MNA, RN I do understand probably more than you know. I have been an LPN for 6 years, have worked in a hospital for 8 years and I have also worked as a Scrub Tech in surgery. It is very scary, all of the situations, wondering if you did forget something. I have experienced a terrible dysfunctional environment and know what it is like. The hospitals are now wanting to become the Magnet Hospitals and one of them is Health East. They now have new RN positions out there, but they all require BSN degrees. I did talk with the RN Recruiter Coordinator there. Times are changing again. When I was an LPN then they were not hiring LPNs and now that I do have my RN, it is difficult to get a job or an interview, as an RN. I have experienced some of those things that you describe in your post. I have also been abused at the work place and set up in surgeries to fail, because the RN's in the department have been nasty. Everyone has been new at one time and I just feel that people are still people and they should not "eat their young". Sadly to say, employers are looking now for the BSN. I am not shaming anyone or any nurse, and I do want the nurses to get what they deserve. I am very disheartened that you feel that I do not understand what you are talking about. I am just about 50 years old, and I do have experiences that also have not been pleasant, and have made me physically sick. Not everyone is born with a thick skin, but that does not mean we do not stand up for what is right for the patients or ourselves. I truly wish I could come and help you at your bed side with your patients, and I would like to! I am sorry if I have offended you, that is not who I am and not what i meant to do. It just seems that there is so much anger out there and I truly hope that things can be resolved.

New Grad, How did this turn into a discussion about the merits of having and ADN versus a BSN degree and the difficulty you and your fellow grads are having finding a job? As I said, I am sorry you are having so much trouble and can empathasize with you as the job market was incredibly tight when I graduated from nursing school as well. I couldn't even get interviews most of the time. As for the club, like it or not that is how it is and when you do get a job you will find that even more true. We are a nasty bunch sometimes and do not hesitate to rip on each other. You are going to find that you need to develop a thick skin and be leery about who you trust. Don't sweat the BSN deal, that changes like the wind. Initially hospitals were hiring LPN's only then they laid off all the LPN's and replaced them with RN's. Then they pushed for RN BSN and still later they didn't care. Now there is an artificial glut so they are caring again. The shortage is still here, nurses are still getting older, retiring, quitting, etc. and those jobs will materialize. The end result of this strike will be creating more jobs as well, a lot of us are really angry and are exploring our options. Finally, I did not insult your critical thinking skills, I only asked that you tried to use them. Your original post was not only condescending (be greatful for what you have, be grateful you have a job, etc) but also shaming. Not a good way to kick things off. Like it or not you are totally green. You have no idea what it is like to be scared to death that you might miss something because you are so damn busy you can't keep up. You have never been yelled at by a patient's family because you took too long to respond to their needs due to caring for another critically ill patient. I have cried on my drive home more times than I care to count because I feel like I didn't provide the care my patients deserve and I have made that same drive many times with my stomach in knots worrying that I may have missed something. Yes I have a job and a paycheck for which I am grateful but my working conditions are really scary sometimes and something I had hoped would change. You really have no idea what it is like but you are about to learn.

Dear MNA RN, Did not mean to offend you or any others. I am not against the staffing ratio or any other stand the nurses are taking. Being a nurse is not a club that new nurses should have to join. We earned our degree just as the rest and every one starts out new. The freezes have been since the beginning of the recession. The acuity of patients in the hospital is also greater. People cannot afford healthcare and cannot afford surgery or care unless they have a grave need. The economy does have something to do with it. Employers every where are cutting hours and staff, even downsizing on the supplies once ordered. Where are the 4,210,000,000 nursing jobs that were to be available in June/July 2010? Veteran nurses are having to stay at their jobs longer because they cannot afford to quit, and taking on extra part time hours that new grads and unemployed could apply for. The economy does have an affect. Now it seems that the Associate Degree RNs are not good enough. There are more unemployed and employers are using that. Leaving job postings out there for 6 weeks and calling back for second interviews only to make people wait another 8 weeks or longer for a decision to be made. Also, since so many people in my area are out of work, there is always someone who has just a little bit more experience that gets the job. I also always have to travel 60 miles one way to work. It is what I have always done. I have applied at many nursing homes, clinics and hospitals, only to find out that the employer wants a BSN Degree. This is all a bit disheartening when you cannot afford to buy toothpaste/food or other essentials of life, How does one gain experience when no one gives you the chance. Please do not insult my critical thinking skills. I am not totally green. I know that you are trying to make it better for all nurses. I have new nurse grad friends that still do not have jobs from last May 2009. Seriously, to have a job right now is a blessing.

