Nurses advocate disclosure on staffing - page 2

The shortage of nurses in the health-care industry continues to be an issue of concern-and debate. The nurses' union in Kansas City thinks one way to address the problem is to make hospitals... Read More

  1. by   UM Review RN
    Quote from lindarn
    . I would love to find a way to someway get them on the computer and on this listserve and show everyone what I wrote. I know that everyone would love it. I wonder if Icould scan them onto the computer, and save it as a document.
    Is it possible that your newspaper archived the letter from that issue? Then you could simply copy it and paste it here. You're right, I'd love to read it!
  2. by   SmilingBluEyes
    Quote from lindarn
    As I stated in a previous thread, I used to work at Sacred Heart, and no one was more surprised than me when I read that the nurses took the issue all the way to the NLRB.

    The nurses in Spokane, as a whole are very passive, and inclined to go along with whatever the hospital does to them. It was a very frustrating 12 years for me. I am from NYC originally, and come from a union family. My dad worked for the Post Office, and in March of 1970, if anyone is old enough to remember, the ENTIRE US POST OFFICE WENT ON STRIKE AND BROUGHT THIS COUNTRY TO ITS KNEES IN THREE DAYS.

    I was considered quite radical when in 1994, after the hospital insitituted "care redesign". I wrote a Letter to the Editor and it got published in a Guest Editorial in the Sunday paper. Everyone said that they wish that they were a fly on the wall in Mike's W.'s kitchen (if you work at Sacred Heart you know who I mean), when he opened up his Sunday morning paper and saw my Letter to the Editor. That goes for the rest of the administrators, as well.

    I was a celebrity when I went back to work that week. Nurses called me in the ICU from all around the hospital, and I went around and signed autographs! My 15 minutes of fame! I will say, that everything that I said in that editorial has come to pass in the nursing and health care world. I said, among other things, that it would be a terrrible flop, that patients would be harmed and that it would cause nurses to leave the profession. I went on to write three other letters to the editor concerning issues concerning our contract negotiations, and other issues pertaining to the workplace and hospital.

    I discovered that I had a talent to write VERY WELL, and I wish that I could harness that talent and make some money with it. I would love to find a way to someway get them on the computer and on this listserve and show everyone what I wrote. I know that everyone would love it. I wonder if Icould scan them onto the computer, and save it as a document. i can them attach it to an Email. I could also send copies to anyone who would want them. I still have the original copies from the newspaper.

    While I am encouraged with this action, I am sure that some St. Martyr Mary
    will decide that this was way to radical, and any power gains that they may have gained from this will quickly vanish. Everything will go back the way it was. Any Sacred Heart Nurses out there? Do you want to comment? PM me.

    Lindarn, RN, BSN, CCRN
    Spokane, WA
    given any thought to politics? We could use an advocate in Congress, frankly. Or even in State Government here in Olympia.
  3. by   casper1
    I am all for Patient ratios. At my facility we average 7 patients on night shifts.
    This is a fair ratio for nights. However days sometimes has the same ratio which I feel is un-managable.

    What do you do when you have 6 or 7 patients and you have that one patient who feel their intitled to a private duty nurse. The patient isn't
    your most acute infact most of the time their the healthest. You find your
    must spend too much of your valiable time tending to their often trivial
    need while patients who need you more and are too sick to complain are
    shortchanged. I feel extremely frustrated when faced with caring for those patients. Because of hippa laws I can't tell them just how sick the other patients are. Therefore I can't make them feel quilty for calling me in every 15 minutes to fluff their pillows.
  4. by   Judee Smudee
    The place I word had sent a memo quite sometime ago threatening to fire anyone who tells a patient or family member we are short staffed. I can't help wondering if you did do it and they did fire you if you could sue and get your job back. Like I said that was several years ago and I have not heard anything about it since.
  5. by   SmilingBluEyes
    Quote from casper1
    I am all for Patient ratios. At my facility we average 7 patients on night shifts.
    This is a fair ratio for nights. However days sometimes has the same ratio which I feel is un-managable.

