Seachange Bulletin #115

August 9, 2003

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Seachange Bulletin #115: AARN/Massachusetts: Democracy in Action

Nurses press to join union
Hospital blocking release of '02 vote
Emily Shartin, Boston Globe, March 9, 2003

Pembroke - Helen Gillam considers her colleagues, nurses at Pembroke
Hospital, a hard-working group, dedicated to their patients and each other.

''That has been the strength of Pembroke Hospital, that we have so many
invested nurses,'' said Gillam, who has worked at the psychiatric hospital for 10
years. ''But we're getting worn down.''

For about nine months, nurses have been pushing for the release of a union
vote held last spring to determine whether they would organize with the
Massachusetts Nurses Association. The ballots have been impounded since hospital
management appealed the decision to allow the election. Hollace Enoch, an associate
executive secretary for the National Labor Relations Board, said the appeal
is still pending, but could not say when a ruling would be made.

The nurses say a union would give them leverage in pushing for more staff and
better working conditions. Several of the hospital's approximately 60 nurses
say there have been regular problems subduing unruly patients because of
inadequate staffing levels, and that employees are frequently assaulted. They
object to cuts implemented by hospital management, including the recent elimination
of a security position. The working environment has led to the resignation of
several nurses and has had a negative impact on patient care, according to
the nurses.

''The conditions are getting worse as time goes on,'' said Jane Davis, who
has worked at the hospital for 17 years. ''We need some support.''

Arbour Health Systems runs Pembroke Hospital - which is licensed by the state
Department of Mental Health - and a similar facility in Westwood. Since
Arbour took over two years ago, CEO Roy Ettlinger said, management has worked to
improve the hospital's services and financial viability. Pembroke Hospital is
accredited by the Joint Commission on Accreditation of Healthcare Organizations,
an independent agency that evaluates 17,000 health-care programs nationwide.

''I believe quality has improved,'' Ettlinger said.

Psychiatric facilities generally are seeing more seriously disabled patients,
Ettlinger said. Although incidents at Pembroke Hospital are not frequent, he
said, safety is an ongoing concern, and the hospital has procedures and
reviews to deal with problems. The company decided to eliminate the security
position because it believed it would be more effective to have another employee
working directly with patients.

''Pembroke Hospital is a safe hospital,'' Ettlinger said. ''That's a very
high priority for us, to keep patients safe and to keep staff safe.''

Pembroke Police Chief Gregory Wright said his department has responded to
numerous calls from the hospital over the past several years, including reports
of out-of-control patients and assaults. Wright does not offer an opinion on
the disagreement between nurses and management, but said he is concerned that
police are called too often because the hospital lacks adequate security.

In mid-February, a doctor at the hospital was severely beaten by a patient,
Wright said. In 2001, a nurse was knocked unconscious and hospitalized after
she was pushed into a door by a patient. Nurses also cite a serious assault by a
patient last year that left another nurse hospitalized.

Michael Weeks, director of licensing for the state Department of Mental
Health, said 11 state investigations involving Pembroke Hospital were initiated in
2002. Although he conceded the number is high compared to the other 60
hospitals the state licenses, he added that it indicates the hospital is doing a good
job of reporting complaints. Most of the investigations have focused on
service and treatment issues, although concerns about staffing levels and reports
of assaults do factor in to the state's reviews, Weeks said. Investigations
usually result in a corrective order.

The state mandates certain numbers of staff per patient, Weeks said, and lets
the hospital determine how it will allocate employees to meet those
requirements. The state has not weighed in on the union drive at Pembroke Hospital, but
Weeks acknowledged the difficulties and potential dangers of the job.

''The staff at these facilities ... have a very tough job,'' he said.

The federal Occupational Safety and Health Administration (OSHA), which
monitors workplace safety, has one record of a complaint at Pembroke Hospital,
registered in 1991. An investigation into that complaint was closed after no
violations were found, according to John Chavez, an OSHA spokesman.

Although they have not seen the ballots, Pembroke Hospital's nurses say they
believe a majority voted in favor the union. Hospital management challenged
the election, arguing that nurses act as supervisors and should therefore not be
allowed to unionize. Ettlinger said Arbour Health Systems believes it can
work more effectively with nurses in the absence of a union, but said it would
respect whatever ruling the labor board issues.

Emily Shartin can be reached by e-mail at
eshartin@globe.com.

© Copyright 2003 Globe Newspaper Company

Tireless, union chief keeps up nurses' fight
Robert Preer, Boston Globe, May 4, 2003

From Friday through Sunday, Karen Higgins works 12-hour days as a critical
care nurse at Boston Medical Center's cardiac and intensive care unit.

On other days and nights, she often walks picket lines, participates in
candlelight vigils and lobbies politicians on Beacon Hill.

For two years, Higgins, 47, a lifelong Weymouth resident, has been president
of the state's largest professional health care association, the 20,000-member
Massachusetts Nurses Association.

