California's Nurse-to-patient Ratio Law -- Update

-jt · Jul 1, 2002

excerpt from the website of the American Nurses Assoc:

Collective Bargaining Is Your Right!

As a professional nurse you have a big stake in the quality of health care your patients receive. As an employee, you deserve a fair wage and good working conditions. You can have a real voice in all of these issues as a member of a collective bargaining unit of your state nurses association (SNA).

It is illegal for an employer to interfere with an employee's right to organize. As a professional employee you have a legal right to:

* Organize with your colleagues to elect your SNA as your bargaining representative and to bargain collectively with your employer.

* Negotiate your economic and professional concerns through the collective bargaining process.

* Obtain a written agreement between your employer and your bargaining representative.

Is Collective Bargaining Professional? Collective Bargaining is a Professional Imperative!.

One of the primary responsibilities of all professional nurses is to advocate for safe quality care for patients. Steps nurses can take to insure quality patient care include:

* Participate in workplace decisions affecting nursing care.

* Acquire the resources needed to perform your job effectively.

* Safeguard the standards of practice set by the profession.

* Protect employment rights and secure terms and conditions of employment to attract and retain qualified personnel.

Advocating for quality care is becoming increasingly difficult for nurses in today's environment of restructuring and mergers, where cost often comes before quality care. Many nurses find that working collectively, through a contract, to ensure a voice in the workplace is one of the most effective ways to protect themselves, their profession, and their patients.

Collective bargaining is the most effective way you and your nurse colleagues can protect patients from inadequate and unsafe care.

Collective bargaining IS professional.

Nurses have a legal right to use the collective bargaining process to protect their professionalism.........>>

http://www.ana.org/dlwa/barg/index.htm

-jt · Jul 1, 2002

you dont see that because no such article exists. In fact, a recent article in the Journal Of Nursing Administration, of all places, made headlines because it revealed findings of a study that indicates that pts have better outcomes in hospitals where the nurses were a union. So even nurse executives had to recognize that nursing unions are good thing. Imagine that!

RN Unions Improve Patient Outcomes

New Study Finds Heart-Attack Patients in Unionized Hospitals Have Lower Mortality Rate

by Anne Schott

Are RN unions good for patients - as most New York State Nurses Association members believe? Or do they foster a harmful, adversarial relationship - as management frequently claims?

Two researchers, Jean Ann Seago and Michael Ash, have just published what may be the first serious attempt to answer those questions.

Their most significant finding was that hospitals in California with RN unions have 5.7% lower mortality rates for acute myocardial infarction (AMI) than hospitals without an RN union.

This result, based on data from 343 acute care hospitals in California, took into account patient characteristics like age, gender, type of MI, and chronic disease. It also controlled for organizational characteristics like number of beds, AMI-related discharges, cardiac services, staff hours, and RN wages.

The article, "Registered Nurse Unions and Patient Outcomes," appears in the March 2002 issue of the Journal of Nursing Administration.

How Do Unions Affect Care?

In examining how unionization may affect patient outcomes, the authors consider several factors:

Unions may improve the quality of care by negotiating increased RN staffing levels, which have been shown to improve care. They may affect the way nursing care is delivered by facilitating better RN-MD communication and strengthening what is known as nursing's "voice." They may raise wages, thereby decreasing turnover, which could improve patient care.

Although the authors did not establish a clear causal relationship between these factors and improved patient outcomes, they reported, "There is something beyond wages and number of hours in union hospitals that predicts better outcomes. Perhaps having an RN union promotes stability in staff, autonomy, collaboration with MDs and practice decisions that have been described as having a positive influence on the work environment and on patient outcomes."

This study is part of a growing body of work that connects RNs and various characteristics of their work environment with patient outcomes. If, as this study shows, RN unions improve patient care, there is enormous opportunity for improvement in the healthcare system. In California, where the study was done, only 35 % of hospitals have RN unions. Nationwide only 16.9% of the RN workforce is unionized.>>>>>>>>

(as reported in the newsletter of the New York State Nurses Association May 2002)

http://www.NYSNA.org

-jt · Jul 1, 2002

Thats it "in a nutshell". The current "nursing shortage" at the bedsides now is not a hoax, its a misnomer. And there is data to prove it. At the urging of the ANA, Congress commissioned a research report to find out if there was really a current shortage & where our nurses were. The report, released last year, found that there are about 500,000 experienced, licensed nurses (18% of the nursing workforce in this country) NOT working in nursing today. Yet there are only about 126,000 vacant nurse positions in hospitals, as reported by the American Hospital Association. The report says that there is not yet a "nursing shortage" because there are so many nurses available but just not working in hospitals. Rather, it calls this a "Maldistribution" of nurses. Meaning what we are calling a current bedside "nursing shortage" is actually a REFUSAL of nurses to work in those jobs.

