Calif RN disagrees with CNA in many ways. Am I alone? - page 7

Hello! I am new to this site but felt compelled to ask the question. Am I the only RN in Calif that disagrees with CNA's "teamster tactics" regarding important health care and nursing issues? These... Read More

  1. by   pickledpepperRN
    Quote from bluesky
    Darn you're good!
    I've been to class. And i probably the dumbest web surfing geek and ALLNURSES.COM addict.

    This years classes - http://www.calnurse.org/?Action=Category&id=196
  2. by   nursbaybie
    Quote from spacenurse
    I've been to class. And i probably the dumbest web surfing geek and ALLNURSES.COM addict.

    This years classes - http://www.calnurse.org/?Action=Category&id=196
    Thanks for your information. I have read all of that information several times, but I still have some questions.

    First of all, we do utilize an acuity system, and base staffing on that for the most part. But say our acuity calls for 8 staff members (they don't count the ward clerk in that of course) sometimes they will give only 6 or 7. Is that as much of a breech as exceeding the ratio?

    Also, if the acuity calls for 6 staff members, if the nurses want a charge nurse to help them, help all the LVNs, etc, we would have to sacrifice a CNA.

    Here is the biggest problem of all. Our acuity system, I believe as do many others, is completely inaccurate. It is not evaluared by nurses ever. i have informed the DON, as the charge nurse, that it is not accurate. She said if i don't have anythng better, the that is all we have. I have tried to find other systems, but I have been unsuccessful.

    I think the acuity systemshould take into account how many scheduled meds a pt has. I also think if pt. has accuchecks q 2h, it should count differently than a pt only ac andhs. i think the tele pts should have points for being monitored and peds should have points for the frequency ofiv checks, etc. we are a mixed m/s, tele, peds unit.

    Currently our acuity system is similar to the following

    ambulates with assist - 1 assist with eating 1
    up to chair/bsc -2 feeder 2
    bathes with assist -2 tube feeding 3
    complete bed bath--3 ng tube care 2
    restraints -4 hyperalimentation 4

    brp with assist (simple) -1 psychosocial support 2
    bedpan -2 in depth teaching 3
    incontinence care------3 diabetic monitoring 2
    lethargic but oriented 1 neuro checks >2/shift 2
    confused 2
    at risk for breakdown --1 independent with most ADL 1
    existing breakdown 2 needs assist w/ >50% adl 2
    surgical incision 2 bedbound or w/c bound 3
    dressing changes 3 completely disabled 4

    foley catheter 1 iv meds >3/shift 2
    wound drain 2 pain meds >3/shift 2
    central line care 2 blood transfusion 2
    chest tube care 2 pre op activities 2
    tracheostomy care 2 post op 1st 8 hrs 2

    I know I am missing a few things, but nothing important. So we circle all the numbers that apply to the patient and add up the numbers.
    1-5 =====1
    6-10=====2
    1-15=====3
    16+======4

    for pm shift 1= 0.75
    2= 1.5
    3 = 2.25
    4=3

    so you multiply all the 1s by .75, all the 2s by 1.5, all the 3s by 2.25, etc.
    then add all the totals and divide the total number by 8 to get the number of staff needed.

    Am I alone in thinking that the types of things being measured don't acuratley reflect the acuity?

    Any suggestions on acuity systems that may be more accurate?
    Thanks
  3. by   pickledpepperRN
    I do not envy your DON. It IS the responsibility of the admistrator of nursing to formulate a staffing plan for each unit. There must be a committee consisting of at least 50% sirect care RNs.

    None of the commercially marketed systems meet the needs of the patients. They also don't meet the requirements of AB 394.

    Your system uses averaging, which is not allowed.
    Also it seems to be task oriented rather than process oriented. I don't notice anything about assessment, formulating a care plan, re evaluation, or patient advocacy.
    Just implementation.

    Why our manager has done (with lots of work by our PPC committee) is institute RN over ride.

    We no longer have to hear some secretary in the nursing office tell us, "That is all the staff you get." because some secret computer program spit out inadequate staffing.

