Congratulations to California Nurses! - page 2
California Nurses Association Wins Mandatory Overtime Ban, Record Gains at Kaiser Permanente in Nation's Largest RN Contract... Read More
Sep 8, '02Originally posted by sjoe
Well, having worked for Kaiser (and as a CNA member, for that matter) and consistently learned not to trust either of them, I automatically think:
1) an end to mandatory overtime might not mean a lot if there is not a simultaneous, and strictly enforced, reasonable nurse/patient staffing ratio. When a fellow nurse refuses to work an extra shift, that just may mean increasing another nurse's patient load from 10 to 15, say.
Currently there is a 1:4 ratio, 1:2 in CCU. But, I think smaller facilities are afforded this on a day-by-day basis.
2) An increasing percentage of LVNs and CNAs being hired to perform work previously done by RNs, for the RNs to supervise.
LVN's and CNA's cannot perform RN duties, its not in their scope of practice. RN's do "cover" an LVN, but normally a unit is staffed with 3 or 4 RN's and 1 or 2 LVN's. Additionally, The higher patient load is given to the LVN.
Example: (21-bed unit, low census)
RN1, 2 patients plus cover 1 LVN. 1rst up for admission. 2 of LVN's patients has abx's ordered, the rest are PRN IV meds. 1 of RN's patients have various abx through out shift.
RN2, 3 patients plus cover 1 LVN. 2nd up for admit. 3 of LVN's patients have abx's scheduled, No abx's for their actual patients.
LVN1, 5 patients, first up for transfer from another unit.
LVN2, 5 pateints, 2nd up for transfer from another unit.
I've seen this schedule before. And I've always wondered about some RN's (not all!) that say "I'm covering the LVN" who NEVER does nothing more than "agree" with what the LVN has assessed in the nursing notes. It gives the impression that they are doing total care on my assigned patients and I can go home. I guess some wish that LVN's would go home. I know they would much rather have an RN take over, but....Sigh...
3) an increasing number of unlicensed medical workers of whatever titles being hired to perform work previously done by RNs, for the RNs to supervise.
The State of California, with its standards wouldn't hear of it. Plus any LVN or under would or should know not to jeapordize their license by performing care that IS NOT in their scope of practice.
4) forcing RNs to work unwanted shifts and days.
What's an unwanted shift? (I'm not being funny....! I really don't know! I'm happy to be employed in California!). Some like days, some like eve's and other's NOC's. Everybody ]usually get what they want, OR put/buy their time in and move into the shift they want. CNA wouldn't hear of it, and they are a phone call away! :chuckle
5) reconfiguring shift hours and days and forcing all RNs to rebid on them in order to keep their jobs (as they did with my unit).
CNA, CNA, CNA....Union at its best!..."kinda". And you know "change" is a bad word to staffers! (hehehe).
6) forcing more floating, whether the RN is trained/experienced on the new ward or not.
The advantage of NOT having a float pool AND staff hired to a specific department.
7) who knows what else....NOW that's the truth!! (hahaha). It's also true not to trust so very easily! take care Sjoe...Good "What if's" to consider!
Sep 8, '02Step 1, $24 or so. After passing the new grad orientation, I beleive it goes up to $28.00. Not the exact figures, but close.