DEBRIDE the SCABS

Nurses General Nursing

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Replacement nurses arrive to prepare for possible strike http://www.startribune.com/viewers/qview/cgi/qview.cgi?template=health&slug=nurs30

Alternately titled....

SCABS-R-US on the move......

Replacement nurses arrive to prepare for possible strike

Maura Lerner

Star Tribune

Wednesday, May 30, 2001

A small army of replacement nurses has started to arrive for training in the Twin Cities, as a dozen hospitals in the area brace for a probable walkout Friday by more than 7,700 registered nurses.For now, hospital officials are doing their best to keep the incoming nurses out of the public eye. They've scheduled orientation sessions for today and Thursday at secret locations and won't say where the nurses will be housed.

"It's a security thing," said Linda Zespy of the Children's Hospitals of Minneapolis and St. Paul."It's just the way that it's done with replacement nurses," Zespy said.So far, no new talks have been scheduled. But the hospitals called on the Minnesota Nurses Association on Tuesday to let its members vote on the latest contract offer, which the union's negotiators rejected last week."The hospitals have heard from some of their nurses that they would like the opportunity to vote on the proposals," said Shireen Gandhi-Kozel, spokeswoman for the Minnesota Hospital and Healthcare Partnership.She said four of the six negotiating teams, which represent nurses and managers at the 12 hospitals, agreed on staffing, which is one of the thorniest issues.

The main stumbling block was money, she said, with the hospitals offering a 19.1 percent increase over three years and the union seeking a 35 percent increase."We're asking the Minnesota Nurses Association to put the proposals to a vote," she said.But the union said it has heard no such request from its members. "That's the intent of the hospitals, to override the negotiating committee," said Jan Rabbers, the union's spokeswoman. "But what they'll find is that the membership is the one that's driving the demands." On May 17, the nurses voted overwhelmingly to reject the hospitals' contract offers, which included an 18 percent raise over three years. But nurses say staffing levels are a major issue because they're often stretched too thin to care for patients safely.Hospital officials said replacement nurses would need a day or two of training before replacing the striking nurses Friday. They scheduled the sessions off-site, at secret locations, to keep them away from any possible harm.

"I can understand why they wouldn't want to disclose the location and have 10, 20 media people descend on them, as well as picketing going on outside," said Gandhi-Kozel. "The primary focus is to make sure that they receive education, and we need to have a productive environment for that to happen." Hospital officials said that the replacement nurses, hired by agencies that specialize in strike staffing, have a minimum of two years' experience in hospital care and an average of five to 12 years in their specialty areas. "Whether we're talking about physicians or nurses, we have national standards," said Dr. William Goodall, vice president of regional medical affairs at Allina Health System, which owns four of the affected hospitals. "So if you are a degreed and licensed RN, it's highly likely that you're competent to begin with." Thousands of replacement nurses will be arriving, although the hospitals won't say just how many. They will be expected to work 12-hour shifts six days a week, hospital officials said.

In return, they'll get $40 an hour, plus free housing, transportation and other perks.At HealthEast's three hospitals, 340 visiting nurses are expected to replace 1,100 striking nurses, many of whom are part-time. And the two Children's Hospitals expect 300 replacement nurses to help fill in for the 1,200 or so who will go on strike. To help orient them, officials have brought ventilators, IV systems and other hospital equipment to the off-site training location, Zespy said. "It won't be the same; we want our nurses back," she said. "But in the meantime, we'll assure the high-quality, safe care that we're known for."-- Maura Lerner is at [email protected] .

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© Copyright 2001 Star Tribune. All rights reserved.

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Christina Terranova RN, LNC

Our Unity is our Power www.geocities.com/nurseadvocate

www.florenceproject.org

The Florence Project, Inc.

Charles,

I agree your ideas are unique. But I also think it is naive to think that you are immune to competition. I imagine if nurses as independent contractors became the norm it would become extremely cut-throat and competitive.

Originally posted by RNPD:

chas, it sounds like a great concept. I am happy that you have been able to raise nursing practice at the bedside to a new level. But by your own admission it is not for everyone, especially the timid and the novice. Also, could the fact that you're a man have anything to do with your success? Are any of your partners women? If so, do they have children and families?

You see a lot of nurses are either supporting families, or work less than full time. And being women is a disadvantage from a business perspective in the eyes of a potential "client" (i.e. healthcare facility). So you are right, your model is not for everyone, and may never be a viable alternative for the bulk of the profession.

That said, why is it that you and others who have had success within the profession (the percentage of which is low when discussing bedside care) feel that those of us who are unable to follow your indepedndent practice model and negotiate better conditions for ourselves are someone the less for joining a union to try to get the best situation that they can given THEIR circumstances? I don't have the business ability or financial wherewithall, or even the desire to work as hard as I would need to to be an independent contractor. Why then, should I not take advantage of having a designated leader (i.e.union) to speak for me and others like me to negotiate the best possible deal for MY circumstances?

