MN Accent January:February 2011.pdf - Minnesota Nurses ...

January/February 2011
Volume 83 No. 1
Feature news
Headline news
- Standing Proud for Patients
- What are HMOs Hiding See page 4
Also in this Issue:
• 200 Jennie Edmundson Nurses Chose MNA Reprsentation P. 5
• Thank You Bettye Shogren P. 9
• Lifelink Solidarity; Bagley Pushback P. 10
• Interruptions and Disruptions P. 11
• Legislative Session Preview P. 12
• More Personnel Changes P. 14

Feature news:
Standing Proud for Patients
Nurses were instrumental in electing
Governor Mark Dayton who signed an
historic health care achievement for the
state’s poorest and neediest. On January
5, 2011, MNA member Gen DuPlessis
was at Governor Dayton’s side when
he signed paperwork officially allowing
the state to opt in to Federal Medical
Assistance (MA) funds that will provide
secure, affordable health coverage for
nearly 95,000 Minnesota residents that
were unable to obtain health care coverage
on their own. It is the biggest
expansion of Medicaid in the country
under the new federal health care law –
the Affordable Care Act.
The moment was a significant triumph
for nurses who dedicated thousands of
hours to influence the political process
with their votes and campaign efforts.
“Who we elect matters to our patients,
our families and our communities,” said
MNA President Linda Hamilton. “This
victory would not have been possible
without the work of MNA members
over the past two years.”
Hamilton credited the success to passionate
grassroots organizing by nurses
and coalition partners. She noted energized
actions, like the brilliant march
on the Capitol during blizzard-like
conditions in October 2009, demanding
then-Governor Pawlenty to restore
funding for the General Assistance
Medical Care program. Nurses lobbied
tirelessly – and effectively - resulting in
compromise legislation.
2 The Minnesota Nursing Accent January/February 2011
When Governor Pawlenty rejected
federal funds generated from the passage
of the Affordable Care Act, nurse
–friendly legislators wisely adopted
a provision to allow Minnesota’s next
Governor to extend the state’s opt-in
deadline through January 15. Nurses
knew the lives of 95,000 vulnerable
Minnesotans balanced on the Nov. 4
election.
The perseverance paid off. With nurses’
votes and support, Dayton narrowly
won the election and specifically requested
MNA presence at the signing
ceremony.
On The Cover - Gen Duplessis from Hennepin
County Medical Center represented MNA nurses
at the historic signing by Governor Dayton
to opt into Federal Medical Assistance funding.
Minnesota Nursing Accent
Minnesota Nurses Association
345 Randolph Avenue, Ste. 200
Saint Paul, MN 55102
651-414-2800/800-536-4662
January/February, 2011
EDITOR
Walt Frederickson
MANAGING EDITORS
Jan Rabbers
Chris Reinke
BOARD OF DIRECTORS
President:
Linda Hamilton, RN, BSN
1st Vice President:
Eileen Weber, RN, JD
2nd Vice President:
Bunny Engeldorf, RN, BS
Secretary:
Linda Slattengren, RN
Treasurer:
Dee Dee Bloch, RN
Directors:
Nancy I. Carlson, RN
Greg Dooley, RN, BSN
Diane C. Johnson, RN
Judy Russell-Martin, RN, BSN
Pamela Scott, RN, BSN, BSE
Juli Uzlik, RN, BSN
Patricia Webster, RN,C
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Headline news
One Nurse’s Story: Why Medical Assistance
is Better for Patients
I am the RN clinical coordinator for patients on
the current GAMC program at Hennepin County
Medical Center. I am thrilled and delighted that
Governor-elect Mark Dayton is opting to enroll
GAMC patients into the new MA expansion program--an
option made available under the new
federal health care law. I strongly believe patients
on the MA expansion program will have better access
to care, and as a result, their overall health condition
will improve over the slimmed-down GAMC
program enacted under the Pawlenty administration.
Frequently patients on GAMC suffer from significant
mental health and chemical dependency
disabilities. In addition we have patients who
should have had a manageable chronic disease,
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
but instead experienced life threatening illnesses
because of lack of access to health care. I have seen
patients with treatable diseases, like diabetes, progress to kidney failure requiring dialysis. What’s more,
the advancement of the diabetes can lead to blindness or other irreversible conditions. Many of these
complications occur because people do not have access to care and couldn’t afford the medications needed
to control their disease process.
As anyone can well imagine the cost of taking care of these patients with progression of their disease
is much more costly than would have been with a consistent primary care providers’ attention.
I was saddened and disappointed to witness patients having to travel miles and hours to HCMC because
huge cuts to the GAMC program closed doors to their previous long term primary care provider in
greater Minnesota. I also believe the significant cuts and inadequate funding imposed by the Pawlenty
administration, played a major part in reduced nursing hours at HCMC. Not only were nursing hours cut
but we saw ancillary staff reductions, included nursing assis¬tants, clerical workers, which further negatively
impacted the care of patients.
I am hopeful and firmly believe with stable adequate funding we will be able to provide improved
cost-effective care under the new MA program and get on with what we do best, taking care of patients.
Also, my hope is this will position and allow HCMC to reinstate the hour reduction to nurses and other
staff that have been adversely impacted by the reduction in funding. Thank you Governor-elect Dayton
for improving the health of all Minnesotans!
MNA Mission Statement
Promote the professional, economic,
and personal well-being of nurses. Uphold
and advance excellence, integrity,
and autonomy in the practice of nursing.Advocate
for quality care that is accessible
and affordable for patients and
consumers.
MNA Strategic Goals
1. MNA works to empower registered
nurses to use knowledge and
experience to advance their
professional practice and leadership
skills.
2. MNA advances a positive and
powerful image of nursing.
3. MNA promotes effective RN
staffing and safe working conditions
for both patients and registered
nurses.
4. MNA works to maintain and
enhance the scope of practice for
Minnesota’s registered nurses.
5. MNA membership and participation,
as a professional union, increase
through effective internal and
external organizing.
6. MNA membership and participation,
representing all categories of
registered nurses, increase through
effective member orientation,
education, services and mobilization.
Organizational Priorities
· Position MNA for negotiations from
strength across Minnesota.
· Organize to increase MNA
membership and participation to
promote MNA mission and strategic
goals through political activism and
collective action.
· Educate and mobilize members
around health care reform and
pursue short and long term
strategies to achieve a single payer
health care system with guaranteed
health care for all.
· Ensure the integrity of nursing
practice, nursing practice
environments and advance safe
patient staffing standards and
principles through collective
action, collective bargaining,
legislative initiative, grassroots
organizing, political action and
education consistent with the MNA
Strategic Plan and the objectives of
National Nurses United.
The Minnesota Nursing Accent January/February 2011 3

