jobs with Justice plans ing of the vast majority of businesses in the next steps for campaign state. On June 5, under the coordination of Lower personnel management costs: Jobs with Justice (JWJ), more than 50 Mas- Without responsibility for developing and sachusetts unions and community groups managing health benefi t plans, human mobilized their members to wear stickers resources offi ces could easily be downsized. Lower costs related to workers’ compen- supporting health care for all. To keep up the momentum, the next step of the JWJ health sation: Since the medical costs of workers Reprinted with permission of Dan Wasserman and The Boston Globe care action committee is to launch a two- pronged membership mobilization this fall: 1. JWJ will design materials that union, New campaign launched to preserve—not privatize—Medicare religious, and community groups can use to train their leaders about health [Editor’s Note: Medicare is a very successful members of Congress about the dangers tion among doctors and hospitals seeking care issues and reform. After leaders single-payer insurance system that can serve as the of privatizing Medicare and the need for to provide the best care. It should not be are trained, JWJ will pick one day to foundation for a national program guaranteeing alternative legislation that will strengthen replaced with a system that gives benefi cia- “take 10 minutes for health care,” comprehensive health care for all. Below is a mes- the program by making it more responsive ries a voucher to buy health coverage from where all participating leaders will sage from a group called Campaign to Preserve to the needs of older Americans and people private insurance companies. Privatization conduct a mini-class with members Medicare, reprinted from Action for Universal with disabilities. The campaign will keep would mean the end of Medicare’s guaran- on universal health care. Health Care, April/May 2003.] activists around the country informed about teed benefi ts and free choice of provider. 2. JWJ will work with groups to mobilize The Medicare program has been a success. the latest legislative developments and make Prescription drug benefi t: Comprehensive for the Oct. 8 State House hearing on It assures the elderly and people with disabili- public education materials available to grass- outpatient prescription drug coverage should S.686—a bill that would guarantee ties access to reliable health care coverage with roots groups. be included in the Medicare benefi t package every Massachusetts resident health a defi ned set of benefi ts. Its administrative so that is available to every American who care coverage by replacing the cur- costs are much less than the administrative Medicare program core principles relies on Medicare. rent patchwork of public and private costs of private health insurance, and it works Guaranteed benefi ts: Medicare success- Prescription drug coverage should not be health care plans with a uniform and better than any market-based model to con- fully provides a guaranteed and defi ned set of privatized: Medicare benefi ciaries should not comprehensive health plan. tain costs and ensure reliable coverage with a benefi ts at the same price for all—regardless be forced to join a private insurance plan to 3. A planning meeting for both “10 defi ned set of benefi ts. Reforms should make of where a benefi ciary lives, his health status get coverage for their prescription drugs. It minutes for health care” and the Oct. the program’s coverage more comprehensive or his income. This should continue. should be made available to benefi ciaries 8 hearing will be held on Aug. 14 from in order to refl ect a national commitment to Free choice of physician: The traditional directly through the traditional program noon to 2 p.m. at the new Teamsters an inclusive Medicare program. The program Medicare program guarantees benefi ciaries and Medicare HMOs. Local 170 union hall in Worcester. should provide coverage to rich and poor, frail free choice of physician, throughout the Meeting the needs of all: Medicare must MNA and MASS-CARE are two of the and healthy, and preserve one community of country, at an affordable price. This should be improved to meet the needs of people who many organizations sponsoring this meet- interests among all groups rather than pitting continue. have chronic, long-term conditions and dis- ing and the ongoing campaign. If you would one group against another. Medicare should not be privatized: The abilities—including the need for long-term like to participate in the JWJ activities, please The Campaign to Preserve Medicare current Medicare program already contains community services and coordination of RSVP with Tiffany at [email protected] aims to educate the public, the media and the most important competition —competi- care. or 617-524-8778. August 2003 Massachusetts Nurse Page 3

Executive Director’s column Why the hospitals are still fi ghting us on RN-to-patient ratios By Julie Pinkham the most acute the industry, and the industry is unwilling to Waltham Hospital spent the $2.5 million on MNA Executive Director patients being invest what it takes to create the environment that Fenway Park sponsorship. One would think that after making the admitted or nurses require and want in order stay at the Hospital administrators argue that facili- “where’s-the-data” argument for a number remaining in hospital bedside. ties will close. Let’s see…they have already of years, hospitals would acquiesce to what Massachusetts Instead, the industry continues to pursue closed more than 20 for reasons unrelated to is now validated by research: hospitals. efforts to replace you. Remember, the condi- this issue. I suggest they look elsewhere for • Current RN-to-patient assignments in • Several major tions we now face were purposefully created the genesis of that problem: the mirror would med/surg areas beyond four result “networks” by the industry in an effort to save money be a good start. The latest casualty, despite in increased morbidity and mortality have developed before there was a nursing shortage. Hospi- the MNA’s efforts, is Waltham Hospital for Massachusetts patients. And with consolidating tals replaced nurses via layoffs, non-posting which closed because of insuffi cient physi- a one-to-eight ratio comes a 31 percent hospital power of positions and substituting/eliminating 20 cian referralsnot RN staffi ng. Do you think increased risk of injury or death to a to leverage Julie Pinkham percent of the RN workforce. This initiative Partners Healthcare’s pursuit of that physi- patient. reimburse- was called “redesigning” or “re-engineering” cian referral base had an impact? You decide, • Massachusetts has more RNs per person ment from insurers, including Partners, and it was done without data regarding its because the new Waltham Newton Wellesley/ than any other state, yet less than 40 Caregroup and Caritas Christi. Each of impact to patients or nurses. Partners URGI Center was scheduled to open, percent of the licensed RNs work at the these networks has its own bureau- The industry still has “redesigning” as as well as a new fl oor at Newton Wellesley acute-care bedsidethe place where the cracy with CEOs, VPs and offi ces. This an objective in spite of the data, including Hospital, well before Waltham’s board voted largest need for RNs is cited. administrative budget is substantial its own, that says the quality of patient care to close the hospital. • 65 percent of RNs not currently work- and, as a result, it is money that does has diminished. We now have hospitals that Whatever the system of hospital reimburse- ing at the bedside would consider not go to direct patient care. Such is propose to replace nurses with EMTs in the ment, patients must be secured the right to returning if the MNA’s legislation for the outcome of “market driven” health emergency room, and, in one hospital, in safe patient care in a hospital. Patients stay in RN-to-patient ratios were passed. Of care. Substantial money is also spent on the ICU. At Newtown Wellesley Hospital, the hospital because they need nursing care. this number, over 40 percent said they advertisements to lure patientssuch our members had to fi ght off an attempt to Look at it this way: if you knew that a par- would strongly consider coming back as $2.5 million dollar advertisement replace nurses with PCAs. They are pursuing ticular prescription for a patient presented with the passage of this law. these strategies even though all the research a 30 percent risk of harm or death, would • One in three RNs say they are aware of clearly shows that the best and safest way to you continue to administer it? And if you patients’ death attributable to under- run a hospital is with a rich mix of RNs. did, could you honestly try to maintain that staffi ng. The public doesn’t want a The public doesn’t want “a redesign,” it you’re a patient advocate? To you as RNs the • Since the 1990s, more than 20 Massa- redesign. It wants safe staffi ng. wants safe staffi ng. H.1282 will ensure that answer is transparent, but don’t expect the chusetts hospitals closed for reasons patients have reasonable access to RNs and same insight from the “industry.” unrelated to nursing. Yet with 30 safe care, but hospitals want to continue to Over 500 of you made your way to the State percent fewer beds, hospital adminis- experiment with patients and the nursing House on June 18 to lobby and testify for this trators claim they have been unable to deal between Beth Israel/Deaconess profession. bill, and the media and legislative responses hire nurses. Hospital of Caregroup and Fenway The scripted argument by the industry in were incredibly favorable as a result. Legis- • RNs as a percent cost of hospital bud- Park. Billboards and TV sponsorships response to H.1282 is that legislative ratios lators now need to hear from all of you who gets have been fl at for the same decade. are common, but they are not cheap and will prevent them from having more RNs or want H.1282 to pass, but who could not make The simple answer is that hospitals do they do not improve patient care. that individual needs of patients won’t be the trip on June 18. not invest in nursing, but choose to So to summarize, we have more RNs than addressed. This means they have not read Contact your representatives and senators, spend their resources in other areas. any other state available to work and we the bill, because it does both effectively. encourage them to sponsor this bill, and thank • Managed care has grown signifi cantly, have 20 fewer hospitals than we did a decade Their next line of defense is the “cost issue.” them if they already do. Write them a personal making Massachusetts one of the three agoyet we have a shortage of RNs who are Let me just ask this, which is worth more: letter about what it is like to practice in this states with the largest penetration of willing to work at the bedside. safe RN-to-patient ratios or a billboard at environment, and ask them to push H.1282 HMOs. The net results are shorter Why? Because nurses are no longer willing Fenway Park? Before you answer, remember through the Health Care Committee so that stays for patients that allow for only or able to stomach the conditions created by that the same hospital that sought closure of we can move it forward to a vote.

…Ratios

From Page 1 McVay noted that many CNA-represented hospitals have already hired hundreds of additional RNs in preparation for implementing the law, and, as a result of unprecedented CNA gains in compensation, retirement security, and workplace improvements, intended to enhance retention of current experienced RNs and recruitment of new RNs. CNA, which has campaigned since 1992 to enact safe RN staffi ng ratios, will work with RNs across the state to monitor enforcement of the law and encourage hospital compliance. CNA has also sponsored a new bill to help assure compliance. The bill authorizes state health offi - cials to conduct unannounced inspections, and provides for fi nes of up to $5,000 a day, on hospitals that continue to maintain unsafe RN staffi ng after fi nal implementation of the ratio law. The MNA recently congratulated its counterparts in Cali- fornia and the state’s policymakers for standing up to the hospital industry and protecting patients from dangerous staffi ng practices. A bill to mandate ratios in Massachusetts hospitals is pending in the legislature and has garnered signifi cant legislative and public support, with 102 of 200 legislators signed onto the bill, and with 60 health care and consumer organizations endorsing the measure. To learn more about the Massachusetts bill, H.1282, An Act Ensuring Quality Patient Care and Safe RN Staffi ng, visit the MNA Web site at www.massnurses.org. CNA members rally in support of RN-to-patient ratios. Page 4 Massachusetts Nurse August 2003

