Is this any way to retain nurses?

Nurses Activism

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Soooo..... We've been unionized with our state nurses assoc since 1983, with significant monetary and professional standard contract gains ever since, and once again are in negotiations with the hospital for a new contract. Is it just us, or does anyone else get the impression that this hospital is doing all it can to drive our nurses out of their jobs???......

On the first day of the first negotiating session, in its opening statements, the hospital refused to recognize some of the RNs on our negotiating team - which had been elected by the rest of the staff RNs to represent them - and refused to release them for negotiations, even though it is required to do so according to our contract. So, in the first 5 minutes of the first negotiating session, the hospital committed an illegal act & we had to stop to file a grievance for arbitration. Nice way to set the tone.

They canceled the next session and gave us dates to meet only once a week. They have given us dates into September, so they apparently have no plans to settle this contract quickly. It expired in June.

At the following session, they announced that recruitment and retention is their focus - BUT they specified that they meant recruitment & retention of new grads. In keeping with that, they proposed to cut the experienced RNs' tuition reimbursement in half & apply that money to establishing sign on bonuses for new grads. They blatantly said they want to be able to take money from experienced nurses & give it to new hires who already start with a base of almost $60,000/yr right out of school. Nice slap in the face for the nurses who already work here.

Then our hospital is refusing to implement retirement benefits that our union RNs have obtained at other area hospitals and, to add insult to injury, is also insisting on cutting its contributions to our retirement annuity plan in half. They also do not want to allow new hires to be vested in 3 years, as the rest of us are, and want to create a 2-tier system by forcing new hires to wait 5 yrs for vesting. So they can work 5 yrs worth of wasted time with nothing added to their retirement funds.

It's insisting on reducing our medical benefits and wants to make us start paying for them too. And it wants to deny new hires the immediate medical benefits they are currently entitled to - forcing them to work more than a month with no benefits at all. Theyll just be out of luck if they get hit by a car on the way to work. What incentive is there for a new nurse to work here when they are more valued at the next facility?

The hospital also wants the right to change our medical benefits plan and providers whenever it feels like it. It's prevented from doing that now.

It's also refusing pay increases in experience, education, charge, shift, or preceptor differentials and offered only a 2% raise. It wants to cut our continuing ed days and reimbursements. It got rid of all the clinical nurse specialists and expects the staff RNs to assume that role for new nurses - without compensation and without a decrease in the RN's pt load. It refused to increase pay for outside experience and insists on being allowed to continue paying a newly hired experienced nurse for up to only 10 years of her outside experience, while we have gotten hospitals all around us to do away with that ceiling and they now pay the nurse for ALL her years in nursing. This hospital also wants to cap the salaries of its own long-time nurses and stop their current increases paid for anything over 25 years at this facility - no matter how long they work there. Again, not competitive with our other hospitals that now recognize and compensate the RN for all her years in nursing. Whats the incentive for an experienced nurse to work here when she is valued more at the next hospital?

The hospital is violating the contract restrictions on mandatory ot pending the arbitration hearing on the matter. It also wants cuts in sick time and retribution against us if we use a sick day. THEN, if we have a sick day, but work an over time shift in that same pay period - mandatory or voluntary - they want to only pay us straight time for the OT and not count the sickday hours in the calculation. We envision the supervisors searching the rolls for anyone who had a sick day that week. We forsee that that's the person who will be mandated to work OT so the hospital can save on the time and a half payroll expense.

There is a punitive atmosphere of intimidation and nurses are suddenly being disciplined for every little thing (like thats really going to scare us into backing down). For example, a unit secretary didnt do her paper work "in a timely fashion" so the NURSE was disciplined. An neurosurgical RN was floated to a med-surg floor & paired with a nurses aid who was floated from mother/baby. An order was written for a lab draw on a pt at change of shift. Lab techs have been laid off & the nurses aid is expected to do those jobs. The RN was still busy with pt care. The mother/baby aid was not certified to draw labs so the RN delegated the lab draw to the aide coming onto the next shift. She gave report, alerted the next RN, stayed late to finish her charting, reminded the aid & the RN about the labs, and went home. She was then written up for not drawing the labs herself before she left.

