I'm posting this fast, and don't yet have all the details, but here is what I do know:
CNA just won a representation election for the RNs at Cypress Fairbanks Hospital, a part of the Tenet chain in Houston Texas.
Other than a small number of RNs employed by the federal government, this represents the first unionized nurses in the entire state a very tough organizing environment. It is the first major fruits of a three year statewide campaign.
The election was run under an organizing agreement won at the bargaining table by Tenet nurses in California.
Don't yet have numbers or other details, will make a second post when I do. I've met some of these Texas nurses and they are just the greatest. This is only the first of many organizing victories to come in this state.
Tenet has an sweetheart agreement with the union. there is no union bashing going on. do your research. CNA has done nothing and has decerts right in there own state. they want your dues. Nurse patient ratios are just that, nurses, NOT RN, read the legislation..........WAKE UP PEOPLE
Be sure to check out the adjudicated clarification to the Ratios law. It was upheld in court that 'nurse' meant 'RN' when it came to pt-to-nurse ratio (because the nurse had to 'assess' the patient in an ongoing manner. ONLY RNs can assess by law). CNA fought to assure that was clear. If your employer is doing otherwise they are breaking the law.
The law states that the ratios are to be maintained at all times---meaning that when you go on break or lunch your patients must be covered by an RN who's nurse-to-patient number still abides by the ratios law. If your employer is doing otherwise they are breaking the law.
The ratios law also was made such that ancillary staff was not to be cut. Now, employers will try to get away with cutting, but that's why it's best for us nurses to unite so we can say to them as a group, "No you don't; you may not."
That's what we had to do at my hospital.
Employers will try to get by making the most profit. We have to stand guard making sure that they follow the law and do what is right for our patients.
We have the Ratios law here in California because of the foresight and hard work of the nurses of CNA. Patients get taken better care of because we don't have too many and are not spread too thin. And we benefit because we finally have time to do most of the things we know we should for our patients.
We had Title 22 with ratios of 1:2 or better in the ICU since the 1970s because of the foresight and hard work of the nurses of CNA back then.
If you are a California nurse, you benefit with some of the best wages and benefit packages in the nation because of the hard work of the California Nurses Association.
Check out this article about Suzanne Gordon's latest book. She and co-authors in Australia chronicle the benefits that have come to California and Victoria, Australia since the implementation of ratio laws.
Specializes in Critical care, tele, Medical-Surgical.
i did do my rsearch, nurse not rn, read this years amendment.
is there a link to this years amendment?
the enabling legislation ab 394 includes:
"...(h) in case of conflict between this section and any provision or regulation defining the scope of nursing practice, the scope of practice provisions shall control......"
so for example in pediatrics where the maximum number of patients that may be assigned to a licensed nurse is four how can an rn assume responsibility for more than four patients?
title 22 under the section with the ratios also states, "licensed vocational nurses may constitute up to 50 percent of the licensed nurses assigned to patient care on any unit, except where registered nurses are required pursuant to the patient classification system or this section."
so if as the rn you are certain that the acuity is low and know the competency of the individual lvn you may accept the assignment of responsibility for up to eight pediatric patients.
in my experience patients with low acuity are discharged and replaced by a newly admitted patient who is much sicker. you only have one license so i think it prudent to protest an unsafe assignment.
the same section states, "nothing in this section shall prohibit a licensed nurse from assisting with specific tasks within the scope of his or her practice for a patient assigned to another nurse. "assist" means that licensed nurses may provide patient care beyond their patient assignments if the tasks performed are specific and time-limited."
how can complete responsibility for patient care including ongoing assessments be considered "specific and time limited"?
the law is not perfect but what we have is better than the regulations in any other state -to my knowledge.
and rns are not accepting a double assignment without protest at any hospital i know of.
I did do my rsearch, nurse not RN, read this years amendment.
I would love to see that amendment. Where did you hear about it?
'Nurse not RN' was certainly the argument put forth by the hospital association and entities like SEIU, but it lost out in court to the logic that patients require ongoing assessments. Only RNs have the skills, knowledge, education, training and expertise to do ongoing assessments by law.
Tenet has an sweetheart agreement with the union. there is no union bashing going on. do your research. CNA has done nothing and has decerts right in there own state. they want your dues. Nurse patient ratios are just that, nurses, NOT RN, read the legislation..........WAKE UP PEOPLE
Bittersweet,
Please read the ratio law!
A nurse, is a nurse, is a nurse? Although only LVNs and RNs may call themselves "nurses" in the State of California, their legal scope of practice, and accountability is different. An LVN has a dependent license, and must work under the direction of the RN accountable for the patient. Therefore, the ratios are in fact, RN ratios.
Many administrators and executives like to misquote the law and take it out of context of the other regulations that govern scope of practice. LVNs make important contributions to the basic nursing care of patients. The ratio law states, "Licensed vocational nurses may constitute up to 50 percent of the licensed nurses assigned to patient care on any unit, except where registered nurses are required pursuant to the patient classification system or this section."