MNA on Beacon Hill

Legislative update ISSN 0163-0784 USPS 326-050

MNA scores victories in state budget President: Karen Higgins For legislators on Beacon Hill, complet- tion Advantage was the right choice for our Worcester State Hospital Vice President: Patrick Conroy ing the state budget for fi scal year 2004 was seniors and our health care system. Secretary: Sandy Eaton After Gov. Romney proposed the clo- Treasurer: Janet Gale a diffi cult and challenging process. Faced sure of Worcester State Hospital, the MNA MassHealth/Medicaid with a sluggish economy and decreasing worked with the Coalition to Save Worces- District Directors, Labor: District 1: state revenue, legislators faced a $3 billion The Legislature implemented a program ter State Hospital and the entire Worcester Patricia Healey, Irene Patch; District 2: budget defi cit. Still, the MNA worked hard to cover 36,000 long-term, unemployed and delegationincluding Sen. Harriette Chan- Edith Harrigan, Mary Marengo; District to protect and preserve many health care uninsured residents (former MassHealth dler and Rep. Vincent Pedoneto have the 3: Stephanie Stevens, Tina Russell; initiatives. Basic). The MNA argued that if these ser- House and Senate include language to protect District 4: Jeanine Hickey, vacant; Dis- The MNA sent a very important and clear vices were lost, there would be an increase Worcester State Hospital from closure. After trict 5: Barbara Norton, vacant. message to legislators during the months of in emergency room visits and there would including this language in the budget, they Directors (At-Large/Labor): Sandy budget debate: that an ounce of prevention be a guaranteed increase in health care costs overrode the governor’s veto of the item. is worth a pound of cure when it comes to as people ended up needing more expensive Ellis, Denise Garlick, Kate Maker, precious health care dollars. And from the carebecause they never received appropri- The Fernald Center and the Sharon McCollum, Beth Piknick, beginning, the MNA criticized Gov. Rom- ate primary and preventive care. And yes: you Department of Mental Retardation Elizabeth Sparks, Jan Spicer. ney’s budget proposal as one that cut core would see people die. The MNA worked with the Coalition of Directors (At-Large/General): Rick and essential services. Families and Advocates for the Retarded, Lambos, Jim Moura, Margaret O’Malley, School nursing Much of the public dialogue over the past Sen. Susan Fargo, and Reps. Thomas Stanley Deb Rigiero, Jeannine Williams, Nora several months regarding the budget was The MNA fought to secure $12 million in and Peter Koutoujian in opposing the clos- Watts, John Bogrette.. centered on maintaining these “core and state funding for school nurses. Governor ing of The Fernald Centerarguing that a Labor Program Member: Beth Gray- essential services.” Why? Because health Romney eliminated the funding for school “one-size-fi ts-all” approach to caring for the  Nix care is not only a core service it is a safety nurses in his budget proposal, but the MNA retarded does not work. net, a matter of life and death for vulnerable argued that school nurses are a critical com- “The MNA believes that the time for budget Executive Director: Julie Pinkham children, senior citizens, and mentally ill and ponent of our front-line health care delivery cutting in health care is over, and that the time Managing Editor: David Schildmeier retarded citizens. As a result, we must con- system and in many cases serve as a child’s for revenue generation has arrived. The health Editor: Jen Johnson tinually work towards maintaining programs main health care provider. The House and care safety net is not only frayed, it is in tat- Production Manager: Erin M. Servaes that foster prevention of illness and basic care Senate funded the school nursing program ters—and there is no room for further assaults Photographer: Rosemary Smith to our citizenry. If not, it will mean that the and overrode the governor’s veto of the on our health care system. As nurses, we have Mission Statement: The Massachu- most vulnerable members of our community item. seen the human toll our lack of investment setts Nurse will inform, educate and suffer more serious complications that require in health care has taken. It’s time to invest in Sexual Assault Nurse Examiner meet member needs by providing timely more costly care. the well being of our citizens, not to support information on nursing and health care The MNA worked with a number of health The MNA worked with a coalition of advo- draconian policies that will harm them,” said issues facing the nurse in the Common- care advocates, coalitions and legislators to cates in health care, women’s groups and law Karen Higgins, RN, MNA president. protect and preserve many of these important enforcement offi cials to level fund the Sexual wealth of Massachusetts. Through the health care programs. We applaud them for Assault Nurse Examiner program (SANE). Uncompensated Care Pool editorial voice of the newsletter, MNA seeks to recognize the diversity of its working to fi nd a solution to our budget crisis. SANE creates the coordinated, expert forensic The MNA served a recent Special Commis- membership and celebrate the con- care necessary to increase successful prosecu- sion created by the Legislature to examine Prescription Advantage Program tributions that members make to the tion of sex offenders and to deliver the highest the uncompensated care pool. The governor, nursing profession on the state, local The Legislature maintained this successful level of care to sexual assault victims ages 12 House and Senate proposed various plans to and national levels. program, which provides seniors with access and under. By the end of fi scal year 2003, the stabilize the pool and include in the budget to affordable prescriptions. As front-line SANE program will have served over 2,400 a signifi cant infusion of dollars to stabilize Published nine times annually, in nurses, you’ve see fi rst hand the ill effects of victims of sexual assault in the 18 designated the pool, reduced the pool’s burden on January/February, March, April, May, seniors who cannot afford prescriptions when SANE sites in the commonwealth. hospitals and implement several reforms to June/July, August, September, October they arrive on your fl oors and in your units. reduce costs. and November/December by the Mas- Implementing and maintaining Prescrip- sachusetts Nurses Association, 340 Turnpike Street, Canton, MA 02021. Subscription price: $20 per year …Web Foreign: $28 per year Single copy: $3.00 From Page 1 Periodical postage paid at Canton, MA units are able to post open nursing positions need to conduct a precise job search.” dmeier. In addition, Capwiz will enable Web and additional mailing offi ces. for free, while all other positions can be site visitors to educate themselves on MNA posted for just $50 a month. “We’ve found On the horizon issues; identify their elected representatives Deadline: Copy submitted for publica- that many organizations are interested in According to Weston, the MNA’s Web site at the state and local levels; and share their tion consideration must be received at listing their nursing positions with the MNA will constantly be evolving in order to make it views with their lawmakers via targeted MNA headquarters by the fi rst day of for two reasons,” he said. “It is an excellent a best-in-class resource for members and visi- e-mails, letters, faxes or hand-delivered the month prior to the month of publi- economic alternative to larger job Web sites, tors. “We’re looking to continuously update letters. cation. All submissions are subject to and the MNA brand is an excellent way of and maintain everything without making the In addition to the introduction of Capwiz, editing and none will be returned. drawing in nurses who are looking for new site more diffi cult for users to navigate,” she the MNA plans to add a hosted chat room to Postmaster: Send address corrections opportunities.” explained. “But there will always be a level of its site. “This tool will allow us to set up online to Massachusetts Nurse, Massachu- In addition, the MNA recently established familiarity for users who come back again and meetings where members and others can log  setts Nurses Association, 340 Turnpike a partnership with BostonWorks.com the again, so fi nding a favorite link will be easy on and ask questions, for example, to a labor Street, Canton, MA 02021. Web-based job search tool owned and man- and exploring a new link will be simple.” relations expert,” said Schildmeier. “We will aged by the Boston Globe. “The partnership Some of the soon-to-be-added links and also have the ability to set up a ‘virtual’ peer www.massnurses.org allows Web users to link from BostonWorks resources Weston referred to include a virtual collaborative community that will help the directly to the MNA’s site,” explained Schild- “legislator locator” and a hosted chat room. MNA engage, understand and communicate meier, “but there is also an area on the MNA’s “We’ll soon be adding an award-winning with its members and the nursing community career services page that lets users search for feature called Capwizwhich is an original as a whole.” nursing positions listed on BostonWorks. and leading Internet advocacy-action tool that Visit the MNA’s new Web site at Overall, the partnership is an excellent way will connect MNA members to their elected www.massnurses.org and send your Web-spe- to provide members with the right tools they offi cials quickly and effectively,” said Schil- cifi c feedback to [email protected]. August 2003 Massachusetts Nurse Page 5 June 18 hearing a success—fi ght continues to win safe staffi ng

By Charles Stefanini an increase in com- survey proved to be invaluable because your area, please do everything you can to MNA Legislative Director plications due to hundreds of MNA nurses were on hand to attend. The June 18 Joint Committee on Health understaffi ng. The announce that the statistics were real. They Check the list on Page 6 of the 102 legisla- Care hearing was packed with registered survey proved to told their fi rst-hand stories about what life tors that have signed on to H.1282. If your nurses, advocates, doctors and patients be an invaluable as a front-line nurse is like—and those stories state senator and/or representative have from across Massachusettsand they were tool for helping us mirrored the survey statistics exactly. signed on to the bill, write them a letter of all there to support H.1282, the Safe Patient to bring the issue But June 18 was just the beginning. thanks. If they have not signed on, write them Care/Safe Staffi ng Legislation. RNs fi lled a of safe staffi ng The fate of this legislation lies with RNs a letter and ask them to support H.1282. press conference room before the hearing; directly to the leg- throughout Massachusetts. You must get The MNA also needs you to talk with they fi lled the hearing room itself; and they islature and media involved to help pass this bill. Make a phone family, friends, colleagues and community traveled throughout the halls of the State on June 18, but its call and write a letter to your state senator groups about the importance of this legisla- House to meet with their senators and repre- value wasn’t in and state representative. As we move forward tion. We need to have you involved. statistics alone. Charles Stefanini we will be holding meetings in the districts If you get involved, RN-to-patient ratios Instead, the of key legislators. If these meetings occur in will become a reality in Massachusetts

