[RN4MERCY]

Originally Posted by bittersweet symphony

Tenet has an sweetheart agreement with the union. there is no union bashing going on. do your research. CNA has done nothing and has decerts right in there own state. they want your dues. Nurse patient ratios are just that, nurses, NOT RN, read the legislation..........WAKE UP PEOPLE

Bittersweet,
Please read the ratio law!
A nurse, is a nurse, is a nurse? Although only LVNs and RNs may call themselves "nurses" in the State of California, their legal scope of practice, and accountability is different. An LVN has a dependent license, and must work under the direction of the RN accountable for the patient. Therefore, the ratios are in fact, RN ratios.

Many administrators and executives like to misquote the law and take it out of context of the other regulations that govern scope of practice. LVNs make important contributions to the basic nursing care of patients. The ratio law states, "Licensed vocational nurses may constitute up to 50 percent of the licensed nurses assigned to patient care on any unit, except where registered nurses are required pursuant to the patient classification system or this section."

* Ratios must be based on a standard of individualized patient care needs with sufficient RN staffing to ensure that patient care reflects proper assessment, nursing diagnosis, planning, intervention, evaluation and patient advocacy. The law states: "The basic principles of staffing in the acute care setting should be based on the patient's care needs, the severity of condition, services needed, and the complexity surrounding those services."

* Mandates additional nursing staff as needed based on individualized patient needs and severity of illness [acuity]. "Additional staff (above minimum ratios is determined by) the severity of the illness, the need for specialized equipment and technology, the complexity of clinical judgment needed to design, implement, and evaluate the patient care plan and the ability for self-care, and the licensure of personnel required for care."

* In the event of a conflict between the health and safety code pertaining to nurse staffing and regulation defining the scope of nursing practice, the scope of practice provisions shall prevail

California Code of Regulations, Title 22, Section 70215 (a) (2) "A Registered Nurse shall directly provide:

The planning, supervision, implementation, and evaluation of the nursing care provided to each patient. The implementation of nursing care may be delegated by the registered nurse responsible for the patient to other licensed staff, or may be assigned to unlicensed staff, subject to any limitation of their licensure."

http://www.dhs.ca.gov/Lnc/pubnotice/...ation_Text.pdf

http://www.rn.ca.gov/pdfs/regulations/npr-b-53.pdf

[bittersweet symphony]

go to the hospitals and work the floors.............I've been an RN for 30 years in and out of unions, unions take your money, waste time in negotiating contracts, you can wait for a contract for 2 yrs and everything is frozen. unions promis but only the hospital delivers. Scripps decerted the CNA, St Rose voted down the CNA, meanwhile they raid each other and claim to be a "brotherhood". it's more like Mafia families. The CNA just got themselves in some deep water in the state of Iowa. The SEIU is raiding NYSNA. It's become a series similiar to the Sopranos......... And the UAN is where in all of this?

[bittersweet symphony]

and as for the ratios............you can argue that point as much as you want, i saw the amendment to the ratios from the DOH in California this year. What happens to patient acuity???????

[HM2Viking]

If you have concerns about imperfections in the minimum staffing law feel free to write your legislator to ask for changes. (Arguably the professional coore nursing values expects nurses to take that action.) Or if you are in CNA get active AND WORK FOR CHANGE! Express your concerns. Work for change....Organizations are only as good as the people who are working to make things better.....

Don't let the perfect be the enemy of the good.....

[herring_RN]

Originally Posted by bittersweet symphony

and as for the ratios............you can argue that point as much as you want, i saw the amendment to the ratios from the DOH in California this year. What happens to patient acuity???????

Please provide a link to the amendment.
Or at least type it?