The grievances will get all these ridiculous disciplines thrown out, but the effect that nonsense like this has on morale is not so easily fixed. One nurse reported a patient safety problem in his unit to our union delegate. That nurse was then harrassed by management and fired. That was illegal and he will win his job back, along with back pay once the arbitration is heard - but he will not accept the job back - and we lost another excellent RN. There are all these grievances, arbitrations, and Unfair Labor Practice charges filed with the NLRB up the wazzoooo, but the hospital doesnt seem to care.

It's demanding that we allow nurses to be disciplined if there are any doctor complaints about them or their unit or if their unit's Press Ganey patient satisfaction surveys are not improved - even though doctors' and patients' complaints usually stem from the fact that there isnt enough staff - and that is not the nurses fault - but the hospital is demanding that we actually agree to hold ourselves responsible for it. It also wants to be able to force the nurses who have received complaints or nurses on units that have not improved their customer satisfaction surveys to attend "customer satisfaction" courses - on our own time and at our own expense as punishment.

In this current round of contract negotiations, the hospital is even demanding the elimination of our clinical divisions and wants to be allowed to have unrestricted floating, irregardless of whether the RN has training in the area she is floated to or not. Thats something we did away with 20 years ago! But the hospital wants it back. It's refusing to implement 12 hr flextime on units that dont already have it, even though our contract allowed for alternative work schedules and required the hospital to consider it on any unit where the RNs want it. Although they agreed to that long ago, the hospital has refused to abide by it - another violation - and told us to "take it to arbitration".

Ok. Done.

It also wants to change our hard-won staffing ratios - because there is no state law that says they must have staffing ratios. (our union's nurses wrote the bill for that state law, got it into the legislature, but it hasnt yet been passed, therefore the hospital is not yet forced to provide staffing ratios by law). So, they want the critical care RN-to-pt staffing ratio changed from 1:2 to make it 1:3. They want the med-surg and oncology ratio to go up to 1:8/9. They want the L&D ratio to be 1:2 instead of 1:1. They accused the nursing staff of slacking off on the job and think we dont have enough work to do to justify our salaries if we dont have that many patients to be responsible for. Instead of instituting measures that would make the place one that nurses want to work in, being able to attract, hire, and keep the staff we need, the assistant VP of Human Resources shrugged his shoulders and actually stated "We dont have the staff for the current ratios. They need to be changed because we dont have the staff. If you force us to comply with your ratios, we'll just mandate YOU with ot to meet them".

Cant even call that a "hidden" threat.

With all the media attention on why nurses are leaving hospital jobs, youd think this kind of attitude towards nurses would be past us & administration would be eager to find ways to bring us back to the bedside. No such reality here.

Why would any nurse want to work at my hospital? Maybe the fact that they wont doesnt matter. The hospital is also demanding to eliminate our entire long-standing job security clause from our contract. Hmmm... does that mean Lay-offs are planned??

After hearing all these proposals, I thought they were joking. Our jaws hit the floor when we realized they werent. We asked if they read the newspapers lately and if they knew what the reasons were that RNs do not want to work at the bedsides anymore.

The corporation VP told us to our faces: "This is a business. We have to run it economically and do whats best for the business. We are not going to lose in business just for some RNs. If we dont have business - YOU dont have a job."

We responded:"Without nurses, YOU dont have a business".

And that was the end of that negotiations session.

I cant believe that they actually had the audacity to seriously make these kinds of demands of us in this time of bedside nurse shortages - and in the same breath state they are "focusing on retention". How is any of this going to attract nurses & keep them working here? Its just going to drive them straight to the hospital around the corner or down the street, where the RNs are in the same union and the hospital administration there does read the newspapers.

Bear in mind that if we were not a union, the administration could have made all these changes already all by itself & we'd already be living with it all. But since we ARE a union, they cant do any of it unless we agree. And we dont. The hospital so far will not change its position or even listen to reason, so the nurses are already demanding that our union take a strike vote to make it listen. This is how hospitals provoke and cause nurses strikes.

Our hospital just posted about 30 vacant RN positions. Some had been filled just a few months ago but those nurses have already left. And it thinks that while its doing all of the above, sign-on bonuses for new grads, with money stolen from experienced nurses, are going to make a difference.

The hospital has the attitude it has towards nurses, makes the kinds of contract proposals and demands that it has just made, and then cant understand why it cant fill the spots & keep them filled.

Well... duh.....