Headline news
What are HMO’s Hiding
The $3 Billion Dollar Question
In the midst of a $6.2 billion dollar
state budget deficit, a $3 billion breach
of the public trust has come to light.
For fifteen years now, “non-profit”
HMOs have been getting rich from
public dollars - posting annual surpluses
while Minnesotans are forced to cut
critical public services. All the while,
every dime of the $3 billion of taxpayer
funding they receive goes untracked
and unaccounted for.
MNA has had deep concerns about this
issue for a while, but gained a powerful
ally in November when David Feinwachs,
who had been relieved of his duties
as General Counsel at the Minnesota
Hospital Association approached MNA
staff with a shocking revelation. His
research had uncovered the fact that
many insurance companies in Minnesota
are receiving government funding
to the tune of $3 billion, but have no responsibility
to report how that money
is spent.
On a privatization kick in 1995, the
state outsourced the administration of
David Feinwachs presents at MNA offices
4 The Minnesota Nursing Accent January/February 2011
public health programs to various insurance
companies, such as HealthPartners,
Medica and UCare. This program
has come to be known as PMAP, or the
Prepaid Medical Assistance Program.
Department of Human Services (DHS)
officials have looked the other way
while these health plans have racked
up almost $3 billion PER YEAR in coverage
for services they cannot prove they
have provided. There are no records/
documents that can be produced for
public review. No audit information of
any sort exists on where our dollars entrusted
to HMOs have gone. No documents
have been produced to track
how much - or if - regional and local
providers are being paid by the health
plans. No other government contractor
has this ability to operate in such
cloaked secrecy. Every other contractor
is required to account for every taxpayer
dollar they receive.
Imagine the reaction from your employer
– and the impact on your patients
- if you received your paycheck,
but refused to chart or report and expected
everyone to assume you completed
your work.
These HMOs were given the responsibility
of administering our public dollars.
No one at DHS or within the Pawlenty
administration has even given the appearance
of holding the HMOs accountable
since no accountability measures
are in place. Can the State of Minnesota
afford to hand over our public dollars to
HMOs who are profiting at taxpayer expense
Doesn’t the state have a duty to
Minnesota taxpayers to make sure their
money is spent as it was intended Any
monies not needed should be either
paid back or used in the best interests
of our citizens.
$3 billion is at stake - half of our state’s
total current budget deficit – and all of
which is best dedicated to making sure
patients get the care they deserve.
MNA is taking a lead role in exposing
this travesty. On January 13,100 members
attended a presentation that was
offered simultaneously on site at MNA
offices and online by webinar, where
Feinwachs carefully outlined his case.
Suzanne Long, a
nurse at Bethesda
Hospital in St.
Paul heard the
facts and she
is ready to begin
a crusade. “I
will write emails
regularly and do
whatever I need
can, because what the insurance companies
are doing is just plain wrong,”
said Jones. She advises colleagues to
conquer their fears and step up to correct
this problem.
Diane McLaughlin practices at Abbott
Northwestern and is mother to a 36
year-old Downs
Syndrome son.
“What they are
doing to the elderly,
blind and
vulnerable populations
makes my
blood boil,” she
said. “We need to
make this stop.”
Additional informational meetings
are being conducted to also allow attendance
on site or online. Please visit
the MNA web page for more details
and learn how you can become more
involved. www.mnnurses.org.
Informational Meeting on
the $3B Question
Tues., Feb. 15
10:00 a.m. – 11:00 a.m.
3:30 p.m. – 4:30 p.m.
Two ways to attend:
1 MNA offices, 345 Randolph Ave.,
Ste. 200, St. Paul
2
Suzanne Long
Diane McLaughlin
Online Webinar from your computer
Contact Eileen Gavin to register
651-414-2871
Eileen.gavin@mnnurses.org

Come to the Capitol; Be Influential
Join with hundreds of other
nurses from all over Minnesota
for this energizing and empowering
event. Together we will:
Meet and educate the large
class of new legislators about
nursing and healthcare issues
This event is an opportunity
to introduce ourselves to a
huge group of new legislators,
many of whom know very little
about the realities of nursing
and healthcare in the 21st Century.
This is an opportunity to build relationships with legislators, and become their
resource for nursing and healthcare issues.
Keep the spotlight on unsafe staffing This is the first major statewide event since
the 2010 contract campaigns that put staffing on the front burner. Elected officials
need to know that we won’t back down until our concerns about patient safety are
addressed.
Demand accountability for tax dollars funneled through HMOs for public
healthcare programs Minnesota is facing a $6.2 billion budget deficit, yet HMOs
are making huge profits off of tax dollars set aside for public healthcare programs,
without providing any accounting of how they spend these funds. We don’t know
how much of the $3 billion they receive every two years goes toward providing
healthcare, and how much goes to profits. This has to end.
You will have a chance to learn about the legislative issues that affect our practice
and our patients. You will also get to meet nurses from all over the state, and
come together to speak with one voice on the issues that affect all of us. Whether
you work in a large metro hospital or a small rural hospital, we are all advocates for
our patients.
The event includes an education session and dinner on February 28 at 5:30, and
legislative visits starting at 9:00 am on March 1, followed by a rally at 12:30 pm.
There is no charge for this event.
To sign up, visit www.mnnurses.org/dayonhill or contact Eileen Gavin at eileen.
gavin@mnnurses.org or 651-414-2871.
Welcome
Jennie
More than 200 nurses at Jennie Edmundson
Memorial Hospital voted
overwhelmingly on December 17 to
join MNA
“This is an important step our nurses
wanted to take to ensure representation
by a professional nursing association,”
said Doris Ballantyne, a Registered
Nurse at the hospital. “I think this week’s
vote was a confirmation of what many
of us already knew – that the nurses of
Jennie Edmundson want the Minnesota
Nurses Association to represent us in
labor negotiations.”
Nurses approved the move by an
78 percent margin. Jennie Edmundson
RNs were left looking for new representation
this fall when the Iowa Nurses
Association, which had traditionally
represented the RNs during contract
negotiations, said it was moving away
from collective bargaining on behalf of
its members.
“After the upcoming transition period,
we are hoping Jennie Edmundson’s
executives will come to the bargaining
table ready to do what we’ve done for
the past 44 years,” said Laura Fox, an
RN at the hospital. “That means agreeing
upon a strong union contract and
continuing a relationship with management
that allows nurses to step up and
advocate for the best possible patient
care for our community.”
Jennie Edmundson nurses are the
third group of Iowa RNs to formally
choose representation by MNA. On
November 16, 2010, 123 nurses at Marshalltown
Medical & Surgery Center
in Marshalltown, Iowa, voted by an 82
percent margin to join the Minnesota
Nurses Association. In addition, nurses
at Spencer Municipal Hospital in Spencer,
Iowa, have been represented by the
MNA for more than a decade.
The Minnesota Nursing Accent January/February 2011 5