New Grad: I hate to break it to you but the hospitals have been on a hiring freeze since the start of the recession. Now lets use some of those critical thinking skills you have just been taught. If the nurses obtain minimum staffing ratios then more staff will be needed so there will be more jobs available. You can understand how that would benefit you right? You should be behind us and hoping for us to succeed rather than buying into the hospital propaganda and attempting to shame people that are in the profession you are hoping to join. Your husbands lack of employment, although unfortunate, is not the nurses fault. Nor is the fact that your savings is gone. I am very sorry that you are having such difficult times right now but attempting to connect the two is really quite silly. Finally, here is a tip for you, when I graduated nursing school and passed boards the job market was tight as well. I got out the phone book and called every hospital and nursing home within 75 mile of where I lived. I found a nursing home that was hiring but had not put an ad in the paper. I got the job and drove 80 miles round trip for two years. I suggest you try doing the same

I am in awe that as nurses both mna and temp that we are attacking each other. We should support one another and be respectful. How dare one criticize nurses for having enough balls to stand up for patient care and what they beleive in. MN nurses have worked long and hard to get where we are and that is what makes mn nursing care so great. Maybe if you did the same down south your working conditions wouldn't be as they are. I am very appreciative to have a job and i love what i do but i will not be pushed around and allow my patients to receive less care then they deserve. Yes i am very effecient and manage my time well but patient acuity has increased so much. People are living through disease and illness that they would have never had a chance to survive in the past. Patients now are so complex with their medical problems that they require much more time, care, and compassion. Not to mention family dynamics that create a lot of time and management. Patients are not getting the emotional, holistic, and mental support that they deserve. Nursing is not just medical it is also mind and soul. I have no problem with nurses that come to care for patients while we strike because they need you guys. I have heard disturbing stories from our aides about the quality of care that they have received while on strike. Vents not being payed any attention to, charting not done and meds not given. I heard that some were too busy taking pictures in the hallway with there new friend instead of focusing on patient care. I am sure there were only a select few. But as a nurse it is our duty to advocate for patient care and if one is not willing to do this then they shouldn't be a nurse. If CEO's are making millions then i don't want to hear there is no money.

I am a new grad who passed her boards in March. Our market here is saturated. My husband and I have been unemployed for 7 months. Our savings is gone. I would gladly take a nursing job available, if I could get one. The nursing strike has caused freezes as well as, our economy. To have a job in this economy is a blessing. Go to work,be grateful for what you have, take care of you patients with compassion. It can all slip away in a mater of months. Work for God and not for man. Disheartened New Grad RN, WI

Vulcanus Rex, this article and my response relates to the failure of the doctors to get behind the nurses on the staffing issue and support us as well as their failure to understand fully what the staffing issue actually is. Since you seem to have failed to grasp that fact I will respond briefly to your nurse / union bashing. No we have not rescinded all of the bargaining points you mentioned nor do we plan to. I would like a cost of living raise of 2% just as all of the non contract employees are receiving. The cost of my utilities, groceries, gas, etc are increasing just as everyone elses is. Also, before you start carrying on about step increases, by the TCH own admission less than 40% of nurses get a step increase so without an annual 2% raise more than 60% of us get nothing. As for RN's getting benefits at .5 "just like everyone else" my question is did "everyone else" voluntarily decrease their FTE to .4 at the employer request to save jobs and is "everyone else" now being thanked for that by having their benefits pulled out from under them? I work at a .9 so this really has no effect on me personally but it seems inherently wrong. As for the benefit and pension question, I actually agree with changing from the pension to a 401 K with a match and that our health insurance should not be better than the non contract insurance. Unfortunately the hospitals are not interested in talking about alternatives to the pension and the majority of my peers are not interested in talking about the health insurance, The flu shot issue? Non contract folks including lab techs, Xray techs, etc who have just as much patient contact as nurses are not mandated to get a flu shot so why should the nurses be? On a personal level I agree with the concept but on the larger this is still America level I don't. Finally your assertion that the hospitals would be willing to talk about staffing if we gave everything else up is simply not true. They won't even give on the issues that will cost them NO MONEY because they are trying to prove a point.