* Ratios must be based on a standard of individualized patient care needs with sufficient RN staffing to ensure that patient care reflects proper assessment, nursing diagnosis, planning, intervention, evaluation and patient advocacy. The law states: "The basic principles of staffing in the acute care setting should be based on the patient's care needs, the severity of condition, services needed, and the complexity surrounding those services."
* Mandates additional nursing staff as needed based on individualized patient needs and severity of illness [acuity]. "Additional staff (above minimum ratios is determined by) the severity of the illness, the need for specialized equipment and technology, the complexity of clinical judgment needed to design, implement, and evaluate the patient care plan and the ability for self-care, and the licensure of personnel required for care."
* In the event of a conflict between the health and safety code pertaining to nurse staffing and regulation defining the scope of nursing practice, the scope of practice provisions shall prevail
California Code of Regulations, Title 22, Section 70215 (a) (2) "A Registered Nurse shall directly provide:
The planning, supervision, implementation, and evaluation of the nursing care provided to each patient. The implementation of nursing care may be delegated by the registered nurse responsible for the patient to other licensed staff, or may be assigned to unlicensed staff, subject to any limitation of their licensure."
go to the hospitals and work the floors.............I've been an RN for 30 years in and out of unions, unions take your money, waste time in negotiating contracts, you can wait for a contract for 2 yrs and everything is frozen. unions promis but only the hospital delivers. Scripps decerted the CNA, St Rose voted down the CNA, meanwhile they raid each other and claim to be a "brotherhood". it's more like Mafia families. The CNA just got themselves in some deep water in the state of Iowa. The SEIU is raiding NYSNA. It's become a series similiar to the Sopranos......... And the UAN is where in all of this?
and as for the ratios............you can argue that point as much as you want, i saw the amendment to the ratios from the DOH in California this year. What happens to patient acuity???????
If you have concerns about imperfections in the minimum staffing law feel free to write your legislator to ask for changes. (Arguably the professional coore nursing values expects nurses to take that action.) Or if you are in CNA get active AND WORK FOR CHANGE! Express your concerns. Work for change....Organizations are only as good as the people who are working to make things better.....
Don't let the perfect be the enemy of the good.....
Specializes in Critical care, tele, Medical-Surgical.
and as for the ratios............you can argue that point as much as you want, i saw the amendment to the ratios from the DOH in California this year. What happens to patient acuity???????
Please provide a link to the amendment.
Or at least type it?
I cannot find any repeal of the requirement to staff to the indivual needs of the patients as determined by the assessment of the direct care registered nurse.
Specializes in Critical care, tele, Medical-Surgical.
RN-to-Patient Ratios
CNA’s historic first in the nation Safe Staffing RN Ratios took 12 years to win and has been in effect since January 2004 despite continued efforts of the hospital industry and Governor Schwarzenegger to have the law overturned or otherwise weakened.
When Governor Schwarzenegger decided to roll back CNA's staffing ratios and called nurses a "special interest who don't like me because I'm always kicking their butt,"
CNA ignited a broad grassroots movement that led to the sweeping November 2005 electoral defeat for the Governor's special election initiatives. Two days later, Schwarzenegger dropped his year-long fight against the ratios.
Safe RN ratios have improved quality of care and nurse recruitment and retention in California hospitals. Ratios continue to improve. A 1:4 ratio in telemetry and specialty units scheduled took effect in 2008.
Ludlow
109 Posts
Be sure to check out the adjudicated clarification to the Ratios law. It was upheld in court that 'nurse' meant 'RN' when it came to pt-to-nurse ratio (because the nurse had to 'assess' the patient in an ongoing manner. ONLY RNs can assess by law). CNA fought to assure that was clear. If your employer is doing otherwise they are breaking the law.
The law states that the ratios are to be maintained at all times---meaning that when you go on break or lunch your patients must be covered by an RN who's nurse-to-patient number still abides by the ratios law. If your employer is doing otherwise they are breaking the law.
The ratios law also was made such that ancillary staff was not to be cut. Now, employers will try to get away with cutting, but that's why it's best for us nurses to unite so we can say to them as a group, "No you don't; you may not."
That's what we had to do at my hospital.
Employers will try to get by making the most profit. We have to stand guard making sure that they follow the law and do what is right for our patients.
We have the Ratios law here in California because of the foresight and hard work of the nurses of CNA. Patients get taken better care of because we don't have too many and are not spread too thin. And we benefit because we finally have time to do most of the things we know we should for our patients.
We had Title 22 with ratios of 1:2 or better in the ICU since the 1970s because of the foresight and hard work of the nurses of CNA back then.
If you are a California nurse, you benefit with some of the best wages and benefit packages in the nation because of the hard work of the California Nurses Association.
Those are just the facts.