Originally Posted by jeolsz
Yeah, great info, but where in all those statements does it say unions alone improve nurse-patient ratios? My experience with unions is that they mainly consentrate on salary and benefits, not so much working conditions such as staffing. And while it is true you can file grievences thru the union and they act as an advocate for you in such issues, you can also have much of the same without a union. Most hospitals have policies and procedures, with a manuel supplied to every floor. If a policy is not followed and an adverse event happens because of it, there is a procedure that is followed to rectify the situation. Now, of course this requires less whining and complaining to a 3rd party and more interaction on the part of the employee and manager.
Prevention of decubiti requires more than just turning q 2.. Today there are special beds that help.. Teamwork and prioritization also help to prevent bedsores. And while its true some days seem endless and stressful I still believe it is part of the job, and no union can fix all problems.
A union is only as strong as the solidarity of it's members. They must act collectively, and in unity on solutions to the working conditions that are barriers to safe and effective patient care.
Your experience, evidently doesn't include active membership and participation in a union as a nurse organizer, bargaining council member, nurse rep, or steward.
The California Nurses Association members worked to achieve passage of the first in the nation safe staffing law. It was a 12 year fight to establish minimum nurse to patient ratios. In addition, the law requires employers to "staff up" from the minimum, and additional staff must be included, based on the acuity of the patients, to meet their needs. The acuity of the patients is determined by the independent professional judgement of the direct care nurse.
http://www.calnurses.org/nursing-pra...ios_index.html
With regards to grievances, RNs have a responsibility to notify their supervisor of any condition that they believe is unsafe. Hospitals have policies and procedures, but in my experience there has been a distinct trend away from fair and legal treatment of employees. There may be a policy regarding leave of absence, or overtime, or staffing; employees are told, "you don't qualify" or "do the best you can" or "you're not a team player" and they often fear retaliation when they respectfully and thoughtfully seek redress for their issues. RNs who do so are often unfairly branded as whiners and complainers in an often times successful attempt to marginalize and ultimately silence them. Many excellent nurses leave the profession; thus, the industry contributes to the so-called nursing shortage. I don't believe that silencing protects nurses or their patients; those working conditions shouldn't be endured and worn as a "badge of honor" and accepted as "coming with the territory"!
Unfortunately, being a good nurse is not the same as being a good employee in many hospitals. Union members raise the bar, collectively for all workers, in terms of wages, hours, and working conditions. Unions have been responsible for worker comp laws, meal and break laws, equal pay for equal work laws, and freedom of association and rights for workers to form and belong to unions, and Weingarten rights, so you don't have to go into the manager's office or HR without representation and due process.
CNA/NNOC is not a third party union. It is a democratic member run labor and professional organization. A standard provision in our contracts is for the election of direct care nurses to an independent committee, called Professional Practice Committee. No management appointees. Nurses need a forum to speak freely and collectively work on solutions to present to management when staffing and acuity concerns are ignored at the unit level. We document our concerns, in writing, to eliminate administrative deniability. This becomes important if there is a poor patient outcome because it proves that management was notified that, in the judgement of the nurse, staffing was insufficient to meet the needs of the patient. Liability for staffing decisions that cause harm to patients rests with management; a nurse can "do their best" and still errors, or omissions occur because of poor working conditions. Our union documentation and "just cause discipline" provisions prevents administration from blaming the nurse for a system failure.
Regarding pressure ulcers, there are many contributing factors including age, diabetes, incontinence, immobility, mulitsystem organ failure, low albumin/poor nutrition, etc. If there aren't enough special beds to go around, or enough nurses and lift teams, or aides to turn the patients those are environment of care issues that will also predispose a patient to acquiring pressure ulcers or pose a barrier to healing them.
Many states now have ratio laws progressing through their legislatures, as the result of the collective action of NNOC members. Hospital associations and executive management groups are spending huge amounts of money to oppose them, like they did in California. They want to retain control of their ability to blame nurses for their failures to budget to meet the needs of patients; it's often all about their bottom line. If employers can circumvent their legal responsibilities and squeeze their nursing staffs to make a buck, many do so.
Without a union contract, and members willing to enforce the laws at the facility level, management can give, and management can take away, at will. Your job, your benefits, your will to continue to practice nursing, the way you were educated and are legally required to do.
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Re: To Unionize or Not To Unionize: Questions that every nurse should ask themselves
