Today's post brings nursing work news from the Great Lake State and out east in Maryland. In Michigan, bargaining nurses reached a triumphant agreement with the University of Michigan Health that bodes well for nurse retention and could be an example of how hospitals can make it easier and safer for nurses to work. Moreover, the state's legislative attempts to address nursing staff issues appear misguided and may exacerbate the problem. While in Maryland, funding for school nurses may be at risk for the schools that need their presence the most.
University of Michigan Health and Nurses Reach Favorable Nursing Work Agreement
Ann Arbor nurses have worked without an active contract at a facility since July 1 and have been engaged in negotiations and collective bargaining for weeks. On October 2, the Michigan Nurses Association (MNA) voted to agree to a new four-year contract with the Healthcare facility with special incentives for nurses to work. The critical wins for nurses in the agreement are: incremental raises over the four-year contract reaching a 22.5% increase at the end of the four years, a $5,000 for each nurse this year, nurses currently employed who remain so at the end of March 2026 will receive a $2,000 retention bonus, expanded staffing guidelines, no more mandatory overtime (with exception to emergencies), and nurse-to-patient staffing ratios enforced with the ability to levy fines to the university in case of non-compliance.
The facility can undoubtedly expect that the attractive contract terms will help nurse retention in the coming years and their recruitment as well. Reportedly the facility has hired over 1,000 nurses during 11 months (July 2021-May 2022) and has brought its vacancy percentage to an enviable 5% which is well below the nationwide hospital average of 17%.
We can't help but wonder what the effect on nursing burnout and nurse retention would improve if more hospitals and healthcare centers agreed to withdraw mandatory overtime edicts, implemented safe nurse-to-patient ratios, and offered occasional bonuses to nurses and incremental raises to nurses who remain with their employers.
Michigan Legislative Attempts to Address Nurse Staffing
Is there a nursing shortage in Michigan or not? We know that there is a nursing shortage on a broad national level. Of that, there is little argument. However, it seems debatable which cities, states, and rural areas have a nursing shortage, as opposed to the regions that argue there is a nursing shortage when it might be a shortage of interest.
Faculty members from the University of Michigan, Deena Kelly Costa and Christopher Friese, recently published an article in the New England Journal of Medicine that challenges readers to consider perspective when speaking of nursing shortages. It's easy to blame staffing issues on the nursing shortage crisis when the root of the problem may require fundamental changes in policies and employment.
In concise terms, the article states, "We contend that there isn't a shortage of nurses, but a shortage of hospitals that provide nurses with safe work environments and adequate pay and benefits."
What do the authors think of the recent contract agreement? Based on what we know of the contract, it seems to address the root of the problem that the authors pinpoint.
In September, a bill was introduced to the Michigan legislative session, HB 6364, to cap how much temporary staffing agencies can charge for travel nurse and PRN nurse services. Instead of introducing legislation to support safe nurse-to-patient ratios and prohibit or strictly regulate mandatory overtime edicts (both measures that would protect nurses already working) - this bill, if approved, will limit hospital and facility capability to meet staffing demands but does nothing to support the nurses currently working and the bill for Michigan to join the eNLC which would make it easier for nurses from other states to help with nursing demand was vetoed by the governor.
Funding at Risk for School Nurses in Maryland
In August, the Maryland Hospital Association released a report on the workforce landscape with alarming statistics sourced from 49 of the 51 Maryland hospitals surveyed. According to the report, as of the end of 2021, the vacancy rate for licensed practical nurses (LPNs) was 37.7%, registered nurses (RNs) 25.4%, respiratory therapists 23.7%, and nursing assistive personnel 22.9%.
Amid the backdrop of alarming nurse vacancies in hospitals, concerns have been raised by the Maryland Nurses Association that Baltimore City Public Schools may not fund full-time school nurses for all its public schools. HB 1004, if approved, would require city governments to support a full-time RN at each public school. Vacancies in school nurses' offices, in this case, wouldn't be due to shortages but funding. Ultimately, a vacant school nurse office means a whole community of children without access to healthcare.
School nurse positions are often competitive because of the set work hours. What school nurses do ranges from caring for minor scrapes and cuts to helping children manage chronic health diseases and aiding behavioral and mental health efforts.