First off, let me just say that I value my employer, I value my job, and I stand behind my hospital's mission of providing high-quality, compassionate, cost-effective healthcare to the community we serve. RN's are on the frontlines of patient care. We are the central component of the healthcare system. We are continually being asked to change the way we practice, and for the most part have adapted well. But more and more is being expected of us. Nursing is on an upward trajectory with regard to complexity, workload, and job stress. No Twin Cities nurse would fail to notice rising patient acuities, shrinking lengths of stay, and heavier patient assignments. The factors that threaten patient safety in the first place are DAILY taking their toll on nurses. With all due respect ICU MD, you are NOT on the floor to witness these things. WE are. We want to do our job, do it right, and to the best of our ability. But many times we feel like frauds. What do physicians know about a typical floor RN's shift? Please allow me to enlighten you...My assignment last week consisted of 2 total care patients, both needed to be turned every two hours to prevent skin breakdown. Both had G tubes and each had over ten meds (to be crushed and flushed down the PEG) due at the same time. One of them had to be suctioned hourly to prevent respiratory distress and possible aspiration. Meanwhile, I had to discharge two patients, and recieved a fresh surgical and an admit from the ER. Hmmm if I'm doing the math corectly, I had a total of six patients on one evening shift. Don't forget to add in all of the paperwork, charting, physician's orders, dealing with patient's families, and oh yeah that little thing called patient care. Do you think that in juggling all of those responsibilites that it is possible that ALL of my patients got the best possible care that day? What if you were the patient that unintentionally slipped through the cracks? What if that patient was your loved one? Do you think that I enjoy leaving work knowing that I couldn't possibly give at least one of my patients the kind of compassionate, efficient care that I strive to give EACH and EVERY one of my patients. Do you think I enjoy leaving work telling myself, "tomorrow's shift has got to be better." Well ICU MD, newsflash, it's not getting any better! We need help! And please do not confuse that phrase with us wanting "to do less work." You do not know the reality of what it is to be a floor RN. And if you think for one second that a raise is the driving force behind this strike you aren't giving the 12,000 Twin Cities RN's the respect that they deserve. We know that we aren't getting raises. We are however hopeful that something good will come out of us having to make the heartwrenching decision to "leave" the bedside. We hope that we did not make that decision in vain. We are asking for one extra nurse per shift per floor. Where is the shame in that? Vulcanus rex, maybe the hospitals should cut some of the "top heavy" middle management jobs and give us the help we need and deserve on the frontlines.

I am an RN who also worked the one day strike. I worked at United Hospital and the managers are absolutely wonderful. We were all made to feel very welcome by all. I work at a hospital in the south and I can tell you about short staffing. I have been the only RN on the shift with my only help being on call. I have had to take care of several patients all alone, but I was able to work in a timely and efficient manner and still get all done that needed to be done, and above expectations at that. Yes, there are times when we don't get an official lunch break, but this is to be expected at times. I actually think the busier it is, the better. It makes the time go by faster. But if you want to continue to strike and whine for more money and staffing, that is fine by me. That way I can get paid awesome money doing what I love to do.... Taking care of people. So stay at home without pay and let the smart ones reap the rewards!!!

