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Joined Mar 14, '04 - from 'California, USA'. herring_RN is a retired registered nurse. She has '>40 years' year(s) of experience and specializes in 'Critical care, tele, Medical-Surgical'. Posts: 16,572 (72% Liked) Likes: 32,108

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  • Feb 14

    Quote from OrganizedChaos
    I just can't imagine a place where women can't have access to the healthcare they need. Having affordable healthcare access to things like birth control can prevent so many unintended pregnancies & help women with certain medical disorders.

    I am not fond of abortions but sometimes it is a better decision than women having children & those children being put in foster care or having to live in horrendous conditions. Would you really want the system clogged up with kids who weren't wanted? That costs so much more than an abortion. What about all the children that are born into abuse & the many that are killed? No child deserves that.
    I am pro-life yet some of my tax money pays for the death penalty.

  • Feb 14

    Quote from pmabraham
    Because being in a union offers ZERO guarantees of anything being better. So you have less in your paycheck to support those who may not be doing a single thing to make things better. And if they help bad employees stay employed, then they take a part of your pay to make life worse.
    If "bad" employees are kept it is due to incompetent management.
    A union contract generally requires that discipline, including termination, be for "Just Cause".

    The most extreme I read about in the paper was a hospital where employees were allowed to be late routinely because they traveled from another job. Also some took lunch breaks that took up almost half their shift:
    ... Some employees habitually fail to show up, logging weeks, even months, of unexcused absences each year. And those who do come to work often don't do their jobs, causing one consultant in 2002 to remark that they had "retired in place."
    Others are distracted or impaired. County Civil Service Commission filings tell of staff members grabbing and clawingeach other's necks; inspection reports tell of patients literally dying of neglect.
    Underfunding is a myth, but the squandering is real - LA Times
    The most extreme example I've been told about was a nurse who wanted to fight a termination after he was caught with narcotics in his socks. His fellow nurses were there when he refused to stay when the count came up short, ran, and was stopped by security.
    Because the union had to provide representation a rep attended the meeting and took notes as one after another witness reported the same.
    The union refused to go to arbitration, he threatened to sue. He was given a list of attorneys because he was also reported to the board. He never sued.

    I remember once I was asked to attend an arbitration at another facility. An RN had been terminated for rudeness.
    The manager had written her up once before for refusing to care for a patient in ICU and and four others on her telemetry unit. She had fought that because she was not competent to work in ICY and because it was physically in another nearby unit.
    Even though that nurse had prevailed the manager felt there had been progressive discipline.

    The "rudeness" consisted of an accusation that she had been rude to a patient. The assignment sheet did not include that patient.
    In report she was told the patient was discharged and just waiting for a ride. She was getting an admit from ER into that bed.

    About 7:20 pm she saw the patient in a wheelchair in the hallway. The secretary said no one had been able to contact his family to take him home. The nurse called both phone numbers and left a message. She bought him dinner from the cafeteria because he was no longer in the computer. She helped him to the bathroom.
    he then told the charge nurse who called the supervisor. She put her concern that her assignment was unsafe because her patient had no room and with him to care for she was assigned more patients than allowed by the ratio regulations. The supervisor said, "Do the best you can."

    About 10:30 pm she noticed the patient was gone. The secretary told her, "The daughter came and got him."

    She testified at the arbitration that she had told her manager that she had neither discharges the patient nor took him down to the car, but her manager accused her of lying.
    Plus he was no her patient because he had already been discharged.

    The daughter testified that the doctor had told her at 3:00 pm her father would stay another night. She went shopping. She didn't have a cell phone with her. When she got home she was surprised and angry with the message. She came to get her father and a nurse seemed to be in a hurry. She pushed him out to the car. That nurse was so rude she wouldn't answer any questions. After her father was in the car she asked, "Why is my father going home? The doctor told me tomorrow."
    She said, "That rude nurse just kept saying, "OK, Bye."

