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Star Tribune business columnist Evan Ramstad was right to compare Minnesota and Florida. Both states have made lasting decisions on who they care about and what kind of state they want to be. ("Mayo Clinic was right to fight the Legislature," May 24)
On almost every other point, Ramstad is fundamentally wrong.
This year, Minnesota made monumental progress in education, health care, criminal justice reform, human and civil rights, reproductive freedom and worker protections.
Florida, meanwhile, has become a hostile place for teachers, librarians, immigrants, BIPOC and LGBTQ residents, unions and more. Last year, Disney executives spoke out against Gov. Ron DeSantis's horrific "Don't Say Gay" bill. That decision resulted in a series of vengeful threats aimed specifically at Disney, the state's largest employer, which then said it would reconsider or take its planned business expansions elsewhere.
Here in Minnesota, when legislators considered long-sought compromise to bring nurses and hospital leaders together to agree on how best to staff facilities and care for patients, the Mayo Clinic threatened to pull billions of dollars in promised investments in Rochester if it was not given a specific exemption.
Evan Ramstad thinks these two situations are the same. In fact, they are not, and the comparison is offensive.
The Keeping Nurses at the Bedside Act was built to give nurses a stronger voice in hospital staffing plans in order to bring back and retain the nurses leaving hospital practice. This was evidence-based policy that mutually benefits hospital systems and the staff who work there: Safe staffing conditions helps retain nurse, improves quality of care and increases the bottom line. It is the powerful marriage of caregiving and strategic business of health care.
The bill was heard in multiple committees in the House and Senate throughout the legislative session. When the proposal moved closer to passage, Mayo issued an ultimatum by demanding an exclusion from the law. It's not the first powerful corporation to do so, but it is wrong: We are not a state of corporations, we are the state of Minnesota. Our laws must apply equally.
Naturally, other corporate hospital systems objected loudly. The debate among corporate competitors subsumed the purpose of the legislation; retaining nurses and safe patient care. Once it did, the bill died.
Ramstad wrote that acquiescing to Mayo's demand regarding a stronger voice for nurses was a smart business move. What he didn't share is the well documented contribution of skilled nursing to a hospital's bottom line. Patient falls, hospital acquired infections and skin ulcers are all nursing sensitive indicators that are directly related to staffing and costly to patients and hospitals. So is perpetual hiring and training to replace the burned out nurses who are exiting because of management's staffing decisions, which are creating a professional dilemma for nurses and risking patient safety.
This corporate hijacking of the effort to retain our skilled nurses to care for our loved ones in our hospitals will be remembered as part of the unfinished work of the 2023 Legislature. Our schools of nursing are preparing new nurses. Minnesota has plenty of licensed nurses but the hospital vacancy rate is chronically high as nurses leave the practice of hospital nursing.
If you listen to the trusted voices of nurses, they are leaving because of persistent short staffing. Short staffing risks patient safety, putting nurses at odds with the law that licenses them and the Code of Ethics that guides them. It is why they continue to raise alarms and act for change.
There is a growing and dangerous gap between the business of health care and the care needed by patients. Registered nurses are required under law to refuse an additional hospital patient if, in their judgment, the patient's life, health or safety is at risk. But when patients are admitted and a nurse refuses, they are often pressured, sometimes bullied and sent home from a shift if they don't comply. The power imbalance is real with little protection against retaliation and a nurse's professional and ethical responsibility becomes subordinate to their boss' demand. This is how patients get hurt. Our hospitals' business model has to include adequate nursing staff and patient safety if care is to remain at the center of health care.
When you enter hospital facilities in Minnesota, chances are you'll be greeted by beautiful art, baby grand pianos and fancy marketing campaigns. But maybe hospital executives should reconsider their decisions and put those resources back into caregiving. And if executives aren't willing to invest in adequate staffing, then nurses will continue to advocate and fight for their role in keeping patients safe. It is their professional obligation in a system that is no longer solely about care.
It is true, as some have observed, that a certain hospital in Minnesota is known to care for princes and princesses. But to act like their nurses don't deserve to have a voice in their staffing, or that Mayo's exertion of corporate power is similar to what's happening to Disney, is believing in a fairy tale.
Erin Murphy, DFL-St. Paul, is a member of the Minnesota Senate.