So, MNA RN, since you choose only to write about staffing, are we to assume that the MNA will cede all other bargaining points? That MNA will agree that, in the interest of patient safety, RNs shall get annual flu shots, unless medically contraindicated? That RNs will agree to no pay increase except step increases? That RNs will get benefits at 0.5 FTEs like everyone else? That RN pensions/retirement pay will look like all the other hospital employees? If so, I bet that the Twin Cities Hospitals would look more carefully at fixed staffing ratios. But so far the union talks about staffing to the public, but keeps all those other issues hidden from the public.

Janet, apparently someone needs to contact the author of that study and let her know that the study is inherently flawed as staff is not needed at night because the patients are all sleeping

I have read this study and the authors highlight many possible explanations for their results including the lack of witnesses, fewer physicians around, and the nurse staffing at night being less experienced. To emphasize one explanation over others is disingenuous. It could be any or all of these or something else entirely-like the possibility that there tends not to be hospital administrators around at night which might be protective to patients.

I find the comments from the MD's here regarding the hard work of the nurses heartwarming and your lack of understanding regarding the staffing issues NOT surprising. I think most of the doctors in the affected hospitals probably agree with you. Make no mistake however, this is not because the staffing issues are not a problem, rather it is just that the nurses are really good at making it appear that it is not. Doctors do not care how something gets done, they just want it done. Nurses walking a fine line between maintaining and chaos is not their problem. Nurses not being able to use the restroom, eat, or even drink a glass of water not their problem. Nurses driving home in tears because they feel like they didn't do a good job is also a non issue for them,. As long as when they arrive to see their patient all of the tests are complete and available and the cares are done, life is good. Child Care providers, jailers, and teachers all have minimum staffing ratios but the nurses are lazy and greedy when we ask for the same. Nurses save the doctors backsides every day but that doesn't matter. We run interference with families and patients, identify early signs of trouble, and catch mistakes before they reach the patient. None of this is important because after all they are the doctor. We are only a team when they need something from us. When we need something from them we are on our own. So you are 100% correct Mr Lee, their silence is deafening.

Mary Ann Peberdy, MD, et al., JAMA, February 20, 2008 A national study on the rate of death from cardiac arrest in hospitals found that the risk of death from cardiac arrest in the hospital is nearly 20 percent higher on the night shift. The authors highlight understaffing during the night shift as a potential explanation for the death rate. “Most hospitals decrease their inpatient unit nurse-patient ratios at night… Lower nurse-patient ratios have been associated with an increased risk of shock and cardiac arrest,” the authors stated.

I am a private practice physician working at some of the hospitals subject to employment actions by the MNA. First, Mr. Lee, you should know that the Minnesota Medical Association is not a union, but a professional organization. Physicians, whether employed or self-employed, are not required to be MMA members, and the MMA does not negotiate employment contracts for physicians. Only about half the physicians in Minnesota are MMA members. Second, after patients, physicians know better than anyone how integral our wonderful Minnesota nurses are to providing care for these patients. HealthEast Care System, which has three hospitals subject to work actions, was named one of the Top 10 Health Care systems in the country by Thompson-Reuters, in no small part to the combined efforts of nurses, physicians and the administration. For nurses to say that quality is compromised, well quality can ALWAYS be improved upon. Our nurses work darned hard, and the administration should recognize this. But nurses also need to recognize the constraints that hospitals face with reduced reimbursement from state and federal sources. They operate on razor-thin margins, and investment gains can quickly become investment losses. They should not be counted on as part of operating income. Finally, if the nurses are really all about patient safety, then why are they bargaining to be EXEMPTED from getting annual flu shots, which clearly protect patients and staff? The only one busting up the union is the union itself, through its unreasonable bargaining positions. Minnesota nurses are being used as pawns for the greater goals of the NNU to attract other nursing units around the country. Unfortunately for all involved, there strategy is going to backfire in Minnesota.

Mr. NLRB KNowledge, Please do share your profound grasp of the law and delineate what charges are ill suited to be considered a ULP. As a practicing attorney, if i do not have the facts I would never make unequivical statements about how the law will be applied unless I had the facts and even then I would issue a qualification.. Since you suggest that you are well versed in labor law as well as the facts sorrounding pending ULP claims. Please take a minute and list the bogus infractions as well as any relevant administrative decisions that would be applicable. The legal community awaits your incisive reply.