Gender really has no bearing on the success of any idea or concept. Passion does, however. We have passion and drive... As for the demographics of our group, we are highly diverse: ages from 29-60, men, women, married, single, 0 children to 5 children, African American, Guyanese, Hispanic, ADN to doctoral candidates, Advanced Practice Nurses, Nurse Lawyer...In a nutshell, we are all unique individuals with passion.

I support anyone who has the drive to make a change for her/his life. I do not and have not made disparaging remarks about collective bargaining on this website. There has been a need for this activity and I am open enough to see that. I merely take offense at name calling and labeling. So, I applaud your efforts for yourself and your co-workers. Just be open to look at different ideas along the way!

regards

chas

Specializes in Pediatric Rehabilitation.

so, chas...are you in essence saying you too are a "scab"??

Just as an FYI. Possibly the reason that the nurses who cross the lines can work multiple shifts is because when there is a strike.

THE HOSPITAL IS MANDATED BY FEDERAL LAW TO STAFF AT 1 AND A 1/2 TIMES THE NORMAL STAFFING PATTERN OF THE FLOOR, DURING A STRIKE.

So think of your own floor now. Mine a 25 bed staff 6 nurses during the day, so if they strike they would staff my floor with 9 nurses. :eek:

Chas, this is really the most complete explanation I have heard you give of what you do and it has been really great. Typically, when you are at the bedside are you staff nurse, mentor or problem solver or case manager or something else? Just curious.

I worked for a nurse entrepeneur here in KS who had sub-contracted to do Case Management for tech dependent kids. She started out being humored by her hubby ("Nice little job. Hope you're having a good time.") and ended up making more than he did in his job. But I found being a sub-contractor is pretty all-consuming and found that I was not built for being on call virtually 24 hours out of the day, 7 days per week. (I think some of my former colleagues would disagree and I think there has to be a certain ability to shut the job off--I never could.) Still, I think she [my former sub-contracting "boss"] would describe the sensation much as you do. High Autonomy=high control=high accountability and for her high satisfaction. Truly there was a sense of ownership of outcomes that pretty uniquely awesome.

Do you see, Chas, all bedside nurses becoming entrepeneurs? My sis-in-law (also a nurse) got really excited by this idea, but I did not see a way around that nursing services are "content of service" of the hospital stay. The trend in insurance reimbursement is toward bundling as much reimbursement as possible and unless nurses could see the worth of their services itemized (somehow) and reimbursed not as part of a bundled reimbursement, I don't see how this will work. Any nurse here would love to see nursing services itemized--ie the care of the normal post-op thoracotomy person vs the person with a septic, contaminated post-surgical abdominal wound that gets wound packed mutliple times a day.

I hope that nurses will also be aware that the real profiteers in health care, I think, are insurance companies. When I did CM, people shied away from us (being m/caid) because of low reimbursement, but now I am told we are actually one of the better reimbursers compared to commercial insurances. I believe the balance of power in health care is not toward docs, hospitals, or the patient but toward the insurors and I believe there is some abuse of power there.

Thanks again,

Originally posted by nurs4kids:

so, chas...are you in essence saying you too are a "scab"??

I almost did not respond to your question nurs4kids because it seemed as if you did not read any of the foregoing. But maybe you did, so being the tolerant soul that I am, I will simply point out that you missed the point...the label is offensive and continued pejorative remonstrations solve nothing. Look deep inside and know that providence has a way of putting us in the path of that which we fear and loathe the most. The person you label today could be the person who is caring for you tomorrow. I see both sides of the cause.

chas

Originally posted by MollyJ:

Chas, this is really the most complete explanation I have heard you give of what you do and it has been really great. Typically, when you are at the bedside are you staff nurse, mentor or problem solver or case manager or something else? Just curious.

I worked for a nurse entrepeneur here in KS who had sub-contracted to do Case Management for tech dependent kids. She started out being humored by her hubby ("Nice little job. Hope you're having a good time.") and ended up making more than he did in his job. But I found being a sub-contractor is pretty all-consuming and found that I was not built for being on call virtually 24 hours out of the day, 7 days per week. (I think some of my former colleagues would disagree and I think there has to be a certain ability to shut the job off--I never could.) Still, I think she [my former sub-contracting "boss"] would describe the sensation much as you do. High Autonomy=high control=high accountability and for her high satisfaction. Truly there was a sense of ownership of outcomes that pretty uniquely awesome.