    When the union representative's turn came to question the daughter he said, "Do you know the name of the nurse?
    daughter, "Yes it is *****." (the name of the terminated nurse)
    Union rep, "Did you read her name tag?"
    Daughter, "No ***** told me her name." (gave name of terminated nurae)
    Union rep, "Would you recognize her if you see her?"
    Daughter, "Yes I would. I looked at her face and asked her questions and she just said, "OK. Bye"
    Union rep, "Is she here in this room?"
    The daughter looked at all us women. She made eye contact with me and the six other women at the table and against the wall. Then she said, "No. She is not here."

    The terminated RN began to cry. The arbitrator said, "I will reverse the termination. You will receive my written judgment in three days."

    The RN was crying. She asked her manager, "Why do you hate me?"

    The manager yelled, "Because you look like the woman my husband left me for."

    That was the most exciting arbitration.
    But although most are tedious and boring they are important sometimes when a nurse is terminated and there was no just cause.

  • Feb 14

    Quote from nrsadvocate
    I believe the most important issue that unions resolve is nurse-patient ratios. That's why unions are able to organize and get voted in by nurses. It's all about patient safety. I would like to hear from the nurses who are never short staffed and feel that their patients and nursing licenses are never in jeopardy because of short staffing. Do these hospitals exist??? Unions have nurse committees for the purpose of bargaining and negotiating, so that their members voices and needs are at the forefront. If union dues are the issue, just think about the cost of one mistake...it could cost your license and your career So where are the hospitals that staff their floors appropriately on a regular basis because I would like to apply for a job at these hospitals. Let's get real, hospitals are not going to provide safe staffing unless forced to do so.
    While nothing is perfect it is SO MUCH BETTER since our ratios went into effect January 1, 2004!

    Until we elect new members of congress I think ratios will have to be done state-by- state or in union contracts.

    National Campaign for Safe RN-to-Patient Staffing Ratios:
    National Campaign for Safe RN-to-Patient Staffing Ratios | National Nurses United

  • Feb 14

    On line I found this bargaining update for St. Mary's hospital RNs in Reno. It is dated September 2013.
    http://www.nationalnursesunited.org/...ain-090613.pdf

    In October they settled a contract. They seemed to get a better deal with health insurance. They were unable to improve the previous contractual ratios of 1: 6 in med/surg and 1:5 in telemetry. The nurses wanted to improves these. They were already OK with their critical care ratio of 1:2 or fewer patients per RN.
    St. Mary’s Regional Medical Center RNs Ratify | National Nurses United

    Las Vegas St. Rose Dominican Dignity Health RNs and California dignity RNs have the same contract. Nurses I know who work at Dignity hospitals are pleased with their contract:
    New Four-Year Pact for 12,000 California and Nevada Dignity RNs | National Nurses United

  • Feb 8

    Quote from Joeyzoom208
    Hi all!! 4 year veteran LVN in SoCal here. I'm looking to finally get my RN and am looking into the 30 unit option here in L.A. Now, I already know that I can not take this outside California unless I get an actual degreed RN .. but what about getting an RN job here
    IN Cali ?? Anyone go through this program ? Anyone KNOW anything about job prospects ?

    I am a very independent learner, so I'm not worried there at all -- I just want to complete an RN as soon as possible. I have an email into the Director of Nursing at UCLA, as many of their postings DO NOT state "must be graduate of accredited RN school", but many do.

    ANY insight here would be appreciated. My other options are of course the LVN to ADN, or LVN to BSN .. but with my work schedule that may never be possible (or at a snail's pace!). I'm 34, and really wanted to have my RN 4 years ago! C'est la vie! ;-)

    Thank you all in advance for deeper insight into this option here in California !
    I was doing the "Snail's Pace Option" taking one prerequisite a semester while working nights as an LVN. When it became clear that hospitals were phasing out LVNs I went full time, took a test to skip the first year of the associates program, and then applied to the RN program at my local community college.

    When I started the program I went to eight 12 hour nights in a two week pay period. The RN program was easier than LVN school had been because of my experience. I was so tired that I easily slept in my car during a two hour break between classes. But I graduated and passed NCLEX.
    Years later I did an RN to BSN program.

