Nurse Strike at MCP/Hahnemann???

RNangelER · Nov 21, 2003

Originally posted by -jt
Interesting how the hospital keeps talking about how "fair" their offer is because it has an 11% wage increase ---- while the nurses are saying its not the money, its the WORKING CONDITIONS. When are these employers gonna "get it"?
Opps! I forgot. . . . .
Thanks -jT for your post. . . . It is about the working conditions and mandation. But in responce to the 11% raise (over 2 years). . . . . TENET forgets to mention when they talk about this 11% raise that they want to increase our health insurance payment to 50% So where did the 11% go?????

-jt · Nov 22, 2003

Thats a very important point to mention. And about the staffing and OT, heres some ammunition that supports your stand on those issues. Nurses cannot ignore the data and results of so many studies that show pts outcomes (and lives) depend on safe RN staffing. How our employers can fight so hard to ignore it all themselves, even going so far as to force us out on strike to do so, is just mind boggling. The public should be as outraged as the nurses cause theyre the ones deliberately being put at risk in the hospital, all for the almighty profit margin.

JAMA Article Links Hospital Staffing and Patient Mortality, Nurse Burnout and Job Dissatisfaction (Linda Aiken's study - conducted at 168 Pennsylvania hospitals & included 232,342 PA patients)

http://nursingworld.org/pressrel/2002/pr1023.htm

Institute of Medicine's Study reinforces call to eliminate mandatory overtime; improve staffing levels, work environment

http://nursingworld.org/pressrel/2003/pr1105.htm

Harvard University Study Identifies Inadequate Nurse Staffing as A Major Factor in Medical Errors

http://nursingworld.org/pressrel/2002/pr1216.htm

JCAHO report underscores long-standing concerns of the nursing community

http://nursingworld.org/pressrel/2002/pr0807.htm

New England Journal of Medicine: Study Reveals Link Between Increased Nursing Care, Better Patient Outcomes in Hospitals

http://nursingworld.org/pressrel/2002/pr0529.htm

Institute of Medicine of the National Academies: Substantial Changes Required in Nurses' Work Environment To Protect Patients From Health Care Errors -

Transforming the Work Environment of Nurses

http://www.nap.edu.

107th Congressional Research Report Says: 'Maldistribution' of Nurses is More Likely Than Actual Shortage

http://nursingworld.org/gova/federal/legis/107/gacrs.htm

ANA SURVEY REVEALS DETERIORATING WORKING CONDITIONS, DECLINE IN QUALITY OF CARE

http://nursingworld.org/pressrel/2001/pr0206.htm

ANA Survey: Nurses Say Health and Safety Concerns Play Major Role in Employment Decisions

http://nursingworld.org/pressrel/2001/pr0907b.htm

Federal Legislation to Mandate Safe Nurse-To-Patient Ratios

http://nursingworld.org/pressrel/2003/pr0506.htm

Federal Mandatory Overtime Legislation Introduced

http://nursingworld.org/pressrel/2003/pr0212.htm

Statement of the American Nurses Association

for the Institute of Medicine's Committee on

Work Environment for Nurses and Patient Safety

http://nursingworld.org/pressrel/2002/iom924.htm

ANA Addresses the Impact of the Nursing Shortage at Senate Committee Hearing

http://nursingworld.org/pressrel/2001/pr0614.htm

University of Pennsylvania Receives Federal Grant to Study Nursing Work Hours, Fatigue and Patient Outcomes

http://nursingworld.org/pressrel/2001/pr1016.htm

Pennsylvania State Nurses Association (PSNA): PA State legislation Introduced To Impose Limitations on the Use of Mandatory Overtime

http://www.psna.org/HotIssues/MObill.htm

PSNA Nursing Leadership Platform on PA Nursing Shortage

http://www.psna.org/HotIssues/NSforum.htm

RN-PA, RN · Nov 22, 2003

WOW, -jt-- Thanks for putting such wonderful links all in one place! The meeting I recently had with upper management regarding nurse-to-patient ratios on our med-surg unit didn't seem to move our CEO to consider any changes except to add ONE extra PCT on 3-11 shift to share between 2 units of a total 65 beds. :stone :rolleyes:

Thanks for giving me more "ammo" to bring back to them in the near future!

