A report published last week in Health Care Management Review downplays the importance of nurse-patient staffing ratios in the quality of patient care. But Linda Hamilton, two-term president of the Minnesota Nurses Association, maintains that those ratios are still the 20,000-member organization's utmost concern.

They’re what led thousands of Minnesota nurses to walk off the job for a day in June of 2010 before negotiating a surprising three-year contract with six Minnesota hospital chains that gave the union little of what it asked for.

With talk of striking aside (for now), the union has instead been making news recently for throwing its support behind the OccupyMN movement, an interesting choice for the loud, sometimes criticized organization. “We are expected to advocate for people, whether you’re ill or not, and let’s face it, right now America is pretty sick,” declared National Nurses United (MNA’s national union) President Jean Ross in a video blog from October.
     
In an interview with MedCity News, Hamilton — who was re-elected in October — explains the organization’s jump into social justice and reflects on the strike with another year under her belt.

Q: A big concern for your organization is the nurse-patient staffing ratio, and you’ve had to compromise quite a bit. Are there any signs that you will ever get what you’ve asked for?

A: Right now, hospitals are doing everything in their power to prevent better nurse-patient ratios. They’ve made it no secret that they aren’t going to follow through on the promises that they made. It’s been quite discouraging for us and for our patients. There’s been a number of times where it’s just plain bad behavior being done by our employers when it doesn’t even make financial sense what our ratios are.

Q: What are some of the other big concerns for your nurses right now?

A: We are also undertaking the Main Street Contract for America. It’s a social justice contract. Essentially, what we’re saying is that Wall Street got us into this situation and it’s time for them to take responsibility. The people that are on Wall Street, their behavior has been way too risky and not in the interest of anyone. If you live in America, you have the right to shelter, healthcare, education, a clean environment and that taxes you pay should be just.

One of our main objectives for the long-term is everyone in America having equal, quality healthcare. To do that, we’re going to have to take on more than nurses traditionally do.

Q: Why did the union throw its support behind the Occupy Wall Street movement?

A: Our movement into the social justice, we made that transition because fixing healthcare isn’t enough. Occupy Wall Street is a sign that the people of America are going to come up and say, we give billions of dollars to those financial institutions that make illegal deals that are hurting us. Those of us at the bottom of the economic rung are just as valuable as those at the top. We need people to start demanding their value.

We’ve discharged patients to a car. I work in the newborn intensive care unit, and in one instance, a newborn baby was going to live in a truck. That’s not America. We can do better than that.

Q: Reflect on the strike last summer. What did that do for MNA? Looking back, what would you have done differently?

A: I think the strike in 2010 engaged and united our entire membership. I don’t think ever before there’s been 12,000 nurses united. And we gave the media total access — the media talked to members of the union that we didn’t pick. Whether they had been in the profession for two weeks or 40 years, they all had the same message. That solidarity we had was very interesting.

It was phenomenal when you looked out at the road and saw people for blocks. No one could walk down the sidewalk because of the sea of red. We also had other unions out there, churches, Kiwanis, Lions, because they felt that our fight was for them as well. There’s not a soul in Minnesota that doesn’t think about nurse staffing when they have to go in the hospital. You always get scared when you have a party that no one’s going to show up, but people showed up.

We really did a great fight and we really did the right fight. I can’t think of anything we would have done differently.

Q: How, specifically, has social media helped your organization?
I think that has grown to people who would never have been involved. The nurses that work on the Saturday night shift, they now have access to information. They can relate to each other at 3 a.m. when they’re all awake. It’s been about waking up our membership that isn’t always there, and the younger people.

It’s also helped get our message out to the public and media. We allowed everything to be up there (on Facebook during the strike), whether it was positive or negative. People used it responsibly. It was a great tool for people who are kind of on the edge — it gave them the opportunity to do little things like just read and respond.

Q: Tell us a little about your background as a healthcare professional.

A: I’ve been a nurse for the last 32 years, in the newborn intensive care unit at Children’s Hospital in Minnesota for 26 years. Before that I worked six years in a nonunion facility where we had mandatory overtime, staffing was horrendous and you could count on the fact that you’d be working the night shift. We had no method to advocate for patients at all. At my old job, they had ventilators and respirators coming into the unit and nurses had to read the manual or teach themselves how to use them. I made the move very consciously to go to a unionized facility where we now regularly use the contract for patient care. For example, we put in contract that they have to teach nurses how to use new equipment that comes in.

Q: What are your long-term goals for the MNA?

A: Long-term, [we] want to see MNA and nurses united. As well, we’d like to make sure that we’re growing, not just in number, but in power at the bedside. We have organized masses that are fighting for nursing and patients that we care for. We’ve found that a wake-up call has been sent.