Twin Cities hospitals prepare for nurses' walkout

Leaders of 14 Twin Cities hospitals facing a nurses strike are reassuring the public that they have plans in place to operate safely.

The chief medical officers said at a news conference Tuesday that they are training replacement nurses ahead of Thursday's planned strike.

Dr. Penny Wheeler of Allina Hospitals says the emergency rooms and childbirth wards of all 14 hospitals will be fully staffed with nurses. But some hospitals are taking steps to reduce the number of patients they have, mostly be rescheduling elective surgeries.

Thousands of Minnesota nurses are expected to walk off the job at 14 Twin Cities hospitals starting at 7 a.m. on Thursday. They won't return to work until 7 a.m. the following day.

Hospitals have been advertising for replacement nurses for months. They haven't released any details yet on how many nurses they have recruited, but hospitals have said that their staffing will be sufficient to provide critical care. Twin Cities nurses predict it won't be easy to replace them -- even for a day.

The nurses strike will play out in different ways for each of the 14 hospitals. Some are large urban hospitals that employ thousands of nurses and have bustling emergency departments. Other hospitals have smaller nursing pools and fewer daily demands for emergency services.

We want the public to feel comfortable that we are going to be there when they need emergency care.

The strike will undoubtedly cause disruptions for all them. Hospital spokeswoman Maureen Schriner says the hospitals have taken extra precautions to handle those disruptions.

"Just to make sure that the day goes ahead smoothly, we'll actually have some additional medical staff who are going to be there on a constant basis," Schriner said. "Rather than just making rounds, we're going to have an elevated presence to ensure our patient safety."

That elevated presence includes doctors, pharmacists, respiratory therapists and other medical professionals who ordinarily might not spend their entire day at a hospital. Schriner says having a beefed-up medical staff on hand will make it easier for replacement nurses to transition into their temporary work assignments.

Mary McGibbon, a critical care nurse at Methodist Hospital in St. Louis Park, will hand off her duties to replacement nurse on Thursday. McGibbon says even with additional help, it will still be hard for replacement nurses to hit the ground running.

"Just based on, who do I call from respiratory? How do I use the paging system here? Find out who's on call for any particular specialty," she said. "That's going to be a big craziness."

McGibbon says even if replacement nurses are highly qualified, an unfamiliar work atmosphere can lead to potentially dangerous situations for patients. And a new study adds some evidence to her claim.

Samuel Kleiner is co-author of the report, "Do Strikes Kill? Evidence from New York State." The study examined health outcomes from 43 hospitals in New York that experienced strikes from 1984 to 2004. Kleiner found that strikes do appear to affect patient outcomes.

"Basically during a nurses strike there's increases in the in-hospital mortality rate as well as the 30-day readmission rate," Kleiner said.

The 43 New York hospitals experienced one additional death for every 286 patients admitted to the hospitals. They also had one additional patient readmission for every 111 patients during nurses' strikes.

Kleiner says the results are not that surprising because hospitals are labor intensive entities. He says an interruption in their normal day-to-day process is bound to affect quality.

"This is an effect that's been demonstrated in industries like manufacturing, where labor is a smaller percentage of production costs," he said. "So given just the impact that nurses do have in sort of the day-to-day operations in hospitals, I think it's a result that, I think it makes sense."

But Kleiner acknowledges that his study looked at a strikes that were limited to New York state. It could be that Minnesota's health care situation is quite different from New York's. One obvious difference is that the strike in the Twin Cities is only scheduled to last one day.

Twin Cities Hospitals spokeswoman Maureen Schriner says patients shouldn't worry.

"We want the public to feel comfortable that we are going to be there when they need emergency care, when they need the care that they're looking for at the hospitals, and the strike just sort of puts in their mind that there's something additional to worry about and that's really the unfortunate part about this strike," she said.

It is also possible that the strike could be settled before Thursday. Eleventh-hour negotiations averted a strike at five of the six Twin Cities hospital systems in 2001. But neither side is holding out much hope of that happening this time.

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