Under her leadership, the union, which is based in Canton and has 50
employees, has emerged as a key player in the debate over health care policy in
Massachusetts.

The organization is pressing for legislation that would set strict
nurse-patient ratios - four patients per nurse in most units - at all hospitals in the
state. Better working conditions would help to alleviate the shortage of nurses
in the state, according to the association.

The union earlier brought to the fore issues of mandatory overtime and other
stresses on nurses with protracted strikes at Brockton Hospital in 2001 and at
St. Vincent's Hospital in Worcester in 2000.

The union's strong stance on patient care issues and its job actions have
reverberated at the national level. In 2001, the Massachusetts Nurses Association
terminated its affiliation with the more conservative American Nurses
Association.

With nurses' unions from California and Maine, which also broke away from the
national group, the Massachusetts Nurses Association has formed an alternative
group, the American Association of Registered Nurses.

It is rare for the president of a union as large and active as the
Massachusetts Nurses Association to continue to work a regular job. Higgins said she
sees her union and patient care work as part of the same mission.

The fact that she has continued to work as a nurse gives her credibility with
the membership, according to union officials.

''It's important that she's a front-line nurse,'' said Barbara Cooke, a
Brockton Hospital nurse and member of the union negotiating committee during the
strike. ''She knew what we were going through.''

Higgins often walked the Brockton picket line, which nurses maintained
round-the-clock during the work stoppage.

Higgins's two-year term as union president ends this fall. She is seeking
reelection, and no challengers have come forward yet.

The second oldest of six siblings, Higgins got into nursing shortly after
graduating from Weymouth South High School. She enrolled in a nursing school that
was attached to what was then Quincy City Hospital. The school closed in the
late 1970s, and the hospital is now an independent institution affiliated with
Boston Medical Center.

''I never quite figured out what drove me into nursing,'' she said in a
recent interview at the union's offices in Canton. ''I guess coming from a large
family ... it seemed like we were always taking care of each other.''

While she was in nursing school, her father, who is now deceased, suffered a
heart attack and was treated at University Hospital. She admired the care he
received there, and she applied for and received a job at the Boston University
institution shortly after she graduated.

She has worked at the hospital - renamed Boston Medical Center after its
merger with Boston City Hospital - for 27 years. She said she has a high regard
for the institution.

''Nurses are involved in everything there,'' Higgins said.

In the 1980s, the health care system in Massachusetts and elsewhere was
pressured to cut costs. To save money, hospitals restructured their work forces,
requiring new duties of some nurses and replacing others with lower-paid
technicians.

''What we were seeing was that hospitals were becoming a business - which
they never had been before,'' said Higgins. ''There was a feeling that patients
didn't come first.''

Higgins became involved in union affairs at that time. In the 1980s, she was
among the activists who pushed for a more militant approach from the
Massachusetts Nurses Association, which had functioned more as a professional
association than as a labor union.

The organization became involved in a series of disputes with hospitals. In
most of the conflicts, traditional union issues of pay and benefits were
secondary to working conditions and patient care. In the Brockton and Worcester
disputes, the union contended that mandatory overtime put too much stress on the
nurses and caused patient care to suffer.

Throughout the 1980s and 1990s, Higgins moved up the union ladder, holding
positions first with her hospital's local, then serving on state committees.

Higgins, who is single, lives in her childhood home in Weymouth Landing, near
Sacred Heart Church, but the house has been divided into a three-family
residence, with her mother in one unit and her sister in the other.

Union rules prohibit Higgins from serving more than two terms. She said she
hopes to stay involved in health policy matters, perhaps at the local level.

© Copyright 2003 Globe Newspaper Company

As National Nurses Week Begins, Massachusetts Nurses
Association Membership Reaches All-Time High
More than 22,000 Registered Nurses and Health Professionals Belong
Massachusetts Nurses Association, May 7, 2003
<
http://www.massnurses.org/News/2003/05/membership.htm>

Canton - As nurses seek to improve staffing ratios, working conditions and to
achieve fair pay and benefits as a means of improving patient care in the
Commonwealth, a growing number are turning to the Massachusetts Nurses
Association as a vehicle for nursing and patient advocacy. This month, membership in the
Massachusetts Nurses Association, which is both the professional association
for registered nurses and the state’s largest union for registered nurses,
topped 22,000, the highest membership count in the Association’s 100-year history.

Membership in the MNA, which reached a high in the early 1990s of just over
20,000 members, dipped below 20,000 for most of the 90s, but has surged in
recent years as the organization has gained stature and visibility as a powerful
voice for nurses through successful public policy initiatives on Beacon Hill
and through high-profile union contract efforts. In the past year, the MNA has
seen a 10 percent increase in its membership, with the new membership equally
split between union and non-union nurses.

For the last 10 years, the MNA has been the leading voice in the nursing
community on public policy issues related to patient safety, access to quality
health care for all residents, the protection of health care facilities from
closure and, most important of all for nurses, legislation that would regulate how
many patients are to be assigned to a nurse.

