DEBRIDE the SCABS

Nurses General Nursing

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Replacement nurses arrive to prepare for possible strike http://www.startribune.com/viewers/qview/cgi/qview.cgi?template=health&slug=nurs30

Alternately titled....

SCABS-R-US on the move......

Replacement nurses arrive to prepare for possible strike

Maura Lerner

Star Tribune

Wednesday, May 30, 2001

A small army of replacement nurses has started to arrive for training in the Twin Cities, as a dozen hospitals in the area brace for a probable walkout Friday by more than 7,700 registered nurses.For now, hospital officials are doing their best to keep the incoming nurses out of the public eye. They've scheduled orientation sessions for today and Thursday at secret locations and won't say where the nurses will be housed.

"It's a security thing," said Linda Zespy of the Children's Hospitals of Minneapolis and St. Paul."It's just the way that it's done with replacement nurses," Zespy said.So far, no new talks have been scheduled. But the hospitals called on the Minnesota Nurses Association on Tuesday to let its members vote on the latest contract offer, which the union's negotiators rejected last week."The hospitals have heard from some of their nurses that they would like the opportunity to vote on the proposals," said Shireen Gandhi-Kozel, spokeswoman for the Minnesota Hospital and Healthcare Partnership.She said four of the six negotiating teams, which represent nurses and managers at the 12 hospitals, agreed on staffing, which is one of the thorniest issues.

The main stumbling block was money, she said, with the hospitals offering a 19.1 percent increase over three years and the union seeking a 35 percent increase."We're asking the Minnesota Nurses Association to put the proposals to a vote," she said.But the union said it has heard no such request from its members. "That's the intent of the hospitals, to override the negotiating committee," said Jan Rabbers, the union's spokeswoman. "But what they'll find is that the membership is the one that's driving the demands." On May 17, the nurses voted overwhelmingly to reject the hospitals' contract offers, which included an 18 percent raise over three years. But nurses say staffing levels are a major issue because they're often stretched too thin to care for patients safely.Hospital officials said replacement nurses would need a day or two of training before replacing the striking nurses Friday. They scheduled the sessions off-site, at secret locations, to keep them away from any possible harm.

"I can understand why they wouldn't want to disclose the location and have 10, 20 media people descend on them, as well as picketing going on outside," said Gandhi-Kozel. "The primary focus is to make sure that they receive education, and we need to have a productive environment for that to happen." Hospital officials said that the replacement nurses, hired by agencies that specialize in strike staffing, have a minimum of two years' experience in hospital care and an average of five to 12 years in their specialty areas. "Whether we're talking about physicians or nurses, we have national standards," said Dr. William Goodall, vice president of regional medical affairs at Allina Health System, which owns four of the affected hospitals. "So if you are a degreed and licensed RN, it's highly likely that you're competent to begin with." Thousands of replacement nurses will be arriving, although the hospitals won't say just how many. They will be expected to work 12-hour shifts six days a week, hospital officials said.

In return, they'll get $40 an hour, plus free housing, transportation and other perks.At HealthEast's three hospitals, 340 visiting nurses are expected to replace 1,100 striking nurses, many of whom are part-time. And the two Children's Hospitals expect 300 replacement nurses to help fill in for the 1,200 or so who will go on strike. To help orient them, officials have brought ventilators, IV systems and other hospital equipment to the off-site training location, Zespy said. "It won't be the same; we want our nurses back," she said. "But in the meantime, we'll assure the high-quality, safe care that we're known for."-- Maura Lerner is at [email protected] .

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© Copyright 2001 Star Tribune. All rights reserved.

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Christina Terranova RN, LNC

Our Unity is our Power www.geocities.com/nurseadvocate

www.florenceproject.org

The Florence Project, Inc.

