Massachusetts Nurse Newsletter :: October 2004

October 2004 Inside… Single payer health care: Incremental approaches do not work..................................2 Health premiums rising ...............3 THE NEWSLETTER OF THE MASSACHUSETTS NURSES ASSOCIATION www.massnurses.org VOL. 75 NO. 8 President’s column: MNA focuses on latest industry strategy to avoid ratios, boost reimbursements Looking back, looking ahead.......3 MNA on Beacon Hill ....................4 As nursing crisis continues, hospitals turn to Magnet program By Mary Crotty consultant-driven process that is being used Labor Relations News Associate Director of Nursing to give the illusion of nurse empowerment,” Understaffing problems In the wake of an onslaught of studies and said Karen Higgins, RN and MNA president. at Taunton State Hospital .........4 reports detailing deplorable nursing care in “The fact that Magnet status is being used as NLRB ruling favors MNA hospitals and a massive exodus of nurses who a public relations gimmick to avoid providing nurses in Western Mass............5 are refusing to work under such conditions, safe staffing levels and that it is trading on and in the face of a growing movement by the public’s trust in nursing as a vehicle for Health & Safety nurses, the public and legislators for the marketing have raised concerns among our Carbon monoxide detector imposition of mandated RN-to-patient ratios members and the Board of Directors.” saves life of MNA staffer ...........8 to correct these deficiencies, the hospital The MNA’s Board of Directors started industry has increasingly turned to a volun- an extensive evaluation of the Magnet pro- Importance of flu vaccine tary “JCAHO-like” process of accreditation gram and its impact on nursing in general for health care workers..............8 and validation of its nursing programs. This and MNA members in particular. This issue designation, known as “Magnet recognition” of the Massachusetts Nurse is devoted to an Special report on has been around for years, but more recently initial and detailed backgrounder on the Magnet status.......................10-12 has been embraced by hospital and nursing Magnet program for our members. In the administrators as a means of boosting public coming weeks, the Board will be finalizing MNA member benefits ..............13 confidence in their nursing care, improving and producing an official position statement retention of its nursing staff and, perhaps on the program. In this issue you will find a Continuing education.................14 more importantly, increasing its reimburse- history of the Magnet program; an analysis ment for services by the federal government of how the Magnet program and unions Peer support for nurses.............15 and private insurers. members have asked for information about match up; and a first-hand account of one Here in Massachusetts, two this program: what it is, what it means for MNA bargaining unit’s experience with the Labor Education & hospitals Massachusetts General Hospi- nurses, and more importantly, for infor- Magnet process. Training survey ..........................17 tal and Winchester Hospital have achieved mation on its viability as an approach to “Magnet recognition,” and a number of other addressing the problems nurses face in What is a ‘Magnet’ hospital? Benefits corner ..........................18 hospitals are involved in the process of seek- their practice and in their workplace. For In the early 1980s, in reaction to pressure to ing recognition. Hospitals formally seeking unionized nurses, where the union is the resolve a nation-wide nurse staffing crisis, the recognition where the nurses are represented primary vehicle for addressing concerns of American Academy of Nurses (AAN) identi- by the MNA include Jordan Hospital, Dana nurses, nurses have questioned if and how fied a number of hospitals that demonstrated Safe RN Staffing Starts Farber, Caritas Norwood, Newton-Wellesley the Magnet program can be incorporated into a better-than-average ability to attract and and Northeast Health System (see associated the labor-management process. retain professional nurses. They also studied at the Ballot Box story on Page 10 for details of Northeast Health “We have real concerns about the legiti- factors associated with higher staff retention Systems’ pursuit of Magnet status). macy of the Magnet program, especially in rates. The term “Magnet” came into popular In response to this activity, many MNA light of the fact that it is yet another expensive, See Magnet, Page 12 Government report finds JCAHO more ‘lap dog’ than ‘watch dog’ By David Schildmeier are required in order to receive Medicare and they spend months preparing to get As hospitals continue to promote their payments—a monetary figure that totals ready. Staffing always improves