More and more nurses are joining the MNA because they understand that we are
the voice for nurses on issues most important to them, which are issues that
deal with their ability to provide safe, high quality patient care, said Karen
Higgins, RN, president of the MNA since 2001, and a key force behind the MNA's
success. Nurses know the MNA is not afraid to stand up to the health care
industry and the insurance industry to make sure that their voice is heard and
that the needs of their patients are being adequately addressed.

On the policy front, the MNA has become a powerful force on Beacon Hill,
winning passage of numerous pieces of legislation in the last five years,
including a bill to mandate identification of licensed health care workers to ensure
patients know who is providing their care, a law providing whistle blower
protection for nurses and other health professionals in reporting unsafe patient
care conditions to appropriate authorities; and the MNA led the effort to pass a
law to require the use of safe needle systems in hospitals to prevent
needlesticks and HIV infection of health care workers. The organization also played a
role in helping to pass legislation regulating drive-thru deliveries and
landmark legislation granting consumers a patients bill of rights under managed
care.

The most important initiative for nurses and the MNA, and the issue that has
mobilized the nursing community behind the organization, has been a push to
improve patient care, protect patients and address the nursing shortage by
passing a law to regulate RN-to-patient ratios in Massachusetts hospitals. The bill
filed by the MNA, H. 1282, An Act Ensuring Quality Patient Care and Safe
Registered Nurse Staffing, has already garnered 101 legislative sponsors and has
been endorsed by more than 55 consumer and health care advocacy organizations.

Nurses Turn to MNA Union for Protection

The MNA made headlines throughout the late 1990s for its efforts on behalf of
unionized nurses to address issues of safe staffing, mandatory overtime and
to prevent the replacement of nurses with unlicensed personnel, all of which
are strategies the hospital industry employed as a means of cutting costs by
cutting back on the publics access to nursing care.

These efforts garnered national attention in 2000 and 2001 with widely
publicized strikes by MNA nurses at St. Vincent Hospital in Worcester and Brockton
Hospital over the issue of RN staffing conditions and the use of mandatory
overtime. In both cases, the strikes ended in the nurses favor, resulting in
groundbreaking contract language to prohibit mandatory overtime and to require the
hospitals to provide better staffing conditions.

MNA now represents nurses for collective bargaining in 85 different health
care facilities, including representing the nurses at 51 of the 76 acute care
hospitals in the state, which makes the MNA a leader in the nation in union
penetration, with 65 percent of hospital nurses represented by the MNA, and 25
percent of the total nursing population in the state.

Throughout the late 1990s, the MNA's success as a union helped generate a
boom in union organizing for nurses in the state with the MNA. Between 1997 and
2000, the MNA organized a total of seven hospitals, three VNAs and four school
nursing units, totaling more than 2,800 nurses under the MNA union umbrella.

During the same time period in 2000, the MNA also made a historic and
controversial decision to disaffiliate from its national organization, the American
Nurses Association. The MNA believed the ANA had become too conservative in its
policies and positions and was failing to adequately represent the interests
of front-line nurses, who comprise the vast majority of the MNA membership.

On March 24, 2000, more than 2,400 nurses flocked to Mechanics Hall in
Worcester to cast a historic vote to split from the ANA, with 83 percent supporting
the measure. This was the largest gathering of registered nurses in one
location ever assembled in the state.

The move to disaffiliate was a defining moment for the MNA, providing the
organization with greater resources and a clear focus on a core mission to
protect and promote the interests of front-line registered nurses and their
patients. In 2001, the MNA joined with other like-minded organizations to form a new
national organization, the American Association of Registered Nurses,
collectively representing more than 80,000 nurses.

# # #

Founded in 1903, the Massachusetts Nurses Association (MNA) is the largest
professional health care association and the largest union of registered nurses
in the Commonwealth of Massachusetts. Its 22,000 members comprise every role
and area of nursing practice, working in more than 85 different health care
facilities across the state, ranging from large metropolitan hospitals to
community hospitals to visiting nurse associations. The MNA's membership includes
registered nurses in acute care, rehabilitation, long term care and mental health
care, as well as school nurses, public health nurses, nurse practitioners,
nurse midwives, nursing educators, nursing administrators and researchers. In
the public sector, MNA represents more than 2,000 health professionals (which
includes physicians, psychiatrists, occupational therapists, etc.) working in
the state departments of mental health, public health, mental retardation and
social services.

Serving as a voice for the nursing profession, the MNA works to advance
nursing and health care by fostering high standards of nursing practice, promoting
the economic and general welfare of nurses in the workplace, projecting a
positive and realistic view of nursing, and by lobbying the Legislature and
regulatory agencies on health care issues affecting nurses and the public.