MNA forum
Nurse Vigilance Needed Near and Far
Patients Deserve Answers in $3
Billion HMO Hide & Seek Game
Our state faces a budget deficit of over $6
billion, and every penny spent is being scrutinized
EXCEPT nearly $3 billion! We as taxpayers
are handing over to 3 billion dollars
to HMO’s to administer the Prepaid Medical
Assistance Program (PMAP) with virtually no
financial oversight. We literally have no idea
how effectively or efficiently that money is
being used. We do not even know if it is being
used to actually provide care to our medical
assistant population. Once again, corporate
greed could be putting the safety of our patients
at risk.
As nurses on the front lines, we are reminded
every day of the financial cuts and sacrifices
being made in order to balance budgets. If
financial waste or mismanagement is occurring
in these programs, it directly impacts our
ability to do our job and the quality of care
that our patients receive. When providers
don’t get paid or are paid less than they are
supposed to, they respond to these financial
shortfalls by cutting patient care that means
cutting nurses.
We need to demand HMO’s are accountable
for the taxpayer dollars given to them to provide
health care is in fact used to provide that
care. The days of handing Wall Street and
Healthcare CEOs billions of dollars with no
questions asked needs to stop. As taxpayers,
we need to make sure our money isn’t being
wasted and regulations or stipulations are in
place for how these healthcare services are
delivered. Any contracting of public dollars
for health care should hold strong provisions
regarding high quality care, including safe
staffing levels.
This is NOT a partisan wedge issue. We
must demand our public officials “follow the
money.” We need our legislators and policy
makers to attach accountability measures
to these healthcare dollars so we know our
patients are getting the quality and efficient
health care for their tax dollars.
6 The Minnesota Nursing Accent January/February 2011
Advocacy for Safe Staffing at the
Bedside, in St. Paul and Washington
D.C.
We continue to have our work cut out for
us every hour of every shift. It is clear our
employers are also putting profits before
patients. We need to expose them. Together,
we are the best defense a patient has against
inadequate and substandard care. Every one
of us must be a part of the action. It can be as
simple as saying “no” to another patient assignment
based on patient safety, or calling
managers or administrators, or banding with
co-workers to protest staffing cuts. NEVER let
an unsafe assignment go without protest.
Our consistent actions will remind hospital
administrators of their duty to assure proper
nursing care is at the heart of their business.
We must also continue our fight to put
staffing into law - not into the hands of our
hospital administrators. Our national union
of 166,000 nurses strong will lobby Congress
this year to fund the Agency for Health Quality
Research (AHRQ) to study the effect of specific
ratios on patient care. We are confident
a government-sponsored study will validate
the work done by Linda Aiken, proving patient
outcomes do improve with safe patent
staffing using ratios. (Aiken, et al. 2010)
Nurses and All Americans Deserve
A Secure Retirement – Save Social
Security
The nation’s budget deficit has triggered
the President’s Deficit Commission to suggest
we raise the retirement age and impose
severe restrictions to middle class workers.
These cuts will keep nurses on the job until
we are 70 years old. I cannot imagine myself
practicing this profession at that age, and
suspect many of my colleagues fear the prospect
of facing the demands of this work with
increasingly debilitating physical challenges
- poor eyes, poor ears, bad knees, bad backs.
And wouldn’t it be a shame if no jobs exist
for young nurses to bring new ideas and
energy into our workplaces
Older citizens do have plenty to offer; we
can and should continue the careers we love.
However, those less fortunate should not be
president’s column
forced to work beyond their ability. We must
call our senators and representatives to today
to tell them not to accept the cuts to Medicare
and Medical Assistance.
Our Strong Common Foundation is
Our Best Asset for Positive Change
MNA’s diverse membership offers a wealth
of political perspectives, but I believe we
have little disagreement on some fundamental
values:
1. Taxpayers have a right to know where
their money is being spent and that it
is used for what it is intended-- not to
line someone’s pocket.
2. Workers have a right to get paid for the
hours they work.
3. Workers have a right to go to work in a
safe environment.
4. Seasoned workers who are no longer
able to do the job should have a
pension and social security to maintain
a dignified life after work.
5. All patients deserve safe, efficient
health care.
6. Nurses must have the time to provide
safe quality nursing care to their patients.
Let’s keep talking to each other and equally
important, let’s talk to our legislators in St.
Paul and Washington D.C. It is imperative
they hear from us. One of our most convenient
opportunities is MNA’s Nurses Day on
the Hill. Please join me March 1!
“Perseverance is a great element of success. If
you knock long enough and loud enough at
the gate, you are sure to wake up somebody.”
~ Henry Wadsworth Longfellow

