Union collaborates with nurse execs on delegation standards- opinions please

[Julia RN]

I had come accross this document a long time ago and did not realize it was still being regularly updated.

Its primary focus is on delegation and assignment of care activities to LPNs and "unlicensed assistive personnel" but it touches on RN to RN delegation as well.

I can say with some certainty, that input was not solicitied from the rank and file of the union. Not surprisingly, there is no mention of delegating impossible patient loads or mandating additional work hours.

I know the legal definition of delegation and assignment varies among the states, but I am interested in opinions here on professional unions collaborating with organizations like NYONE in coming up with standards like this.

Thanks

Delegation NYSNA_NYONE.pdf

[NRSKarenRN, BSN, RN]

This article focuses on the the act of delegation of nursing care along with rights/responsibilities each level nursing has in delegating care to others involved in healthcare.

delegating impossible patient loads or mandating additional work hours

These issues fall under UNIT STAFFING.

I can say with some certainty, that input was not solicited from the rank and file of the union

When was the last time you served as district or union delegate or

attended a NYSNA convention? Most policy statements and all resolutions are circulated and discussed by district officers and delegates (who membership elects to represent them) at district meetings along with state and national conventions. Ideas to reword, add/delete item are then sent to NYSNA for inclusion with final adoption by board of directors and in the case of all resolutions by voting delegates at state convention

I'm positive there are many rank and file nurses that had input into document......I sure added my for the 20 yrs I was a staff nurse attending PSNA meetings. I've been in policy and resolution hearings where haggling occurred over just such topics. If you feel YOUR VOICE is not being heard, then attend the meetings and conventions read the NYSNA website weekly and write your NYSNA Board of Directors --- you will be heard!

[Julia RN]

Look at the definition of delegation in NY very closely- it differs from other states. In NY delegating is nurse to nurse, assigning is nurse to UAP.

If an RN is "in charge", making an assignment, in NY she is delegating the nursing care of those patients to that RN. So, if the charge nurse does not feel she can safely delegate, do to lack of staff, she can protest and get an administrative level RN to make the decision. I encourage RNs doing this when they cannot safely make an assignment (delegate)- we "invite" managment to share in the responsibility.

But I will write to Barbara Zittel, sec of NY SED, for clarification. She seems very approachable.

I am active in both the union and professional "parts" of the Association- at state and local levels. That's why I was shocked that I did not know that this document was updated.

In NY, the districts really have little input. That seemed to go away with requiring membership- bilevel, trilevel- remember those days? There is a constituent assemby- they can give their opinion. How do you give an opinion on something that you don't know is being done?

Voting body is whoever shows up at convention. And voting body is a blended group- managers and staff nurses. Who do you think has an easier time getting off to attend?

New Busniess?? Sorry, out of time.

As a staff nurse, I have and continue to fight to be heard. Both in the workplace and in the Association. I have been demonized in both venues, threatened with termination of my employment and my membership. But I'm still here, carrying on.

I'm really interested in opinions concerning unions collaborating on standards like this. I'm sure some brothers and sisters here have some thoughts.

Thanks

[Julia RN]

Karen,

Wondering-- Is this the kind of thing that caused PSNA to split- the union from the professional arm? Did conflicts over policy contribute to the break up?

I don't know much of that history- not as much as I do CNA and MASS. KNA seems to be splitting as well.

I don't see what difference a split would mean to a member like myself- I would still be active in both. Probably just more dues! But the association looses many members and resources.

If the associations- state and national- don't embrace better communication, open dialogue and debate, more democratic and less top-down stuctures- and really act on these- not just give them lip-service, I think most will end up this way.

[Chico David, BSN, RN]

From Julia RN

"Voting body is whoever shows up at convention. And voting body is a blended group- managers and staff nurses. Who do you think has an easier time getting off to attend?"

And there you have in a nutshell one of the key reasons why the associations that try to be all things to all people can not be truly effective. A manager, by the nature of their job, must support the interest of the employer. I was a manager for 13 years and it was well understood that part of the job requirement was to subordinate my own opinions and beliefs and support the agenda and plan that was decided on from the top. To a very limited degree, I could question in private, or question while a plan was being devised, but once the plan is final, all managers must fall into place and support. When you no longer can support, you need to stop being a manager. And sometimes, the interests of management are in direct conflict with the interests of staff nurses. Professional organizations as traditionally structured all are dominated by managers and academic nurses, for the reason you mention above. As such, they can not do an effective job of representing the needs of staff nurses.

Back in the bad old days in CNA, we had a situation where the staff nurses were on strike aat a hospital where the state president was a senior manager. How can that work?

So things changed. I believe that nurses should be represented by nurses organizations, and that those can fulfill both union and professional functions, but the only way to keep them from being management dominated is to keep the union part primary and the managers out altogether. There are plenty of organizations for managers.