Mass. Nurses Association Condemns Tenet-SEIU Neutrality Pact
Supports Calif. Nurses Assn. Challenge of Deal as an Illegal
Attempt to Deny Employees Choice that Could Harm Patients
Massachusetts Nurses Association, May 8, 2003
<
http://www.massnurses.org/News/2003/05/Tenet.htm>

Canton - The Massachusetts Nurses Association (MNA) joined the California
Nurses Association (CNA) in condemning a deal announced on Monday by Tenet
Healthcare and the Service Employee International Union (SEIU) as an attempt to
bribe Tenet employees, deny them a democratic choice on who should represent them
and, in the end, create a "company union" that will deny nurses at
California-based Tenet hospitals from having a real and powerful union voice on patient
care issues.

The Tenet-SEIU agreement would allow SEIU to conduct organizing campaigns and
hold union elections at 28 Tenet hospitals in California and two in Florida -
with the blessing of Tenet's hospital management. In return, and in advance
of any employees voting for the union, SEIU union locals at the Tenet hospitals
are required to accept pre-negotiated wages in a four-year contract agreement
and give up their federally legislated right to strike.

The deal follows months of bad press and scrutiny of Tenet Healthcare,
including government probes into allegations of widespread Medicare fraud by the
company, and is seen by many as a way to squelch true organizing efforts at Tenet
facilities, as well as to buy the silence of long-time critics of the
corporation. The MNA also believes Tenet has cut the deal to work with SEIU as
opposed to the powerful California Nurses Association, which has negotiated much
stronger agreements for nurses in the state.

"This kind of back-room dealing by a union with the country's most notorious
anti-union and anti-patient corporation is nothing less than shameful and
represents a major setback for the labor movement in California," said Julie
Pinkham, RN, executive director of the Massachusetts Nurses Association, an
independent nurses union representing more than 22,000 RNs and health professionals
in Massachusetts. "The point of collective bargaining is to organize a union to
negotiate a contract that meets your needs. This deal forces nurses to except
a contract in order to have a union, and a union without the power to act
like a union at all."

World renowned consumer advocate Ralph Nader has also joined CNA and the MNA
in questioning the agreement and its impact on patients.

"Tenet is notorious for its commitment to profits regardless of the
consequences for the public's well being," said Nader. "As has already occurred with
other arrangements, SEIU's back room deal degrades independent professional
responsibility of nurses for patient care protection."

The Massachusetts Nurses Association represents two Tenet-owned hospitals in
Massachusetts and is currently negotiating a new contract at Tenet-owned St.
Vincent/Worcester Medical Center in Worcester, Mass. In 2000, the nurses at the
facility led a highly publicized 49-day strike over the issues of unsafe
staffing and mandatory overtime, ultimately winning landmark contract language to
prohibit the practice at the facility.

"We believe employees should be free to form unions with a representative of
their choosing, in an environment free from company coercion," Pinkham said.

On Thursday, registered nurses at seven Tenet hospitals in Los Angeles and
Orange County petitioned the federal labor board for a representation election.
That process, which provides RNs at those hospitals with a genuine democratic
choice and allows other unions t participate, supersedes the Tenet-SEIU pact
and will proceed.

"Free elections should be a model for Tenet RNs and all Tenet employees. In
the United States, employees still get to choose their union and should not
have the company choose it for them," said CNA executive director Rose Ann
DeMoro.

"It's outrageous that non-union Tenet RNs and other employees, who are far
behind the economic standards of other hospital workers, especially RNs
represented by CNA in 150 facilities across California, would be compelled to join a
union anointed by Tenet to qualify for pay increases," DeMoro said.

"Tenet should immediately provide the pay increases and any other
improvements promised in this back room deal to its deserving employees - without
conditions, and without denying their democratic rights to freely select a union of
their choice," DeMoro added.

Instead, Tenet employees would be locked into a long term agreement with the
main terms decided in advance in closed door meetings with top managements of
Tenet and SEIU.

Further, there are no indications that Tenet RNs, in particular, will be
permitted to continue to exercise their patient advocacy obligations and be able
to freely protect their patients. In the Kaiser Permanente deal with SEIU and
AFSCME which SEIU cites as a model in its press release, those unions agreed to
silence on hospital closures or any business decisions that compromise
patient care and SEIU co-wrote harmful programs such as bonuses for telephone advice
clerks who limit patient referrals to physicians.

CNA said yesterday that it will file charges with the National Labor
Relations Board and is considering other legal actions against the pact. Several
provisions of the deal are illegal including:

Forcing employees to join SEIU as a condition for receiving pay and benefit
increases.
Bribing employees with the promise of increased pay solely based on joining
SEIU.
Selecting for employees what union they have to join and granting exclusive
favors to that union.

For Tenet, said DeMoro, "This appears to be a short term public relations
strategy designed to drive up their stock prices with the supposed promise of
'labor peace'. Perhaps they are guided by illusions of hefty profit taking for
top executives who have seen their stock portfolios plummet in recent months
due to numerous federal and state investigations into Tenet's billing practices
and patient care conditions."