MollyJ, the HOSPITAL has lost the trust of the community, not the nurses. By and large, the community backed the nurses. Once it came out in the local papers that the hospital spent that kind of money to break the union, as well as another $14 MILLION unaccounted for and being investigated by the NYS Attorney General, ($33 MILLION in total, at a hospital that had posted PROFITS for most of the previous decade), the hospital lost all credibility. There is now a new admin in place and apparently the workers are willing to give them a chance because an effort to organize non nursing personnel by the CWA (Communications Workers of America) this week was defeated by about a 2 to 1 margin. And from what my friends who work there tell me the new DON is great, very pro nursing and trying VERY hard to heal all rifts. Amazingly, there doesn't seem to be much animosity between staff and supervision. In fact, one friend told me that when she went back the only real instances of animosity that she encountered were on the part of a SUPERVISOR toward the staff. This hurt the staff very much. I don't know anyone who works directly with the staff scabs that crossed the line, and so i don't know how that worked out. But my friend says that the ones she knows of who crossed were not all that well liked in the first place.

One thing that i have to say again, NO ONE wins in a strike. The loss of income or capital, as well as lack of trust, has lingering implications for a long time to come.

Originally posted by MollyJ:

I appreciate our neighbors to the north who reflect their discomfiture with the idea that some of us would even see essential services not covered.

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Please don't misinterpret my statement of fact to mean I agree that nurses should not be allowed to strike when conditions demand it. I think it is a sick double standard that nurses are selfish if they strike for better conditions. I don't believe that in your country essential services could not be covered by other hospitals in the same city or area. Here we are essential services because ALL the hospitals are staffed by nurses in the same union in each province.

Less than a year ago northern docs in my province "withdrew services" (not a strike :rolleyes :) solely for the issue of money. Nothing about patient care. NOTHING. I had one patient with multiple fractures (including a broken hip) who was transported to our hospital, 8 hours from his home in an ambulance because orthopedic surgeons wouldn't help him. That is disgusting. When nurses are striking to improve wages and conditions and patients can go to other hospitals in the area, it is necessary and courageous.

Originally posted by RNPD:

"My focus is on nurse retention at the bedside, always has been and always will be, just in a different way than you. There are other options besides across a bargaining table.....Just remember that your solution is not the only one."

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Chas-what are some of the options you have used to focus on nurse retention? I would like to hear some other solutions that have worked for you. I have always felt that it would be better if nurses were respected enough to do their own bargaining and to be listened to when they try to tell admin what is needed for the good of the patients. Unfortunately, I have never met an admin like that, and so collective bargaining is the next best thing. But without, I have never seen more than three nurses at a time agree with ANYTHING!.

Thanx folks for the great thread. There are some interesting levels to this discussion. The question posted above concerning the Supreme Court decision about LTC RNs in supervisory roles is a poignant example of how RNs must be informed when seeking employment. In nursing school we were taught to advocate on behalf of patients. This seems to be an obvious nursing role. What our instructors failed to mention, however, is the blurred line between our rights, responsibilities and obligations as RNs licensed by individual government authorities (states) and our obligations and responsibilities as employees of companies/hospitals/healthcare agencies when we accept employment. From time to time, these 2 roles (the role of the licensed Registered Nurse and the role of employee) are diametrically opposed to one another and cause internal and external conflict (the recent Supreme Court decision and the numerous whistle blowing legislation occurring in many states today are examples). The fact is that when one becomes an employee of any organization you automatically assign the organization the right to control your behavior on some level. Look at your employee handbook, your human resources policies, your nursing policies and procedures to get an idea of how much control the organization has on your behavior, individually and collectively. Employees give the organization the right to sanction and to reward. Organization theory/research has done much over the last 2 decades to look at employee roles and how they are enacted by professionals, paraprofessionals and non-professionals. Professionals have more conflict in bureaucratic and hierarchical organizations and are more suited to working in organizations with a more open system approach to management/leadership. Registered Nurses have a higher authority than the organization...State Law. Much of our conflict occurs when our obligations by law are opposed to our obligations to employers. Having studied organization theory extensively, I have come to the understanding that RNs really must look to law first. I founded a Professional Practice Group (equal partners) of RNs who are engaged in Independent Practice for that very reason. We take our roles as Registered Nurses seriously. We are not employed by anyone, yet we practice in organizations expertly and professionally. We make our own opportunities and we reap our own rewards. My message to RNs is clear...if you choose to be employed, you choose to have control exerted over you.