The numbers are out there, if even a fraction of those 500,000 came back to work, to end the staffing crisis tomorrow. But if the conditions that keep these nurses away are not rectified, we WILL have a REAL shortage in numbers in the next few years as the majority of us,working or not, begin to reach retirement age en mass.

Peeps Mcarthur · Jul 1, 2002

A "hoax" is a type of fraud.

That's how I look at the way the hospitals are using the information.

Anyhoo JT, don't you just looooooove it when your on the righteouse side of an issue?:kiss

Thank you for those posts. I'll read them tommorow when my eyes aren't falling out of my head!!:stone

-jt · Jul 1, 2002

That's how I look at the way the hospitals are using the information.>

Ok I see that point. I agree that the AHA is using this so called "nursing shortage" as an excuse to lobby for Nurse Practice Act changes that will give more of the RNs responsibilities to UAPS, & then hire the less expensive UAPS to provide pt care - as its already trying to convince the legislators, media, & public that these measures have to be taken because "there just are no nurses to be found" - at the same time ignoring the fact that there is a whole ready-made population of 18% of the nursing workforce out there to be recruited from. Its easier & less expensive to just convince everybody that there are no nurses rather than spend money to improve the workplace & attract some of those 500,000 non-working RNs back or stem the flow of other nurses from the bedsides. So yes I guess it is a hoax when the hospitals say "there are no nurses" or there is a "nursing shortage". It would be more accurate for the AHA to say "we have destroyed nurses working enviornment with a decade of cost-cutting, lay-offs, abusive management practices like mandatory ot, devaluation in the form of inadequate compensation, & just plain treating them like theyre a dime a dozen & now, though they are out there, they wont work for us anymore - until we improve things - but we wont spend our profits to do that, so my dear pts, you will have no RN at your bedside".

Gomer · Jul 1, 2002

To Jay,

Yes, Jay, I am convicted that unions never solve any issues and exists only to take $$$ from the people who can least afford to pay. They talk a good game, have "pretty" tee-shirts, and can market themselves very well; but all they are after is the $$$$$. Have you ever heard of a union fighting for patient care issues without adding..."oh yes, we want a raise for all our members too" (of course the dues will go up to!) Maybe if I could find a union that didn't have $$$$ as a main issue, I might respect them. But then that's really all they are about.

As for having an e-mail address, I feel there are too many spammers and nuts out in cyberspace. Also, some BB sell their members' e-mail address...that's how they pay for these free BB.

Peeps Mcarthur · Jul 1, 2002

Gomer, Gomer, Gomer,

Is it not about money? All businesses need it to operate and a union needs it to guarantee its strength to its members. What do you think the hospitals will use to fight unions.................Greenstamps?.............cookie sales?..........Nope, the hospitals have been getting the main source of revenue on the cheap in exchange for the output that keeps its doors open.

All they have left to protect that pile of money now is the loyalty of people like you that believe that union leaders are powerless con-men that just want to part you with your money and slink off into the night.

If that were true, then where are all the stories about how the unions are just screwing people? I see PLENTY of bad press about the hospitals, but where are the stories about unions that don't do anything?

All I see is how the unions are getting nurses SOMETHING other than the same old poridge(Oliver Twist reference) they've been told to put up with since they had to stand up when a doctor entered the room and submit to their place on the foodchain.

If you're a hospital and not a union you could tell an employee that you respect them and know that they gross what you pay in taxes and still turn down a raise request. You could tell the nurses how much you wish those ratios of nurses to patients could improve if you could just keep costs down while you collect your bonus for profits. If you were a hospital you could ask a tired nurse that just gave 150% of their effort to make sure the patients were taken care of in the short-staffed dept. to work a forced shift so you won't have to pay another benefit plan or an agency and make your new budget goal for your bonus. If you were a hospital you could call our present situation a "shortage" so you can recruit nurses from 3rd world countries so you can hold costs down even more and fuel the shotage by driving those "money-grubbing" nurses away from the bedside and put those frightened foreigners in the place of the pro-union nurses.

Then I guess you can say that the unions are all about the money and handing out t-shirts and they don't care about patient issues or nurses because they have asked "more poridge please"

Show me some facts Gomer.