    What do you do when you have 6 or 7 patients and you have that one patient who feel their intitled to a private duty nurse. The patient isn't
    your most acute infact most of the time their the healthest. You find your
    must spend too much of your valiable time tending to their often trivial
    need while patients who need you more and are too sick to complain are
    shortchanged. I feel extremely frustrated when faced with caring for those patients. Because of hippa laws I can't tell them just how sick the other patients are. Therefore I can't make them feel quilty for calling me in every 15 minutes to fluff their pillows.
    YOu can politely suggest the names of agencies where Private Duty nurses can be hired for pillow-fluffing and other such tasks that you can't do all the time. And you can politely explain that you do, indeed , have 7 other patients with needs as acute or MORE SO than theirs. And you can only do so much in 8 or 12 hours and your time is very tightly scheduled to see ALL your patients get the care they need. Sure, they may complain, but you have violated NO policies or laws saying these things.....you are not insinuating "short staffing" or giving away info protected by HIPPA.
  6. by   jnette
    Yep, I like this idea as well. This should be public information, and patients should be able to "hospital shop" just as we shop for other services. If I am to go for a procedure or hospital stay, it would be nice to know in advance just what I'm getting for my money, right? I'd want to know what my care will be like, what to expect. I would have a choice.

    This way hospitals might be more be motivated to provide better care through better ratios in order to not lose patients (income) to the competion...

    Yeppers, I LIKE it !
  7. by   SmilingBluEyes
    I like it too, but how realistic is it when you have people like FRIST in Congress? To get this done, you are gonna have to appeal to politicians NOT in the hospitals' back pockets, right????
  8. by   lindarn
    Quote from SmilingBluEyes
    given any thought to politics? We could use an advocate in Congress, frankly. Or even in State Government here in Olympia.

    Actually, I did want to go to Law School. I applied and did not get accepted.
    I now do Legal Nurse Consulting exclusively. I attended the Legal Nurse Certificate Program here in Spokane, and enjoyed learning about the law immensely. One class that I took, that I feel would be especially helpful to nurses, is the Employent Law class. I wish that it had been available when I still worked at Sacred Heart, but it is a speicalty class and is only offered every other year. I wholeheartedly recommend a class on Employment Law for ALL NURSES. It will give you some clout when dealing with administration in the hospital. Kaplan on line has a Legal Nurse program, and I think that they offer Employment Law. You could also contact a Paralegal Progam and inquire there.

    For instance, I am an Air Force Reserve nurse, who was involuntarily activated for Desert Storm in 1991. I was gone for four months, and left behind an 8 month old baby. I got back three days before her first birthday.

    Fast forward forward three years to 1994. To digress, at Sacred Heart, the contract from WSNA has nurses only acruing seniority by the actual number of hours worked, or on paid time, such as vacation, sick time, etc. Not the date of hire. When the hospital started to cut back in 1994, with care redesign, they had to start putting our seniority hours on our paychecks, so people would know where they stood in seniority. My numbers were way down from the time that I had been employed there. Come to find out, that the hospital had not given me credit for the time that I was at activated, or on a school tour for an Air Force Course.

    When I called down to administration and inquired, I was told by an arrogant nurse administraton, that "Sacred Heart is exempt from Federal Labor laws".
    Now, I took political science when I went to college, and I will be the first to admit that I was not always the sharpest tack on the bulletin board. However, I remembered that the dominant theme was that Federal Law was the law of the land. How could Sacred Heart be exempt from Federal Labor Law?

    I called WSNA, for what that was worth. They told me that I had to abide by the contract that stated that I only accrued seniority when I was on the books. It took almost an act of God to find an attorney who would help me. It seems, when you are covered by a union contract, you CANNOT seek help from an outside attorney. You are required by law, to go through internal grievance procedures before you free to seek help from an attorney. Many lawsuits have been thrown out because an individual did not follow the procedures outlined in the employment handbooks, and internal union remedies.

