This week’s discussions focused primarily on staffing and a proposal submitted by MNA/UMPNC regarding mandatory nurse-to-patient staffing ratios which is a key component in staffing discussions. The University is currently reviewing the proposal to determine how it impacts the rest of the contract.

Introducing mandatory staffing ratios into the contract would affect both the health system and our nurses, so our team wants to review the proposal within the scope of the entire contract before negotiating it further.

Michigan Medicine supports staffing levels that enable our nurses to provide safe care for our patients, but also allow flexibility in scheduling to meet the ever-changing needs of a health care system. The current collective bargaining agreement, reached in 2018, includes a commitment to maintaining staffing levels outlined in an addendum.

We have worked to meet the staffing levels agreed to in that contract, but the COVID-19 pandemic has made it difficult to maintain those levels consistently. There are many factors that impact the number of nurses available to work every shift on every unit, including:

• paid time off (scheduled or unscheduled)
• maternity or paternity leaves
• other short-term leaves (medical, disability, etc.), including additional time off specifically for COVID-19

If multiple nurses on the same unit are out on leave for an extended period of time, other nurses are in orientation, and another nurse schedules a long weekend using PTO, it can be difficult for a manager to find coverage for a shift if anyone else calls in with an unexpected absence. These types of challenges have been exacerbated by the COVID-19 pandemic as staff members needed time off due to illness or taking care of sick family members.

While we hope that lower COVID-19 transmission rates will provide some much-needed relief to our health care system, and ease the burden on all of our providers, we acknowledge there is work to be done in addressing the nationwide staffing shortages that we are facing. We understand that staying late and working overtime are not ideal for our nurses, but the needs of patients are unpredictable, and we need to have tools available to ensure we are meeting our patient’s needs.

Additional discussion focused on a second topic that impacts staffing levels – multi-unit positions. These were introduced in the 2018 contract as an opportunity to have greater flexibility in staffing units. Nurses hired in these positions have a “home unit” but are also available to be scheduled in one or two other specified units, in the event they have a need.

MNA/UMPNC has expressed their members’ dissatisfaction with multi-unit positions, and we are interested in engaging in further discussions about the topic. Staffing is a very complicated process, which is interrelated with several articles in the contract, and it is important to discuss them together because changes made in one area will have a large impact on another.

As part of the staffing discussions, the teams discussed the union’s proposal to eliminate mandatory overtime and the University’s proposal for an expanded use of on-call systems as a means to reduce the need for mandatory overtime.

We have asked MNA/UMPNC to negotiate over staffing ratios as a part of our comprehensive proposal, which includes changes to the scheduling process that will help managers create a schedule that meets patient care needs but also allows nurses to schedule much-needed time off.

The Michigan Medicine nursing recruitment team has also been working diligently on recruitment efforts, and we hope to have more information to share on those efforts soon.