    The RN assigned to the patient in consultation with the charge nurse have the authority to over ride the decision of the computer. If our manager is there she participates too.
    Sometimes with brainstorming there is a way to safely work with what the staffing sheet says. Other times there is not. Then we get the extra help.
    For instance, even without an order we can use an extra CNA as a sitter to prevent having to restrain a patient. The other patients don't have to suffer because we have an EXTRA person. We didn't just assign someone thus depriving the other patients (and our backs).

    I've got to sleep now because I work tonight.
    I may not check in foe a few days because I'm scheduled for three 12 hour nights in a row. I usually only do 1 or 2.
  4. by   Lawdo2
    I agree with you 100%. I deliberately try to get jobs where I do not have to become a CNA member. CNA should not take full credit for the nurse-patient ratio. I believe that nurses have the power to move mountains "without CNA", the power is within us. We have given that power to someone else who clearly has reduced nursing to an "unprofessional" level.
  5. by   shodobe
    Your going to love this! Today all of the non-RNs recieved a bonus check for up to $400 for helping CHW make a profit last year. The CNA RNs DID NOT get this at all. I was told, on the side, by a manager that CNA refused this because it wasn't large enough for the nurses. The union rep is supposed to come tomorrow because I left a ratherhostile message on his voicemail asking how they could keep this from us, we did not know this was happening, and why we weren't asked if WE wanted it. All the RNs in my department, the OR, are up in arms about this and want some answers. The letter that was given to the SEIU members, along with their checks, implied they were the only ones that helped CHW turn this profit. That is total bulls**t! I for one have given far more than any SEIU employee here at this hospital and work harder than any of them. If this is the way the CNA is going to treat us by going behind our backs and making decisions without our consent, then they, the CNA, can just blow it out their blowhole. I will do everything I can to eliminate them as our reps when our contract comes up for renewal. God, I hate unions! I was wondering if there are any other CHWs out there that did the same thing or something like this. The CNA has to ask their members what should be done and not take it upon themselves to make these decisions.
  6. by   JustMe
    Quote from shodobe
    Your going to love this! Today all of the non-RNs recieved a bonus check for up to $400 for helping CHW make a profit last year. The CNA RNs DID NOT get this at all. I was told, on the side, by a manager that CNA refused this because it wasn't large enough for the nurses. The union rep is supposed to come tomorrow because I left a ratherhostile message on his voicemail asking how they could keep this from us, we did not know this was happening, and why we weren't asked if WE wanted it. All the RNs in my department, the OR, are up in arms about this and want some answers. The letter that was given to the SEIU members, along with their checks, implied they were the only ones that helped CHW turn this profit. That is total bulls**t! I for one have given far more than any SEIU employee here at this hospital and work harder than any of them. If this is the way the CNA is going to treat us by going behind our backs and making decisions without our consent, then they, the CNA, can just blow it out their blowhole. I will do everything I can to eliminate them as our reps when our contract comes up for renewal. God, I hate unions! I was wondering if there are any other CHWs out there that did the same thing or something like this. The CNA has to ask their members what should be done and not take it upon themselves to make these decisions.