I am a staff RN in the ICU and am on the negotiating team. Yesterday I kept getting called to the phone to take calls from staff nurses all over the hospital wanting to make it clear that, if the hospital doesnt move off its stance, the nurses are ready to take a strike vote & authorize our union to schedule a strike, rather than allow any of the hospitals demands as they are. (The union takes direction and its orders from the staff nurses - it's not the other way around)

Another negotiating session is tomorow.

I just cant wait to hear what the hospital has come up with to show how much it disrespects & devalues us next.

Seems to me the administration either does not care about patients or is ignorant enough to think they don't need nurses.

Nurses give them trouble wanting equipment and personnel to care for patients. Unlicened people wouldn't know enough to ask for what the patients need.

Thanks for the explanation -jt. But I think if you look at contract negotiation on the big picture, everything is re-negotiable since either side can bring up as many changes as they want. And, consider yourself very lucky not to have to pay for health insurance. Most hospitals in my area give the employee only the minimum coverage (HMO). If you want a PPO or POS or family coverage you must pay extra (out of your own pocket).

It had nothing to do with luck, gomer. It was a damn hard fight that union nurses in my city began 40 yrs ago and won - making free healthcare benefits a professional standard. Some even went on strike to achieve that. We dont pay for our & our families healthcare benefits, and we have the determination of union nurses to thank for that.

Luck had nothing to do with it.

sooooo back to my initial question.....

Is it just us, or does anyone else get the impression that this hospital is doing all it can to drive our nurses out of their jobs???......

I've said it before and I'll say it again; there is NO shortage of nurses, only of tolerable places to work. And I think some hospitals are not interested in keeping RNs. They are looking at the bottom line only, which is cheap help. Either they are happy with a constant stream of new grads, who they can provide minimum benefits for, lower pay, and as you say, not vest for 5 years...or they are looking to have minimum RN staffing and replace RNs with aides and other less expensive help...or they are looking to fill the slots with foreign nurses--who they can pay less, work OT without paying for it, and treat anyway they want to. The nurses are bound by a contract usually, and if they quit, they will probably have to pay back money and be sent home. So at least until they get a green card, the foreign nurses are a hospital's dream.

:(

Keep us posted jt. Sounds like you've got a good group of nurses there who are willing to stand up for themselves and not be bullied by management. :D

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by -jt

sooooo back to my initial question.....

Is it just us, or does anyone else get the impression that this hospital is doing all it can to drive our nurses out of their jobs???......

BINGO. I would have to agree based on all I have read here. It's a sorry way to treat the backbone of the business---the literal bread-and-butter of their existance. Disgusting.

This story illustrates my point very well. If we (nursing) rely on labor unions or nursing unions or any kind of union, it only reinforces and perpetuates the notion that we are common hourly manual labor, a line item expense that must be controlled. We may need unions for the short term but that is not the answer. We must unite, become active in the political system to get laws changed that will recognize the contribution and value of a professional RN. We must also understand the environment we are working in and the people (administrative types) that we are working with. Economics and money is the bottom line. If revenue does not exceed expenses, your doors will close, you will be out of business, and no one will have a job at that place of business, hospital or otherwise. Instead of setting an adversarial situation with a labor union, why not acknowledge the issues that administration has and demonstrate how nursing can help them solve those problems. Why not focus on what we bring to the healthcare system, what our contribution is to the outcome of patients, how we help the hospital. Bickering and demanding things from administration does not work, will not work, and only makes things worse. I have read comment after comment here from nurses that "administration" is not interested in good patient care and only interested in money. I don't think that is exactly true. In any business, to be successful, the first thing you must have is a quality product that people want and will come back for because you did such a great job. Administrators know this very well. Sure they will ALWAYS look for the cheapest way to deliver the product. It should be the job of nursing to demonstrate how nurses help keep the product very high quality and contribute to customer satisfaction. Everyone knows (even administrators) that you get what you pay for. So instead of petty bickering over some contract, why not stand up and look for ways to create a win-win situation, demonstrate with quantitative data how nurses help the hospital improve itself and deliver high quality care that people will return for, show how nurses GENERATE revenue not consume resources. Everyone wants the $$$, even nurses, we all want higher wages, better benefits etc. We need nurses to assume positions of authority and decision-making in hospital administration. It is easy to criticize when you do not have all of the data and facts. We need to know the facts and get the data and show that we are all on the same team working for the same goal--good patient care, good patient outcomes, good place to work, and everyone making a good living!!!!!!

One company U.H.S. per their own literature made a 2 billion 800 million dollar profit last year and says it cant afford to pay its nurses more.