    Look for a school with Accelerated Fast Track (AFT) program that admits LVNs only. The education is set up to only teach what was not learned in the LVN program. Regardless of the program you will need the required supervised clinical experience. Some are quite time consuming compared to regular college classes. (For example my two unit maternal/child class required two clinical days, six hours of which was at the bedside and 1 1/2 hour for pre and post conference. then we had to do care plans and tuen them in on the 1 1/2 hour classroom day. We also had to read the chapters and pass the written tests. 17 1/2 hours a week, not counting study time, for 2 units.

    Here are the accredited programs:
    Board of Registered Nursing - RN Programs

  • Feb 1

    Nurses worldwide have a proud history of political activism in advocating for our patients, public health, and the welfare of all people.

    In the United States the ANA has accomplished a lot:
    http://www.nursingworld.org/Function...icalReview.pdf

    Nurses achieved state registration and licensing to protect people from uneducated and untrained people holding themselves out a nurses. Only those with an RN, LPN/LVN are nurses under the law.
    Nurses were instrumental leaders in women getting the vote, stopping child labor, and public health.
    I am certain nurses will continue to work for the health of us all.

    Some may be interested in an event happening in D.C. this coming Thursday:
    First Broad Post-Election Rally – Thursday, DC Sen. Bernie Sanders to Join Day of Action | Common Dreams | Breaking News & Views for the Progressive Community

  • Jan 28

    I don't think management is represented by the union.
    Many managers appreciate having rules written in the union contract. It makes it easier regarding pay, schedules, vacation and other time off, and such.
    Disciplinary rules are written too.
    My nurse manager liked working where we had a contract.

  • Jan 27

    Management thinks nurses are an expense.
    Fact is that patients are hospitalized because they need nursing care.
    As soon as they no longer need nursing care they are discharged.
    All other care is available as an outpatient.

    The "product" of a hospital is nursing care.

  • Jan 27

    Quote from pmabraham
    For safe ratios, you need strong laws which are enforced rather than corruptible unions
    I hope we don't let OUR union be corrupted.
    Ratios were achieved by thousands nurses working with their union.

    Timeline of nurses achieving safe staffing ratios:
    www.nationalnursesunited.org/page/-/files/pdf/ratios/12yr-fight-0104.pdf

  • Jan 27

    Quote from dnptobe20
    In many other countries physicians, pharmacists and other healthcare providers are unionized because there is more power in a unified voice than there is in 1. Of course the executive rank and file and management in many organizations have traditionally been anti union because it does't serve their bottom lines. In our country unions have been more associated with blue collar workers than white collar and many have used this to stigmatize any group that tries to unionize as unprofessional (to me this is nonsense, by the way) i rememver nursing professors not-too-subtly making this assertion in nursing school and discouraging unionization.

    Weeeell, i am an NNU member at my hospital..not terribly active in any way but happy to be one. We enjoy the higest wages in our area, union representation anytime our management wants to sanction us for anything, guaranteed 1:2 or 1:1 ratios in our icus with no exceptions, etc etc...when it comes ro scheduling and vacations each unit has some leeway in determining how it works and things are working out pretty well for us. Our union has fought for $10,000 a year towards education, guaranteed pay and seniority structure as well as annual raises etc etc. And you can't just be fired for any odd reason. Our union has fought for and brought back many nurses fired during a major snowstorm...these nurses were fired because they had kids at home they could not leave to come to work since the hospital did not provide transport. The union had them rehired and the hospital provided backpay for ALL the time they were unemployed!

    Needless to say, I am happy with our union and all the gains we have won for ourselves as nurses.
    With better staffing new nurses are more likely to stay until they have seniority.
    I'm so very glad your nurses got their jobs back. In 2010 when roads were closed and trains and buses don't run some nurses could not get to work.

    Did your hospital have a plan for staffing during this year's recent snow storms?

  • Jan 27

    Quote from pmabraham
    Because being in a union offers ZERO guarantees of anything being better. So you have less in your paycheck to support those who may not be doing a single thing to make things better. And if they help bad employees stay employed, then they take a part of your pay to make life worse.
    If "bad" employees are kept it is due to incompetent management.
    A union contract generally requires that discipline, including termination, be for "Just Cause".