Do you see, Chas, all bedside nurses becoming entrepeneurs? My sis-in-law (also a nurse) got really excited by this idea, but I did not see a way around that nursing services are "content of service" of the hospital stay. The trend in insurance reimbursement is toward bundling as much reimbursement as possible and unless nurses could see the worth of their services itemized (somehow) and reimbursed not as part of a bundled reimbursement, I don't see how this will work. Any nurse here would love to see nursing services itemized--ie the care of the normal post-op thoracotomy person vs the person with a septic, contaminated post-surgical abdominal wound that gets wound packed mutliple times a day.

I hope that nurses will also be aware that the real profiteers in health care, I think, are insurance companies. When I did CM, people shied away from us (being m/caid) because of low reimbursement, but now I am told we are actually one of the better reimbursers compared to commercial insurances. I believe the balance of power in health care is not toward docs, hospitals, or the patient but toward the insurors and I believe there is some abuse of power there.

Thanks again,

Molly...thank you and I am pleased I cleared up some stuff for you. I did not intentionally mean to be vague previously. Teaching what we do is about a 2 day seminar (which we hope to begin in the fall, by the way) so it is sometimes difficult to be succinct, yet clear.

In the best of all worlds I would love to see nurses move from the ranks of employed to the heights of entrepreneurship. Realistically, this will not happen in my life time, nor will we get close. But....my dream is intact and so is my long term vision. There is a real opportunity now for nurses to begin examining models of practice/reimbursement that moves them into the 3rd party arena. Nurses produce the bulk of the work in healthcare. As you know from your own experience that case management models can be high quality and cost effective. What would it be like if nurses were aligned in their own private practices to produce nursing work both inpatient and outpatient for certain populations of patients. Using business, case management and even parish nurse models to the fullest extent possible might just allow us the autonomy we seek. We might also be able to demonstrate improved outcomes for patients and at the same time help to lower healthcare costs. It is all possible, but not without a great deal of effort, re-education and political saavy to get reimbursement privileges. I believe in my heart that we have a bright future ahead of us and that in the future nurses will rise out of the ashes, so to speak, and really take the lead in healthcare and become the gatekeepers to the healthcare system. I have faith in my colleagues who follow in the next generations. My mission now is to help nurses regain their resolves to make things better for those that follow, hoping to stimulate some changes for the better in the here and now.

I would love to have a discussion with you one-on-one. email me if you like.

best regards Molly

chas

Specializes in Pediatric Rehabilitation.
Originally posted by Charles S. Smith, RN, MS:

I almost did not respond to your question nurs4kids because it seemed as if you did not read any of the foregoing. But maybe you did, so being the tolerant soul that I am, I will simply point out that you missed the point...the label is offensive and continued pejorative remonstrations solve nothing. Look deep inside and know that providence has a way of putting us in the path of that which we fear and loathe the most. The person you label today could be the person who is caring for you tomorrow. I see both sides of the cause.

chas

Chas,

Thank you for your reply and your patronizing tolerance. Quiet to the contrary, my question arose only AFTER I read your description of what you do. You still did not answer my question, or were rather evasive, so I am only left to assume. I apologize if the term is offensive to you, but this is a country of free speech. Just as you are offended by the term, so are many of us by the actions of a "scab". Only those with flexible lives (not the primary caretaker of children, family, etc) benefit by scabbing. Those same people hurt those of us who do NOT have the flexibility. Were there no scabs, the hospitals would be more flexible to our needs. A hospital would do all possible to prevent a strike if it knew it had no scabs to take the place of regular nurses. So, you see we are all offended or hurt one way or another.

Originally posted by nurs4kids:

Chas,

Thank you for your reply and your patronizing tolerance. Quiet to the contrary, my question arose only AFTER I read your description of what you do. You still did not answer my question, or were rather evasive, so I am only left to assume. I apologize if the term is offensive to you, but this is a country of free speech. Just as you are offended by the term, so are many of us by the actions of a "scab". Only those with flexible lives (not the primary caretaker of children, family, etc) benefit by scabbing. Those same people hurt those of us who do NOT have the flexibility. Were there no scabs, the hospitals would be more flexible to our needs. A hospital would do all possible to prevent a strike if it knew it had no scabs to take the place of regular nurses. So, you see we are all offended or hurt one way or another.

Yes, we are all hurt or wounded in one way or another. Wounds do not heal by heaping salt into them. I do not participate in either polarized group, yet am equally wounded as a nurse by the divisiveness because both groups supposedly represent my profession. Focusing on the issues rather than the people involved brings a bit of sanity to the situation I think. Name calling, hating, aggressive behavior, militancy, and all of the other negatives damage us all immeasurably in the end. Stand up for your beliefs, yes....destroy others for theirs...no.

chas

"Focusing on the issues rather than the people involved brings a bit of sanity to the situation I think."