If you get involved, Personal contact helps to make bills become laws: send a note today RN-to-patient ratios Send your state legislator a hand-written call: the Senate switchboard is there will be patient deaths or com- will become a reality in note today and tell them why safe staffi ng is 617-722-1455, and the House plications after surgery. vital to patient care and the future of nurs- switchboard is 617-722-2000 • H.1282 will save lives and protect Massachusetts. ing. A list of the 102 legislators who have Massachusetts patients from cost- signed on to H.1282 is located on Page 6. Sample ‘talking’ points: cutting measures. Addressing your letter: • As an RN, I am writing to thank • Massachusetts has more RNs per The Honorable ______you for sponsoring (urge you to capita than any other state in the sentatives. For those RNs who attended, there State House, Room # ______sponsor) House Bill 1282, An Act nation, so the shortage can be cor- was an energy and synergy in the State House Boston, MA 02133 Ensuring Quality Patient Care and rected easily once safe staffi ng ratios that had never been there before. Dozens of Safe Registered Nurse Staffi ng. are established. legislators lined up to testify in support of the Tips: • Please urge your colleagues on the • Safe staffi ng ratios mean less turn- bill and several of the 60 endorsing organiza- • Remember to include your name, Health Care Committee to support over among nurses, which saves tions provided written and oral testimony to address, phone number and e- this bill. money on training costs and the the committee. mail • Massachusetts patients must share hiring of temporary nurses. Money In addition, the MNA released the results of • If your legislator is a co-sponsor of their nurse with too many other will also be saved because patients an astounding survey—the fi rst of its kind in H.1282, thank them for co-sponsor- patients. This understaffi ng of RNs will receive better care, experience nine years to examine Massachusetts nurses’ ing the legislation. is dangerous. fewer complications and will not views on the quality of patient care and nurse • If your legislator is not a co-spon- • Mistakes, errors and complications need to stay in the hospital for as staffi ng in area hospitals. The survey spelled sor of H.1282, ask them to sign on become more likely when nurses long. out in detail the conditions that endanger and show support for patients and are asked to take care of too many A particularly easy way to locate your patients and that have caused, and exacer- nurses. patients at once. state state senator and representative is to bate, the current nursing shortage. • Include a personal anecdote about • A recent study in the Journal of the visit the Web site www.wheredoivotema.com/ According to the survey, nearly one in three patient care, without divulging any American Medical Association found bal/myelectioninfo.php. For your legislators’ nurses report patient deaths directly attribut- confi dential information. that the higher the patient-to-nurse contact information, visit www.state.ma.us/ able to having too many patients to care for; • Follow up your letter with a phone ratio in a hospital, the more likely legis/legis.html 67 percent report an increase in medication errors due to understaffi ng; 64 percent report An interview with state Rep. Patricia A. Haddad assachusetts Nurse recently sat Haddad: First of ing about diffi cult health care issues, but it is on a number of community projects and down with state Rep. Patricia all, I’m honored to also a very vital committee. programs and am a mother of two. I guess MA. Haddad from the 5th Bristol be on these impor- Massachusetts Nurse: What issues do my ability to remain open to new ideas and District, which includes Dighton, Somerset, tant committees; you believe will dominate this legislative varying opinions has been an underlying trait Swansea and Taunton. Haddad currently each carries with session? that has served me well. serves on the Health Care Committee where it a great deal of Haddad: First of all, the state budget and Massachusetts Nurse: What are the main she has been an outspoken advocate on issues responsibility that I our attempt to stabilize the economic climate priorities of your legislative agenda for the affecting nurses. In addition to the Health do not take lightly. of the commonwealth is our priority. Then, upcoming year? Care Committee, she serves on the Medicaid The Ways and I would suggest that spiraling health care Haddad: My focus is on protecting seniors, and Ways and Means Committees. Means Committee costs and related health care services would education programsfrom early childhood Prior to being elected to the House, Rep. is important in that be next, particularly where senior citizens, through post secondaryand health care. Haddad served on the Somerset School Patricia Haddad every bill which has young families and those unable to advocate Massachusetts Nurse: What would you Committee, as its vice chair and, then, as money attached to tell the nurses out there reading this column that body’s chair. Her tenure coincided it must go through Ways and Means: state about the importance of building a relation- with the implementation of the Educa- budgets, tax increases and costs for commis- ship with their local legislators? tion Reform Act of 1993. Prior to her many sions and studies. The Medicaid Committee, Haddad: Get involved…call your legis- years on the school committee, she served which is a brand new committee, is unique in lator. Realize that we welcome your input on Somerset’s Playground and Recreation that its mission is to review Medicaid and its on the issues that affect you and your Commission. increasing fi nancial burden to the common- families. Also realize that we must balance A graduate of Bridgewater State College wealth. Did you know that approximately 26 and temper that variety of suggestions and with a degree in health and physical educa- percent of the state budget relates to Medicaid opinions in order to conclude, generally, tion, her priorities include education, health costs? It is an issue that needs to be addressed. for themselves are concerned. what is best for the district and people that care and women and family issues. And of course one of the most important Massachusetts Nurse: How does your back- we serve. Your opinions help us to build a Massachusetts Nurse: You were appointed committees in the House, the Health Care ground help prepare you to be an effective consensus. to the Health Care, Medicaid and House Ways Committee, is a committee that allows me state legislator? Massachusetts Nurse: What do you enjoy and Means Committeesthree high-profi le to address issues that are of great concern Haddad: My background is varied. I taught most about your work as a state legislator? committees. Tell us about these appoint- to the vast majority of my constituents. It is middle school for thirteen years, worked in Haddad: By far, the ability to assist con- ments and the important work of these a sometimes heart-wrenching committee in my husband’s small business for fourteen stituents in maneuvering through the maze Committees. terms of participating in hearings and learn- years, served in local politics, volunteered of government bureaucracy. Page 6 Massachusetts Nurse August 2003 Legislators line-up to support safe staffi ng legislation

Dozens of legislators testifi ed before the Health Care Committee on June 18, as well as provided written testimony in support of the MNA Safe Patient Care/Safe Staffi ng Leg- islation, H.1282. Please take the time to call them and thank them for their supporting this important patient safety initiative. Sen. Marc Pacheco, Taunton Sen. Charles Shannon, Winchester Sen. Jo Ann Sprague, Walpole Marc Pacheco Charles Shannon Jo Ann Sprague Richard Tisei Steven Tolman Jennifer Callahan Christine Canavan Sen. Richard Tisei, Wakefi eld Sen. Steven Tolman, Brighton Rep. Jennifer Callahan, Sutton Rep. Christine Canavan, Brockton Rep. Edward Connolly, Everett Rep. Michael Costello, Amesbury Rep. Paul Demakis, Boston Rep. Carol Donovan, Woburn Rep. Mark Falzone, Peabody Rep. David Flynn, Bridgewater Rep. Lida Harkins, Needham Edward Connolly Michael Costello Paul Demakis Carol Donovan Mark Falzone David Flynn Lida Harkins Rep. Louis Kafka, Sharon Rep. Rachel Kaprielian, Watertown Rep. Brian Knuuttila, Gardner Rep. Peter Kocot, Northampton Rep. Robert Koczera, New Bedford Rep. Susan Pope, Wayland Rep. Michael Rush, West Roxbury Rep. Frank Smizik, Brookline Rep. Ellen Story, Amherst Rep. Timothy Toomey, Cambridge Rep. James Vallee, Franklin Louis Kafka Rachel Kaprielian Brian Knuuttila Peter Kocot Robert Koczera Susan Pope Michael Rush Rep. Steven Walsh, Lynn Rep. Alice Wolf, Cambridge At press time pictures were not available for the following legislators: Rep. Gale Candaras, Wilbraham Rep. Ann Gobi, Spencer Rep. Anne Paulson, Belmont Rep. Walter Timilty, Milton *Note: If a legislator testifi ed or provided writ- ten testimony and is not listed here, our apologies. Massachusetts RNs appreciate the support. Frank Smizik Ellen Story Timothy Toomey James Vallee Steven Walsh Alice Wolf Legislative sponsors of H.1282 Senators Deborah D. Blumer, D-Framingham Louis Kafka, D-Sharon Mary Jane Simmons, D-Leominser Robert A. Antonioni, D-Leominster Garrett Bradley, D-Hingham Jay Kaufman, D-Lexington Frank Smizik, D-Brookline Stephen Baddour, D-Methuen Jennifer Callahan, D-Sutton Rachel Kaprielian, D-Watertown Robert Spellane, D-Worcester Stephen Brewer, D-Barre Christine E. Canavan, D-Brockton Thomas P. Kennedy, D-Brockton Joyce Spiliotis, D-Peabody Harriette Chandler, D-Worcester Gale Candaras, D-Wilbraham Brian Knuuttila, D-Gardner Karen Spilka, D-Ashland Cynthia Creem, D-Newton Mark Carron, D-Southbridge Peter Kocut, D-Northampton Thomas Stanley, D-Waltham Susan Fargo, D-Lincoln Edward G. Connolly, D-Everett Robert M. Koczera, D-New Bedford Ellen Story, D-Amherst Guy Glodis, D-Worcester Michael A. Costello, D-Newburyport Peter Koutoujian, D-Newton Benjamin Swan, D-Springfi eld John A. Hart, D-Boston Robert Coughlin, D-Dedham Paul Kujawski, D-Webster Kathleen Teahan, D-Whitman Robert Hedlund, R-Weymouth Geraldine M. Creedon, D-Brockton Barbara L’Italien, D-Andover Walter Timilty, D-Milton Cheryl Jacques, D-Needham Robert DeLeo, D-Winthrop James B. Leary, D-Worcester Timothy Toomey, D-Cambridge Brian A. Joyce, D-Milton Paul Demakis, D-Boston David P. Linsky, D-Natick Philip Travis, D-Rehoboth Michael R. Knapik, R-Westfi eld Paul Donato, D-Medford Paul Loscocco, R-Holliston James Vallee, D-Franklin Marc Pacheco, D-Taunton Carol Donovan, D-Woburn Elizabeth Malia, D-Boston Anthony Verga, D-Gloucester Charles E. Shannon, D-Winchester Jamie Eldridge, D-Acton Ronald Mariano, D-Quincy Joseph Wagner, D-Chicopee JoAnne Sprague, R-Walpole Mark V. Falzone, D-Saugus Jim Marzilli, D-Arlington Martin Walsh, D-Boston Bruce Tarr, R-Gloucester Michael E. Festa, D-Melrose Robert Nyman, D-Hanover Steven Walsh, D-Lynn Richard R. Tisei, R-Wakefi eld Barry R. Finegold, D-Andover Thomas J. O’Brien, D-Kingston Alice Wolf, D-Cambridge Steven Tolman, D-Boston David Flynn, D-Bridgewater Marie Parente, D-Milford Susan Tucker, D-North Andover John Fresolo, D-Worcester Anne Paulsen, D-Belmont Marian Walsh, D-Boston William C. Galvin, D-Canton Vincent Pedone, D-Worcester Dianne Wilkerson, D-Boston Colleen M. Garry, D-Dracut Douglas W. Petersen, D-Marblehead Anne Gobi, D-Spencer Susan W. Pope, R-Wayland Representatives Emile Goguen, D-Fitchburg Kathi-Anne Reinstein, D-Revere Cory Atkins, D-Concord Shirley Gomes, R-Harwich Michael Rodrigues, D-Westport Demetrius Atsalis, D-Barnstable Mary Grant, D-Beverly Michael Ruane, D-Salem Ruth Balser, D-Newton Lida E. Harkins, D-Needham Michael Rush, D-Boston John J. Binienda, D-Worcester Frank M. Hynes, D-Marshfi eld Byron Rushing, D-Boston Stand Up For Safe Staffi ng August 2003 Massachusetts Nurse Page 7

Labor Relations News Department of Labor seeks to limit eligibility for overtime pay By Roland Goff mately 1.3 million However, the threat to senior RNs in facili- the proposed regulations, an employer could Director, Department of Labor Relations more workers the ties that are not covered by union contract violate the laws and regulations that deter- In 1938, Congress passed the Fair Labor right to overtime or whose contracts may not have overtime mine who is eligible for overtime pay, but Standards Act requiring employers to pay pay. However, provisions is great. The average RN salary avoid paying the overtime to the employees workers overtime (time and one-half rate) other regulatory in the United States is $52,520 and in Massa- and avoid any fi nes or penalties provided for work beyond 40 hours in a week. Today, changes would chusetts it is $60,630, so the right to overtime the employer makes post-violation changes the Department of Labor, directed by the allow employers pay for many senior RNs is in jeopardy. This to comply with the law and regulation. I don’t Bush administration, is proposing changes who pay work- new salary limit may be a step down the think that we could dump our garbage in the to regulations governing eligibility for ers a guaranteed slippery slope to excluding more workers median of Route 128 and, when caught, avoid overtime pay that could result in over one salarynot just from overtime eligibility. The underlying paying a fi ne by promising not to do it again. million workersincluding many senior expected hourly threat to all RNs is that the next round of This proposed change highlights the intent of nurseslosing the right to overtime pay. In earnings in regulatory changes may seek to establish the Bush administration: to weaken the laws addition, the proposed regulations would excess of Roland Goff a bright line rule that any worker earning and regulations that protect workers. allow employers who violate the law and $65,000.00, to more than $65,000not just receiving a Modifi cations to the current regulations regulations to avoid penalties if they change exclude employees from the right to overtime salary above $65,000would be excluded may be required by changing times, but these their policies upon notice of the violation. pay. Fortunately, MNA contracts contain pro- from the right to overtime pay. Although we proposed changes go too far and weaken Although modifi cations are needed to visions that state the RNs right to overtime, would still have the right to negotiate differ- enforcement of overtime rights to the extent address rising wages, the proposed changes thus shielding members from the impact ent overtime contract provisions, it would that regulations become suggestions. MNA go too far. Currently, any manager or supervi- of these proposed changes. In addition the provide the employer with a legal basis for members are protected by their contract, but sor earning more that $8,060 per year is not current climate would limit the ability of a its unseemly position. only by their contract. If the proposed regula- eligible for overtime pay, and this ceiling hospital to limit overtime pay since RNs could The proposed changes include a provision tory changes are adopted, federal and state needs revision. The proposed regulation fi nd employment with a more enlightened (or allowing employers to violate the law and agencies charged with protecting workers will raises the ceiling to $22,100, granting approxi- self-interested) employer. regulations without threat of penalties. Under fail to meet their historic mandates.

