Rights and Responsibilities for a Member of

Rights and Responsibilities for a Member of the Nursing Union in Minnesota recent MSNBC Health article on the state of the nation's health noted that despite the nation's joblessness crisis, nursing remains woefully understaffed as a profession across the nation. The current shortage of a few hundred thousand RNs could reach a staggering 750,000 by 2020, given the aging population and rate of retirement in the 'Baby Boom' generation.

The danger of this scenario, of a rapidly aging population and a rapidly retiring nursing profession, is highlighted by a recent lawsuit waged against the Wesley Hospital in Kansas in July of 2000. There, a jury awarded a $2.7 million malpractice settlement to the family of a woman who almost died due to chronic nursing understaffing at the hospital. Thus, the nursing shortage has costs for both hospitals as well as patients that could prove disastrous.

(Johnson, 2004) shortage of nurses is a factor in about one-fourth of patient injuries or deaths in hospitals, according to the Joint Commission on Accreditation of Healthcare Organizations' 2002 report. A 2002 study by Harvard and Vanderbilt university researchers, examining millions of 1997 hospital cases, found preventable deaths and patient complication rates were up to nine times higher in hospitals where the most care was given by licensed practical nurses and aides, not better-trained RNs.

For each additional patient over four assigned to a nurse, the risk of dying after surgery rose 7%, according to a 2002 survey of 168 Pennsylvania hospitals by Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. (Johnson, 2004) These grim statistics highlight the need for members of the nursing profession today to live up to their responsibilities in an increasingly stressful environment.

What are those responsibilities from a legal standpoint? According to Minnesota Statute 2003 148.171 a clinical nurse specialist practitioner is defined as one who is authorized in the provision of patient care in a particular specialty or subspecialty of advanced practice registered nursing within the context of collaborative management. A nurse's responsibilities thus includes, according to the law, (1) diagnosing illness and disease; (2) providing non-pharmacological treatment (non medicinal treatment) including psychotherapy; (3) promoting wellness; and (4) preventing illness and disease.

The certified clinical nurse specialist is certified for advanced practice registered nursing in a specific field of clinical nurse specialist practice. (Subsection 5) A general "advanced practice registered nurse," abbreviated APRN, in contrast is any "individual licensed as a registered nurse by the Minnesota Board of Nursing and/or certified by a national nurse certification organization acceptable to the board to practice as a clinical nurse specialist, nurse anesthetist, nurse midwife, or nurse practitioner.

Every person who practices professional nursing in Minnesota must hold a Minnesota registered nurse (RN) license or temporary permit and every person who practices practical nursing must hold a licensed practical nurse (LPN) license or temporary permit. (Minnesota Board of Nursing, June 2004) Thus, a nurse is not simply an aid to a doctor, but must actively promote wellness and prevent ailments through diagnosis, physical and mental counseling, and seeking specialized training in the medical field.

His or her responsibilities are curative and caring according to the terms set by law and by the Board of Nurses. This it is why the current nursing shortage is so critical to the nation. It also highlights why nurses seek to ensure that conditions for nurses, particularly in regards to the numbers of patients they must care for, are kept under control, so that nurses can do their duty to the best of their ability. Many see California as a model for nurse ratios.

In January, the state enacted the nation's first hard-and-fast ratios, ward by ward. An RN may care for six patients at most, and only four in the ER and two in critical care units. (Johnson, 2004) Minnesota has placed no such ratio limits in place, although nursing unions within the state and across the nation have praised their value in helping nurses fully function within the context of their rights and responsibilities, perhaps because in Minnesota, that shortage remains so dire.

Recently a federal grant was awarded to the state, in an attempt to address the shortage by providing funds for a School of Nursing and five health care partner firms, with the idea of helping new nurses to complete their education, to encourage new nurses to enter the profession, and also to help current nurses to improve their credentials in areas of needed new specialties, such as midwives and eldercare.

(Minnesota Board of Nursing, May 2004) For a nurse to fulfill his or her rights and responsibilities to a patient regarding care and proper treatment, a nurse's own rights must be protected on the job. This.