Where's the union money going?

I can CLEARLY see where the hospital money is going.

Follow the money Gomer. Follow the money.

nell · Jul 1, 2002

Gomer,

Not all unions are alike. It sounds like you're in the Bay Area - well there are at least 3 hospitals in the south bay that have their own unions:

Stanford/Packard has CRONA

http://www.crona.org/

El Camino has PRN

http://www.prnatech.org/

and Santa Clara Valley Medical Center has RNPA (no website)

These unions work hard for their members, not for the $$$

Gomer · Jul 1, 2002

I never meant to start a "union vs non-union" fight. My original post was just to inform the readers of this BB that while one union (CNA) had supported the Calif. Nurse/Patient Ratio law, the other (SEUI) had suggested that other professionals be included in the ratio figures. (SEUI represents both RN's and others and wanted to extend its membership; while CNA covers only RN's)

You want a union...fine...you don't want a union, also fine. Personally, I would never work in a union hospital...but that is my preference.

And to answer your question, Peeps..."where is the union money going?"...well, how much are union bosses paid?...do they also get bonuses?...I really don't know, nor do I care (any more than I care what my CEO makes). When you chose nursing were you expecting to make millions? Or even 6-figures? We might look at in another way...the law of supply and demand...yes, if there aren't enough RN's willing to work at bedside nursing the hourly rates may go up (nothing to do with unions). But, if our economy/stock market keeps dropping, those who return to the field (to support their families) may find very little if any increase (also nothing to do with unions -- simple economic fact).

Peace to you, one and all....some of us just march to a different drummer....

Peeps Mcarthur · Jul 1, 2002

I'm sure union bosses don't get bonused when the nurses get the shaft. You have a very strange perception of the nursing stuggle as far as I can tell. You seem distant from the issues and as far as I can tell, you are not a nurse at all, but what do I know.

Union bosses would get bonuses by actualy taking care of the people they represent if that hypothetical actualy existed.

Don't you think?

I mean, if the union guys put thier incomes before nurses issues like the suits do I don't think there would be many members to abuse. Difficult to see how they would profit from it. The SEIU is not really a nursing union, so I can see how they could do it.

The stockmarket is another hoax of big business being used to give an excuse for not raising the living wage to match the cost of living. The hospitals don't sell luxury cars or lavish vacations they sell healthcare at a very steep mark-up. The supply of sick people won't run out because some big companies cooked the books. You don't really believe that "economic downturn" crap do you?

Uhmmm.........Gomer.......are you an administrator by any chance?

You can't sit in the middle my friend. Union or not, the real issue here is respect for nursing as a profession. If you are a nurse Gomer, then the union's fight is your fight too. You don't have to carry a union card to believe that.

The future of nursing is up to you still though. You can't run away from it. It will eventually find you. Each individual nurse carries thier banner into battle everyday and is just as responsible as the next one for not laying it down.

None of the banners say "pro-union" or "pro-business" they say......................... "pro-nurse"

So it's simple you either carry a banner or you don't, but there is no middle ground.

Yes, I'm going to make a six-figure income someday, but nobody will suffer because I do and I can live with that.

ANnot4me · Jul 1, 2002

I am a nurse who lives in California and I still work at the bedside. I am also a member of the CNA. Until last October, I lived in Illinois and left nursing for 2 years because it sucked. nursing here is better, but it could use some serious improvement. We just ratified a 3-year contract and the hospital fought hard against any inclusion of ratios and the CNA essentially caved. I just found out that my Nurse Manger is going to New Zealand and Singapore to recruit RNs.

I never expected the staffing legislation to be implemented because the corporations own the politicians and run the country anyway. The hospitals will spend tons of money to delay and recruit from overseas until there is no longer a shortage. Nurses will never gain the upperhand because they can't get unified.

Gomer · Jul 1, 2002

Ah, Peeps, you are so funny.

Let's see, so far you've accused me of not being a nurse (x3) and of possibly being administration. Why? Just because I disagree with you? And you seem to favor conspiracy theories..."big business", "the bosses". Even your title (under your screen name)..."Anti" tells a story.

As I said before...you want a union, fine, good for you, hope you are happy. I don't and that's my right.

Oh, and this probably wont sound very nursey either...but I'm Pro-Me. I've always felt that too many nurses never put themselves first, were too co-dependent....but then that may be because many women have been taught to put others first...now, I bet you will think I'm not a woman!