A second issue involves the mantle of intense competition that RNs have assumed over the years. I remember in nursing school the intense competition to be the best, make the best grades, perform the best procedures, know the most...etc. While my instrutors may have used competition to pull the best from us, the negative effects of pitting student against student was to have one clear winner and the rest losers. Think back on your educational experience and examine the times you were negatively sanctioned by your instructors. Are there experiences there that are memorable for you? Extend this thought process to your nurisng unit and look at your co-workers. How much competition is there? If you want to really know, look at the amount of criticism heaped on others (overtly or covertly), the verbal sanctions that occur, your evaluation system that lumps everyone into a homogeneous group rather than extols the virtues of the individual and the group. We seem to have bought the notion that competition is the healthiest model for our work relations. What about collaboration? Collaborative practice is a win-win. Again, my message to RNs is clear...examine collaborative practice as a viable model for your nursing foundation rather than competition. Independent Practice can offer you the opportunity to practice to your highest capacity wihout destroying others in the process.

best regards

chas

chas, I think your ideas are wonderful. I don't know that I will ever see the day where RNs can practice as non employees, but it is certainly the way a professional group ought to practice. I commend you for being able to practice at the bedside as an independnt employee. Do you get a fee for service from the hospital as well as reimbursement? What is the nature of your practice? How do you see your individual situation applied to the general population of staff nurse?

I agree that your way is the ideal and there would not be a need for unions if we all could accomplish this. But until then I will remain a unionized employee, since I have found it better than non union.

Thank you for adding an interesting aspect to the discussion.

Originally posted by PeggyOhio:

Charles,

I agree your ideas are unique. But I also think it is naive to think that you are immune to competition. I imagine if nurses as independent contractors became the norm it would become extremely cut-throat and competitive.

No one said our group is immune to competition. We don't compete with each other. We are highly selective in the partners we take on. We create our own demand, thus eliminating the overt competitive nature. The competition thoughts above were related to internal competition, not external market competition. I am curious about your cut-throat statement, however. Please say more.

chas

Originally posted by RNPD:

chas, I think your ideas are wonderful. I don't know that I will ever see the day where RNs can practice as non employees, but it is certainly the way a professional group ought to practice. I commend you for being able to practice at the bedside as an independnt employee. Do you get a fee for service from the hospital as well as reimbursement? What is the nature of your practice? How do you see your individual situation applied to the general population of staff nurse?

I agree that your way is the ideal and there would not be a need for unions if we all could accomplish this. But until then I will remain a unionized employee, since I have found it better than non union.

Thank you for adding an interesting aspect to the discussion.

Thanx for your comments..independent practice is certainly a different twist. I do believe this type of practice can be accomplished by anyone who wants to really change her/his perspective on professional nursing, but it takes work to change mindsets and it takes work to run a business...all with positive outcomes i might add. Simply put, we eliminated the middle man from the equation and bill directly for our services. My hope is that one day we can change law to allow us to bill insurance companies directly as well...but that is down the road a bit. I had a dream of professional practice model over 20 years ago and the timing was right, so i jumped at the chance. Now I teach others who are interested.

chas

The whole subject of scab nurses makes me angry. what leverage do we have as nurses to effecdt changes within our profession when these money hungry "nurse" are willing to work in strike conditions? :mad: Check out this http://www.afscme.org/una/unalt011.htm

there is also a scab.org where scab nurses can post and it makes me sick to hear them complain about how hard it is to leave their family and travel to strike locations. they should stay home and find a real job.

Charles,

Perhaps the problem is I am confused to what it is you are actually doing.

In one post you say you work in a hospital setting at the bedside, as an independent contractor. This sounds to me like a fancy name for agency nurse. Only you are your own agency.

Then you say you "create" your "own demand". How do you do this go out and knock down a few little old ladies? ;) Last time I heard you had to be admitted to a hospital by a physician.

It is rather hard to get an idea of exactly what it is you do.

At any rate. For the sake of discussion I am assuming that you do indeed work as a staff nurse at the bedside in a hospital. And you do this as a "independent professional practioner".

Let us assume that you have successfully convince nurses to follow this new "model" of "professional independent practice". It's several years down the road now everybody doing it. And since the nursing shortage created a huge demand many wages have skyrocketed, and many, many folks have decided to follow the money. And the shortage no longer exists.