"But it will be a failed strategy," DeMoro continued. "If Tenet is doing this
for investor security, investors should feel anything but secure."

More information about CNA, Tenet, and SEIU is available on the CNA website
at
www.calnurse.org <http://www.calnurse.org/>.

Campaign to Save Fernald Continues, Despite Governor’s Veto
Massachusetts Nurses Association, July 1, 2003
<
http://www.massnurses.org/News/2003/07/cofar.htm>

Mansfield - Advocates for the Fernald Developmental Center and other state
facilities for the mentally retarded vowed today to continue their campaign to
save the facilities, despite a veto by Governor Mitt Romney of language in the
current-year state budget that would protect them from summary closure.

"We think we have a great chance of an override in the Legislature," said
Thomas Frain, President of the Coalition of Families and Advocates for the
Retarded (COFAR), which had been lobbying at the State House since April in support
of the facilities.

"It’s a shame that the governor has continued to target these facilities,
which provide such vital services for some of the most vulnerable citizens of
our state," Frain continued. "We know what the real reason is, of course. It’s
a land grab and a bonanza for certain private service vendors."

Frain noted that the governor’s veto came less than a week after COFAR
delivered a final set of petitions to Romney’s office, containing signatures
collected from more than 14,000 people across the state, who oppose the facility
closures. Romney also never responded to several invitations from COFAR, and one
from State Senator Susan Fargo (D-Lincoln) and other legislators, to visit
Fernald before making a final decision on its closure.

Compounding the problems that will be caused by the closures of the state
facilities, the governor Monday also vetoed some $3,334,000 in funding earmarked
by the Legislature for a wide range of community-based programs for the
retarded. Frain noted that in failing to adequately fund community programs, the
administration is "setting the stage for a major crisis when and if they start
transferring hundreds of state facility residents into community residences. It
won’t be just a quality-of-care issue. There will be no place to put them.
There will be a huge increase in regressive behaviors and even deaths."

The governor’s state-facility veto concerned budget language approved late
last month by the House and Senate, which would require that a cost-benefit
analysis be done before either Fernald or the other state facilities could be shut
down. That language would also require that the Department of Mental
Retardation (DMR) determine that any residents transferred from those facilities would
receive equal or better care in any community-based setting to which they are
sent.

The budget language also specifically precluded the shutdown of Fernald
before October 2004 in order to ensure community, client, and family member input
into the closure planning process. It also would require that the DMR report on
the steps taken to minimize increases in travel distances for family members
visiting residents who have been transferred from one facility to another.

"This language was completely reasonable and moderate - providing certain
conditions and a humane time-frame before closure could be considered," said
Colleen Lutkevich, COFAR’s Executive Director.

In addition to vetoing the facility protection language, the governor reduced
funding to the state facilities in the current fiscal year by more than
$698,000.

The governor first announced in February that he was targeting Fernald and
potentially five other remaining state facilities for the retarded in
Massachusetts for closure as a budget-cutting measure. The administration, however, has
never provided backup figures for what have turned out to be declining savings
projections in closing Fernald. The administration first projected a $4
million savings in closing Fernald, and later revised that projection to $2.3
million. COFAR contends the closures will put the entire continuum of care for the
retarded in Massachusetts at risk, without saving the state money.

A significant portion of the 309 residents of the Fernald Center are among
the most severely and profoundly retarded in the state, many are elderly, and
many have acute medical needs. Fernald and the other state facilities currently
provide state-of-the-art care for those residents. That intensive level of
care is not currently available anywhere in the community-based system, according
to Lutkevich.

Lutkevich noted that COFAR and other advocacy organizations have offered to
work with the administration to find other, compatible uses for the 187 acres
of land at the Fernald site. In addition to the Fernald Center, a number of
other facilities on the grounds would be closed under the administration’s plan,
including a skilled nursing facility for 27 people with mental retardation,
two state-operated group homes housing 12 people, and a shelter for homeless
women. In addition, the Shriver Center, which provides medical services to the
Fernald residents and a Tufts dental clinic would be evicted.

Since the Governor announced his intention to close the facilities, COFAR
volunteers have made at least three visits to the State House to lobby for the
facility protection legislation and to deliver petitions to the Governor’s
office. Last week’s visit included the delivery of final petition signatures to the
offices of both Senate President Robert Travaglini and House Speaker Thomas
Finneran.

Leading by Example
Nurse leader sets the tone by letting her actions follow her words
Pauline Greenberg, ADVANCE For Nurses, July 7, 2003
<
http://www.advancefornurses.com/common/editorialsearch/viewer.aspx?FN=03jul7_n6p10.html&AD=7/7/2003&FP=nw>

Karen Higgins, RN, is on a mission. She wants to make nursing care safer for
patients and for nurses. So she's gathering support and encouraging nurses
everywhere to step up and get involved.