    The most extreme I read about in the paper was a hospital where employees were allowed to be late routinely because they traveled from another job. Also some took lunch breaks that took up almost half their shift:
    ... Some employees habitually fail to show up, logging weeks, even months, of unexcused absences each year. And those who do come to work often don't do their jobs, causing one consultant in 2002 to remark that they had "retired in place."
    Others are distracted or impaired. County Civil Service Commission filings tell of staff members grabbing and clawingeach other's necks; inspection reports tell of patients literally dying of neglect.
    Underfunding is a myth, but the squandering is real - LA Times
    The most extreme example I've been told about was a nurse who wanted to fight a termination after he was caught with narcotics in his socks. His fellow nurses were there when he refused to stay when the count came up short, ran, and was stopped by security.
    Because the union had to provide representation a rep attended the meeting and took notes as one after another witness reported the same.
    The union refused to go to arbitration, he threatened to sue. He was given a list of attorneys because he was also reported to the board. He never sued.

    I remember once I was asked to attend an arbitration at another facility. An RN had been terminated for rudeness.
    The manager had written her up once before for refusing to care for a patient in ICU and and four others on her telemetry unit. She had fought that because she was not competent to work in ICY and because it was physically in another nearby unit.
    Even though that nurse had prevailed the manager felt there had been progressive discipline.

    The "rudeness" consisted of an accusation that she had been rude to a patient. The assignment sheet did not include that patient.
    In report she was told the patient was discharged and just waiting for a ride. She was getting an admit from ER into that bed.

    About 7:20 pm she saw the patient in a wheelchair in the hallway. The secretary said no one had been able to contact his family to take him home. The nurse called both phone numbers and left a message. She bought him dinner from the cafeteria because he was no longer in the computer. She helped him to the bathroom.
    he then told the charge nurse who called the supervisor. She put her concern that her assignment was unsafe because her patient had no room and with him to care for she was assigned more patients than allowed by the ratio regulations. The supervisor said, "Do the best you can."

    About 10:30 pm she noticed the patient was gone. The secretary told her, "The daughter came and got him."

    She testified at the arbitration that she had told her manager that she had neither discharges the patient nor took him down to the car, but her manager accused her of lying.
    Plus he was no her patient because he had already been discharged.

    The daughter testified that the doctor had told her at 3:00 pm her father would stay another night. She went shopping. She didn't have a cell phone with her. When she got home she was surprised and angry with the message. She came to get her father and a nurse seemed to be in a hurry. She pushed him out to the car. That nurse was so rude she wouldn't answer any questions. After her father was in the car she asked, "Why is my father going home? The doctor told me tomorrow."
    She said, "That rude nurse just kept saying, "OK, Bye."

    When the union representative's turn came to question the daughter he said, "Do you know the name of the nurse?
    daughter, "Yes it is *****." (the name of the terminated nurse)
    Union rep, "Did you read her name tag?"
    Daughter, "No ***** told me her name." (gave name of terminated nurae)
    Union rep, "Would you recognize her if you see her?"
    Daughter, "Yes I would. I looked at her face and asked her questions and she just said, "OK. Bye"
    Union rep, "Is she here in this room?"
    The daughter looked at all us women. She made eye contact with me and the six other women at the table and against the wall. Then she said, "No. She is not here."

    The terminated RN began to cry. The arbitrator said, "I will reverse the termination. You will receive my written judgment in three days."

    The RN was crying. She asked her manager, "Why do you hate me?"

    The manager yelled, "Because you look like the woman my husband left me for."

    That was the most exciting arbitration.
    But although most are tedious and boring they are important sometimes when a nurse is terminated and there was no just cause.

  • Jan 25

    I hope we discuss the causes, effects, and actions to take to promote a healthy rested nursing workforce?

    Fatigue in hospital nurses — ‘Supernurse’ culture is a barrier to addressing problems: A qualitative interview study
    Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes.
    Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce...

    ... All nurses in the current study experienced fatigue; yet they had varying perspectives on the importance of addressing fatigue in relation to other health systems challenges.
    A new construct related to nursing professional culture was identified and defined as “Supernurse”.
    Identified subthemes of Supernurse include: extraordinary powers used for good; cloak of invulnerability; no sidekick; Kryptonite, and an alterego.
    These values, beliefs, and behaviors define the specific aspects of nursing professional culture that can act as barriers to fatigue risk management programs and achieving safety culture in hospital organizations.
    Nurse fatigue and attributes of nurse professional culture also have implications for nurse satisfaction and retention.