Economic and General Welfare
Union-wide Solidarity for Life Link III
Members Has Employer Sputtering
MNA’s bargaining unit at Life Link III consists of members who offer life-saving
skills in that critical pre-hospital time period. Life Link III’s RNs, paramedics, EMTs and
Dispatchers all contribute to life and quality of life of patients, but the employer is
subjecting them to shameful anti-worker tactics.
The contract expired on Dec. 31, 2010 and management notified MNA that 35 of
the 80 Life Link III employees would be laid off by January 31, 2011. Among other
egregious actions, the Human Resources Director refuses to answer her phone to
bargaining unit members, or open emails from MNA Business Agent Keri Nelson.
The employer has placed surveillance cameras throughout the workplace and blatantly
attempted to intimidate workers, including union stewards. The bargaining
unit has filed seven Unfair Labor Practice charges against the employer for these
measures as well as for failure to bargain in good faith, failure to show up for bargaining
and failure to provide information.
“We have no intention of backing down,” said MNA Life Link III negotiator, Bill Bush.
He has great reason for confidence. The team’s communication network is a streamlined
masterwork. And hundreds of MNA members have signed petitions in support
of their colleagues. 98 percent of the bargaining unit itself signed a separate The Life Link III Dog & Pony show
petition earlier in negotiations.
The message of solidarity was also emphatically delivered from Nov. 15 - 19 as union members stood united each morning
for a week outside the Life Link III base across, ironically, from the offices of the Federal Mediation and Conciliation Services.
The action was initiated after particularly contentious bargaining sessions in which the employer presented no specific detailed
proposal list, demanding to “open up and discuss” the entire contract and then accusing MNA negotiators of being
unprepared, saying “this is the end of your dog and pony show - you have had your fun.” The fun had just begun. Much to
the embarrassment of Life Link III management, workers and supporters gathered for coffee and donuts every day for a week
outside the offices, sending a clear statement of stamina and determination.
“We’re in this fight for as long as it takes,” said Bush. “We will not stop demanding our rights under the law.”
GO
Today
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Commission on Economic & General Welfare Members
Deb Haugen, RN, BSN, Chairperson
Jennifer Michelson, RN, BSN, Vice Chair
Barb Martin, RNC, RN, Secretary
Jeanne Delie, RN
Patricia Dwyer, RN, BSN, CRRN
Melissa Hansing, RN
Sue Johnson, RN
Candy Matzke, RN, C
Nellie Munn, RN
Gail Olson, RN
Barbara Warren-Bloms, BSN, RN-C, CCRN
The Minnesota Nursing Accent January/February 2011 7

Economic and General Welfare
Bagley Nurses Seek
Accountability in Hospital Deal
MNA nurses working at Clearwater
Health Services (CHS) in Bagley, MN
were effective in their efforts to slow
down an effort to sell the hospital under
questionable circumstances. In November,
nearly two dozen nurses stood
together to voice significant concerns
about the potential sale of Bagley’s
Clearwater Health Services (CHS) to Cocoon
Holding Company, LLC, which is
located in Grand Forks, North Dakota.
County officials were preparing to
sell Clearwater County Memorial Hospital,
Clearwater Health Services Clinic
and Clearwater Ambulance Service to
Cocoon. Typically, when a public hospital
is sold, County officials hold public
meetings and solicit public comments
over the course of several months or
even years.
While CHS Nurses were not opposed
to the sale of the county’s hospital to
a private entity, they were deeply concerned
that the pending deal is not a
good one when it comes to ensuring
a sustainable hospital and exceptional
healthcare for their friends, neighbors
and fellow taxpayers in Clearwater
County.
“We’d been given almost no information,
other than being told that as a result
of this sale, nurses are going to be
terminated and forced to re-apply for
their jobs,” said Jodie Omang, an RN at
CHS. Omang pointed out that not only
nurses weren’t being communicated
with, but taxpayers as well. “This is a
situation that could significantly impact
one of our community’s largest public
Commission on Economic & General Welfare Members
Deb Haugen, RN, BSN, Chairperson
Jennifer Michelson, RN, BSN, Vice Chair
Barb Martin, RNC, RN, Secretary
Jeanne Delie, RN
Patricia Dwyer, RN, BSN, CRRN
Melissa Hansing, RN
assets. Why is there such an obvious
lack of transparency and explanation
for what is going to happen with this
potential sale”
Actions by the nurses created enough
stir in the community that county officials
held a public hearing on December
4 and plans remain on hold regarding
the transaction.
Prior to the meeting, Omang reflected
the intentions of her colleagues. “Nurses
want to express our concern that
the sale of our community hospital to a
North Dakota-owned, for-profit company
with no ties to our community puts
the future of health care in Clearwater
County at risk,” she said. “Rural hospitals
have been closing around Minnesota at
a rapid rate. Since 1987, 28 rural hospitals
have closed in our state. CHS nurses
are committed to our patients and our
community, and we’re going to continue
demanding answers while reaching
out to our neighbors and colleagues. All
of us deserve answers, and we need to
work together in order to protect one of
our community’s most important public
assets.”
Sue Johnson, RN
Candy Matzke, RN, C
Nellie Munn, RN
Gail Olson, RN
Barbara Warren-Bloms, BSN, RN-C, CCRN
MNA Social
Media Links
The next time you’re online,
take a moment to join the conversation
on MNA’s Facebook
page, www.Facebook.com/MinnesotaNurses.
You can also find
MNA on Twitter at @mnnurses
and see the latest MNA videos at
www.YouTube.com/mnnurses.
In addition, the new MNA Blog
is up and running at www.MNA-
Blog.com. See you in cyberspace!
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8 The Minnesota Nursing Accent January/February 2011