Collective bargaining updates

St. Vincent nurses ratify three-year contract will no longer be restricted from the top step of the and safety language and a variety of small language improve- Nurses at St. Vincent Hospital in Worcester overwhelm- scale. ments in the articles dealing with vacancies, fl oating and the • ingly ratifi ed a three-year contract in July after weathering a Vacation accrual was changed to 15 days per year for use of travel nurses. seven-month contract battle with the Tenet-owned hospital. In less than fi ve years of service, 20 days per year for fi ve Most salary differentials were improved, as was call pay. addition to pushing for improvements to the current contract, to 15 years of service, and one additional day each year Between the merging of salary scales, across the board the 17-member bargaining committee was faced with fending until maximum of 25 days per year after 15 years of increases and step raises, the salary for a staff nurse was off more than 30 management take-away proposals. “After service. improved by 20 percent over the two-year contract. • fi ghting so hard for our fi rst contract, we weren’t about to let Total number of personal days will be increased by one Wachusett Regional School any of it go,” said Pat Mayo, bargaining unit co-chair. day for a total of three days per year. • Priorities for the new contract included competitive wages, Attendance at mandatory classes, i.e. ACLS and PALS, The fi rst MNA contract for the Wachusett Regional School preservation of the staffi ng minimums agreement and capping will be compensated. Nurses was settled in June. This settlement came after a one- • the number of fl exible-hours positions. The nurses were suc- Differentials will be increased for the following areas. year struggle for recognition and the need to call in a state cessful in accomplishing all three in addition to many other Degree differential will be increased to 50 cents per hour mediator after only three sessions of negotiations. improvements. for bachelor’s and $1 per hour for master’s. Seniority The settlement entails fi rst-time professional development The top of the wage scale will increase by 30 percent pay will be increased to $240 for 10 years, $480 for 20 language granting the nurses access to certifi cation and other over the life of the contract with the top step going from years and $720 for 30 years. Weekend differential will be educational support from the district. The three-year agree- $32.42 to $42.40. Another important win was an internal increased to $1.85 per hour. On-call pay will be increased ment (2002-2005) grants a 3 percent raise in each year of the wage-equity adjustment that advances close to half of the to $3.75 per hour. Pay for relief in a higher classifi ca- contract and a new top step in September 2003. It was ratifi ed permanent nurses in the bargaining unit extra steps on the tion is now $2 and $1.85 for charge. Transfer pay will unanimously on June 26. step scale based on years of RN experience in addition to be increased to $1.25 per hour for standard and $2 per Cambridge Hospital birth center the across-the-board increases to the scale. The result is that hour for ACLS certifi ed nurses. Certifi cation pay will be about two-thirds of the bargaining unit is at the top of the increase to 50 cents per hour, but will only be applied After voting to join the MNA in a labor board election, the wage scale. Some nurses will realize increases in excess of to one degree. nurse midwives working in the birth center at Cambridge 40 percent over the life of this contract. “The most impor- The wage scale was completely readjusted by dropping Hospital ratifi ed an agreement to become part of the MNA tant thing about the wage and salary package is that it puts the fi rst fi ve steps of the scale and adding additional steps contract at Cambridge Hospital. us in the ballpark with other facilities, and it will help us to the scale for a total of 15 steps. Individuals will then be Special language for the midwives addressing hours of retain nurses,” said Sandy Ellis, MNA board member and redistributed on the steps based on years at the facility with work, extra shifts and work schedules and coverage will bargaining unit secretary. consideration given to years of experience. appear in the contract. Other hard-fought gains include a new contractual health Results of wage adjustments will be 13 to 24 percent in A salary schedule was developed with 12 steps. Each mid- and safety committee; an MNA voicemail line; an “association across-the-board increases for the three years of the contract, wife was placed on the step that was next above her current leave of absence” provision for nurses to come work for the as well as gains made in the initial readjustment and place- salary rate. Newly hired employees will be credited with MNA and retain the right to return to her/his hospital posi- ment. their years of experience for purposes of step placement. As tion; guaranteed minimum one week, prime-time summer Total gain for the life of the contract will be 24 to 35 per- of April 6, the salary range for full-time midwives is $63,128 vacation for all bargaining unit nurses; a new preceptor cent through readjustments, across the board increases and to $102,447 annually. program including preceptor differential. scheduled annual step increases. Step ranges will be $26.32 to Norcap Lodge counselors joins MNA “Overall we are very pleased with the contract. It includes $39.82 for RNs, and $29.65 to $44.85 for clinical coordinators stronger protections for our patients and nurses,” said Deb at the end of the contract. Counselors and evaluators at Norcap Lodge—a substance Rigiero MNA board member and co-chair of the bargaining Other changes: abuse treatment facility—voted unanimously April 10 to join • unit. “We now begin the exciting work of internal organizing Tenure requirements have been eliminated. the MNA and became a part of the existing bargaining unit • and strengthening our bargaining unit committees to ensure Health insurance cost increased by 5 percent. of registered nurses and health care professionals employed • the very best contract enforcement.” Payroll will be converted to a bi-weekly schedule. by Caritas Good Samaritan Hospital in Brockton. The election was supervised by the Labor Guild after Nantucket Cottage Hospital Newton Wellesley Hospital a voluntary election agreement was reached with Good The tentative agreement between the MNA and Nantucket MNA nurses of Newton Wellesley Hospital ratifi ed a new Samaritan. The 10 new members were incorporated into Cottage Hospital was ratifi ed on July 7 and will be imple- two-year contract on April 29 after 20 sessions. Major gains the existing contract, realizing an immediate increase in mented on Oct. 1. Within the agreement: include per diem language allowing a staff nurse to arrange their differentials. They also became eligible for education • Per diems will continue to advance on the wage scale her own coverage by a per diem, reduction in force language and certifi cation differentials amounting to $500 to $1,000 based on years of service and experience, however they outlining a fair procedure and a severance package, health annually. Page 8 Massachusetts Nurse August 2003 MNA Convention 2003 100 Years of Caring for the Commonwealth

October 15, 16 & 17, 2003 Mechanics Hall 321 Main Street, Worcester, Mas s. Convention schedule Featured speakers All events are being held at Mechanics Hall in Worcester except where noted. Anita Hill, Attorney Wednesday, October 15 “Speaking Truth to Power: Social Change and Workplace Realities” Thursday • 9:30–10:30 a.m. 6:00–7:00 p.m. Cash Bar for Awards Banquet, Crowne Plaza Worcester Anita Hill is an attorney, legal professor and human rights 7:00 p.m. MNA Awards Banquet activist. She refl ects on the events before, during and after the Clarence Thomas hearings and states, “I did not choose Thursday, October 16 the issue of sexual harassment, it chose me.” Hill, who has 7:30 a.m. Registration and Continental Breakfast; Exhibits/Silent conducted research examining recent social and legal gains in Auction open today’s workplace, will share processes that can not only reduce 8:30–9:30 a.m. A Primer for Nurses: “Worcester County’s Role in the confl ict but that can enhance the workplace. Anita Hill Advancement of Women and Nursing” Paul McCarthy, President, Collective Bargaining Associates 9:30–10:30 a.m. Keynote Address: “Speaking Truth to Power: Social Change “Capturing Power in the Health Care Arena” and Workplace Realities,” featuring Anita Hill Thursday • 10:45 a.m.–Noon 10:30–10:45 a.m. Coffee Break Paul McCarthy is a labor union specialist who works closely 10:45–noon Plenary Session: “Capturing Power in the Health Care with union offi cials to solve organizational problems and build Arena,” featuring Paul McCarthy union power and effectiveness. His motivational presentation will address both the capability and responsibility of organized Noon–2:00 p.m. MNA District 5 Annual Meeting Luncheon held at Crowne nurses to create, apply and capture power in the health care Plaza Worcester arena. The focus will be on the long overdue “coming of age” of Noon–2:00 p.m. Luncheon for MNA convention attendees; Exhibits/Silent nurses’ unions and their becoming infl uential and active players Paul McCarthy Auction open in the development of health care policy in the U.S. 12:30–2:00 p.m. Unit 7 Business Meeting Larry Tye, Author and former Boston Globe reporter 2:00 p.m. Exhibits close “The Ten Commandments of Dealing with the Ungodly Press” Friday • 10:45 a.m.–Noon 2:00–6:00 p.m. MNA Business Meeting 7:30 p.m. Improv Boston Dinner Theater held at Crowne Plaza Larry Tye is a former Boston Globe medical reporter and cur- Worcester. A very limited number of tickets will be sold at rently directs the Health Coverage Fellowship, which provides the door on a fi rst-come, fi rst-serve basis. We encourage education and intensive training to 10 medical journalists from purchasing advanced tickets. See registration form for a variety of media. He has won a series of national reporting details. Tickets $55 in advance; $65 at the door. Proceeds awards, is the author of “The Father of Spin” and is currently will benefi t NursePLAN completing a new book. His topic will focus on how to get your message to the public and dealing with a persistent press. Larry Tye Friday, October 17 7:30 a.m. Registration; Silent Auction Hotel Information 8:00-9:30 a.m. MNA NursePLAN full breakfast and meeting for all MNA The MNA Convention 2003 is being hosted at The Crowne Plaza Worcester. The Crowne Plaza is offering a special convention room rate of $99/night for single, dou- members ble or triple occupancy. (12.45% MA occupancy tax additional.) For reservations call 9:30–10:30 a.m. MNA 100th Birthday Celebration, MNA District 2 The Crowne Plaza at 1-800-628-4240. Rooms at this rate available until 9/24/03. 10:30–10:45 a.m. Coffee Break Refund Policy 10:45–noon Plenary Session: “The Ten Commandments of Dealing with Requests for refunds will be accepted in writing until October 3, 2003. A $25 ad- the Ungodly Press,” featuring Larry Tye ministration fee will be deducted from each registration refund. No refunds will be granted after October 3, 2003. On-site registration is contingent upon space. Noon–2:00 p.m. Luncheon with live auction 2:00 p.m. Silent Auction closes Chemical Sensitivity Attendees are requested to avoid wearing scented personal products when at- 2:00–3:30 p.m. Plenary Session: speaker to be announced tending this program/meeting. Scents may trigger responses in those with chemi- cal sensitivity. Contact Hours MNA Business Meeting Continuing nursing education contact hours will be awarded by the Massachusetts October 16, 2 p.m. Nurses Association which is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The MNA business meeting is open and free to all MNA members, regardless of whether you Questions register for Convention. Call MNA’s department of nursing at 1-800-882-2056, x 727. August 2003 Massachusetts Nurse Page 9