I am an RN that was at the strike also..we were not impressed with the condition our patients were left and we were thinking of writing up each and every nurse that left her patient in a dirty room with linens overflowing..pt was in isolation..Orders for labs were entered one part of a chemistry at an hourly rate..in other words sodium order alone and potassium order an hour later and so on and so on..the patient had a low H&H and if I had followed this prank my patient would have by the end of the shift been lower in blood volume over the sixteen hours of work. I fixed it and the patient was not impaired due to someone's idea of a joke. This is putting a father or mother, wife or husband life at risk for what I ask? It was not funny to me and if I had shared this with the family I think someone would be receiving in the mail a letter from the Board of Nursing and also the lawyer of the patient with some very serious charges in the letter. Nothing is worth loosing your license over and most importantly someone loosing their love one. I am shocked to have to tell you this but I am returning, yes to take care of the very patients you are walking out on and I wish I could take you home with me to see what we are sealing with where I live. Many nurses in the country are out of work. Many of nurses and their families are selling their homes but guess what? No one is buying. Times are hard in the country and maybe it has not hit you in this state but it is coming and it will be here faster than you will have to prepare for it. I think you have to weigh all things today and make the best of what you have now. Because you might not have it tomorrow. I have friends in New Orleans they never in a million years thought the oil spill would put so many of them out of work so quickly. None of them have no hopes for the future because the spill is still on going as you all know. These things I hope do not happen to you all. In another way you do not have the same situation. But we are all in a critical time now and we need to work with each other more than ever before. The times of having everything we want when we want it are coming to an end. THink about your patients and stay with your hospital and give the best care you can or you might find that there will be no jobs in this area for you. I never thought in a million years that as a nurse there would be a shortage in jobs. But there is and more shortage are coming. Keep your jobs nurse of Minnesota. I think you need to know this and maybe the union and coworkers have not let you know that this is something you need to do for now. Unions in other parts of the country have caused closing of male dominated workplaces, yea not female dominated workplaces, to close down fast and hard. Think about the quality of life for your patients and I am sure that your quality of life will be better for it. I could use the work you will give me if you strike. But I would rather see you learn what we already know before it gets too late for you all to see the light. You need to keep your jobs in this time of our country's crisis. It is much bigger than the one you are facing in your state.

Enough. To strike under the public guise of "staffing concerns" and worse yet to "sell" that ideal to your patients as a fear/intimidation factor is disgusting at best. This is about money, pure and simple. Anyone who claims otherwise is either lying or delusional. The charges filed with the NLRB are a joke. The union, with forethought and malice, chose not to respond to the hospital's notice regarding staffing following the strike (which was prudent and correct as after weeks of public announcements the hospitals knew their patient levels would be far lower than normal during this period) though they had a very long period of time to do so. Instead, the union knowingly ignored the communication (which did not follow the letter of the contract but absolutely was clear and precise in language and admittedly received with much advance notice) choosing to wait until the hospitals turned away unneccessary staff follwing the strike in order to be able to file charges. This hurt their "members" as well. This was a set up. Shame on the hospital's attorney(s) for not forseeing this act of manipulation on the part of the union. The ultimte price paid if there is an NLRB fine will be paid by the patients in their charges. Just as the ultimate price for an exorbanant pay raise will be covered by patients. What I would love to know is why the nurse's union, in this climate of pay freezes or cuts throughout the industry, feel they deserve a raise of such large proportions above all others and at the expense of others? Are their jobs so much more important than all other hospital employees? Is it not clear that at hospitals without union nurses the care is as good or better? Regarding the NLRB: Judges are appointed, not elected. They are in the union's pockets. It is NOT in any respect an unbiased court. The union will likely prevail there and yet another injustice will be served. All nurses striking: You ought to be ashamed of yourselves. You are holding patient care as a threat over cash. Many are afraid to go to a hospital where you are in fear that you won't do your job correctly at this time. You have accomplished the mistrust of your patients and community. Nothing more.