Higgins, president of the Massachusetts Nurses Association (MNA), is the
force behind HB 1282, An Act to Ensure Quality Patient Care and Safe RN Staffing,
a bill before the Massachusetts legislature that would set staff ratio
standards. It's an issue that is close to this nurse's heart.

She's been a staff nurse in the ICU at Boston Medical Center for 28 years and
still puts in 32 hours a week on the floor while she fulfills her role as MNA
president.

"I'm a strong advocate of seeing staffing ratios put into effect," Higgins
told ADVANCE. "It means that the patients will be safer, but also that nurses
will be practicing safer."

The Knick of Time

Massachusetts is losing new nurses faster than the attrition rate of older
nurses, Higgins said. And the reason this is happening, she added, is due to the
pace and workload facing nurses today.

Nurses can expect to care for 5-6 patients on a floor. Some studies show that
safety standards for a med/surg floor call for a 1-to-4 nurse-patient ratio.
And the number of patients should drop to 3 per nurse if any of the patients
require extra care.

"We're a 24/7 group," Higgins said. "You go into it because you really do
care and want to take care of patients and their families. It's very sad that we
have a generation of nurses that haven't been able to care for patients
safely."

Higgins is counting on HB 1282 to change things for the better. As head of
the MNA, she's spearheading the campaign. The group has been meeting with
legislators in small groups and working on educating the public. Last year, the MNA
garnered 80,000 signatures in 2 weeks in support of the bill. This year,
Higgins and others from MNA organized a rally June 18 - the hearing date for the
bill (see What's in a Number? page 13) - at the State House.

Her Story of Caring

But the staffing bill is only one of the major impacts Higgins has had on
nursing care over the past 2 decades.

From a large family in Weymouth - she still lives in her family home -
Higgins was the oldest girl of six kids. She has always taken care of somebody.
Nursing was a natural choice.

Her dad, who worked for the local highway department, piqued her interest in
politics and activism by his own involvement in local issues. She graduated
from Quincy School of Nursing in 1975 and went right to work for Boston Medical
Center (then called University Hospital).

"The first 2 years of nursing," she said, "your total focus is surviving and
becoming who you are as a nurse. Once you get past that you start looking
around at some of the things going on. As much as it's a wonderful profession,
it's not a perfect profession."

University Hospital was unionized, so it was easy for Higgins to get
involved.

"You can complain and do nothing or get out of the profession. Or you fight
to make a change, to improve what you don't like and fight to make things
better," she observed.

"I was not willing to give up. It was worth the fight to ensure that we can
practice safely."

Movin' on Up

Before long, Higgins was the chair of the local bargaining unit; then she
moved on to the state level and became chair of the labor program. She never
expected that she'd become the president of one the largest nursing groups in the
state. MNA is also one of the most vocal state nursing organizations in the
country, frequently commenting on medical and nursing news from Maine to Florida
to California.

When the labor program merged with the MNA in 2000, Higgins ran for union
president. "A 12-person cabinet became a board of 29. It's a great dynamic group
of nurses who have put a lot into nursing," she added.

It was with the support of this group that Higgins led the MNA's
disaffiliation from the American Nurses Association (ANA).

"It was a tough decision," she admitted. "We stayed with the ANA believing
that the changes could be made to make ANA more reflective of the members. They
represent a large variety of nurses and it's tough to meet everyone's needs."

The ANA straddled the fence on some very important issues for the 22,000
members of the MNA, she explained.

"We don't have the luxury of not offending anyone. We needed to do this for
our members and we made the commitment that we're not giving up on having a
national voice and national organization."

Along with RNs from California, Maine and Pennsylvania, the MNA helped form
the American Association of Registered Nurses. The group is now almost as large
as the ANA.

"We're thrilled to be part of this group," she said. She added that she has
not ruling out the possibility of seeking a national position in the future.

An Endless Horizon

Higgins said she plans to run for one more term as MNA president. After that,
who knows?

"I've always loved nursing and don't think there is a better profession to be
in," she concluded. "My gut instinct is that whether through MNA or some
other group, I will always be involved in something.

"Life hands you things, and wherever I am I hope I'm doing something good."

Pauline Greenberg is a freelance writer for ADVANCE.

Copyright ©2003 Merion Publications

St. V RNs win contract, more pay
Jim Bodor, Worcester Telegram & Gazette, July 12, 2003

Nurses at St. Vincent Hospital at Worcester Medical Center have ratified a
new three-year contract that includes raises of as much as 44 percent for some.

The contract covers about 700 registered nurses working full time or part
time at the hospital, owned by Tenet Healthcare Corp. of Santa Barbara, Calif.

The contract, which was ratified by the nurses union during day-long voting
Thursday, steadily increases the wage for nurses at the top of the scale from
$32.42 per hour now to a high of $42.40 by July 2005. The biggest increases
come in the first year of the contract, and every nurse will receive at least a
13 percent raise.