MNA Convention 2003 Safe Staffi ng Saves Lives Registration Form Pass H.1282 Understaffi ng of registered nurses is dangerous to patients. Mistakes, errors and complications become more likely when Name ______nurses are asked to take care of too many patients at once. A study of six million patients reported in the New England Address ______ Journal of Medicine show that patients without adequate City/State/Zip ______nursing attention are more likely to die or suffer serious complications: the more nurses per patient the better the Telephone: Day ______medical outcomes. Evening______ The Journal of the American Medical Association reported that in a study of 232,000 surgical patients the higher the I am a(n): ❏ MNA Member patient-to-nurse ratio, the more likely there will be a death or ❏ *Full-time Student/Unem ployed/Retired serious complication. Each additional patient above four that ❏ Non-Member a nurse cared for produced a 7 percent increase in mortality. * (Includes full time students [minimum 12 credits], unem ployed, If a nurse is caring for eight patients instead of four, there is a retired and student nurse asso ci a tion members.) 31 percent increase in mortality. ❏ Check here if you require vegetarian meals The fact that nurses are burned out from high patient ❏ Check here if you require special assistance during convention loads is causing them to leave the profession. One in three and please call the MNA at 800-882-2056, x727 registered nurses under the age of 30 say they are planning to leave nursing within the next year. 3 Convention Packages: Thursday & Friday, Oc to ber 16 & 17 To Preserve Quality Care and Protect Patient Safety Full Two-Day Convention Package — Thursday and Friday: join a growing list of organizations that support H.1282 Includes ALL events on Thursday (excluding Improv Boston) and Friday. MNA Members $75 All Others $100 Re duced Mem bers* $70 $ Ad Hoc Committee to Defend Health Care Mass. Association of Nurse Anesthetists AIDS Action Committee of Massachusetts Mass. Association of Older Americans Please register below if you plan to attend these Thursday events: AIDS Care Project Mass. Association of Public Health Nurses ❑ Unit 7 Business Meeting/Lun cheon • 12:30 p.m. n/c Alzheimer’s Association, Mass. Chapter Mass. Brain Injury Association ❑ District 5 Annual Meeting/Lun cheon • 12:30 p.m. n/c American Cancer Society Mass. Breast Cancer Coalition American Diabetes Association of Greater Mass. Coalition of Nurse Practitioners Thursday-Only Package: Boston Includes ALL events on Thursday: keynote, plenary session, all meals, exhibits, Mass. Federation of Teachers American Heart Association auction (excluding Improv Boston Dinner Theater). Mass. Human Services Coalition American Lung Association of Greater MNA Members $35 All Others $45 Re duced Mem bers* $30 $ Mass. Immigrant and Refugee Advocacy Norfolk County Coalition Friday-Only Package: American Lung Association of Mass. Massachusetts Nurses Association Includes ALL events on Friday: keynote, two plenary sessions, American Psychiatric Nurses Mass. School Nurse Organization NursePLAN Breakfast, all meals, exhibits, auction. Association—New England Chapter Mass. Senior Action Council MNA Members $40 All Others $50 Re duced Mem bers* $35 $ Amyotrophic Lateral Sclerosis Association Mass. Society of Eye Physicians and Arise for Social Justice Surgeons Boston AIDS Consortium Sister Rosellen Gallogly of Market Optional Ticketed Events Boston Health Care for the Homeless Ministries, Inc. Program Awards Banquet • Wednesday, October 15, 7 p.m. • $40 $ Mass NOW (National Organization for Boston Women’s Commission Women) Improv Boston Dinner • Thursday, October 16, 7:30 p.m. Cambridge Women’s Commission Massachusetts Spina Bifi da Association Theater Advance tickets • $55 $ Cape Organization for Rights of the MASSPIRG (All proceeds from this event benefi t NursePLAN) Disabled Mental Health Association, Inc. Family Economic Initiative MetroWest AIDS Program Total Convention Fees $ Favorite Nurses Favorite Temps MetroWest Latin American Center Payment Gay and Lesbian Advocates and National Association of Social Workers Please mail this completed form with check made payable to MNA to: Massa chu setts Defenders – Massachusetts Chapter Nurs es Asso ci a tion, 340 Turn pike Street, Can ton, MA 02021. Tel. 800-882-2056, x727. Greater Boston Diabetes Society National Kidney Foundation of Mass., RI, Reg is tra tion forms postmarked prior to October 3, 2003 will be entered in a drawing Health Care for All NH, Vermont, Inc. to win a free conven tion reg is tra tion. Independent Living Center of North Shore Neighbor-to-Neighbor Payment may also be made by VISA or MasterCard. and Cape Ann, Inc. New England Coalition for Cancer Account # ______Jobs with Justice Survivorship Jonathan M. Cole Mental Health New England Patients Rights Group, Inc. Exp. Date: ______Consumer Resource Center Search For A Cure Fax credit card registrations to: 781-821-4445. Latin American Health Institute The Abortion Access Project League of Women Voters of Mass. The Consortium for Psychotherapy For Offi ce Use Only: Lynn Health Task Force The Episcopal Diocese of Western Mass. Charge Code: ______Amt: ______Date: ______Ck#: ______Ck. Date: ______Init: ______V/MC: ______Mass. Asian AIDS Prevention Project Victory Programs, Boston Mass. Association of Councils on Aging Vineyard Health Care Access Program Page 10 Massachusetts Nurse August 2003

So you think it’s safe at work? Notes from the Congress on Health and Safety Sensitivity to personal fragrances often a concern for visitors, patients, staff By Evelyn I. Bain, MEd, RN, COHN-S chemical I am sensitive to is a known skin sen- direct effect on his condition. impart a scent, but even products without a Associate Director/Coordinator, Occupational sitizer that can cause skin allergies. Because When my son was moved to a regular strong odor still seemed contain fragrance Safety and Health Specialist of this, my son’s ICU chart was fl agged to room, the patient-care kits and body wash chemicalsincluding skin sensitizers. Many Betty Bridges is a member of Health Care indicate that no scented products were to were the same as those used in the ICU. But hand-washing products used by the staff also Without Harm and has worked extensively on edu- be provided as part of his patient-care kit. despite the fact that his chart was still fl agged contained fragrance. cation and awareness issues related to exposure to The in-hospital body wash, deodorant and to indicate that no scented products be used, As my son continued through his treat- personal fragrances and pesticides. The following baby powder, which were not a part of the there were several scented products in his ments and rehabilitation, I was able to is a note Betty sent while her son was hospitalized patient-care kit, were also scented and it was room and many had already been used. I learn, fi rst-hand, several important things following an auto accident. It is reproduced here, my plan to provide unscented toiletries in also noticed that the unit secretary wore a about chemical sensitivities and in-hospital with permission, to promote awareness among place of these. very strong perfume and I saw air freshener chemical use: fl agging a patient’s chart does readers on how personal fragrances and various While helping with my son’s bath one being sprayed in the halls to cover odors. not ensure that scented products will not chemicals can affect people. morningbefore I had an opportunity to My son later moved to a spinal rehabilita- be used on and around the patient; scented As some of you already know, my 19- bring in my own unscented productsI used tion unit that seemed to be almost entirely products containing known skin sensitizers year-old son was seriously injured in an the Dial soap that the hospital provided. Dial fragrance free. I do know, however, that are routinely used; most patient-care items auto accident on May 16. This has given me generally causes me no problems, but when products to clean the unit’s fl oors and sur- are scented; scented products are frequently a different kind of up-close experience with I washed my son’s face he commented that faces did contain fragrance, because they used by staff on their person; most cleaning fragrance use and exposure in the hospital his lungs felt uncomfortable. Generally he triggered my respiratory symptoms despite products are scented; and scented products setting. has no sensitivity to fragrance, but because the fact that they seemed to have little can be a problem for those with compromised My own severe respiratory sensitivity to a he had been on a ventilator for almost fi ve inherent odor. The purpose of the fragrance lung function due to injury as well as for those specifi c fragrance chemical makes me acutely days, and because his left lung was bruised was probably to mask odors rather than to with asthma and respiratory diseases. aware of the presence of fragrance, and the in the accident, the soap seemed to have a Exciting MNA Group Trips to Italy

Health & Safety Notes Still available: Montecatini Spa, Tuscany, Italy: $1469* (Oct. 21 – 29, 2003) This all-inclusive trip to the Tuscany region of Italy includes tours of Florence, State-supplied fl u vaccine will be limited next season Venice, Pisa, Siena and San Gimignano while staying in the world-famous spa city of Due to funding reductions, the amount of infl uenza vaccine available through the Mas- Montecatini. Air, transfers, hotel, all meals and full sightseeing tours included. sachusetts Department of Public Health for this coming infl uenza season has been reduced. State-supplied infl uenza vaccine is being prioritized to high-risk children, long-term care Coming in 2004 facilities and public provider sites (i.e. local boards of health, visiting nurse associations and Northern Italy lakes tour: $1,599* (May 19 – 27, or May 26 – June 3, 2004) community health centers). Taormina, Sicily tour: 1,759* (Oct. 27 – Nov. 4, or Oct. 29 – Nov. 6, 2004) Unfortunately, DPH will not be able to supply infl uenza vaccine for adults seen at private provider offi ces. However, fl u vaccine is available for purchase from the following manu- *Prices listed are per person, double occupancy based on check purchase. Departure taxes not included. facturers: For more information, contact Carol Mallia at 781-830-5755 or via e-mail at [email protected]. Aventis, 800-822-2463 General Injectable and Vaccine (Medeva), 800-521-7468 If you have questions, contact the DPH Vaccine Management Unit at 617-983-6828. Medicare has nearly doubled the reimbursement rate for the administration of fl u and Unit 7 Consent To Serve pneumococcal vaccine over 2002 rates. The new rates for 2003-04 are: $9.41 per dose in met- ropolitan Boston and $8.60 per dose elsewhere in Massachuetts. Statewide Election—Unit 7 State Chapter Health Care Professionals For more information on roster billing, please contact Cheryl Cipolla at 781-741-3256. Consent to Serve for the Executive Board Study of workplace health & safety I am interested in active participation in State Chapter, Health Care Professionals. If elected by the Unit 7 membership, I am willing to serve as (check one)* : Researchers at the University of Massachusetts Lowell, in partnership with the MNA and selected healthcare institutions, will be conducting a study of workplace health and safety Offi cers ❑ President ❑ Treasurer called PHASE in Healthcare. Nurses working in the hospital environment are invited to par- ticipate in focus groups concentrating on a variety of health and safety issues. Focus groups Directors ❑ Nursing (4 to be elected) ❑ Physical Therapy (1 to be elected) will be held during the fall at the MNA’s Canton offi ce and at other locations around the state. ❑ Medicine (1 to be elected) Participation will be confi dential. For more information or to sign up to participate, please contact Kathy Sperrazza, nurse * All Unit 7 members are eligible to run for president or treasurer. Only members of each discipline may serve as a director representing that discipline. All terms are for 2 years. research consultant, at 781-239-0485 or via e-mail at [email protected]. Please type or print — Do not abbreviate. Work-related asthma is a reportable health condition in Mass. Massachusetts law requires that asthma caused or aggravated by exposures or conditions Name______at work be reported to the Massachusetts Department of Health’s Occupational Safety and Address ______Health Program. A specifi c form is required for reporting and it can be obtained by calling the MNA’s Health and Safety Program at 781-821-4625. City/State/Zip ______Length of time in Unit 7: ____ years The purpose of reporting is to identify chemical or other agents in the workplace that can cause or aggravate asthma so that exposures can be eliminated or controlled through engi- Phone (Home) ______(Work) ______neering interventions. Your employer is required by law to provide a safe and healthful work Present Employment Dept. ❑ DMH ❑ DPH ❑ DMR ❑ Other (specify): ______environment that is free from recognized hazards. Work Site______Title ______Present Offi ces/Association Activities/Local Unit Activities: Benefits Corner brought to you by… Save on Six Flags New England tickets The MNA is offering discount admission tickets to the Six Flags New England Amuse- Past Offi ces/Association Activities/Local Unit Activities — past 5 years only. ment Park in Agawam. Members can purchase tickets directly from the MNA for $22 per person, a savings of $17.99 for every ticket. This is the lowest individual admission price offered for any operating day during the 2003 season. In addition, purchasing tickets ahead of time means there is no waiting in line at the front gate. Signature of Member: ______Tickets can be purchased at the MNA’s Canton offi ce or by calling Chris Stetkiewicz, Return Deadline: September 1, 2003 781-830-5726. Quantities are limited, so passes are available on a fi rst-come basis. Return to: MNA, Unit 7, State Chapter Nominating Committee, 340 Turnpike Street, Canton, MA 02021 August 2003 Massachusetts Nurse Page 11 Reaching out to the special people of Beijing