Unions and strike mandates tarnish the professional status and community respect that nursing has worked so hard to establish since the days of Florence Nightingale. We have a responsbility to care for patients. Abandonment is intolerable. Yes, 4:1 and 5:1 med/surg patient ratios and 2:1 ICU patient ratios are an integral piece in providing a safer environment of care. However, temper tantrums such as strikes are inappropriate methods to use to influence change. Study the research or engage in your own, share the results of those studies with anyone who will listen. Speak to your legislative representatives, write letters to congressmen and newspaper editors, provide and share that evidence to support your beliefs. Losing some benefits is the nature of the beast in this economy. I gladly took a 2 year pay freeze if it meant securing the jobs of my colleagues and other employees of the hospital. As a healthcare professional caring for people at their most vulnerable, patients and their families place their trust in you and the other members of the care team to provide that care. Walking out and abandoning those patients breaks that implicit trust placed with you. Sadly, there are clearly more and more people that entered the nursing profession for monetary gain more so than a passion for caring for others. Shame on you.

As a nurse who has worked both patient care and management (not in management currently) I find this very frustrating. Break the union? What are you talking about? Force a strike? I don't know what lies you are listening to, but you are perpetuating a mindset that will do nothing but destroy nursing in the long run. Like the traveling nurse who has seen other parts of this country, I too have traveled. In MN we have the BEST care outcomes in the country and the BEST working conditions. Some doctors in the Twin Cities have been forced to take a 10% cut in pay without a decrease in work because of the economny. This isn't about trying to break the union or nurses. This is about how do we fairly treat staff and keep a healthy bottom line. Hospitals made money last year, but there are more mandated reimbursement cuts coming and this strike you support will cost more than you realize. Hospitals won't be able to keep providing all their current services so patients will get less care and there will be fewer nursing jobs. The mandated staffing ratios is just plain wrong. Especially with the demands that units be staffed as if they were full. You talk about saving money by accomplishing things faster. There will be no money saved if hospitals can't send nurses home when the work is done. The staffing ratios will increase the cost of care and escalate the impending nursing shortage. I know when I first came to MN I was shocked and embarrassed with how small my patient care load was. I realize that we nurses work really hard and sometimes the intensity is overwhelming, but this is taking the pendulum too far the other direction and will do much more harm then good. Our patients get the best care in the country and yet, you call this a strike for patient safety? Open your eyes and see what this looks like from the outside. No other profession can get full benefits and only work half time AND make a living wage doing it. We're not the only ones who work nights, weekends, and holidays. This is not helping the image of nursing. The hospitals have bargained, but the union doesn't want to let you know that because that weakens their own self-serving agenda. If the hospitals do what MNA wants, health care costs WILL go up.

TO ICU MD: You're right - The staffing ratios in the ICUs are not the issue and those are not the ones we are asking to change. I know you must have had a patient transfer back to the ICU for the purpose of closer monitoring and more intensive nursing care. In the step down units, telemetry, and general care is where alot of the problems arise. This is the place where the critical work of strengthening, recovery, teaching, and discharge planning is done. If these areas have better nurse staffing, those things will be accomplished better and faster - thus, saving healthcare dollars. (And lives) I don't know how many times and in how many ways we have to say it - this is not about the money - that is a bargaining chip. The proposal hasn't changed because the TCHs won't bargain. It has become painfully obvious that they simply want to force a strike in order to bust the union. We won't let that happen, but if it did, Twin Cities Hospitals would cease to be national leaders and end up no better that those "other states" that you suggest we try. Teamwork??? Collaborating is great, and best for our patients isn't it? Common Doc - Walk the walk!