    Oh, yeah. I work for CHW and CNA did it to us as well. But I'm willing to give up my bonus if they would just give us air conditioning! My unit only gets side air from another unit--it's sweltering in the heat (not to mention us "hot mommas" going through menopause) :angryfire . We also would like our beds to work (they've started breaking down) and a call light system that works. There's too much to fix around here without giving out bonuses! We heard that we will eventually get our bonus checks but I'm willing to give up mine to get equipment that works!
    Just a side note: you pay union dues? YOU are the union and you need to get involved if you want to change things. If you want to get rid of CNA you need to start NOW. Disaffiliation takes time and commitment from a majority of your RNs under contract. Good luck!
    Last edit by JustMe on Sep 29, '05
  7. by   Nancy2
    Quote from shodobe
    Your going to love this! Today all of the non-RNs recieved a bonus check for up to $400 for helping CHW make a profit last year. The CNA RNs DID NOT get this at all. I was told, on the side, by a manager that CNA refused this because it wasn't large enough for the nurses. The union rep is supposed to come tomorrow because I left a ratherhostile message on his voicemail asking how they could keep this from us, we did not know this was happening, and why we weren't asked if WE wanted it. All the RNs in my department, the OR, are up in arms about this and want some answers. The letter that was given to the SEIU members, along with their checks, implied they were the only ones that helped CHW turn this profit. That is total bulls**t! I for one have given far more than any SEIU employee here at this hospital and work harder than any of them. If this is the way the CNA is going to treat us by going behind our backs and making decisions without our consent, then they, the CNA, can just blow it out their blowhole. I will do everything I can to eliminate them as our reps when our contract comes up for renewal. God, I hate unions! I was wondering if there are any other CHWs out there that did the same thing or something like this. The CNA has to ask their members what should be done and not take it upon themselves to make these decisions.
    If you are serious, check out www.stopunions.com you can find out how to start a decertification at your hospital and print out a petition to get started. Good luck!
  8. by   SFCardiacRN
    The hospital where I work does not have CNA...The hospital where I work has the lowest paid RN's in town.
  9. by   lindarn
    Quote from imkw_np
    I don't fear them. I object to their public behavior because it reflects badly on nursing. I don't believe the CNA leadership has the nursing profession's best interests as their central mission. Expanding membership, collecting dues and partnering with other "service unions" seem to be the top priorities. Strong-arm tactics and blatent rudeness do not advance our profession. Nor do they lend a strong and intelligent voice to vital health care issues which nursing must speak to. The staffing ratios legislation was a great victory for nursing and for patient safety but haggling over the delay in further reducing from 6:1 to 5:1 is not necessary.
    Tell me something, with all the protest about CNA, and their "Strong Arm Tactics", where has nursing gone with their, "Nice Girls Don't Fight", mentality, and just cave in to the "Strong Arm Tactics by the Hospitals". Just for the record, as far as I am concerned, ANA has done absolutely NOTHING FOR NURSING, except cow tow to the Hospitals, and Insurance Companies. Where was the ANA when "care redesign" took over, and nursing positions were cut all over the country, and when, "medication aides' took over over professional duties, when unlicensed assitive personnel (who didn't even have to have a HS Diploma), were given the job to take care of patients, while we went nuts trying to be acountaable for everyone AND THEIR/OUR 25 PATIENTS. Let me tell you- THEY WERE NO WHERE TO BE FOUND, EXCEPT IN THEIR IVORY TOWERS HAVING THEIR NAILS DONE. That is why I support CNA. They put their money where there mouth is. Actions speak louder than words. JMHO, and my $0.02.