By May Ling, RN Horace and his family for four weeks. This Member, MNA diversity committee time around though, we wanted to be more Beijing, the capital city of China, is well than just tourists. known for its tourist attractions and my Horace works with Operation Blessing husband and I have been fortunate to visit (OB), a non-profi t, charitable organization this amazing city on several occasions. Our registered with the government to carry fi rst trip was in 1979, shortly after President out humanitarian projects in China. OB staff Nixon’s historic visit. At that time, the people members pay regular visits to homes for the of China were noticeably subduedeven elderly and orphanages; promote educational depressed. We saw quarrelling in the streets, programs; and help victims of disasters. They and we only heard whispered discussions also manage medical clinics in China’s impov- about the cultural revolution. erished areasarranging surgeries for people But in 1997, we briefl y visited Beijing again. who suffer from crippling or life-threatening The changes in the Chinese people were obvi- conditions. During our month-long stay in Beijing, we worked closely with OB: helping with translations and visiting elderly homes and orphanages. I trained OB’s volunteers on MNA member May Ling, front row fourth from left, with staff and volunteers from Opera- health care issues relating to the elderly and tion Blessing on a visit to China. children, and also accompanied them on their sheet and a blanket or a poorly constructed weekly outreach efforts. wooden door. The heating system usually Operation Blessing has 15 full-time staff consisted of a pipe running along the wall, members and many part-time volunteers. Two and this was only operational from 5 a.m. to regular staffers are in charge of the elderly vis- 11 p.m. sometimes until midnight if it was itation program, and they arrange programs extremely cold. to help meet the needs of each particular nurs- A few of the homes we visited had health- ing home. For example, there were two homes care workers who were responsible for giving that had a special need for thermal underwear medicine, injections, immunizations and IV during the cold winter season. These residents fl uids when neededbut, although these wore layers of clothes because the tempera- workers were trained, they were not licensed ture inside was just above freezing during healthcare professionals. the day. The rooms of the elderly residents The Chinese volunteers we traveled with ous: they were clearly much more at ease, as living in this home were, for the most part,  when we visited the elderly were lively and well as being more lively and happy. Last sparsely furnished usually housing just a engaging people. In one instance, a group of November, my husband and I visited Bei- bed and a night stand. The entrance to each retirees went with us to the Furong home to A 1-year-old orphan in a bamboo stroller. jing for a third time and stayed with our son room was either covered with a thick plastic perform, dance and to sing for the residents done skin grafts to keep infection out. He had theremany of who had physical or mental no ears, and he couldn’t properly open his disabilities. There was a paralyzed man who eyes or mouth. He had been begging in the was being taught how to exercise using the streets to support himself and his mother, but Donations needed for healthy side of his body in order to help his the foreigner hired his mother to work for weak side, and there was a woman with him and kindly took the boy into his home. It dementia who was encouraged to dance. We was clear that Cheng Zhen would need much all watched with a sense of joy as she twirled, MNF Annual Auction! plastic surgery to correct his deformities. waltzed and pranced around the room. Because it was close to Christmas, the OB We also had the opportunity to visit an staff asked Cheng Zhen what he wanted for orphanage where virtually all of the children We Need Your Help a gift. He surprised everyone by saying he were either physically or mentally impaired. wanted an education. As it turned out though, th As soon as we entered the front yard, a 13- The Massachusetts Nurses Foundation is preparing for its 20 no school would accept him because his year-old boy ran over to the OB staff member, disfi gurement was so shocking and school Annual Silent & Live Auction to be held at the MNA Convention hugged her and wouldn’t let her go. The force offi cials were concerned that he would be a nearly knocked her over, and it was truly a in October. Donations are needed to make this fundraising event a distraction to the other students. He could not heartwarming sight. go to a school for the mentally handicapped big success! Your tax-deductible donation helps the foundation raise The children at this particular orphanage either, because he was mentally competent. were all there because their parents had aban- funds to support nursing scholarships & research. But the staff at Operation Blessing still doned them at birth due to their congenital managed to give Cheng Zhen his gift: they defects. The youngest orphan on the day we Your support is appreciated: arranged for volunteer students from Beijing visited was a baby girl who was only four University to tutor him three and a half hours Jeanine Williams, MNF President days old. Her parents abandoned her because a day, three days a week. Hopefully OB will she had a severe harelip and cleft pallet. But Patricia Healey, MNF Secretary be able to fi nd donors and medical organi- other than that surgically repairable condi- zations to fund proper corrective surgeries Liz Joubert, MNF Treasurer tion, she was a beautiful healthy baby and Cheng Zhen. Operation Blessing was planning to arrange My husband and I are so thankful for our corrective surgery for her just as soon as she most recent trip to Beijing, and we often Valuable Personal Items Craft Items was old enough. There was also a 1-year-old think back on what we experienced during girl who was said to have heart problems that month-long visit. We are so thankful that Gift Certifi cates Memorabilia & Collectibles when she arrived and was incapable of sit- God works through so many faithful people ting up on her own, but on that day she was Works of Art Vacation Packages to give help to the helpless and hope to the sitting up in a stroller made of bamboo and hopeless. looking quite healthy and rosy-cheeked. All donations will be appreciated! For more information on Operation Bless- A week before we left Beijing, a boy was ing, visit www.obchina.org. brought in to the OB offi ce by a foreigner. The Special note: The burn center at Shriners boy’s name was Cheng Zhen and he was from Contact the MNF at 781-830-5745 to obtain an auction donor Hospital in Boston has kindly offered to help Henan province, south of Beijing. Two years Cheng Zhen. He will arrive with his mother form or simply mail or deliver your donation to the Massachusetts earlier, a gasoline explosion severely burned in Boston this September for additional cor- his face, head, arms and one thigh. Miracu- Nurses Foundation, 340 Turnpike Street, Canton, MA 02021. rective surgeries. lously, he survived and received some poorly August 2003 Massachusetts Nurse Page 15 Proposed MNA Bylaw Amendments d. The Nominations and Elections Committee shall: d. (1) Publish a list of incumbent offi cers and members of the d.(1) Strike “constituent districts” and insert regions. Consistent with proposed amendment of Article IV—Constituent Board of Directors and Congresses, with their respective If adopted, will read: Districts. constituent districts and a statement as to which are eligible d.(1) Publish a list of incumbent members of the Board of Directors for re-election. and Congresses, with their respective regions and a statement as to which are eligible for re-election.

(3) Actively solicit and receive nominations from all constituent d.(3) In fi rst sentence, strike “constituent districts” and insert regional Consistent with proposed amendment of Article IV—Constituent districts, Congresses, Networks, Standing Committees and councils. Districts. individual members. All nominations must be accompanied If adopted, fi rst sentence will read: by a written consent–to-serve form. d. (3) Actively solicit and receive nominations from all regional coun- cils, Congresses, Networks, Standing Committees and individual members. Proposed by Districts II, III and 5. F. Article VIII – Elections Current Proposed Rationale Section 1: Section 1: Schedule of Elections a. The President, General; Secretary, General; fi ve district Directors, a. Strike “fi ve district Directors, Labor” and insert a Director from Consistent with proposed amendment of Article IV—Constituent Labor; four At-Large Directors, Labor; three At-Large Directors, each region, Labor. Districts. General; one Labor Program Member who is a non-RN Health- Strike “representing each District” and insert representing each region. care Professional; fi ve members of the Nominations and Elections If adopted, will read: Committee representing each District; fi ve members of the Bylaws a. The President, General; Secretary, General; a Director from each Committee; six members of each Congress and two members of region, Labor; four At-Large Directors, Labor; three At-Large Di- the Center for Ethics and Human Rights shall be elected in the rectors, General; one Labor Program member who is a non-RN odd year. Health-care Professional; fi ve members of the Nominations and Elections Committee representing each region; fi ve members of the Bylaws Committee; six members of each Congress and two members of the Center for Ethics and Human Rights shall be elected in the odd year. b. The Vice President, Labor; the Treasurer, Labor; fi ve District b. Strike “fi ve district Directors, Labor” and insert a Director from Consistent with proposed amendment of Article IV—Constituent Directors, Labor; three At-Large Directors, Labor; four At-Large each region, Labor. Districts. Directors, General; fi ve members of the Committee on Nomina- Strike “representing each District” and insert representing each tions and Elections representing each District; fi ve members of region. the Bylaws Committee; six members of each Congress and two If adopted, will read: members of the Center for Ethics and Human Rights shall be b. The Vice President, Labor; The Treasurer, Labor; a Director from elected in the even year. each region, Labor; three At-Large Directors, Labor; four At-Large Directors, General; fi ve members of the Committee on Nomina- tions and Elections representing each region, fi ve members of the Bylaws Committee; six members of each Congress and two mem- bers of the Center for Ethics and Human Rights shall be elected in the even year. Proposed by Districts II, III and 5. G. Article IX – Networks Current Proposed Rationale Section 2: Section 2: Designation Strike “District Leaders Network” and insert Regional Leaders Net- Consistent with proposed amendment of Article IV—Constituent There shall be a District Leaders Network and Member Net- work. Districts. works. If adopted, will read: There will be a Regional Leaders Network and Member Networks. a. The District Leaders Network will be made up of the leaders of a. In fi rst sentence strike “District Leaders Network” and insert Regional Consistent with proposed amendment of Article IV—Constituent the Districts. Their work will be to discuss issues of membership Leaders Network. Strike “Districts” and insert Regions. Districts. and improved ways of providing leadership within the organization. In third sentence strike “District issues” and insert Regional issues. They will seek to understand District issues of interest to their Strike “districts” and insert regions. membership, identify commonalities and differences and determine If adopted, the fi rst sentence will read: better ways to serve the districts. a. The Regional Leaders Network will be made up of the leaders of the Regions. The third sentence will read: They will seek to un- derstand Regional issues of interest to their membership, identify commonalities and differences and determine better ways to serve the regions.