I cannot find any repeal of the requirement to staff to the indivual needs of the patients as determined by the assessment of the direct care registered nurse.
http://www.dhs.ca.gov/lnc/NTP/default.htm

Please look at pages 7-11 of the regulations that hospitals must comply with. If your hospital is not doing so they are breaking the law.
Do you have a competent RN take report and relieve you for meals and breaks? Do you always have the maximum allowed by the ratio?
If so your hospital is violating the law.
http://www.dhs.ca.gov/lnc/pubnotice/...ation_Text.pdf

[herring_RN]

RN-to-Patient Ratios


CNA’s historic first in the nation Safe Staffing RN Ratios took 12 years to win and has been in effect since January 2004 despite continued efforts of the hospital industry and Governor Schwarzenegger to have the law overturned or otherwise weakened.
When Governor Schwarzenegger decided to roll back CNA's staffing ratios and called nurses a "special interest who don't like me because I'm always kicking their butt,"
CNA ignited a broad grassroots movement that led to the sweeping November 2005 electoral defeat for the Governor's special election initiatives. Two days later, Schwarzenegger dropped his year-long fight against the ratios.

Safe RN ratios have improved quality of care and nurse recruitment and retention in California hospitals. Ratios continue to improve. A 1:4 ratio in telemetry and specialty units scheduled took effect in 2008.

http://www.calnurses.org/nursing-pra...ios_index.html

[RN4MERCY]

Originally Posted by herring_RN

Please provide a link to the amendment.
Or at least type it?

I cannot find any repeal of the requirement to staff to the indivual needs of the patients as determined by the assessment of the direct care registered nurse.
http://www.dhs.ca.gov/lnc/NTP/default.htm

Please look at pages 7-11 of the regulations that hospitals must comply with. If your hospital is not doing so they are breaking the law.
Do you have a competent RN take report and relieve you for meals and breaks? Do you always have the maximum allowed by the ratio?
If so your hospital is violating the law.
http://www.dhs.ca.gov/lnc/pubnotice/...ation_Text.pdf

Thanks, herring. I'm on the same page and appreciate your advocacy and level headed responses to bitters... I hope she shares her point of reference. Those of us who are direct care registered nurses/members of CNA/NNOC know that a democratic union takes work. As we used to say in the Girl Scouts, "many hands make the work light." Many studies have shown that ratios + staffing by individual patient acuity are working! CNA/NNOC members have tools and the benefit of collective advocacy to hold the administration accountable and make them liable for any errors that occur when staff nurses document that staffing is not based on acuity as the law requires. When staffing is strictly "by the numbers", (maximum number of patients to nurse)-without the required "staffing up" based on patient acuity, as determined by the nurse responsible for the patients, it's unsafe. It's our duty and our right to report those unsafe conditions to management without fear of retaliation.

[lindarn]

Where are the NNON and CNA representatives who were at the NTI in Chicago? I am wainting for them to call me, and figure out how to get NNOC and CNA representation Washington State. PM me or call me ASAP. I am ready to rolll! Thanks!!

Lindarn, RN, BSN, CCRN
Spokane, Washington

[HM2Viking]

The article also misrepresents the potential impact of a "right-to-work" initiative, saying that it "would let workers in union shops opt out of the union." Actually. no workers are ever compelled to join a union. Under the National Labor Relations Act, when a union is designated as the representing a specific group of workers, it is legally obligated to represent all the workers in the unit, whether or not they support the union. This means that if a worker is wrongfully fired or is the victim of some other breach of the contract or labor law, the union is obligated to represent the worker's interest, regardless of whether or not the worker supports the union.
In Colorado, as in many other states, unions may sign contracts with employers that require all the workers who it represents to pay a fee to the union for this representation. The initiative discussed in this article would make such contracts illegal, thereby giving workers the option of being represented by the union without paying for this representation. Since the initiative would allow people to benefit from union representation without paying for and does nothing about people's right to work, it can more accurately be described as a "right-to-freeload" initiative.

http://www.prospect.org/cs/blogs/bea...h=05&year=2008

[forrester]

[quote=RN4MERCY;2832770]

Originally Posted by ZASHAGALKA

Historically, nurses have always understood that their first duty is to act, to change circumstances as required, for the benefit of patients. Nursing advocacy, patient advocacy, social advocacy, political advocacy...collect the data, make an assessment, make a plan, implement the plan, evaluate the effectiveness of the interventions.

Too bad our nursing "leadership" has forgotten this simple nursing process.
No one critically reflects on the membership organizations or their leadership. If they did, they would throw most of them out.

Good at making plans, bad at everything else.