Health & Safety
There’s little packing to do in Bettye
Shogren’s corner of the MNA office. A
banker’s box sits on the floor collecting the
last remnants of her 27 year career with the
organization. One poster will remain in position
intentionally until her final day, however.
“Mother Jones – Mary Harris – has long
been a hero,” muses Shogren. “The words
‘Pray for the dead and fight like hell for the
living’ became the instruction by which I’ve
lived my life,” Shogren added. The poster
will accompany Shogren to her retirement
life where it will continue its daily reminder.
Anyone who has met Shogren knows she
doesn’t need the nudge. Fighting for social
justice was in her nature long before she
read Mother Jones, and she’s won abiding
admiration in her own right as a crusader
for health and safety in the workplace for
nurses and other workers.
Because of Shogren’s steadfast devotion
to workplace health and safety, Minnesota
is recognized across the country as a leader
in addressing the myriad health and safety
issues nurse face in their work environment.
Today, many nurses in acute care facilities
across the U.S. are spared debilitating consequences
from back injuries, exposure to
blood-borne pathogens, violence and other
A Healthy Legacy
By Jan Rabbers, MNA Staff
factors thanks to her perseverance and skill.
Dr. Audrey Nelson has gained her own
international reputation for her work in safe
patient movement, but she us humbled by
Shogren’s enduring influence in the field.
“Bettye’s contributions to improving nurse
safety in Minnesota have been profound,
sustained, and effective,” said Nelson.
“Through her efforts, I am hopeful that a
new generation of nurses in her state will
begin their careers protected from the
known hazards associated with years of
manual patient handling.”
In 2009, Nelson was on hand to personally
present Shogren and MNA with the national
Workplace Advocacy Award at the annual
Safe Patient Movement Conference.
Workplace safety takes on many different
aspects for Shogren. Her first assignment
at MNA was to change a work environment
at the former Golden Valley Health Care facility
that was making nurses sick through
infection. Shogren took on state and federal
officials as well as labor attorneys to ensure
dummies used in the Basic Life Support
training were disinfected properly.
She convinced the a Department of Health
Commissioner to make the hepatitis vaccine
available to health care workers at employer
expense, successfully arguing that
the measure was a form of personal protective
equipment. But Shogren is equally
adamant about workplace rights, and has
vociferously defended employees’ refusals
of unilateral attempts to force nurses to receive
vaccines. “It’s a personal Health care
decision and should be left at that,” she has
stated.
Shogren is passionate about helping to
tear down barriers that prevent nurses from
continuing to do the work they choose.
She points to a Harvard study that showed
nurses, as an occupational group, suffer
a disproportionately high rate of illnesses
and other research indicating health care
workers have a higher rate of injury than
any other industry. “Infectious disease,
radiation, chemical exposure, depression,
cardiovascular, muscular-skeletal damage,
you name it, we got it,” said Shogren. “And
the only common factor (in the research) is
the work we do.”
She knows from personal experience. As
a steward of her bargaining unit at Bethesda
Lutheran Hospital, she was disturbed at
learning co-workers would suddenly “disappear”
after suffering an injury. Then, in 1982
Shogren suffered her own “career-ending”
back injury while moving a patient on her
shift. “It was traumatic. I was losing the
career and an identification I loved,” she
said. But she decided to fight. It would be
A Healthy Legacy cont. on page 14
Health & Safety Committee Members
Marie Stuewe, RN, Chair
Jeanne Delie, RN
Niki Gjere, MA, MS, RN, APRN, BC
Gretchen Kingsley, RN, MPH
Barbara Martin, RNC: RN
Evangelene Munn, RN, BSN
Arlene Simones, RN
Stephanie Wells, RN
The Minnesota Nursing Accent January/February 2011 9

Research and Scholarship Opportunities
xxxxxxxxxxxxxxxxxxxxxx
Katharine Densford Dreves
Research Grant
Deadlines: January 1, April 1, June 1,
October 1
Award: Up to $10,000
Qualifications: MNA member; Masters
degree or enrolled in masters program;
completion within 2 years of funding date;
periodic reports on research progress and
budget.
MNAF Research Grant
Deadlines: January 1, April 1, June 1,
October 1
Award: Up to $5,000
Qualifications: MNA member; Masters
degree or enrolled in masters program;
completion within 2 years of funding date;
periodic reports on research progress and
budget.
Clinical Practice Project in
Memory of Linda Knauff
Deadlines: January 1, April 1, June 1,
October 1
Award: Up to $2,000
Qualifications: Completion within 2
years of funding date; periodic reports on
research progress and budget. Nursing
student applicants must be Minnesota
Student Nurses Association (MSNA) members.
RN applicants must be MNA or MSNA
members. Priority will be given to active
MNA or MSNA members.
Cynthia Hunt-Lines Scholarship
Deadline: June 1 - Award: $5000*
Qualifications: Single parent, at least 21
years old, with at least one dependent; accepted
to or enrolled in baccalaureate or
masters program in nursing
in Minnesota or North Dakota. Nursing
student applicants must be Minnesota
Student Nurses Association (MSNA) members.
RN applicants must be MNA or MSNA
members. Priority will be given to active
MNA or MSNA members.
MNAF Baccalaureate Scholarship
Deadline: June 1 - Award: $2000*
Qualifications: Accepted to or enrolled in
baccalaureate program in nursing in Minnesota.
Nursing student applicants must
be Minnesota Student Nurses Association
(MSNA) members. RN applicants must be
MNA or MSNA members. Priority will be
given to active MNA or MSNA members.
MNAF Graduate Degree
Scholarship
Deadline: June 1 - Award: $2000*
Qualifications: MNA member seeking
graduate degree in nursing. Selection
based on career goals, professional activities,
demonstrated leadership ability,
scholarship in nursing, MNA activities, and
community involvement.
Janky Foundation Scholarship
Deadline: June 1 - Award: $2000*
Qualifications: MNA member seeking
graduate degree in nursing. Selection
based on career goals, professional activities,
demonstrated leadership ability, scholarship
in nursing, MNA activities, and community
involvement.
Phillips/Laird Scholarship
Deadline: June 1
Award: $2000*
Qualifications: MNA member seeking
baccalaureate or graduate degree in nursing.
Selection based on career goals, professional
activities, demonstrated leadership
ability, scholarship in nursing, MNA
activities, and community involvement.
Preference will be given to nurses who live
or work in the “former” MNA District 13,
e.g., Owatonna, Waseca, Northfield, Faribault,
Owatonna Hospital, Rice County District
1, Waseca Memorial Hospital.
Rose Dhein Scholarship
Deadline: June 1 - Award: $3000*
Qualifications: MNA member seeking
graduate degree in nursing with evidence
of interest in teaching nursing. Selection
based on career goals, professional activities,
demonstrated leadership ability,
scholarship in nursing, MNA activities, and
community involvement.
Sarah Colvin Social Justice
Scholarship
Deadline: June 1 - Award: $2000*
Qualifications: MNA member seeking
baccalaureate or graduate degree in
nursing with an interest in social justice.
Selection based on nurses who document
evidence of advocating for individuals and
groups harmed by inequities, environmental
exploitation, discrimination, and oppression.
Examples of social justice issues
may include, but are not limited to working
with the mentally ill, impoverished,
abused, or elderly.
*Scholarship awardees are eligible to
reapply for one more year of funding by
completing a new application form. Funding
will be limited to one (1) year only for
the Cynthia Hunt-Lines scholarship and
two (2) years each per baccalaureate and
graduate scholarships
Information about becoming an
MSNA member may be found at
www.minnesotasna.org.
MNAF Board Members
Jennifer Tucker, RN, BSN, Chair
Mary Benbenek, RN
Saundra Crump, RN, MSN, CHPN
Norma Krumwiede, EdD, RN
Patricia Kummeth, MSN, RN, BC
Mary Maxwell, RN, BSN, CCRP
Judy Russell-Martin, RN, BSN, MSN
Kristin Sandau, PhD, RN
Virginia Turba, RN, BSN, AND
10 The Minnesota Nursing Accent January/February 2011