    Lindarn RN, BSN, CCRN
    Spokane, Washington
  10. by   Sherwood
    Quote from SFCardiacRN
    The hospital where I work does not have CNA...The hospital where I work has the lowest paid RN's in town.

    Where do you work? I have heard that said many times. Sometimes even in my own hospital. After a little research it rarely turns out to be true, especially in todays environment. I guess someone has to be paying the bottom rates somewhere, but do they think they can keep their staff for long?

    Why do you work there? It must be a great place to work if you are willing to stay. How much do the "lowest paid RN's in town" make for say an RN with 5 years of experience in an acute care hospital.
  11. by   BillEDRN
    As one of the nurses intimately involved with CNA's attempt to raid our union here in Hawaii, I felt I must comment on some of the statements made in this thread.
    First, to get it straight, CNA has accomplished good things for their membership such as the patient ratios and excellent contracts. However, as good as those accomplishments are, I too, disagree with their tactics and rhetoric. And by tactics, I don't mean being vocal and committed to representing the interests of nurses against those of big business, I mean the healthcare industry.
    CNA could be doing much more for their nurses if they would stop spending union dues on raiding other unions. They should spend their member's money on organizing non-organized facilities. Their tactics of intimidation, lies, subterfuge and misrepresentation of the facts reflects poorly on the unions that do maintain the ethics most of us value and run couter to CNA's actions.
    In our situation here in Hawaii, CNA operatives infiltrated the union and took advantage of an internal dispute to push their agenda. A clear example of CNA's hypocrisy was that during that time CNA was loudly and resolutely against the AFL-CIO and the fact that the United American Nurses (UAN) were members. They used the UAN and AFL-CIO affilation as a ralling cry for Hawaii nurses to get rid of our union, disaffilate with the American Nurses Association (ANA) and affilate with them. They called the AFL-CIO a "blue collar union" and unresponsive to their nurse memeber's needs as well as saying nurses unions should not be associated with "labor unions." Of course what they didn't tell you was that they had tried to join AFL-CIO in the past and failed and that they had a working relationship with a California steel workers union. That relationship basically had the steelworkers giving CNA money so that they could organize non-RNs at CNA hospitals. Most interesting is that when the relationship was discovered, CNA severed ties. Also interesting is that recently CNA is considering another attempt at joining AFL-CIO!
    As in the attempt to raid our and other unions, CNA tried to influence voting by having out of state nurses try and join our union. Maine and Illinois are other examples. In Maine they actually chartered and bused in pro-CNA nurses to Maine and swung the vote to their favor by a narrow margin.
    Bottom line is this: The means do not justify the ends. Nurses are repeatedly viewed as the most trusted professionals. We do not need to jeprodize that base of public support and trust by allowing some, despite their best intentions (I am trying to give CNA the benefit of the doubt) to act counter to the morals and ethics that have allowed us to gain that status. California nurses need to become involved in CNA governence if they are unhappy about what is happening in their union. As others on this post have said, non-unionized nurses are frequently the benefactors of union contract provisions at other hospitals. Unions are good for nurses and the more nurses that belong, the better off nursing as a profession will be. This is increasingly true as hospitals attempt to pad their bottom line, and their adminstration's pockets by reducing RNs at the bedside. Nurses for too long have sat by and let others (usually the hospital associations) influence the political process, mostly to their (the nurses') detriment. It is up to us, union members, to make sure that the unions represent our values, beliefs and ethics. Just like voting; If you don't vote, don't complain about who get's into office!
  12. by   Hellllllo Nurse
    To Cali nurses who don't like the CNA- Why don't you come to Texas and work, where you will get 12-13 pts all by yourself on med-surg, no aides, no unit clerks, just you and ALL your pts-and where the hospitals don't have Workman's Comp, because Texas says they don't have to?

    I was injured on the job here, and the facility refused to pay my ER bill- I had to pay it myself to preserve my credit rating.

    Also, most hospitals and nursing homes here do not offer any kind of health ins plan whatsoever to nursing staff.

    Cali nurses- you don't know how good you have it.
  13. by   BillEDRN
    Decertification is not the way to go. In this era when even doctors are joining/creating unions (because like nurses, many now "work" for organizations where they are no longer independent contractors but employees) to protect their interest, it would be a mistake to not have a union. Those that advocate RNs not belonging to a union because it's "not professional" are naive and short sighted. If you don't like what your union is doing or not doing, get involved and change it. For all of it's problems, CNA has made significant contributions to RN working conditions, pay and political influence. You should not trash all of that because the organization has gotten off track. Do you realize that most of the "anti-union" organizations, including those that provide scabs to striking hospitals, are supported in part by the healthcare industries? Why? Because unions cost them money they would rather keep in their own pocket instead of yours! The hospitals have banded together to push their agenda, realizing full well the benefit of working together to accomplish their goals. Nurses would be wise to do the same.
    Besides, what many who would advocate your decertification won't tell you (or don't know) is that once you decertify, you cannot be represented by a union, any union for a year. During that time the hospital can, and often does, change the previously agreed upon contract terms. They can totally throw out the contract and do/pay/punish as they wish with little recourse available to the nurse. Do you really trust big business, as that is what healthcare has become, to look out for your best interest?

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