    Anyway, Bob did help me, because he realized that this was a no brainer. He called the hospital administration, and told them that they could not deny me my seniority hours because I was activated for the reserves. One of the hospital attorneys happen to be there. He stood there and said, (according to one of the union reps who happens to work on my unit), "you can't do that". It seems that the hospital didn't even ask the hospital law firm if they could deny me my hours. They just went ahead and did it. They just figured that no one had the guts to take it out side of the hospital and inquire. Of course, they were right, Until I came along. I spoke with one of our dialysis nurses who was also a reservist after this. He said to me, "Linda, they have been telling people for years (and making them),that they have to take THEIR OWN VACTION TIME", to go on annual tour, and participate in reserve activites". This by the way, is blatantly against the law, and if there are reservists on the listserve who need more information, PM me and I will get my text on Employment Law (the book that we used was the Federal Employment Statutes). I can give you the citation and you can look it up in FindLaw. I remember when I was in Flight School there was an ER nurse there from Boston. SHe told me that,when she got back, her nurse manager was going to make her work the an extra three weekends, to make up for when she was gone for Flight School. That is also blatantly illegal. You cannot penalize someone for participating in reserve actvities. They will also give you the line that it was/is not required duty. They will tell you that they only have to give you you weekend a month and two week annual tour. This is also covered the the Federal Statute. All training in the military is considered necesary, or they would not offer it to you. As I said, this is covered in the statute.

    "Findlaw.com." by the way has ALL STATE LAW, STATUTES, ETC, for anyone to use. It is free. It is fairly user friendly, althought it is easier if you have learned how to read law books, and and do legal research. But it is not impossible. It is meant for the public to be able to use as well. It is by the way, not that hard to do once you have learned the ropes.

    Also when I was in the Employment Law class, while I was doing research for my midterm, I came across Washington State Case Law, that addressed the issue of union grievances. It dealt with a group of individuals, who had a problem with their employer, had attempted to go through the union grievances, etc, as they were supposed to, and had gotten nowhere.

    In a nutshell, the judge found for the employees. The holding was that an employee, when a case has become futile, and the union has not satisfied the grievance, in a time frame that was designated to be four months, (in other words, it is considerd to be futile if the union has not settled the grievance in a four month time frame), employees can seek assistance (remedies), from an outside attorney of their choice. And the union had to pay all of the legal fees. I emphasize, that this is Washington State Case Law. I am not an attorney, and I am not giving legal advice to anyone. This is what I found in the course of my work for school that I wish I had know when I was still employed as a nurse. If you think that this situation fits what has happened to you, contact an attorney, and speak to them.

    I also think that the nursing schools need to incorporate this kind of stuff in the curriculum, and empower nurses.

    Anyway, thank you for the support, and yes, I wish I had gone to Law School, and gone into Health Law, which is what I had wanted to do.

    Lindarn, RN, BSN, CCRN
    Spokane, Washington
  9. by   leslie :-D
    hey linda,

    when you recommend nurses reading about employment law, i assume you're talking about those that belong to unions....if you're not part of a union, then a nurse has much less legal ground to stand on; you're considered at employee at will and unless there's overt discrimination based on sex, race, age which can be proven, in many states, they can fire you w/o cause.
    so yes i agree that the nurses that belong to unions, employment law would benefit them; yet i don't think it would help those of us who don't have a union. input/feedback?

    leslie
  10. by   lindarn
    Quote from earle58
    hey linda,

    when you recommend nurses reading about employment law, i assume you're talking about those that belong to unions....if you're not part of a union, then a nurse has much less legal ground to stand on; you're considered at employee at will and unless there's overt discrimination based on sex, race, age which can be proven, in many states, they can fire you w/o cause.
    so yes i agree that the nurses that belong to unions, employment law would benefit them; yet i don't think it would help those of us who don't have a union. input/feedback?

    leslie
    Federal Employment Law covers EVERYONE, regardless if they belong to a union. Most employees are not covered by contracts, these days. Keep copies of employment manuals. In someways, you are better off not having a union. A worthless union, (or nurse's association), impedes getting your issues taken care of. As I said, you are required to go through ALL of the union's grievance procedures, before you can involve an attorney.

    If you believe that you have been subjected to unfair/illegal treatment, it might be harder to get justice.You will have to prove it. Most hospitals, employers, are not stupid enough to be that blatant about it. You will have to keep records of what has gone on, what/how others have been treated, etc. Letters that you have written to the manger, administration, ets. It will be work on your part. At will employment does not mean that you have no rightd, or that it is legal for them to allow unfair/discrimination and treatment.