Nursing & Practice
Interruptions and Disruptions
Research addressing the work of
nursing has identified the marked
complexity surrounding the delivery of
care in our current healthcare environments,
and has begun to understand
why intended outcomes are often not
achieved, even with excellent education
programs and redesigned healthcare
systems.
To achieve the intended outcomes
of healthy work environments, namely
quality care, safe patient outcomes
and nurse recruitment and retention,
it is necessary to direct attention to
the invisible, cognitive work of nurses,
i.e., work that promotes suitable work
flow and care delivery, and to factors
that support or complicate this invisible
work. Failure to understand how
registered nurses make decisions in the
context of actual care delivery will lead
to the design of processes, environments,
and technologies that increase
the complexity of RN cognitive work.
This failure in turn will lead to increased
RN stress and dissatisfaction, decreased
RN retention, and ultimately unsafe
care. (Ebright, P., (Jan. 31, 2010) “The
Complex Work of RNs: Implications for
Healthy Work Environments” OJIN: The
Online Journal of Issues in Nursing Vol.
15, No.1, Manuscript 4)
Recent Research on Nursing Work:
• Nurses experience a cognitive interruption, an activity the stops the RN
from performing an immediate nursing process activity required for care,
261 per shift or 5.9 per hour on average. (Potter, et al. (2005) Understanding
the cognitive work of nursing in the acute care environment. JONA, 35(7/8), 327-335.
Other studies have reported up to 14 interruptions per hour)
• Stacking is the invisible, decision-making work of RNs about the what, how,
and when of delivering nursing care to an assigned group of patients. With
each new observation and receipt of information from minute to minute is
a continuous re-ordering of the priorities of the activities. This requires
a high degree of clinical judgment, informed by patient and environmental
cues, to rescue patients from complications and potential death. This work
is often complicated by the rigid, traditional structure of current healthcare
settings. (Ebright, et al. (2003). Understanding the complexity of registered nurse work in
acute care settings. JONA, 33(12), 630-638.
• Complexity Compression is the experiences of nurses when expected to
assume, in a condensed time frame, additional, unplanned responsibilities
while simultaneously conducting their other multiple responsibilities.
Nurses reported that personal, environmental, practice, administrative,
system and technology factors, as well as autonomy and control factors, all
contributed to this experience. (Krichbaum, et al. (2007). Complexity compression:
Nurses under fire. Nursing Forum, 42(2), 86-94)
• Nurses were observed to be multitasking 34 percent of the time with an
overall error rate of 1.5 errors per hour. Nurses were most frequently
interrupted while administering medications (57 percent) and while doing
assessments (43 percent). (Kalisch, et al. (2010) Interruptions and multitasking in
nursing care. Joint Commission Journal on Quality and Patient Safety, 36(3), 126-132)
• In examining system issues confronted by nurses who work in hospitals,
nurses were forced to work around system issues as they sought to
complete patient care efficiently and effectively. Nurses were often
interrupted as they worked; the results led to identification of operational
failures that fell into two general categories: problems and errors.
Problems were defined as disruptions in ability of the nurse to execute a
prescribed task, and errors were defined as the execution of the task that is
subsequently determined to be unnecessary or wrong. (Tucker, A.L. (2004).
The impact of operational failures on hospital nurses and their patients. Journal of
Operations Management, 22, 151-169)
Commission on Nursing Practice Members
Niki Gjere, MA, MS, RN, APRN, BC, Chair
Katheren Koehn, RN, MA
Susan Kreitz, RN
Sara McCumber, RN, CNP, CNS
Deborah Meyer, RN, BAN
Sandra Peterson, RN, BSN
Rebecca Romosz, RNC, BSW, MEd
Mary Schoenleber, RN
Diane Scott, RN, MS
Mary Scott, RN, BSPA
Pamela Wolters, RN, BSN
The Minnesota Nursing Accent January/February 2011 11