So say you have enjoyed a very nice "relationship"(formerly called "job") with your "contractees" (f.k.a. "employer"). And your contract is up for renegotiation. Since everyone is in the market now the "contractee" finds a better offer. (That is sometimes called cut-throat, or bidding wars, etc.) Your "relationship" is terminated.

Since you are an "independent profession practitioner" you have no PTO, no Cobra. Fortunately in your contract there is a written in grace period before termination. Unfortunately the grace period has expired and you have still not found a new "contractor". For all intents and purposes you are now jobless. Without the income needed to pay your own medical, dental, and vision benefits. Unable to make contributions to your IRA, 401K, or SS, income taxes, or pay the accountant that is handling these things for you.

I could imagine hospitals being delighted to go with this new "model" as they would no longer have the administrative costs of maintaining health benefits and retirement benefits since they would no longer have any "employees", well at least "professional" ones.

RNPD I think you may be right about this.

[ June 04, 2001: Message edited by: PeggyOhio ]

Originally posted by PeggyOhio:

Charles,

Perhaps the problem is I am confused to what it is you are actually doing.

In one post you say you work in a hospital setting at the bedside, as an independent contractor. This sounds to me like a fancy name for agency nurse. Only you are your own agency.

Peggy...thanx for the questions...An agency is an employer or broker that extracts a cost over and above the wage paid to the employee. We bill less than agencies but are reimbursed at rates exceeding agency pay rates (cut out the middle layer). No, I am not my own agency, but I am my own contractor along with my business partners. We do not do just staffing. We also teach, consult, coach, LNC work, etc. We have established a professional practice group to allow us to continue practicing at the bedside for a fair market wage, but also allows us the freedom and flexibility to perform other nursing work (missions, parish nursing, etc) at the same time.

Then you say you "create" your "own demand". How do you do this go out and knock down a few little old ladies? ;) Last time I heard you had to be admitted to a hospital by a physician.

We have value added services in our practice group and the hospitals in our area seem to appreciate them. We are not limited to bedside nursing, and offer expert practice to teach and precept, consult, etc. In addition, by keeping our numbers manageable and only partnering with expert nurses, we are well known in the systems where we provide services.

It is rather hard to get an idea of exactly what it is you do.

At any rate. For the sake of discussion I am assuming that you do indeed work as a staff nurse at the bedside in a hospital. And you do this as a "independent professional practioner".

Let us assume that you have successfully convince nurses to follow this new "model" of "professional independent practice". It's several years down the road now everybody doing it. And since the nursing shortage created a huge demand many wages have skyrocketed, and many, many folks have decided to follow the money. And the shortage no longer exists.

Peggy...I have no fear of the "shortage" ending, or all nurses following a different model. There are too many nurses who are afraid of living a full life, fearful of thinking in new ways, and are too entrenched to move out of employment. As is evidenced on this board nurses many times are more comfortable looking at others and taking pot shots than at looking at themselves and making meaningful changes (not a criticism, just an observation) Our model is innovative, yet not for everyone, especially novice nurses. The foundation is expert practice and that takes years.

So say you have enjoyed a very nice "relationship"(formerly called "job") with your "contractees" (f.k.a. "employer"). And your contract is up for renegotiation. Since everyone is in the market now the "contractee" finds a better offer. (That is sometimes called cut-throat, or bidding wars, etc.) Your "relationship" is terminated.

Participating in an economic market is not without its risks. Our relationship is contractual and governed by state and federal laws. We are a business offering service to another business, so it really is not "formally called a job". We all know that our services may not be needed at some point in the future, so we have taken the risk away by preparing to do other things as needed. We are pretty flexible too in terms of the venue where we practice. I can pick up and work anywhere as long as I have negotiated a contract in advance.

Since you are an "independent profession practitioner" you have no PTO, no Cobra. Fortunately in your contract there is a written in grace period before termination. Unfortunately the grace period has expired and you have still not found a new "contractor". For all intents and purposes you are now jobless. Without the income needed to pay your own medical, dental, and vision benefits. Unable to make contributions to your IRA, 401K, or SS, income taxes, or pay the accountant that is handling these things for you.