around the ote “quality care” based on accreditation by the more than $109 billion annually. Here in time of a JCAHO visit, and it goes right back Joint Commission on Accreditation of Health Massachusetts, the Department of Public to normal (usually bad) immediately after. Care Organizations (JCAHO), the Govern- Health accepts JCAHO accreditations, which What good is a voluntary system?” Tuesday, Nov. 2 ment Accounting Office (GAO) has released occurs every three years, as deeming a hospi- The credibility of a voluntary process of a report that found that JCAHO regularly tal “safe.” The DPH will only investigate the accreditation takes on added significance for See Page 6–7 for details. failed to identify “serious deficiencies” at quality of care at a facility after something nurses as many hospitals are moving to the hospitals—problems later found by state terrible has occurred. “Magnet Program,” which is a JCAHO-like inspectors that could “potentially compro- The organization has long been criticized process that was created by ANA and that mise patients’ safety.” for its lax system of oversight, and in 1999 a applies a similar process to nursing. In response to the GAO report, a bipartisan Department of Health and Human Services Based on a survey of 500 hospitals For the latest group of lawmakers introduced a bill under report issued a scathing indictment of the inspected by JCAHO between 2000 and 2002, which Medicare could restrict or remove the JCAHO process of accreditation, saying it the report found that the organization failed developmentsFor the latest authority of JCAHO to accredit hospitals. failed in its mandate to protect the safety of to identify 167 of the 241 deficiencies state impactingdevelopments nurses, “Congress expects the Joint Commission to patients and was too closely aligned with the inspectors later found at the facilities, or 69 impactingvisit the nurses, be a watchdog,” said Sen. Charles E. Grass- industry it was charged with overseeing. percent of the total. Deficiencies that JCAHO visit the ley, an Iowa Republican and one of the bill’s Nurses are among those who have long failed to identify included a Texas hospital MNA Web site, sponsors. “It looks like the Joint Commission criticized JCAHO and the system of oversight that failed to manage a serious infection con- www.massnurses.orgMNA Web site, is instead a lap dog.” for the hospital industry as a complete joke trol problem; a California hospital that had www.massnurses.org JCAHO is a private nonprofit organiza- and an utter failure. no system to ensure sterilization of medical tion that has been granted the authority to “Every front-line nurse knows that JCAHO instruments; and a another Texas hospital ensure that health care organizations meet is a total joke,” said Karen Higgins, RN. “The that administered medication without a the patient care and safety standards that hospitals are given notice of pending surveys, See JCAHO, Page 11 Page 2 Massachusetts Nurse October 2004 October 2004 Massachusetts Nurse Page 3 Nurses’ guide to single-payer reform Incremental approaches to solving the health care crisis won’t work benefits, increasing co-pays, or drop- as Medicaid, which is currently facing Pay or play—a ping coverage for employees altogether. cutbacks due to state budget deficits. 3 failing A Bureau of National Affairs survey in • Small employers in particular face high useless diversion January found that higher deductibles cost and administrative hurdles arrang- are a bargaining goal for 43 percent of ing coverage for their employees. prototypes By Rose Ann DeMoro employers with such provisions, and 17 The barebones nature of a program Executive Director, California Nurses Assn. percent without deductibles intend to financed by employer taxes cannot provide By Peggy O’Malley At a moment when the public response to introduce them. full coverage to vast numbers of people. A In reading newspapers or review- the present managed care system of deliv- • The multi-tiered marketplace of insur- number of them wind up in emergency ing any policy initiatives that address ering health care services ranges between ance plans—the very opposite of a rooms— the most expensive way of delivering covering the uninsured, you often see a apprehension and disgust, and support single standard of care—pushes the care. Thus, the problem of “uncompensated least advantaged workers into the care” remains, resulting in continued cost number of approaches. Of all of them, grows for doing something really meaningful to change the situation, along comes some- lowest tier, into underinsurance, into shifting by hospitals and other providers only single payer guarantees truly uni- thing with the catchy title: “pay or play.” lesser quality care. and raising

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