Governmental Affairs and Political action
Nurses Set to Tackle 2011 Legislative
Session Challenges
The recent elections have resulted in
a historic change in the make-up of the
Minnesota Legislature with both the
Senate and House now under the leadership
of Republicans. The change in
leadership will most likely result in MNA
having to play defense on a number of
our core missions, including protecting
nursing practice, advocating for our
patients and protecting our workplace
rights based on MNA’s past experience
and the voting record of many of these
legislators. A $6 billion dollar deficit
and a pledge not to raise taxes could
also likely to result in deep cuts to the
Health and Human Services Department.
With Mark Dayton as Governor, we
will most likely be able to stop many
the attacks, but it will require significant
staff and member engagement to respond.
MNA’s desire to move a proactive
agenda forward on our goals of single
payer health care and safe staffing will
undoubtedly have to be in the form of
administrative strategies and tactics.
Below is a list of possible issues we may
need to act with defensive and offensive
strategies.
On Defense –
Protecting What We’ve
Achieved
12 The Minnesota Nursing Accent January/February 2011
Threats to Nursing Scope of
Practice and Licensure
Expansion of LPN Scope of Practice
We may see legislation that opens the
Nurse Practice Act to allow LPNs to do
the work of RNs including assessment
and delegation. This effort has been
led by our state Board of Nursing.
Interstate Compact Legislation A
key proponent and author for this legislation,
Sen. Gerlach, may see this as
an opportunity to push his bill again.
Hospitals such as Mayo and others
support interstate as a way to easily
move nurses across state borders - a
major problem for us during a strike.
The real heart of this issue is whether
the control nursing practice rests
with nurses or corporations.
Surgical Tech /EMT expansion Proponents
of legislation allowing certification
of Surgical Technicians is
a backdoor attempt to have them
work under the direction of surgeons.
They have consistently opposed our
amendments requiring RN supervision
despite the fact that the Center
for Medicaid and Medicare requires
it. Another tactic to watch for is bills
that allow EMT/Paramedics to do
public health nursing. We need to be
on high alert about proposals that in
general create the idea of a “universal
worker.” These measures are supported
by the health care industry as an
attempt to cuts costs by substituting
lower labor costs.
Threats to Patient Safety
Cuts to Health Care and Mental
Health Programs Health care represents
approximately 30 percent of the
state budget. In the past, Republicans
have pushed legislation to cut state
public programs for vulnerable populations.
These include slashing GAMC,
attempts to dismantle the Minnesota
Care program and deep cuts to health
and human services. These programs
impact basic human services from
home care to helping people with
disabilities. Not only will the health
of Minnesotans be at stake, but this
could also result in more RN layoffs to
nurses and result in further deterioration
of already unsafe staffing levels.
Cuts to Nursing Homes and Hospitals
Deep cuts to hospitals and nursing
homes would be likely, also leading
to RN and other worker layoffs. We
must oppose these cuts on grounds
that patient care will be impacted by
unsafe staffing levels.
Attacks on Federal health Care Reform
Governor Dayton has opted
into the Medical Assistance Program
for vulnerable populations. This program
brings $1.4 billion into the state
which means improved health care
access and jobs.
p. 2)
Threats to State Nursing
Workforce
(see related article,
With the state budget deficit at $6
billion we will no doubt see legislation
that looks to cut jobs and/or pensions
of state workers. Approximately
700 nurses in the state contract would
be impacted.
Threats to Workplace Rights
Business-friendly Republicans are
proposing a “Right to Work” constitutional
amendment that prohibits
collective bargaining agreements
from making union membership a
condition of employment. In effect,
such changes create an “open shop” in
which MNA must represent everyone,
but no one is compelled to belong to
our union.
The governor has no veto authority
over constitutional amendments. If
the bill passes both houses of the legislature,
it goes directly to the ballot
for voters to decide. To defeat a ballot
measure, MNA would have to exert
significant resources.
There is no doubt this is a direct attack
on our union’s ability to negotiate
fair contracts.

Governmental Affairs and Political action
We must also be on alert for attempts
to repeal some former gains,
such as safe patient handling and independent
practice of APRNs.
On Offense –
Moving Forward
Safe Staffing
We are unlikely to make any progress
in the legislature on this issue, but we
should be prepared to push an administrative
strategy. This may involve working
with Governor Dayton to issue an
executive order on staffing ratios, and/
or tying ratios to Medical Assistance
payment. We will need to continue to
educate the new Republican leadership
of the unsafe staffing levels in the hospitals
and our need for more regulation.
Single Payer Legislation
This is another issue that will likely
stall this year, but we could push the
Dayton administration to allocate funding
in his budget for a cost-study of single
payer health care. The study could
help provide evidence as to how single
payer health care could result in significant
savings to taxpayers.
Additionally, we could push a strategy
around what we call “de-privatization”
of our public health care programs.
Today, the state of Minnesota
hands over millions of dollars to privately
held HMO’s to manage programs
for the poor and disabled. Is it right that
private HMO’s are making millions off
programs for the poor (see story p. X)
Instead, let’s minimize the harm inflicted
from cuts to hospitals and programs
and not let private companies profit off
government health care programs.
Finally, MNA may survey our members
to assess overall understanding
and level of support for single payer
health care.
Creating a More Friendly BON
The current BON has been very active
in working to expand the scope
of LPN practice. With five new seats up
for renewal, Governor Dayton will no
doubt help us appoint MNA-friendly
nurses.
Be sure to visit
the MNA web site
for current
events
and updates.
www.mnnurses.org
Sign Up Today To attend
Nurses
Day on the Hill
Feb. 28 & Mar. 1
Contact Eileen.Gavin@mnnurses.org
Commission on Economic & General Welfare Members
Deb Haugen, RN, BSN, Chairperson
Jennifer Michelson, RN, BSN, Vice Chair
Barb Martin, RNC, RN, Secretary
Jeanne Delie, RN
Patricia Dwyer, RN, BSN, CRRN
Melissa Hansing, RN
Sue Johnson, RN
Candy Matzke, RN, C
Nellie Munn, RN
Gail Olson, RN
Barbara Warren-Bloms, BSN, RN-C, CCRN
The Minnesota Nursing Accent January/February 2011 13