The issue is that when those people get involved & cross RN strike lines, they impede the RNs from being able to get the hospital to address the issues. Its contradictory to support the striking nurses for trying to improve the situation for themselves & their pts & then also support the scabs who come in & are used by the hospital to help prevent the striking nurses from obtaining their goals. Forget the sugar coating. Call a spade a spade. People have to take responsibility for their actions & if they choose that action, they take what comes with the territory. Complaining about words does nothing.

Those striking nurses are out there for pt as well as their own safety. Other nurses come in to feed off their struggle.

Case closed.

None are coming in to walk the line with those nurses in support of their effort to fix problems we all are facing. Imagine if nurses from all over the country came to make a statement WITH the striking nurses & tell the world that we as a professional group are not going to stand for the administrations bottom line menatlity & treatment anymore? Why arent those Southern nurses coming up here to walk with us & let their hospitals know they want the same safe environments & compensations instead of running up here to work strikes because their own jobs pay so poorly?

What is wrong with saying Strike-Breakers Stay Home!

Originally posted by -jt:

"Focusing on the issues rather than the people involved brings a bit of sanity to the situation I think."

The issue is that when those people get involved & cross RN strike lines, they impede the RNs from being able to get the hospital to address the issues. Its contradictory to support the striking nurses for trying to improve the situation for themselves & their pts & then also support the scabs who come in & are used by the hospital to help prevent the striking nurses from obtaining their goals. Forget the sugar coating. Call a spade a spade. People have to take responsibility for their actions & if they choose that action, they take what comes with the territory. Complaining about words does nothing.

Those striking nurses are out there for pt as well as their own safety. Other nurses come in to feed off their struggle.

Case closed.

None are coming in to walk the line with those nurses in support of their effort to fix problems we all are facing. Imagine if nurses from all over the country came to make a statement WITH the striking nurses & tell the world that we as a professional group are not going to stand for the administrations bottom line menatlity & treatment anymore? Why arent those Southern nurses coming up here to walk with us & let their hospitals know they want the same safe environments & compensations instead of running up here to work strikes because their own jobs pay so poorly?

What is wrong with saying Strike-Breakers Stay Home!

There is absolutely nothing wrong with asking RNs not to cross the picket lines! And it is not contradictory to be see both sides of an issue. But there is something wrong with intimidating people and using strong arm tactics to achieve an outcome. Casting all Southern nurses as opportunistic, low paid, etc, is a bit out of line, don't you think? At the end of the day, you struck, you bargained and there is some advancement in your cause in your hospitals. But, I question just what kind of work environment you establish with adversarial approaches. While I do not propsose that hospitals are trusting, safe environments, I do suggest that beginning to move toward one is highly improbable when the atmosphere is charged with "them against us" mentality. And if you want to call "a spade a spade"... when was the last time a contract was turned down based solely on patient issues? I would be interested to know, because what I read suggests that negotiations are usually, if not always stalemated because of nurse wages and benefits. So, to tell the public that nurses are fighting for their safety is a bit inauthentic. Why don't you say to the public that if we don't get more money, more benefits and more of what we want you won't have a nurse period...?

chas

Originally posted by Charles S. Smith, RN, MS:

There is absolutely nothing wrong with asking RNs not to cross the picket lines! And it is not contradictory to be see both sides of an issue. But there is something wrong with intimidating people and using strong arm tactics to achieve an outcome. Casting all Southern nurses as opportunistic, low paid, etc, is a bit out of line, don't you think? At the end of the day, you struck, you bargained and there is some advancement in your cause in your hospitals. But, I question just what kind of work environment you establish with adversarial approaches. While I do not propsose that hospitals are trusting, safe environments, I do suggest that beginning to move toward one is highly improbable when the atmosphere is charged with "them against us" mentality. And if you want to call "a spade a spade"... when was the last time a contract was turned down based solely on patient issues? I would be interested to know, because what I read suggests that negotiations are usually, if not always stalemated because of nurse wages and benefits. So, to tell the public that nurses are fighting for their safety is a bit inauthentic. Why don't you say to the public that if we don't get more money, more benefits and more of what we want you won't have a nurse period...?

chas

I find it incredible that, knowing the history of the nursing profession, you charge that we have established an "adversarial approach" with hospitals. Kudos to you for your entrepreneurial nursing, but surely you must know of the onerous working conditions of nurses in hospitals.

Washington Hospital Center strike-The nurses were offered a 17% raise by the hospital. The union COUNTER-OFFERED with a 16% raise (that is not a misprint) in exchange for mandatory overtime language and more say in nurse/patient ratios. The hospital DECLINED!!!

Current Minnesota strike-The nurses are demanding a say in determining STAFFING ratios.

Brocton strike-ditto. They want a say in how much gets dumped on them in their workday. They also want money. So what?

Is there a reason you can give us that nurses should not be demanding fair compensation for work performed?

Doctors, pilots, teachers, architects. They all have unions. Here's the difference between their professions and ours...they don't have scabs.

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