Anti-Retaliation Bill Would Allow Nurses to Refuse Care; Puts Patient Safety at Risk

April 11, 2024

Patients could be refused care if a bill making its way through the legislature becomes law. 

The Minnesota Nurses Association (MNA) supported bill, SF 4444 (Port, DFL – Burnsville), is known as the Health Care Employee Anti-Retaliation and Labor (HEAL) Act. It would prohibit a healthcare facility from retaliating or discriminating against a nurse who initiates a process outlining patient safety concerns related to inadequate staff levels.  

The bill’s language is similar to what was included in the Keeping Nurses at the Bedside Act, which failed to move in the 2023 legislative session.   

Proponents from the MNA and other labor groups referenced data from the Minnesota Department of Health (MDH) that suggests healthcare worker burnout is leading to the severe workforce shortage in the state.  

Opposition to the bill stems from a provision that would empower a nurse to “decline to accept an additional patient assignment.” 

The MMA shares these staffing concerns. The cited statistics and rising rates of burnout among the healthcare workforce are extremely troubling. However, the MMA has concerns over the legislation's impact on patient care. 

“I understand what the issue is,” said Sen. Alice Mann, MD, an emergency medicine physician, when this bill was heard in the Senate Health and Human Services Committee in March. “I don’t want to see patients suffer. I don’t want to see us be nervous at work, because I know I’m nervous at work all the time because my ER is completely full and it’s awful. We have a lot of work to do. I don’t think this will solve the issue.” 

Hospitals and business groups have also flagged concerns over the legislation, mostly that it will lead to worsened patient health outcomes. Opponents argue that the legislation will inevitably lead to hospital unit closures, delays in care, and add further backups in emergency departments. The legislation could lead to discriminatory practices and inequitable healthcare delivery, despite proponents claiming that won’t happen. 

SF 4444 and its House companion, HF 4200 (Feist, DFL – New Brighton), have been heard in several committees this session. The language will most likely be added as a part of a larger omnibus health and human services bill, but it is uncertain if it has enough support to pass in a floor vote. 

MNA has reacted to the possible lack of votes by running ads on social media, targeting hesitant DFL legislators including Mann, Sen. Kelly Morrison, MD, and Sen. Matt Klein, MD, the three physician members of the Legislature, according to a Minnesota Reformer article. 

“Senators Mann, Morrison, and Klein have been vocal champions for patients throughout their careers,” said MMA President Laurel Ries, MD, in response to the MNA ads. “Their expertise as physicians brings immense value to the policymaking process, and we’re standing with them. It is unfortunate the nurses' union has focused their attacks on their healthcare colleagues for putting patients over politics.” 

The MMA agrees the legislation would not significantly address increased rates of burnout among the state’s healthcare workforce and gives too much power to an individual nurse to refuse to care for a patient.