I'm sick of being jerked around in such matters. My humble opinion is screw them and talk with your feet walking!

What adversarial situation? We've been part of a professional RN union for 20 years. Its nothing new to them. There is no third party. Forget any preconceived Jimmy Hoffa-type notions that people might have about "the union". Its the staff nurses sitting there. WE are "the union". We walked in and were told they want to retain nurses - and then they handed us a list of things that are going to make nurses run to the next facility. What do you think we are doing anyway??? We present facts, charts, & data that show how nurses make a difference & how it is more cost effective in the long run to have adequate staffing. We HAVE said all the things you mention and done all that and it has made no difference. You see what the corporation VPs response was - "we're not going to lose in business (meaning theyre not going to lose profit) just for some RNs". So who is creating the adversarial situation?

In a past crisis, we voluntarily offered to freeze our own wages for 2 years to help the hospital out of a finanical crunch. Every one of 600 RNs gave that hospital $2400 to help it. $2,400 x 600 RNs is how much? The hospital didnt think of that or demand it. WE came up with that idea ourselves & offered it because the crisis was real. We have not been "adversarial". We have always looked for ways to work with the hospital. Thats the point. The attitude of hospital administrators spitting on nurses is undeserved, especially at the same time they cry that they cant find nurses.

Sitting on our side of the negotiating table are 7 staff nurses that the rest of our staff nurses elected to speak for them, an RN who is also a labor specialist and acts as our advisor. And our lawyer, who takes direction from us. Its basically just us - the staff RNs and the HR adminstration. So whats the difference between that and your suggestion of just talking to management? Thats what negotiations is - talking to management and proving your point. And still the hospital treats us this way. The only difference in us being a union is that the employer is OBLIGATED by law to sit down & talk to the nurses & get our permission for anything it wants to change.

If we werent a union, they would not have to do that, would not have to ask our permission to do any of the things they want, and would have already inflicted it all upon us. We could talk till we're blue in the face & it would get us nowhere. If they are treating us this way WITH union labor laws behind us, how do you think this particular administration would be treating us if we did not have even that bit of protection? But this wasnt meant to be a discussion about unions.

BTW, our fearless nursing leaders sit on adminsitrations side of the table and have been SILENT about pt care and the things that affect it - like unsafe staffing. HR, who doesnt know a thing about pt care, is making their decisions for them.

We dont need the hospitals actuarial facts to know that my hospital is losing nurses to other area facilities because it is persisting in unacceptable working conditions that the hospitals down the street and around the corner do not condone and that those other neighborhood hospitals now dont have such a shortage of nurses anymore. We dont need their data to know that it is a contradiction to say that you are sincere about having "a committment to nurses" and then demand give-backs from experienced nurses to be used to entice new grads into these same unacceptable working conditions with sign on bonuses. Or to offer less in compensation, working conditions, and benefits than other hospitals in the area are offering. Or to tell new hires that they dont deserve the same in benefits as others.

How could the focus be on recruiting and retaining if nurses find everything better at other facilities in the area? Whats the incentive to take a job at my hospital or to keep it? Who is going to want to work at this one when conditions, hours, salary, pension, benefits, staffing, and support services are better at the hospital down the street?

We dont need to be rocket scientists to see that its pure BS to say your focus is "nurse retention" and then try to implement policies like unrestricted floating to areas we are not qualified to work in, unlimited mandatory ot, and overwhelmingly unsafe staffing ratios. With these things, there is no good patient care, good patient outcomes, or good place to work. All that will just make more nurses bolt out the door and keep others away. So, sorry but I disagree with you - those issues are not "petty" in the least. And its particularly outrageous for a hospital to be making these kinds of demands in this climate when these are exactly the things that nurses are saying are the reasons why they wont work in hospitals today. If you can give me one idea that will move my administration to realize that, Id be happy to use it tomorrow and let you know how it works out.

We're begining to believe that they really dont want to attract new nurses and would like to see most of the nurses it does have leave. All the recent news articles have not made a dent with this administration. Our own "demonstrating with quantitative data how nurses help the hospital improve itself and deliver high quality care that people will return for, showing how nurses generate revenue, not consume resources, acknowledging the issues that administration has and demonstrating how nursing can help them solve those problems, focusing on what we bring to the healthcare system, what our contribution is to the outcome of patients, and how we help the hospital" has been done and continues to be, but has had no effect on them so far.