A Healthy Legacy from page xx
a two-year battle. “I was unemployed and
litigating from March, 1982 to January 1984,
and winning most of them.” Her perseverance
resulted in Supreme Court ruling in her
favor. “I needed to fight more than I needed
to win,” said Shogren. “I figured I would
make this an expensive experience for my
employer because nobody had done it before
– everybody just ate the job of patient
secretary.” Her husband, Bob, took on two
jobs to help Shogren “fight something I felt
was fundamentally not right.”
Being hired at MNA in 1984 helped her
continue the fight. “They paid me for what
I wanted to do,” Shogren said. What she
did was far-reaching. She championed and
won “Right to Know” legislation that keeps
workers informed about employer workplace
decisions that may impact the health
of workers. She led the effort to make Minnesota
the first state in the nation to pass
a Safe Patient Handling measures in acute
and long-term care facilities, and testified
before a U.S. Senate hearing for a parallel
federal bill.
Shogren negotiated two other national
firsts in contract agreements. Her solution
to the 2001 contentious bargaining was to
insert language that allowed charge nurses
to close a unit to patient admissions based
on the nurse’s judgment. She achieved
an agreement with Allina that provides a
consistent framework and processes for
response and staffing in an Emergency Response
event.
But she contributes any successes to the
collective power of organized nurses. “I
could have stood on the steps of the Capitol
alone all my life and we wouldn’t have
the Safe Patient Handling legislation or the
Right to Know bill. It is the credibility and
strength and union density of this organization
that really made it all possible.”
It is her legacy to have inspired vigilance
and activism in countless nurses over
Shogren’s tenure on staff at MNA, but she
exemplifies the commitment and dedication
required for future challenges.
Ch – Ch - Ch - Changes
In addition to Bettye Shogren, MNA is bidding farewell to two long-term
employees and welcoming back a favorite son.
Jerry Hatalla joined MNA’s Labor Relations
department in 1991 with extensive experience in
union organizing and labor/management relations.
His vast expertise and kind guidance have enlightened
countless nurses over the years. His enduring
influence over 17 years contributed to the growth
and stability of the HealthEast System bargaining
unit. “He taught me to look at the whole picture and
understand the consequences of my decisions,” said
Cindy Olson. “Of all the people I’ve worked with
at MNA, I will miss Jerry the most.” Hatalla is also
admired for his integrity and attention to detail by
nurses in facilities across greater Minnesota.
Hatalla is justifiably proud of the achievements
nurses made during the 2001 contract campaign.
“That was a great settlement,” he said of the 19+
percent wage increase. He stated his most unique
contract item was securing lactation rooms in 2007
negotiations for Dakota County nurses. “I had notes
thanking me from lots of people – including noncontract
workers,” Hatalla said.
Hatalla will hit the retirement road, which might
include frequent trips to San Jose, where his new
grandson is discovering life.
Nan St. George is taking a well-deserved
retirement after 21 years of service to the
organization. St. George has been a steady go-to
gal for many aspects of clerical work throughout
her career. Her diligent data-entry skills have been
the foundation for maintaining the Concern for Safe
Staffing forms. Her ability to maintain a seamless
supply of myriad office equipment and other
necessities is a work of art in itself.
St. George is looking forward to spending more time
with her husband and her growing extended family.
Phil Finkelstein returns as MNA’s General Counsel
after a sixteen-month hiatus. Finkelstein went into
private practice in 2009, and the organization
experimented with the use of outside counsel.
Interim Director Walt Frederickson convinced
Finkelstein to return in Dec., 2010 when he was
heartily welcomed by staff and members.
Finkelstein has assumed managerial duties at MNA,
and is already digging into complicated arbitrations.
14 The Minnesota Nursing Accent January/February 2011

Take a
Mind
Adventure
The Minnesota Nurses Association’s
Ethics Committee
Book Club for Nurses
Provocative discussion on ethical issues posed
in today’s literature
Feature Book
Cutting for Stone
by Abraham Verghese
BOOK SUMMARY
Marion and Shiva Stone are twin brothers born of a secret union between
a beautiful Indian nun and a brash British surgeon at a mission hospital in
Addis Ababa. Orphaned by their mother’s death in childbirth and their
father’s disappearance, bound together by a preternatural connection and
a shared fascination with medicine, the twins come of age as Ethiopia
hovers on the brink of revolution. Yet it will be love, not politics—
their passion for the same woman—that will tear them apart and force
Marion, fresh out of medical school, to ee his homeland. He makes his
way to America, nding refuge in his work as an intern at an underfunded, overcrowded
New York City hospital. When the past catches up to him—nearly destroying him—Marion must entrust
his life to the two men he thought he trusted least in the world: the surgeon father who abandoned him
and the brother who betrayed him.
An unforgettable journey into one man’s remarkable life, and an epic story about the power, intimacy, and
curious beauty of the work of healing others.
REVIEWS
“Masterful.” The Washington Post Book World - W. Ralph Eubanks
“To read the rst page of Cutting for Stone is to fall hopelessly under the spell of a masterful storyteller;
and to try to close the book thereafter is to tear oneself away from the most vivid of dreams.” Pauline
Chen, author of Final Exam
Minnesota Nurses Association
is accredited as a provider
of continuing nursing
education by the American Nurses
Credentialing Center’s Commission
on Accreditation.
Wednesday, April 13, 2011
5:30 to 7:30 pm - MNA Ofce
345 Randolph Avenue, Suite 200, St. Paul, MN 55102-3610
Free to MNA members; non-members $10; light dinner included
Participate in person, by telephone, or forward questions/comments to e-mail below
RSVP to 1-800-536-4662, ext. 122, (651) 414-2822, or linda.owens@mnnurses.org
The Minnesota Nursing Accent January/February 2011 15

345 Randolph Ave., Ste. 200
St. Paul, MN 55102
Your voice at the Capitol can save lives.
You need to be at Nurses Day on the Hill to:
· Meet and educate the largest freshman class of legislators in decades, and
build a relationship as their resource on nursing and health care issues.
· Keep the spotlight on unsafe staffing. This is MNA’s first major public event
since the 2010 contract campaigns that put staffing on the front burner.
We won’t back down until patients are guaranteed safe care in our hospitals.
· Demand accountability for tax dollars funneled through HMOs to fund our
public health care programs. Minnesota is facing a $6 billion budget deficit,
and we cannot tolerate insurance companies making huge profits while
vulnerable Minnesotans lose their coverage.
Feb. 28, Education Session
5:30 – 9:00 p.m.
March 1, Capitol Visits
begin at 9:00 a.m., rally at 12:30 p.m.
Learn about the landscape from both sides of the aisle
Learn more and/or register at www.mnnurses.org/dayonhill
The Minnesota Nursing Accent January/February 2011