I am one of the nirses that worked the strike. I have to say the way the nurses were towards their own patients they left with orders not filled and hiding equipment from us that we needed to care for their patients they say they care about, is a hard story for me and many of my coworkers that had the same situation handed to them. We managed well thru it all and most of the families say they were glad we were there to take care of their love ones. I think that your thoughts expressed for your patients are not the same thing we found when we worked there. I found like most all of us that worked the strike found the hospital administration the best we have ever worked with in a strike situation. The pharmacy, doctors and all the staff that we worked with were the best I have ever worked with in a strike and not in a strike. I think Minnesota is a beautiful state. I loved the people I met ther and many of us would love to move there and work in your hospital. Maybe because lots of us do strikes and travel, gives us a better outlook of what is out there. We have seen many hospitals in good times and bad. What we saw was better than most nurses have around this country. I have been out of the country also. Nothing compares to what you have her in Minnesota. I hope when you walk out that this time when we return that we will see you leave your patients you care about in better shape than we found them in the recent strike. No matter it only made all of us who handled the bad situation look better to families and patients, not to mention all the staff that we worked with that one day. You should listen to ICU MD they speak the truth about what is going on in this economy. Nurse ratio is a problem everywhere. In the South it is something you would not believe. California has a big problem also..but we make it work because we are nurses and we do all care for our patients. I do not mind crosssing the line to care for your patients but know this they know what and how many of your nurses dumped on them for your own self interest which is money. Not all of you did this but a large amount of you did. You are not being fair to your patients that you say come first..it is hard for us and your patients to believe that statement. Maybe you could show your patients that you do care and have all the equipment like needle containers and medications , labs orders entered and most of all give a report to us that is not all over the place not like you were trained in nursing school to go thru the systems and give a good report so the care can be continued in a timely manner.

Registered Nurses do not need the voice of physicians to validate their professional concerns. No one knows as well as nurses that their patients are suffering the consequence of poor care from unsafe staffing, not even physicians.

Janet, I appreciate your thoughts on why physicians have been silent regarding the current contract negotiations with the TCH. I do, however, have a different opinion. This opinion is based on actually being a physician at one of the TCHs where nurses are under contract negotiations, speaking with numerous other physicians at the same TCHs, and working during the period of time that MNA nurses chose to strike requiring the hospitals to bring in replacement nurses from across the country to care for our friends, neighbors, and family members in their time of need. I hope that the nurses that I work with routinely in the ICU do not believe that I have been "socialized" to believe that nursing is incidental to patient recovery. We have a team approach to the care of our patients and nurses are an integral component. I depend on my nurses and trust their opinions. I find your statement about the reason why physicians have been silent to be ridiculous and wrong. Most physician groups and hospital employed physicians have had to re-negotiate their contracts over the last year due to changes in both the economy and reimbursement for patient care. While unhappy about it, all physicians that I have spoken with understand that change is here. These changes generally include working more and making less although I have heard that some groups can work more to keep the same reimbursement level. What the MNA is asking for is working less (Mandated staffing ratios) and making more (Raises over the next 3 years). That won't fly in the current climate. Interestingly, I have yet to meet an ICU nurse that is concerned about staffing ratios. Our hospital already meets, if not exceeds, the staffing ratios required by the NNU for negotiation. The hospitals in Minnesota are some the highest rated hospitals in the nation in patient care, nurse to patient ratio, and nurse reimbursement. I have yet to work at a Twin Cities hospital that I felt there was a nurse staffing issue. The nurses I speak with, however, are very concerned with their pension benefits, and understandably. Ultimately, I support trying to come to an agreement with salvaging some sort of pension that doesn't cripple the mission of these non-profit organizations. I don't support the NNU push for nurse staffing requirements as proposed and have yet to meet a physician who does. Unfortunately, the staffing requirement is the goal of the new union that MNA has alligned itself with. Good luck, but if you won't work here I think you are going to be very unhappy working as a nurse in a different state. Perhaps a different job is best for you. Just don't expect to get a pension, 100% health care benefits and annual raises during a recession while demanding to do less work.

The nursing professionals have historically taken a lot before they rebel and the MD's know it. Best they keep quiet and let the nurses battle out their own issues. This should be an important issue for the medical doctors, but since they are socialized by their own mentors and peers to believe the nursing is incidental to patient recovery their silence is not surprising to most of us.