I was an "Advice Nurse" for Kaiser in Sacramento for a year--a job I quit 18 months ago. The article doesn't tell the half of it. The unions, CNA and SEIU were company unions, for all practical purposes, and did nothing to support or help nurses or the clerks. When calls were transferred to us from the clerks, members usually thought they had already been talking to an RN, when they had not. The computer system was a joke, with multiple inappropriate and useless questions we were supposed to ask in lockstep (many were the same questions the clerks had asked in lockstep before transferring the call to us). We were under constant pressure to get people off the line, the next call would automatically be connected by the computer system--like telemarketing, except these were members calling in, of course. Our breaktimes were computer generated, as were our working hours--all based, apparently, on inappropriate data. It was typical for members to wait on the line for 15-25 minutes before talking to the clerk, and another 15-25 minutes before talking to us. Many, of course, hung up, as Kaiser apparently hoped they would. Appointments were hard or impossible to find in many cases, since cutbacks had occurred throughout the system. I talked with the State Dept of Corporations, who are tasked with oversight of HMOs, for a couple of hours, and supplied them with copious amounts of information, but they had to many other fish to fry to do anything, at least at that time. When it was clear that the system was not going to respond any RN feedback, I left, of course.