For a veteran nurse working 40 hours per week, that would be equivalent to an
annual salary of $88,192 by the end of the contract. Some nurses, lower on
the scale, will benefit more as they move up the ladder.

About two-thirds of the St. Vincent nurses represented by the Massachusetts
Nurses Association are at the top of the scale, according to the union. Their
work weeks vary between 24, 32 and 40 hours.

The raises put the St. Vincent nurses' salaries in line with UMass-Memorial
Health Care Inc.'s Memorial Campus, where nurses signed a contract that will
pay the most senior nurses $43.03 per hour, or $89,500 annually, next year.

"The most important thing about the wage and salary package is that it puts
us in the ballpark with other facilities, and it will help us retain nurses,"
said Sandy A. Ellis, secretary of the bargaining unit, which is represented by
the Massachusetts Nurses Association.

The new St. Vincent contract also includes limits on when and how the
hospital can move a nurse to another unit and guarantees one week of vacation during
the summer for every nurse.

The hospital agreed as well to form a health and safety committee with the
nurses and to limit how often it can send nurses home on forced days off because
of low patient counts. The committee will allow nurses and managers to
discuss such issues as accidental needle-sticks, workplace violence and other issues.

The contract also contains the same restrictions on mandatory overtime that
the nurses won after striking in 2000. The nurses can reject any overtime
request if they believe they are too tired to work it.

"We're very pleased with the outcome and thrilled that we never had to take
any serious job action," Mrs. Ellis said. "Overall, it's a very fair and
equitable agreement for the nurses and the hospital."

Hospital officials said the salary increases will likely result in a 21
percent increase in the overall budget for nurse salaries.

"The new agreement is fair to the parties involved and reflects the overall
labor market for registered nurses in Central Massachusetts," said C. Barry
Dykes, president and chief executive of the hospital. "The terms of the new
contract are consistent with our management policy of providing competitive wages
and benefits to all of our employees."

The contract will expire Jan. 1, 2006.

The nurses' former contract expired Dec. 31, 2002, but both sides agreed to
extend it while talks on a new contract proceeded.

Negotiations on the latest contract began in November 2002 and ended in late
June after an all-night bargaining session.

That process was far different from what nurses and hospital managers
encountered three years ago.

The nurses went on strike for 49 days in early 2000 when contract
negotiations broke down over issues such as mandatory overtime. Hospital managers hired
replacement workers to take the place of the striking nurses. The nurses then
organized rallies and enlisted the support of politicians, including US Sen.
Edward M. Kennedy and US Rep. James P. McGovern.

The two sides finally agreed to a contract that included the limits on
mandatory overtime and salary increases that drove the nurses' top rate to $32 per
hour.

Copyright 2003 Worcester Telegram & Gazette Corp.

Kudos to the State Senate for their vote today to override Governor
Romney's veto of budget language to protect Worcester State Hospital
Massachusetts Nurses Association, July 15, 2003
<
http://www.massnurses.org/News/2003/07/worcester.htm>

The Senate cast a vote last night that rejects Governor Romney's misguided
attempt to close Worcester State Hospital, a vitally important psychiatric
hospital providing a variety of services to some of the most vulnerable mentally
ill residents of the Commonwealth.

Special thanks go to State Representative Vincent Pedone and State Senator
Harriett Chandler, who both worked tirelessly to preserve Worcester State
Hospital. And thanks go to all the legislators who joined them in standing up for
those most in need. For those who have made calls to the legislature over the
past several months in this campaign, now it is time to make one more call to
thank our elected leaders for their courage and commitment.

And last but not least, congratulations to all the members of the Coalition
to Save Worcester State Hospital, including the dedicated staff at the
facility, the many community leaders in Worcester and beyond who lent their voice and
influence to this struggle, to our Congressional Delegation, especially Co
ngressman Jim McGovern and his staff who weighed in on this issue, and to the
media for giving this issue such fair and comprehensive coverage.

This is an example of good government in action, protecting those who can't
protect themselves!

Governor’s Fernald and Community-program Vetoes Overridden
Massachusetts Nurses Association, July 15, 2003
<
http://www.massnurses.org/News/2003/07/fernald.htm>

Mansfield - In a move to forestall a potential crisis in care for the
mentally retarded in Massachusetts, the House and Senate last week successfully
overrode vetoes by Governor Mitt Romney of legislation protecting state-operated
facilities for the mentally retarded from summary closure.

The House and Senate also overrode the governor’s vetoes of nearly $700,000
in funding for the state facilities and more than $4 million in funding for
community-based care for the retarded.

"The Legislature has prevented a full-blown crisis that would have been
caused by the governor’s vetoes," said Thomas J. Frain, President of COFAR (the
Massachusetts Coalition of Families and Advocates for the Retarded). "We are
thrilled with these overrides. It made no sense for the governor to close down
state facilities for the mentally retarded; it saves no money and causes
enormous anxiety and suffering for hundreds of mentally retarded people and their
families. If the vetoes had not been overridden, hundreds of mentally retarded
residents in the commonwealth would be facing eviction."

