Rural Hospitals Worry About Nursing Standards Plan


By Danielle Killey

Rural hospitals could suffer under a proposal aimed at improving patient care, some health care officials and lawmakers say.

Ely hospital administrator John Fossum said a bill that would set state standards for how many registered nurses are on duty “could kill people.”

He said hospitals that would be considered understaffed under the propposed standards might have to send patients to other facilities, and the closest hospital to Ely’s is 50 miles away.

“We’re small and we’re remote,” he said.

Bill author Rep. Joe Atkins said this version of a proposal that has been in the works for years does not set specific quotas for hospitals but focuses on general staffing standards. He said those are necessary to protect patients.

“We’ve got some folks who are doing a great job, but we’ve also got some situations that are downright scary,” the Inver Grove Heights Democrat said. “There’s situations that arise where the numbers are just so far off patient safety is at risk.”

The bill received support from some health organizations, including the Minnesota Nurses Association. Individual nurses also have said the bill will help them provide better care.

“The patients in our care deserve consistency,” Fairview Southdale registered nurse Julie Uzlik said.

Each hospital would be required to create a committee to handle staffing levels and the Minnesota Department of Health and some medical associations would weigh in on standards.

The bill would prohibit hospitals from laying off employees because of any staffing requirement changes.

Rep. Andrew Falk, DFL-Murdock, successfully made a change exempting critical care hospitals, which are smaller facilities often in rural areas, from the staffing requirements. Other rural hospitals still would be affected by the bill.

Atkins said he expects more discussion on the rural issues in upcoming committee hearings and the details of the bill, including the exemption, could change.

“I have not once heard from a single patient, a single nurse or a single hospital in a rural setting (about) the need for this,” Rep. David Dill, DFL-Crane Lake, said.

But, he added, he has heard from Duluth hospitals that there are staffing issues there.

Fossum and other opponents said the bill would increase costs for hospitals and might not reflect their individual needs and situations. Opponents also said patient care would not necessarily be better with more nurses working.

“This legislation would force us to schedule by headcount, not patient needs,” St. Cloud CentraCare chief nursing officer Linda Chmieleski said.

Rep. Steve Drazkowski, R-Mazeppa, said he thinks the bill gives too much power over hospitals to nurses. The Minnesota Hospital Association has said it will add to labor costs and could put the future of some hospitals at risk.

Atkins said he was not expecting many of the concerns he has heard to the plan.

“The idea of setting minimum standards for patient safety, I’m actually a little surprised at the level of opposition to that,” he said.