[MOkoala]

Hello!

I am new to this site and would like to here peoples thoughts on the following: Has anyone had any dealings with the non-professional union - especially within the V.A. system?

Recently I turned in an incident report to my nurse manager at the request of my charge nurse regarding a health tech who went to another department and stopped my patient from receiving a medication because he was a comfort care patient. After this tech was confronted by the manager she called her in house union rep. The following day the tech in question spent the whole morning writing her union grievence, did not do anything for my patients assigned to her except take morning vitals. When our manager and his boss met with the tech and her union rep I was asked to come to the meeting to "clarify" my incident report. I was called a liar by the tech and her union rep, not allowed to give complete information and received no backing from management. No action has been taken regarding my complaint as management states they are still "investigating".

The way I see it there are multiple patient safety issues here and the union should not be able to intervene. Apparently I am wrong about this. If nurses are not given any authority and techs are allowed to have other departments disregard active physician orders, what is the point of distinguishing between licensed staff and unlicensed assistive personel? I feel like I was a "sacrifice" to the union gods. Really, who has nursings back anymore?

Thanks for the rant.

[herring_RN]

I have a question. Who regulates the VA hospitals?
The state or federal government?

[HM2Viking]

VA is federal...

As a former union steward there are a couple issues.

1. Right to due process. In other words Management must investigate the incident objectively.

2. Before discipline can be administered Management must be sure that the tenets of just cause have been met.

3. Whenever a union employee is investigated they usually have a right to union representation during the investigation.

I agree that there are some serious issues here but if I was representing the employee I would question whether systemic errors were at fault. (One big question I would have is "Why did the other department accept the hold from an unlicensed person?)

Why did the charge nurse have you write the incident report?

It is highly irregular for management to have both sides of an investigation in the room at the same time. I think that this speaks more to incompetent management and poorly designed systems.

[HM2Viking]

Just Cause:

Approximately fifty percent of the grievances filed by Unions on behalf of
their members are disputes over the just cause principle as it applies to disciplining
an employee. What does just cause mean?
In determining just cause an arbitrator searches for the reasonableness and
fairness to any disciplinary action. Was the employer’s decision to discipline right
and fundamentally fair? It is generally agreed that seven basic questions need to be
answered in the affirmative in order for a proper disciplinary action to have taken
place. A “no” answer to one or more of these questions can weaken an employer’s
case.
1. NOTICE
Did the employer give the employee forewarning or previous knowledge of the
possible consequences of the employee’s disciplinary conduct?
2. IS THE RULE OR ORDER REASONABLE?
Were the employer’s rules or managerial orders reasonable and conducive to:
(a) the orderly, efficient, and safe operation of the employer’s business?
(b) the performance that the employer might properly expect of the employee?
3. INVESTIGATION
Did the employer, before disciplining the employee, make an effort to determine if
the employee violated or disobeyed a rule or order of management?
4. FAIR INVESTIGATION
Was the employer’s investigation conducted objectively?
5. PROOF
During the investigation did the employer discover substantial proof that the
employee had violated the rule or order?
6. EQUAL TREATMENT
Has the employer applied rules, orders, and penalties evenhandedly and without
bias to all employees?
7. PENALTY
Was the discipline reasonably related to:
a. the seriousness of the employee’s proven offense?
b. the employee’s service record?
If the employer has just cause for disciplining an employee, the answer to all of

these questions should be yes.
http://www.mape.org/locals_stewards/.../justcause.pdf

[MOkoala]

This is not an isolated incident. Licensed staff has brought concerns to management before and because of the protection the unlicensed staff receive from their union nothing is ever done. On our ward more than any other in the hospital the unlicensed staff will fabricate information in support of eachother so that no action can be taken against them. What if any recourse do we have when they are able to create evidence on their behalf? Is there anyway of protecting ourselves? A lot of the licensed staff on the floor are contract employees who are not elgible for the union and find ourselves in a hostile enviroment with the remainder of a contract to fulfill. Who can we turn to to get our due process?

[herring_RN]

Viking:

Our VA hospitals are for the most part excellent.
I have attended a cE class with nurses who say their manager is unfair to some staff.
One nurse complained about not having enough staff at their unit meeting. The manager was very angry.
Then that nurse was assigned to 7 patients for 2 days while a colleague was assigned to only 2.
They worked together so the patients were cared for.

I asked why she didn't file a grievance and she said it is because she is waiting to transfer to another unit.

I wish I had asked if the VA has JCAHO.
I know it is federal. Just wondering if the regulations are on line. JCAHO is not. It is for sale and very costly.
But the library at a local university has the JCAHO regulations to look at.
I once made copies of some pages to show my manager. That helped her.

[HM2Viking]

Herring,
In no way was I trying to be critical of the VA. I have cited it repeatedly over time as an example of a high quality/low cost system. (I think they do offer The Best Care Anywhere.) Please accept my apologies if it appeared that way.

Mkoala,

I don't think that unlicensed staff always appreciate that your license is your livelihood. I think that sometimes an informal conversation about roles can help people correct their behavior without putting you in the firing line. This has the corrolary benefit of letting other staff know you won't tolerate these types of shenanigans. If it recrs than you can discuss the problem with management, point out what you did in an attempt to ameliorate the problem which then gives management more ammunition to use in their attempts to resolve the problems. The incident report system sometimes generates a lot of heat but very little light. (If you do adopt a one strike system like this I would be sure that you had the prior approval of your manager and kept careful records of your interventions. This conversation also gives you cover. Obviously situations that clearly put the patient at risk or rise to abuse/neglect would always need to be reported to protect your license.) These issues are never easy.

Management's job is to manage. I think there may have been a failure in the system which could have been addressed through a memorandum outlining that licensed staff are responsible for medications and that questions about patient care should be addressed to the assigned licensed staff. (IMO the other unit really dropped the ball by not calling the assigned nurse but that is a thread of its own.) I truly am sorry that you were pulled inot the middle of this mess.

I really hope that you can work this out.

Hopefully Siri will stop by and offer you some ideas.

Rgds...

[herring_RN]

Viking:

I know you thing very highly of the VA.

My question was because I can't find information of laws or regulations for the VA.
I would think they would have to follow regulations effective in the state where they are located but was told they do not.

I had no answer for MOkoala because although I worked at the VA many years ago I never really paid attention to my union. I was not yet an RN then.