The Legislature’s actions save the Fernald Developmental Center in Waltham
from closure prior to October 2004 and ensure that a committee will be
established to study the reuse of the Fernald site in order to keep at least a portion
of it as a continuing home for its 300 residents.

Late last month, the governor vetoed language in the fiscal year 2004 state
budget, which would require that a cost-benefit analysis be done before either
Fernald or five other remaining state facilities could be shut down. That
language would also require that the Department of Mental Retardation
predetermine, prior to transfer, that any residents transferred from those facilities
would receive equal or better care in any proposed community-based setting. The
governor had also vetoed an outside section of the budget, which called for the
establishment of a reuse committee to consider alternative uses for Fernald’s
187 acres of land, while maintaining the site as a continuing home for its
current residents. The state facilities in addition to Fernald are the Wrentham
Developmental Center, the Monson Developmental Center, the Glavin Center in
Shrewsbury, the Templeton Developmental Center in Hathorne, and the Hogan Center
in Danvers.

COFAR and other advocates for the retarded have been lobbying since April
against the governor’s plans to close the state facilities, which provide
state-of-the-art care for the retarded. COFAR has argued that given a continuing lack
of adequate funding and oversight of community-based care in Massachusetts,
the proposed state facility shutdowns would place the well-being and even lives
of the state’s retarded citizens at risk.

In addition to his vetoes of the state-facility-protection measures, Romney ve
toed more than $4 million in funding for a range of programs for
community-based care for the retarded. According to Frain, the governor’s vetoes of
community-based funding would have meant the closure of 25 group homes in
Massachusetts "at the very least."

The community-based system is currently unable, due to inadequate funding and
oversight, to provide the level of comprehensive care currently provided to
residents of the state facilities, said Colleen Lutkevich, COFAR’s executive
director. Under Ricci v. Okin, a landmark class action lawsuit that led to
improvements in the care in state facilities starting in the 1970s, residents are
entitled to a wide range of services over their lifetimes, including
residential and day programs, recreational activities, medical, dental, psychological
services, respite care, crisis intervention services, adaptive equipment,
guardianship services, and transportation. A significant portion of the
approximately 1,300 residents of Fernald and the other state facilities are among the most
severely and profoundly retarded in the state, many are elderly, and many
have acute medical needs.

The governor’s vetoes came less than a week after COFAR delivered a final set
of petitions to Romney’s office containing signatures collected from more
than 14,000 people across the state who oppose the facility closures. Romney
never responded to several invitations from COFAR and from legislators to visit
Fernald before making a final decision on its closure.

The governor first announced in February that he was targeting Fernald and
potentially the five other remaining state facilities for the retarded in
Massachusetts for closure as a budget-cutting measure. The administration, however,
has never provided backup figures for what have turned out to be declining
savings projections in closing Fernald. The administration first projected a $4
million savings in closing Fernald, and later revised that projection to $2.3
million. COFAR contends the closures will put the entire continuum of care for
the retarded in Massachusetts at risk - without saving the state money.

In addition to saving the Fernald Center, the Legislature’s overrides mean
reprieves for a number of other facilities on the Fernald grounds, including a
skilled nursing facility for 27 people with mental retardation, two
state-operated group homes housing 12 people, and a shelter for homeless women.

Since the governor announced his intention to close the facilities, COFAR
volunteers have made at least three visits to the State House to lobby for the
facility protection legislation and to deliver petitions to the governor’s
office.

Web Directory:

AARN <
http://www.aarn.org>
Australian Nursing Federation <
http://www.anf.org.au>
California Nurses Association <
http://www.calnurse.org>
Canadian Federation of Nurses Unions <
http://www.nursesunions.ca>
CCDS <
http://www.cofc.org>
Irish Nurses Organisation <
http://www.ino.ie>
Labor Party <
http://www.thelaborparty.org>
LabourStart <
http://www.labourstart.org>
Maine State Nurses Association <
http://www.mainenurse.org>
Massachusetts Ad Hoc Committee <
http://www.massadhoc.org>
Massachusetts Green-Rainbow Party <
http://www.massgreens.org>
Massachusetts Nurses Association <
http://www.massnurses.org>
MASS-CARE <
http://www.masscare.org>
New York Professional Nurses Union <
http://www.nypnu.org>
New Zealand Nurses Organisation <
http://www.nzno.org.nz>
PASNAP <
http://www.pennanurses.org>
PNHP <
http://www.pnhp.org>
Québec Nurses’ Federation <
http://www.fiiq.qc.ca>
Revolution Magazine <
http://www.revolutionmag.com>
Seachange Bulletin <
http://www.seachangebulletin.org>
Southern Arizona Nurses Coalition <
http://SAZNC.homestead.com>
Union Web Services <
http://www.unionwebservices.com>
United Health Care Workers <
http://www.uhcw.org>

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