Section 3: Section 3: Composition a. The District Leaders Network shall be composed of 10 members a. Strike “District Leaders Network” and insert Regional Leaders Net- Consistent with proposed amendment of Article IV—Constituent consisting of two representative leaders selected from each work. Strike “10 members consisting of” Districts. district. Strike “district” and insert region. If adopted will read: a. The Regional Leaders Network shall be composed of two repre- sentative leaders selected from each region. b. The Member Networks shall be composed of 10 members consist- b. Strike “10 members consisting of.” Consistent with proposed amendment of Article IV—Constituent ing of two representatives selected from each district. Strike “district” and insert region. Districts. August 2003 Massachusetts Nurse Page 21 MNA Member Benefi ts Save You Money Personal & Financial Services CELLULAR TELEPHONE SERVICE CINGULAR WIRELESS...... 800-894-5500 PORTABLE HEALTH INSURANCE Lowest rate possible $8.95/month plus $.37/minute off peak with free nights (7:00 p.m. to ELLEN KAPLAN, GROUP HEALTH SPECIALISTS...... 800-604-3303 OR 508-875-3288 6:59 a.m.—an MNA exclusive) & free weekends. Managed care & comprehensive indemnity plans through Blue Cross/Blue Shield as well as other carriers. JIFFY LUBE DISCOUNT MNA MEMBERSHIP DEPARTMENT ...... 800-882-2056, X726 PROFESSIONAL LIABILITY INSURANCE Obtain an MNA Discount card to receive 15% discount on automobile products & NURSES SERVICE ORGANIZATION ...... 800-247-1500 (8:00 a.m. TO 6:00 p.m.) services. Leading provider of professional liability insurance for nursing professionals with over 650,000 health care professionals insured. CONSUMER REFERRAL SERVICE MASS BUYING POWER...... 781-829-4900 CREDIT CARD PROGRAM A consumer referral service offering super savings on products & services. Visit MBNA AMERICA...... 800-847-7378 Exceptional credit card at a competitive rate. their Web site at www.massbuy.com (Password MBP) DISCOUNT ELECTRONICS & APPLIANCES TERM LIFE INSURANCE HOME ENTERTAINMENT DISTRIBUTORS...... 800-232-0872 OR 781-828-4555 LEAD BROKERAGE GROUP ...... 800-842-0804 Term life insurance offered at special cost discounts. Home electronics & appliances available at discount prices for MNA members. OIL NETWORK DISCOUNT LONG TERM CARE INSURANCE COMFORT CRAFTED OIL BUYING NETWORK ...... 800-649-7473 WILLIAM CLIFFORD ...... 800-878-9921, X110 Flexible and comprehensive long-term care insurance at discount rates. Lower your home heating oil costs by 10 – 15%. 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AMERICAN GENERAL FINANCIAL GROUP/VALIC...... 800-448-2542 Specializing in providing retirement programs including 403(b), 401(k), IRA, NQDA, HEALTH CARE APPAREL Mutual Funds, etc. WORK ‘N GEAR DISCOUNT...... 800-WORKNGEAR (FOR STORE LOCATIONS) Receive 15% discount off all regularly priced merchandise. Simply present your valid DISCOUNT TAX PREPARATION SERVICE MNA membership card to pick up your MNA/Work ‘n Gear discount card at any TAXMAN INC...... 800-7TAXMAN Massachusetts Work ‘n Gear store. 20% discount on tax preparation services. Travel & Leisure Products & Services HERTZ CAR RENTAL DISCOUNT AUTO/HOMEOWNERS INSURANCE HERTZ ...... 800-654-2200 MANSFIELD MNA members discounts range from 5 – 20% mention MNA discount CDP#1281147. 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DIGITAL PAGERS UNIVERSAL STUDIOS MEMBER EXTRAS INTERNET PAGING...... 800-977-1997 Discount digital pager program. Log onto the MNA Web site at www.massnurses.org and click on the Universal Studios Link to obtain special discount prices or e-mail [email protected] for LONG DISTANCE TELEPHONE SERVICE information. ALLIANCE SERVICES ...... 888-922-SAVE 4.9 cents/minute for long distance calls & 5% discount (vs. Verizon) on local service—7 days a week, 24 hours a day! Prepaid discount international calling cards also available. MNA’s premier group benefi ts programs help you get more out of your membership and your hard-earned money! Take advantage of these special benefi ts specifi cally designed for MNA members. For information on any of our discount programs, contact the specifi c representative listed or call Chris Stetkiewicz in the MNA For more information, call the MNA, 800-882-2056, x726. membership department, 800-882-2056, x726. Page 22 Massachusetts Nurse August 2003 MNA Continuing Education Courses Your source for career training and advancement

Verbal Self Defense for Nurses Peripheral I.V. Therapy Program

Description This program is designed to provide the nurse with the basic skills for Description This program introduces the RN to the theory of peripheral venipuncture. managing confl ict in the workplace environment. Confl ict resolution It includes anatomy and physiology of the peripheral circulatory system, strategies are discussed. The program will conclude with an interactive fl uid and electrolyte imbalance, infection control and legal issues of the discussion of case scenarios related to confl ict management. practice of venipuncture. Classroom instruction will include procedural Speaker Joe-Ann Fergus, RN, BSN demonstration and return demonstration on I.V. arms. Clinical experi- Date Sept. 4 ence will not be provided. Time 6:00 – 9:00 p.m. (Light supper provided) Speakers Mary Walsh, RN, BS, CRNI, Infusion Therapy Specialist Place MNA Headquarters, Canton Marilyn Bernard, RN, CRNI, Infusion Therapy Specialist Fee MNA members, $45; all others, $65 Date Sept. 25 Contact hours* 3.3 Time 5:00 – 8:30 p.m. (Light supper provided) MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 Place MNA Headquarters, Canton Fee MNA members, $65; all others, $95 Interpreting Laboratory Values Special notes Certifi cate of attendance will be awarded MNA contact Susan Clish, 781-830-5723 or 800-882-2056, x723 Description This program will enhance the nurse’s ability to evaluate and determine the clinical signifi cance of laboratory values. Clinical case studies will be Advanced Cardiac Life Support used to illustrate the relationship of laboratory values to patient conditions. Clinical management of abnormal laboratory values will be discussed Description This American Heart Association course will provide information on the Speaker Carol Mallia, RN, MSN clinical management of cardiac and respiratory emergencies through Date Sept. 9 case study approach. Course content includes assessment, arrhythmia Time 5:00 – 9:00 p.m. (Light supper provided) recognition, intubation, defi brillation and pharmacological interventions. Place MNA Headquarters, Canton This is a two-day certifi cation and one-day recertifi cation course. Recer- Fee MNA members, $45; all others, $65 tifi cation candidates must present a copy of their current ACLS card at Contact hours* 4.1 the time of registration. MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 Speakers Carol Mallia, RN, MSN, and other instructors for the clinical sessions Dates Certifi cation: Oct.1 & 8 Emergency Medical Response Recertifi cation: Oct. 8 only Time 9:00 a.m. – 5:00 p.m. (Lunch provided) to Hazardous Materials and Acts of Terrorism Place MNA Headquarters, Canton Fee Certifi cation: MNA members, $155; all others, $195 Description The Massachusetts Emergency Management Agency (MEMA) is sponsor- Recertifi cation: MNA members, $125; all others, $165 ing this program on emergency medical services in response to hazardous Contact hours* 16 for certifi cation. No contact hours awarded for recertifi cation. materials and acts of terrorism. The program is specifi cally designed for MNA contact Susan Clish, 781-830-5723 or 800-882-2056, x723 physicians, nurses, EMTs, and hospital support staff to provide education in the treatment of individuals exposed to chemical and biological agents. The program will include identifi cation of hazardous materials, toxicologi- Anatomy of a Legal Nurse Consultant cal and biological effects of chemicals and biological acts of terrorism. Description This program will introduce the nurse to the scope of practice of the legal The chemical profi le of common agents, decontamination procedures nurse consultant. The history and evolution of this important role and its and personal protective equipment will be discussed. CDC guidelines LEGALLEGAL NURSNURSE multifaceted components will be discussed, including: practice environ- for surveillance of exposed nurses and other health care workers and CONSULCONSULTATANTNT ments, litigation process, case evaluation for compliance with standards of nursing interventions for patient care will be identifi ed. nursing/healthcare practice, nurse expert witness role, risk management Speakers Anthony Fucaloro, EMT and other important considerations. Professional certifi cation will also be Capt. Lawrence P. Ferazani addressed. Evie Bain, RN, MEd, COHN-S Speakers Barbara J. Levin, BSN, RN, ONC, LNCC; Tammy J. Murphy, RN, LNC; Dates Sept. 10 Kelly W. Shanley, RN, LNC; Jane Mihalich, BSN, RN, LNCC; Erin Weber, Time 9:00 a.m. – 5:00 p.m. (Lunch provided) BSN, RN, CCRN; Elaine Noren, BS, RN, LNCC Place MNA Headquarters, Canton Dates Oct. 9 Fee MNA members, $45; all others, $65 Time 5:30- 8:30 p.m. (Light supper provided) Contact hours* 6.9 Place MNA Headquarters, Canton Special notes Class limited to 25. Fee MNA or AALNC members, $65; all others, $95 MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 Contact hours* 3.2 Basic Dysrhythmia Interpretation MNA contact Susan Clish, 781-830-5723 or 800-882-2056, x723

Description This course is designed for registered nurses in acute, sub acute and Oncology Series for Nurses long-term care settings to learn cardiac monitoring and dysrhythmia inter- Description A three-part series for nurses to increase their knowledge in oncology pretation. Implications and clinical management of cardiac dysrhythmias nursing. Session one series include an overview of cancer management, will also be discussed. Course will include a text book, calipers and require tumor physiology and staging, relevant laboratory testing and treatment study between sessions one and two. strategies and safe handling of neoplastic agents. Session two will dis- Speaker Carol Mallia, RN, MSN cuss chemotherapy administration, classifi cation of chemotherapeutic Dates Sept. 16 & 23 agents, management of toxicities and adverse effects of treatments and Time 5:00–9:00 p.m. (Light supper provided) oncological emergencies. Session three will include pain and symptom Place MNA Headquarters, Canton management, palliative care and an overview of hospice care. Fee MNA members, $90; all others, $125 Speaker Marylou Gregory-Lee, MSN, RNCS, OCN, Adult Nurse Practitioner Contact hours* 9.0 Dates Oct. 21, 28 & Nov. 4 Special notes Class limited to 40. Time 5:30- 9:00 p.m. (Light supper provided) MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 Place MNA Headquarters, Canton Fee Series: MNA members, $175; all others, $225 Each session: MNA members, $65; all others, $95 Contact hours* 3.6 per program. Total for series: 10.8 Special note Completion of Session 1 is required for attendance at Session 2 MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 August 2003 Massachusetts Nurse Page 23