    There is also the issue of disparate treatment/discipline, from one employee to another. As i wrote above, it will be up to you to keep track of what goes on, to prove your case, but it is by no means impossible.

    As I said, if you are having a problem with a manager, another employee, start keeping track. Take a small notebook to work with you. Note the staff assignments, breaks, (smokers taking more breaks than non smokers), etc. Note the time people left the floor, and when they came back. It will be more work on yuor part. It can, and has been done.

    Lindarn
  11. by   menetopali
    Quote from earle58
    hey linda,

    when you recommend nurses reading about employment law, i assume you're talking about those that belong to unions....if you're not part of a union, then a nurse has much less legal ground to stand on; you're considered at employee at will and unless there's overt discrimination based on sex, race, age which can be proven, in many states, they can fire you w/o cause.
    so yes i agree that the nurses that belong to unions, employment law would benefit them; yet i don't think it would help those of us who don't have a union. input/feedback?

    leslie
    employment law protects all employees who fall under the statutes scope (ie some exceptions exist for very small employers and some agricultural work). as i understand it, contract law (as authorized under specific labor laws) is where unions operate. employment law is a different ball of wax, and it applies to all unless specific exemption is enumerated in the statute or by case law and unions do not 'grant' inclusion of law enforcement.
  12. by   live4today
    Quote from casper1
    I am all for Patient ratios. At my facility we average 7 patients on night shifts.
    This is a fair ratio for nights. However days sometimes has the same ratio which I feel is un-managable.

    What do you do when you have 6 or 7 patients and you have that one patient who feel their intitled to a private duty nurse.............................
    I, too, think seven patients (six for that matter) is too many patients for dayshift. And after my last assignment on nightshift, it's way too many for nightshift nurses too because patients do NOT sleep anymore. What's up with that? They want ROUND THE CLOCK hotel service. I'm not talking about the truly sick ones, but the ones who nag you all night long for crackers, soda, coffee, ice..........they never get enough attention. They keep the t.v. on to bother the patient in the bed next to them who WANTS and NEEDS to sleep. OK! What's up with SOME people today! Geesh!
  13. by   UM Review RN
    Quote from cheerfuldoer
    it's way too many for nightshift nurses too because patients do NOT sleep anymore. What's up with that?
    I tell all of my patients that Lab will be in to draw their blood between 2 a.m. and 5 a.m. because the doctor wants to be able to tell whether or not there's an improvement. I also remind the patients (as I wake them) that they will be assessed by a nurse every 8 hour period, and that they will also have vitals taken at least once a shift, and can be as often as q2h for Stroke Protocol patients.

    There might be admissions, confused/combative/noisy patients, fire drills, Codes of various kinds, triaging of patients, movement of equipment, bed alarms, patient monitors, and a host of other noises making a hospital stay extremely stressful due to an inability to actually REST the body to promote healing.

    The value of rest is incalculable, so it isn't taken into account when the bean-counters do their thing.

    Ironically, we do provide earplugs for people who want to watch TV and we turn off telephones to the rooms after 9 p.m. And of course, visiting hours end at 8 p.m.

    So if you think about it, the reason why patients can't sleep at night is because today's hospital is not letting them.

    Why?

    Because it costs money. Because hospitals are a 24-hour gig, and no one's going to tell Mr. J. Schmoe when he can have his Respiratory Failure or heart attack.

    I remember the days when night shift meant hours of down-time. No more. My shifts are spent doing paperwork and keeping my patients alive. I usually have 7 patients and the tech will have the entire hall. I usually have to make the tech take her break, and I grab a coffee and a bite at the desk. And woe betide us if that patient or patients decide to crash after 0500. The day shift nurses start out with a big mess on their hands, and everyone has to stay till 0830 finishing up.

    Don't mean to sound like I'm complaining, because I'm not. It's just the way things are nowadays for anyone in healthcare. The docs, nurses, respiratory therapists, techs, pharmacists--everyone's affected by that one crashing patient.

    The bean-counters fail to realize that nursing down-time is quite different than say, physical therapy down-time. Having better staffing for nurses would ensure that more of those potentially crashing patients might live.

    Sorry about the lengthy rant, folks.
    Last edit by UM Review RN on Apr 24, '05

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