    Conclusions
    Findings from this study further support the role of nursing professional culture as an important barrier to effectively addressing fatigue in nursing work systems. Future work is needed to identify and evaluate innovative culture change models and strategies to target these barriers...
    http://www.journalofnursingstudies.c...16)30227-9/pdf
    The ANA Position on Fatigue;
    Addressing Nurse Fatigue to Promote Safety and Health: Joint Responsibilities of Registered Nurses and Employers to Reduce Risks

  • Jan 22

    California ratios define telemetry and step-down by patient needs. Other units and corresponding ratios are also included in the linked document

    ... Commencing January 1, 2008, the licensed nurse-to-patient ratio in a step-down unit shall be 1:3 or fewer at all times. A “step down unit” is defined as a unit which is organized, operated, and maintained to provide for the monitoring and care of patients with moderate or potentially severe physiologic instability requiring technical support but not necessarily artificial life support. Step-down patients are those patients who require less care than intensive care, but more than that which is available from medical/surgical care. “Artificial life support” is defined as a system that uses medical technology to aid, support, or replace a vital function of the body that has been seriously damaged. “Technical support” is defined as specialized equipment and/or personnel providing for invasive monitoring, telemetry, or mechanical ventilation, for the immediate amelioration or remediation of severe pathology...

    ... Commencing January 1, 2008, the licensed nurse-to-patient ratio in a telemetry unit shall be 1:4 or fewer at all times. “Telemetry unit” is defined as a unit organized, operated, and maintained to provide care for and continuous cardiac monitoring of patients in a stable condition, having or suspected of having a cardiac condition or a disease requiring the electronic monitoring, recording, retrieval, and display of cardiac electrical signals...
    View Document - California Code of Regulations
    This section of hospital regulations is important for patient safety too:
    View Document - California Code of Regulations

    It took us a long time to achieved ratios in California. Now that the bill has moved to the New York State Senate I think it is time for nurfses to write, call, and email your state senators, attend whatever senate committee or other meetings are planned, demonstrate your concern, and educate voters about how safe staffing will help them and/or their loved ones.

  • Jan 21

    California ratios define telemetry and step-down by patient needs. Other units and corresponding ratios are also included in the linked document

    ... Commencing January 1, 2008, the licensed nurse-to-patient ratio in a step-down unit shall be 1:3 or fewer at all times. A “step down unit” is defined as a unit which is organized, operated, and maintained to provide for the monitoring and care of patients with moderate or potentially severe physiologic instability requiring technical support but not necessarily artificial life support. Step-down patients are those patients who require less care than intensive care, but more than that which is available from medical/surgical care. “Artificial life support” is defined as a system that uses medical technology to aid, support, or replace a vital function of the body that has been seriously damaged. “Technical support” is defined as specialized equipment and/or personnel providing for invasive monitoring, telemetry, or mechanical ventilation, for the immediate amelioration or remediation of severe pathology...

    ... Commencing January 1, 2008, the licensed nurse-to-patient ratio in a telemetry unit shall be 1:4 or fewer at all times. “Telemetry unit” is defined as a unit organized, operated, and maintained to provide care for and continuous cardiac monitoring of patients in a stable condition, having or suspected of having a cardiac condition or a disease requiring the electronic monitoring, recording, retrieval, and display of cardiac electrical signals...
    View Document - California Code of Regulations
    This section of hospital regulations is important for patient safety too:
    View Document - California Code of Regulations

    It took us a long time to achieved ratios in California. Now that the bill has moved to the New York State Senate I think it is time for nurfses to write, call, and email your state senators, attend whatever senate committee or other meetings are planned, demonstrate your concern, and educate voters about how safe staffing will help them and/or their loved ones.

  • Dec 26 '16

    Management thinks nurses are an expense.
    Fact is that patients are hospitalized because they need nursing care.
    As soon as they no longer need nursing care they are discharged.
    All other care is available as an outpatient.

    The "product" of a hospital is nursing care.


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