In 20 yrs of negotiating our own contracts, we've been through this kind of thing before. Even worse. We'll get thru it again. A lot of it is just posturing. Im just so livid that they would dare to even attempt this kind of thing and perpetuate this kind of atmosphere in todays shortage of bedside nurses.

If you want a certain product that is in short supply, you woo the supplier, right? (in this case nurses are both product and supplier). You up the ante for the needed product and make the best bid over all the others that also want that product. If there was a shortage of IV tubing, my hospital wouldnt blink twice to give the IV tubing supplier anything he wanted for his supply of tubing. Theyd say "Whatever the next hospital is offering you, Mr. Supplier, we'll offer you better. We need that tubing or we wont have a business. We'll do whatever it takes to get your product". But it looks like my hospital thinks that the rules of supply and demand dont apply when the product is nurses.

:eek: I was honestly amazed at the list of benefits you and the union nurses before you have negotiated, jt. And I think as professionals you deserve every darn one of them. Administrations have repeatedly turned a blind eye to the bottom line of health care. It is NOT money! Money is the first thing to go when a quality product is not provided on a consistent basis. The bottom line is therefore PROVIDING A QUALITY PRODUCT. And if you will excuse the labeling, we, as RNs, are the product. Healthcare cannot phase nurses out and continue to be "healthcare" as we are the backbone-the ones who look out for the patient's well-being from start to finish. But let's not get onto that tangent... I live in the Midwest and generally work in Nebraska as an agency nurse. The regular jobs I've had in no way have provided anything close to good benefits. The least I've ever paid for health insurance is $ 210 per month. My husband, before he met me, thought that all nurses received free health care. He was shocked when I informed him differently. Compared it to paying for a pop when working at Taco Bell! What a lovely thought. Retirement plans are usually 401k, which we've realized are vulnerable, given the slipping profits in the last few years. Most places require 3 years to be vested. Staffing is so bad that staying at one place for 3 years is becoming physically and emotionally impossible. Many places have the PTO vacation plans, and no seperate sick days. Sick calls are points added up against the employee, resulting in write-ups and termination. That's about it for benefits! There are no written standards for anything else like you described, jt. Nurses are at the mercy of others in almost every aspect of the care they try to give. There were votes about implementing unionization in Nebraska several years ago, and the fuss it caused was hilarious. Letters from management circulated wildly, announcing the "hidden" agendas of the union, how they would ruin healthcare and nursing. The union was not voted in, and things have continued in the sad state they have always been. Nurses in the Midwest need to get past the handmaiden state of mind, and realize that what we do is a PROFESSION, not "down-home tendin' and carin'." Midwest nurses will hopefully not take offense-I'm one myself, born and bred in Iowa. I'm just trying to illistrate that the care we provide is Universal, and it's time we respect our work enough to have the same requirements for benefits. I doubt that our voices will fall on anything but deaf ears without a union to amplify it! The corporations who own the major Midwest health systems have had it awful good for a long time. I think it's about time they get a little jolt. By the way, nurses; I have been looking around for a permanent job. The paper had job listings yesterday for one of the major hospitals. Want to know what they are offering for an experienced ICU RN to start? $15.25 + experience. I haven't made that little since I was a graduate nurse. WHEW! Thanks for listening, jt, and hang tough!
Specializes in Critical Care,Recovery, ED.

-jt

You just have to remind them NO NURSES = NO HOSPITAL

Have they changed lawyers or has the hospital board changed significantly since your last negotiation?

Comminity campaigns and political pressure works. And plenty of local publicity.This where you need to start on an external level. Internally you need to be in close communications with your members to insure their agreement and continued support of your positions. Don't take their support for granted.

Try to discern what the hospitals key issues really are? Some level of contrbution to benefit cost, lengthening vesting to that allowed by federal regulation, what give backs are they truly looking for and what are they willing to pay for them?

You are in for a fight but who from the Apple is afraid of one?

I dont work for a unionized facility and boy do I regret it. Mine is suppose to be a privately owned christian run facility. Conjures up images all warm and fuzzy doesnt it. Well forget about it it aint reality. Just wanted to say without a union it is very true they pretty much do what they want to to you and they can get away with it. Mine is not only not unionized but I live in a right to work state. Apparently that means not only can they treat you like doodoo but they can then fire you without cause. Starting to hit pretty close to home for my comfort. Good luck in your negotiations.

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