California RN union (CNA) presence in Texas?

U.S.A. Texas

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I just got a letter and petition in the mail today from CNA/NNOC saying that they are coming to Austin Nov. 14th to present petitions to elected officials who will sponsor a bill mandating RN to patient ratios and protection against retaliation from RN's who blow the whistle on unsafe staffing conditions. It says that they are "experienced RN's working in major acute-care hospitals in SA and Austin".

I don't know much about this so maybe others in TX or CA can fill in the blanks.

My understanding is that the NNOC is the national movement born out of CNA in an effort to get other states doing what CA is doing regarding legislation of patient ratios and other things. Am I correct?

Are they trying to unionize Texas RN's?

Is that even a feasible option in our "Right to work" state?

Has anyone else in Texas gotten this in the mail or know any more about it?

I'm very curious.

information on hospital closings in california.

concerned about the spate of hospital closures in california, attorney general bill lockyer commissioned researchers at u.c. berkeley to examine and explain what was going on. the researchers concluded "_that financial hardship was the common reason cited by all the [23] hospitals that closed [between 1995-2000], a claim which is supported by an examination of their financial performance. in each case, we found declining reimbursements, income per bed and utilization present prior to closure."

the researchers went on to say they "…learned that urban, southern california hospitals, located in close proximity to other hospitals, were the ones that most frequently closed."

it's as simple as that and the villains are easy to identify:

* health plans and their predatory payment practices

* government and its inadequate medicare and medi-cal payments

* unfunded mandates (e.g. seismic safety, nurse staffing, etc.)

* labor shortages and out-of-control labor costs

* spiraling construction costs

* uninsured and underinsured californians

* unbridled demand for services

* non-general acute care hospital competitors (e.g. specialty hospitals)

http://www.hasc.org/lott.cfm?id=77948

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It is sad to me that we don't realize that "voting with our feet" does nothing for the patients who are cared for by too few nurses.

We got the safe staffing law in California because many non union nurses wrote letters and testified about their experience. Many of these nurses don't want a union but they care about their patients. We can only attend to the needs of one patient at a time.

Hospitals were closing before the ratio law went into effect in 2004.

Financial problems were the single most common reason cited for the closure of 23 California hospitals between 1995 and 2000. Most closures occurred in urban areas and in Southern California. - http://www.hasc.org/lott.cfm?ID=77948

This is the organization that spent our tax money to fight the safe staffing ratios. About 50% of the revenue to hospitals is Medicare payments. They have spent many dollars in court delaying the need to make our hospitals safer when the next big earthquake occurs. - http://www.calhealth.org/public/press/archive.asp

Medical center CEO gets raise of $51,000. These are County hospitals so local property taxes and Medicare pay these salaries. - http://www.insidebayarea.com/localnews/ci_4312024

More links:

http://sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2004/03/18/EDGB95M71K1.DTL

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Information on hospital closings in California.

http://www.hasc.org/lott.cfm?ID=77948

These are all of the factors cited for hospital closings in that article:

* Health plans and their predatory payment practices

* Government and its inadequate Medicare and Medi-Cal payments

* Unfunded mandates (e.g. seismic safety, nurse staffing, etc.)

* Labor shortages and out-of-control labor costs

* Spiraling construction costs

* Uninsured and underinsured Californians

* Unbridled demand for services

* Non-general acute care hospital competitors (e.g. specialty hospitals)

This list cites many reasons for hospital closures.

If you eliminated nurse ratios tomorrow, would hospital closures suddenly stop? Based on this list, the obvious answer is .... no.

As Spacenurse points out, the problem with hospital closures was happening long before ratios took effect.

:typing

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Here is some important info regarding the CNA/NNOC:

  • NNOC is a bedside proffessional RN organization that originated from the CNA
  • NNOC has members in 44 states
  • CNA/NNOC does unionize BUT, that is not the main issue - please remember that the ANA unionizes also, sooo what is the difference? Oh wait, the ANA doesn't do anything for the bedside RN or for patients BUT, the CNA/NNOC does
  • Texas nurses are pushing for RN to pt ratios, whistleblower protection, and pt advocacy - the NNOC just so happens to be the vehicle
  • RN to pt ratio law is a guideline but, the pt acuity level always takes precedence, according to the law
  • The Texas RN to pt ratio law is different from CA in some respects, the most important is that it is better!

Hope this clarifies some misconceptions.

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Specializes in ER, tele, vascular.

The hospital that I work for here in the D/FW area had a town hall meeting and told us how they (administration) could handle our concerns and complaints better than a union could. Blah blah blah.

However, I feel the same concerning unions....blah, blah, blah....union or management they both want $$$$ so I will go on caring for my patients as best I can, knowing that neither of these two parties has my pt's. interest nor mine as their main concern.

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I Did vote with my feet. As an LVN for 7 years, I had few options outside of med/surg.

But after getting my RN, I left med/surg and Dallas and refuse to go back to either because the employment conditions are so horrid at every hospital I ever worked in DFW.

The problem was, my coworkers were so spineless and kept taking the 7-9 patient loads with little or no support staff so I was often the only one complaining.

So of course then it just looks like I'm the problem because everyone else seems to handle the patient loads just fine.

Why don't more nurses vote with their feet and start refusing such unsafe patient assignments?

I don't know. But in DFW, too many were afraid of losing their jobs (as if nursing jobs in Dallas aren't a dime a dozen).