Ah..but there you may be underinformed. We are a business and there are contingency plans in all businesses, certainly in ours for the issues you raise. My crystal ball is a bit rusty these days, but it still shows a pretty fair picture of continued work down the road (until my cane gives out and the wheels on my wheelchair fall off). Businesses prepare for economic contingencies and we have done the same with some work left to go. We don't have to beg for benefits. We can make our own and change or enhance them anytime we choose. Can you say the same of regular employees? I think not.

I could imagine hospitals being delighted to go with this new "model" as they would no longer have the administrative costs of maintaining health benefits and retirement benefits since they would no longer have any "employees", well at least "professional" ones.

And you know...that is a marketing concept that we use...the hospitals do not have the burden of all of the extras. We take care of that and they are, as you say, more than willing to participate with us. Our group is reliable, dependable and hard working. The hospitals get a pretty big bang for the buck so to speak and we come out far ahead in terms of work satisfaction, life satisfaction and financial satisfaction. So far, it has been a win-win. We do know that anything can change and that is what we are not afraid of...change.

What I find interesting is that a different model of practice is threatening to nurses. Nursing has a long history of trying new things and this is only one in a long string of them. Often we are critical about that which we are underinformed or of that which we are frightened. Nurses really ought to look at new and innovative ways to create a brighter nursing future. I say bring on any and all ideas. It can only enhance our profession in the long run. Why stay in a rut when all you can see is mud (or at least that is what the complaining is all about)?

I had my share of complaints too, until I woke up one day and said...no more. I will take total control of my life and I did. I am far happier than ever. I would only pray that others will want total control over her/his life as well. It is a wonderful place to be.

RNPD I think you may be right about this.

Thanx again Peggy...just try to imagine what it might be like to really choose......

chas

[ June 04, 2001: Message edited by: PeggyOhio ]

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Charles,

I can see many of my assumptions were incorrect. Thanks for the clarification. It seems that you have really made a nice niche for yourself.

However you readily admit, "Our model is innovative, yet NOT FOR EVERYONE, especially novice nurses. The foundation is expert practice and that takes years." Yet you infer that those who do not or choose not to follow this model are, "nurses who are afraid of living a full life, fearful of thinking in new ways, and are too entrenched to move out of employment."

Risk is a big part of what you are doing. As you state, "We do know that anything can change and that is what we are not afraid of...change." Not everyone can be, "flexible too in terms of the venue where (they) practice. Or,"can pick up and work anywhere...."

Bully for you that you can! :)

[ June 04, 2001: Message edited by: PeggyOhio ]

Originally posted by PeggyOhio:

Charles,

Thanks for the clarification. I can see that you have really made a nice niche for yourself.

I also see that risk is a big part of what you are doing. And bully for you that you can take those kinds of risks. :)

Thanx Peg...it is a niche and certainly not without risk. My mother, God rest her, told me a long time ago that the worst failure in life is to refuse to try. This from a woman who knew the Depression and World War II intimately. There are others out there who will enjoy learning to take calculated risks and I am here for them, one by one.

regards

chas

chas, it sounds like a great concept. I am happy that you have been able to raise nursing practice at the bedside to a new level. But by your own admission it is not for everyone, especially the timid and the novice. Also, could the fact that you're a man have anything to do with your success? Are any of your partners women? If so, do they have children and families?

You see a lot of nurses are either supporting families, or work less than full time. And being women is a disadvantage from a business perspective in the eyes of a potential "client" (i.e. healthcare facility). So you are right, your model is not for everyone, and may never be a viable alternative for the bulk of the profession.

That said, why is it that you and others who have had success within the profession (the percentage of which is low when discussing bedside care) feel that those of us who are unable to follow your indepedndent practice model and negotiate better conditions for ourselves are someone the less for joining a union to try to get the best situation that they can given THEIR circumstances? I don't have the business ability or financial wherewithall, or even the desire to work as hard as I would need to to be an independent contractor. Why then, should I not take advantage of having a designated leader (i.e.union) to speak for me and others like me to negotiate the best possible deal for MY circumstances?

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