Diabetes 2003: What Nurses Need to Know Emergency Medical Response

Description Session 1: This session will discuss the pathophysiology and classifi ca- to Hazardous Materials and Acts of Terrorism tion of Diabetes Type 1 and 2. The nursing implications of blood glucose Description The Massachusetts Emergency Management Agency (MEMA) is sponsor- monitoring will be discussed. Non-pharmacological interventions such as ing this program on emergency medical services in response to hazardous exercise and meal planning will be explained. The program will conclude materials and acts of terrorism. The program is specifi cally designed for with a discussion of oral pharmacological agents. physicians, nurses, EMTs, and hospital support staff to provide education Session 2: This session is designed to provide the nurse with a compre- in the treatment of individuals exposed to chemical and biological agents. hensive update on insulin therapy. The nursing management of the newly The program will include identifi cation of hazardous materials, toxicologi- diagnosed diabetic patient, both complicated and not, will be explored. cal and biological effects of chemicals and biological acts of terrorism. Nursing management of the diabetic patient in the pre/post operative, The chemical profi le of common agents, decontamination procedures ambulatory care, home care and school setting will be discussed. and personal protective equipment will be discussed. CDC guidelines Speaker Ann Miller, MS, RN, CS, CDE for surveillance of exposed nurses and other health care workers and Dates Session 1: Oct. 23 nursing interventions for patient care will be identifi ed. Session 2: Oct. 30 Speakers Anthony Fucaloro, EMT Time 5:30 – 9:00 p.m. (Light supper provided) Capt. Lawrence P. Ferazani Place MNA Headquarters, Canton Evie Bain, RN, MEd, COHN-S Fee MNA members, $65 all others, $95 (Each session) Dates Dec. 3 Contact hours* 3.6 per session Time 9:00 a.m. – 5:00 p.m. (Lunch provided) MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 Place MNA Headquarters, Canton Compassion Fatigue Fee MNA members, $45; all others, $65 Contact hours* 6.9 Description This program will discuss the occupational risk factors and the stress- Special notes Class limited to 25. ors associated with the helping profession. A profi le of the health care MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 professional prone to compassion fatigue will be identifi ed, with specifi c application for nurses. The program will conclude with a discussion about Wound Care—Dressing for Success various methodologies that can be used to reduce occupational stress. Speaker Donna White, RN, MSN, CADAC-II, CARN, NCCDN Description This program will provide a comprehensive overview of the factors Dates Nov. 6 affecting wound care and strategies for managing complex wounds. A Time 5:00 – 9:00 p.m. (Light supper provided) thorough review of wound products will enable the attendee to select the Place MNA Headquarters, Canton optimal dressing based on clinical fi ndings. New dimensions of wound Fee MNA members, $65; all others, $95 care, such as growth factors, hyperbaric oxygen, electrical stimulation, Contact hours* Will be awarded cultured skin replacements and vacuum-assisted closure devices will MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 also be discussed. Speaker Carol Mallia, RN, MSN, CWOCN Nursing Management of Central Lines Date Dec. 9 Time 5:00 – 9:00 p.m. (Light supper provided) Description This program describes the multiple venous access devices used in central Place MNA Headquarters, Canton line therapy. Indications for tunneled vs. non-tunneled lines and potential Fee MNA members, $45; all others, $65 complications will be discussed. The nursing management and legal Contact hours* 4.5 aspects in managing the care of these devices will be described in detail. MNA contact Susan Clish, 781-830-5723 or 800-882-2056, x723 Speakers Mary Walsh, RN, BS, CRNI, Infusion Therapy Specialist Marilyn Bernard, RN, CRNI, Infusion Therapy Specialist Date Nov. 13 Important Information Time 5:30 – 8:30 p.m. (Light supper provided) Place MNA Headquarters, Canton for all courses Fee MNA members, $65 all others, $95 Contact hours* 3.0 Registration Registration will be processed on a space available basis. Enroll- Special notes Class limited to 20. ment is limited for all courses. MNA contact Susan Clish, 781-830-5723 or 800-882-2056, x723 Payment Payment may be made with MasterCard or Visa by calling MNA or Advanced Dysrhythmia Interpretation by mailing a check to MNA, 340 Turnpike St., Canton, MA 02021 Refunds Refunds are issued up to two weeks before the program date Description This course is designed for nurses who have had a basic course in moni- minus a 25% processing fee. No refunds are made less than 14 toring patients for cardiac rhythm disturbances and wish to enhance that days before the program's fi rst session or for subsequent ses- knowledge base with more complex monitoring of advanced dysrhythmias. sions of a multi-day program. The course will describe the EKG changes related to ischemia, injury, Program MNA reserves the right to change speakers or cancel programs and infarction, the EKG abnormalities associated with toxic drug levels Cancellation when registration is insuffi cient. and electrolyte imbalances. The course will conclude with an overview of pacemakers and common pacemaker rhythm disturbances. *Contact Continuing Education Contact Hours are provided for all programs Speaker Carol Mallia, RN, MSN Hours except “Advanced Cardiac Life Support” and “Anatomy of a Legal Dates November 18 Nurse Consultant” by the Massachusetts Nurses Association, Time 5:00- 9:00 p.m. (Light supper provided) which is accredited as a provider of continuing nursing education Place MNA Headquarters, Canton by the American Nurses Credentialing Center’s Commission on Fee MNA members, $45; all others, $65 Accreditation. Contact hours for “Advanced Cardiac Life Support” Contact hours* 3.2 and “Anatomy of a Legal Nurse Consultant” are provided by the MNA contact Susan Clish, 781-830-5723 or 800-882-2056, x723 Rhode Island State Nurses Association, which is accredited as an approver of continuing nursing education by the American Nurses Cardiac and Pulmonary Pharmacology Credentialing Center’s Commission on Accreditation. To successfully complete a program and receive contact Description This program will provide nurses from all clinical practice settings a better hours or a certifi cate of attendance, you must: 1) sign in, 2) understanding of how cardiac and pulmonary medications work. The be present for the entire time period of the session and 3) actions, indications, and nursing considerations will be discussed for the complete the evaluation. major categories of cardiac and pulmonary medications. Chemical Scents may trigger responses in those with chemical sensitivity. Speaker Carol Mallia, RN, MSN Sensitivity Please avoid wearing scented personal products and refrain from Dates Dec. 2 smoking when attending MNA continuing education programs. Time 5:00- 9:00 p.m. (Light supper provided) Place MNA Headquarters, Canton Fee MNA members, $45; all others, $65 Contact hours* 4.2 MNA contact Theresa Yannetty, 781-830-5727 or 800-882-2056, x727 v H.1282: Mandatory RN-to-Patient Ratios for Every Unit and Every Shift The Key to Protecting Your Patients and Your Nursing Practice

Currently, there is no law in place to ensure patients receive a level of nursing care that is Specifi c RN-to-Pa tient Ratios based on ac cept ed standards of nursing prac- Called for by H.1282 tice or on patients’ actual need for care. Instead, Intensive Care Unit ...... 1:2 nurse staffi ng is left to individual facilities to de- termine—and too often those staffi ng deci sions Critical Care Unit ...... 1:2 are driven by fi nancial factors. This has resulted Neo-natal Inten sive Care ...... 1:2 in dramatic cuts in nurse staffi ng levels and an Burn Unit ...... 1:2 increase in the number of patients each nurse is Step-down/In ter me di ate Care ...... 1:3 expected to care for. Operating Room House Bill 1282, An Act Ensuring Quality Patient Care and Safe RN Staffi ng, will reverse these Under Anesthesia ...... 1:1 trends by mandating that nurse staffi ng be suffi cient to care for the planned and unplanned needs of Post Anes the sia ...... 1:2 patients. Post An es the sia Care Unit H.1282 is based upon signifi cant nursing research and expe rience, in clud ing research docu ment ed Under Anesthesia ...... 1:1 Post Anes the sia ...... 1:2 in a 2002 edition of the Journal of the American Medi cal Association (JAMA). Accord ing to JAMA, the higher the RN-to-patient ratio in a hospital, the more likely there will be patient deaths or compli ca - Emergency De partment 1:3* tions after surgery. In addition, it was reported that each addi tion al patient per nurse was associated Emergency Critical Care...... 1:2* with a 7 percent increase in mortal i ty. The difference between four to six and four to eight patients per Emergency Trauma ...... 1:1* * triage, radio or other specialty regis tered nurse would be accom pa nied by 14 and 31 percent increases in mortal i ty. nurse shall not be counted as part of this Under H.1282: number. ✔ Specifi c minimum ratios in place that are the same for every shift Labor and De liv ery Active Labor ...... 1:1 ✔ Specifi c minimum ratios in place for every type of unit/depart ment Immediate Postpartum (one couplet)...... 1:2 ✔ All acute care hospitals required to adhere to minimum RN-to-patient ratios as a condi tion of Postpartum (three couplets)...... 1:6 li cen sure by the DPH Intermediate Care Nursery ...... 1:4 Well-baby Nursery ...... 1:6 ✔ No mandatory overtime or mandatory on call as a means of meeting ratios Pediatrics ...... 1:4 ✔ No fl oating of nurses without proper orientation as a means of meeting ratios Psychiatric ...... 1:4 ✔ Clear and strong language defi ning the role of the licensed nurse Medical and Surgical ...... 1:4 ✔ Hospitals prevented from delegating to unlicensed person nel duties that demand the exper tise of Telemetry ...... 1:4 a licensed nurse Ob ser va tion al/Outpatient treatment ...... 1:4 ✔ A prominent, public posting of the daily RN-to-patient ratios in each unit Transitional Care ...... 1:5 ✔ All facilities to provide patients/families with a toll-free number for the Division of Health Care Rehabilitation Unit ...... 1:5 Quality at DPH that can be used to report inad e quate nurse staffi ng Spe cial ty Care Unit: any unit not otherwise listed above shall be considered a specialty ✔ Standardized acuity system to adjust to increased patient needs* care unit...... 1:4

*Staffi ng ratios must be adjusted based on patient acuity. The patient assignments speci fi ed under these ratios rep re sent the maximum number of patients a nurse would be assigned. For example, if this law passes, no medical/ surgical nurse in Mas sa chu setts will ever be expected to care for more than four pa tients. However, to account for pa tient assign ments with a higher acuity, the law also requires that DPH develop a stan dard ized pa tient clas si fi ca tion system—or acuity scale—that will be used by all hospitals to measure acuity and, when nec es sary, require hospi tals to reduce a nurse’s assignment based on the needs of those pa tients.

781-821-4625 www.massnurses.org Supported by the Coalition to Protect Massachusetts Patients (as listed on Page 9)