I'd quit one job, and start two the next day in that town yet others acted as if their current positions were gold and that they didn't want to rock the boat and upset management by complaining about working conditions.

Thank you for your insight/opinion on unions/CNA.

RN34TX,

My experiences as an RN in Texas have been very similar to yours, only nursing jobs are hard to find in my area. I'm a traveler now. I will not work in Texas under the current conditions. I wish I would have gotten that letter. I just finished a contract the first week of Nov. I would have been at the rally, had I known about it.

I hope the rally had some effect.

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Everyone hasn't benefitted. How many hospital closures have there been, not to mention unit and service closures in California that these standards have attributed to? THe horror stories abound such as the closing of both rural and metropolitan facilities.

But, in my semi-rural area of California, just this week they announced plans for two new hospitals.

You might be interested to know that the CNA facility in my area just negotiated a substantial pay raise for RN's that took effect this year and, that pay raise will be increased even further come January.

Yet ... despite the additional costs of the ratio law, union pay raises, etc. the management of that facility just announced plans to build another hospital in the area. A cardiologist is also trying to get yet another hospital approved. We already have three hospitals in the area yet, these hospital administrators are trying to get approval to build two more.

Doesn't seem like the ratio law is causing closures in my area ... especially since they're trying to build more hospitals. Business must be good at least in some cases, even with RN pay raises and ratios.

It really comes down to how that individual facility is managed. And, whether there's a lot of population growth in the area.

:typing

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Bottom line: there are 2.9 million licensed RN's in this country. Nearly 500,000 of them ... or 17 percent ... choose not to work, probably because of lousy working conditions.

to be fair, that is an assumption; although I have no doubt many choose not to work bedside because of the conditions, there are many other reasons as well.

In California ... the percentage of RN's who choose not to work is a lot less ... only 6 percent. Probably because ratios have greatly improved working conditions.

out of curiosity, could you list your resource for the above statistic? Also, do you happen to know what that statistic was prior to 2004 (and could you provide that source)? Also, do you know how many of the RNs that have returned to the bedside are native Californians, and how many are travel folk?

Something I really don't understand about this whole debate about ratios...the only plausible argument against them is that hospitals would have to spend more. But then to counter, you can use the Aiken 2002 study about ratios which clearly indicate a trend that higher ratios result in bad things (although I don't believe the results showed statistical significance). And with bad things come lawsuits, longer stays in hospitals which often do not get reimbursed by Medicare, etc. All I can figure is that when hospitals did their research they totally discounted the Aiken study (possibly citing statistical insignificance of the Aiken study).

I really wish some preliminary results from the CA ratios would be released to indicate the success of ratios. I have to believe those results would shut up many of the ratios opponents.

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out of curiosity, could you list your resource for the above statistic? Also, do you happen to know what that statistic was prior to 2004 (and could you provide that source)? Also, do you know how many of the RNs that have returned to the bedside are native Californians, and how many are travel folk?

My source is the BRN. I'd have to do more digging to find data from 2004 but, I do know from BRN stats that the total number of licensed RN's in California has increased by 12 percent or 37,000 total licensees in 17 months from April 2005 ... right after the ratio law was enacted ... to September of this year. I don't know how many of those are travelers.

:typing

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the total number of licensed RN's in California has increased by 12 percent or 37,000 total licensees in 17 months from April 2005 ... right after the ratio law was enacted ... to September of this year. I don't know how many of those are travelers.

:typing

I'm a bit confused...the ratio laws were passed in 1999 and they became an active law on January 1, 2004. Could you clarify what you are saying? The "right after the ratio law was enacted" is throwing me off. There are 17 months in the 4/05-9/06 time span, but I'm either totally misunderstanding what you are saying, or my interpretation of "right after" is different from yours. I do know the ratios were being adjusted over a period of 1-4 years (e.g., med surg decreases from 6:1 to 5:1 in 2005, telemetry goes from 5:1 to 4:1 in 2008)...is that what you are referring to?

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I'm a bit confused...the ratio laws were passed in 1999 and they became an active law on January 1, 2004. Could you clarify what you are saying? The "right after the ratio law was enacted" is throwing me off. There are 17 months in the 4/05-9/06 time span, but I'm either totally misunderstanding what you are saying, or my interpretation of "right after" is different from yours. I do know the ratios were being adjusted over a period of 1-4 years (e.g., med surg decreases from 6:1 to 5:1 in 2005, telemetry goes from 5:1 to 4:1 in 2008)...is that what you are referring to?

Oops ... my bad. I was confusing the adjustment in 2005 with the actual enactment in 2004. Sorry about that.

I couldn't find anything for 2004 but, this BRN newsletter says there were 275,000 active California RN licenses in 2003 (p. 7).

http://www.rn.ca.gov/forms/pdf/brnspring2003.pdf

Now there are 315,000 active RN licenses as of September, 2006 with an increase of 41,000 active licenses. Inactive licenses have pretty much remained the same at 18,000 since 2003.

California Board of Registered Nursing - Monthly Statistical Report

So, obviously, the biggest increase has occurred in the last 17 months with those 37,000 new licensees. With a 12 percent increase in just 17 months, that's huge.

Especially when you compare it with U.S. Health Department data that shows the number of licensed RN's nationwide only increased by 3 percent from 2000-2005. And, they're projecting a slight decrease in the total number of licensed RN's nationwide by 2010 (see table at the bottom).

What is Behind HRSA's Projected Supply, Demand, and Shortage of Registered Nurses?

:typing

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