Then, the issue you discuss becomes moot - There are times we can work with management on standards of practice, but we have one and only one point of view we represent - the staff nurse point of view, which properly defined should always also represent the needs of the patient exclusively and never the needs of the management.

[NRSKarenRN, BSN, RN]

Karen,

Wondering-- Is this the kind of thing that caused PSNA to split- the union from the professional arm? Did conflicts over policy contribute to the break up?

You assumptions correct. Non union members balked at $800.00/year dues to support collective bargining needs/ union staff because they never used ounce of these services.... forgetting that workplace advocacy issues affects all level of membership.

Union members upset over support given to advanced practice role expansion in 90's...nothing to do with bedside nurses needs yet vital to growth of nursing as a PROFESSION and that NURSES control our practice, not physicians or other professional groups.

I was one of the few crazy ones that felt membership in a professional association is vital in my practice as RN. Still feel that way 25+ yrs later and it has opened many doors for me. Happier now that monthly dues deduction is around $ 27.00.

[Julia RN]

If the non-represented nurses were paying the same, I could see how that would lead to a disgruntled membership.

My dues is over twice what a non-represented nurse pays. The dues strucure is complicated- many categories. For union nurses, the state is divided into regions, and dues is based on the lowest average salary for that region. Non-represented RNs pay "discounted" dues- usually less than half of the full rate for the region. This leads to less balking, except members who belong to other unions that feel they should maybe get a bigger discount.

[Julia RN]

I believe that nurses should be represented by nurses organizations, and that those can fulfill both union and professional functions, but the only way to keep them from being management dominated is to keep the union part primary and the managers out altogether. There are plenty of organizations for managers.

Then, the issue you discuss becomes moot - There are times we can work with management on standards of practice, but we have one and only one point of view we represent - the staff nurse point of view, which properly defined should always also represent the needs of the patient exclusively and never the needs of the management.

I agree that representing the needs of the patient and direct care nurses must be the sole focus.

If you keep managers out altogether, you may exclude RNs who want to promote those principles. Some RNs are excluded from the bargaining unit through no fault of their own- Kentucky River comes to mind or in places where you try to get other titles (case manager, NP) included in the scope of the agreement but management refuses. You also have to consider RNs who work in other fields- education, publishing, legal, etc- that are an asset to the organization and the cause.

If all these are excluded, you may loose credibility in those situations when you want to work with management on a practice issue.

Michigan has an interesting structure- they have an associate membership. This for RNs not represented for collective bargaining. But I do not think the asscociate can run for office or vote in elections. I'm not sure if they vote on policy. I think the dues is $75. There is a lot of controversy within ANA about them doing this.

I know you have NNOC in CNA. Can an RN who is not eligible for collective bargaining be a NNOC member? Are they eligible to run for office or vote?

[Chico David, BSN, RN]

Julia RN:

"I agree that representing the needs of the patient and direct care nurses must be the sole focus.

If you keep managers out altogether, you may exclude RNs who want to promote those principles. Some RNs are excluded from the bargaining unit through no fault of their own- Kentucky River comes to mind or in places where you try to get other titles (case manager, NP) included in the scope of the agreement but management refuses. You also have to consider RNs who work in other fields- education, publishing, legal, etc- that are an asset to the organization and the cause.

If all these are excluded, you may loose credibility in those situations when you want to work with management on a practice issue.

Michigan has an interesting structure- they have an associate membership. This for RNs not represented for collective bargaining. But I do not think the asscociate can run for office or vote in elections. I'm not sure if they vote on policy. I think the dues is $75. There is a lot of controversy within ANA about them doing this.

I know you have NNOC in CNA. Can an RN who is not eligible for collective bargaining be a NNOC member? Are they eligible to run for office or vote? "

We have a couple of categories of associate member. I don't have the bylaws right at hand, so I'm working from memory, but there has always been a category of associate member in California for the nurse you describe - the person employed in an area where they are not eligible for representation, but who wants to remain involved in the organization. Then when we created NNOC, the National Nurses Organizing Committee, we knew there would be many areas where we would not be ready to organize at the facility level for a long time, but wanted to be able to build membership in those areas, so we created a category of NNOC national member, where the dues are really minimal - something like $35 a year. It's just enough to make a committment, but not enough to inhibit anyone from joining. It's not the money we are after, it's their involvement. They get our magazine and periodic updates on activities. The folks we contact that way are participating in things like campaigns for ratio laws and campaigns for single payer healthcare. Where we have some concentraton of members in an area, we build metropolitan or regional committees and look for opportunities to organize at the facility level.

The associate members in California, who pay higher dues than the national NNOC members but less than collective bargaining members, can vote and hold office, as can retiree members who also pay a lower amount. The NNOC national members can't. No nurse who supervises other members can hold office, but we don't apply the NLRB definition of charge nurses being supervisors, since we disagree with that interpretation and charge nurses are in the bargaining unit at many of our hospitals.