Home Health Columnist / Guide · Nov 22, 2003

als0 fight'em with jcaho:

nursing shortage poses serious health care risk: joint commission expert panel offers solutions to national health care crisis

http://www.jcaho.com/news+room/press+kits/nursing+shortage+press+kit.htm

jcaho's own report:

health care at the crossroads: strategies for addressing the evolving nursing crisis

http://www.jcaho.com/about+us/public+policy+initiatives/health+care+at+the+crossroads.pdf

executive summary

nearly every person's health care experience involves the contribution of a registered nurse. birth and death, and all the various forms of care in between, are attended by the knowledge, support and comforting of nurses. few professions offer such a special opportunity for meaningful work as nursing. yet, this country is facing a growing shortage of registered nurses. when there are too few nurses, patient safety is threatened and health care quality is diminished. indeed, access even to the most critical care may be barred. and, the ability of the health system to respond to a mass casualty event is severely compromised. the impending crisis in nurse staffing has the potential to impact the very health and security of our society if definitive steps are not taken to address its underlying causes.

the shortage of registered nurses is already having ill effects on the u.s. health care delivery system: 90 percent of long term-care organizations lack sufficient nurse staffing to provide even the most basic of care;[1] home health care agencies are being forced to refuse new admissions;[2] and there are 126,000 nursing positions currently unfilled in hospitals across the country.[3] and news of the shortage has reached the american public: 81 percent are aware that there is a shortage, 93 percent believe that the shortage threatens the quality of care, and 65 percent view the shortage as a major problem.[4] further, the current nurse staffing shortage is burgeoning at a time when patient acuity is higher, care more complex, and demand for services often exceeds capacity.

but what is already a bad situation only threatens to worsen. the baby boom generation - all 78 million of them - are aging. more so than generations before them, baby boomers in their old age will have access to scientific advances and technologies that will help them live longer - if the health care delivery system can deliver. given this anticipated additional demand for health care services, it is estimated that by 2020, there will be at least 400,000 fewer nurses available to provide care than will be needed.[5]

aging right along with their baby boomer peers are nurses themselves. the average age of a working registered nurse today is 43.3, and that average age is increasing at a rate more than twice that of all other workforces in this country.[6] only 12 percent of registered nurses in the workforce are under the age of 30, a decline of 41 percent compared to a one percent decline for all other occupations.[7] by 2010, it is projected that the average age of the working registered nurse will be 50.[8] as growing numbers of nurses reach retirement, far too few are coming forward to fill their ranks.

]higher acuity patients plus fewer nurses to care for them is a prescription for danger. according to joint commission data, staffing levels have been a factor in 24 percent of the 1,609 sentinel events - unanticipated events that result in death, injury or permanent loss of function - that have been reported to the joint commission over the past five years. other identified contributing factors, such as patient assessment, caregiver orientation and training, communication, and staff competency, implicate nursing problems as well. conversely, several studies have shown the positive impacts on quality, costs and health outcomes when nurse staffing levels are optimized - fewer complications, fewer adverse events, shorter lengths of stay, lower mortality.[9],[10],[11],[12]

in addition to its impacts on patient safety and health care quality, the nursing shortage is diminishing hospitals' capacity to treat patients. in a recent study conducted on behalf of the american hospital association, respondents reported that the nursing shortage has caused emergency department overcrowding in their hospitals (38%); diversion of emergency patients (25%); reduced number of staffed beds (23%); discontinuation of programs and services (17%); and cancellation of elective surgeries (10%). in this same study, nearly 60 percent of respondents reported that nurses feel it is more difficult to provide quality care today because of workforce shortages.[13]

with its recent reports on patient safety and health care quality, the institute of medicine provided a call to action for the health care industry to substantially reduce the frequency of preventable medical errors and resulting adverse events. in the wake of these reports, health care organizations have rallied around the safety issue, introducing a variety of measures to reduce error. but what is being done to solve the nurse staffing problem, and the compromised patient safety and health care quality that lie in its wake?

with that question in mind, the joint commission convened a multi-disciplinary expert roundtable on the nursing shortage to analyze the problem and, most importantly, to frame its solutions and identify accountabilities for these solutions. roundtable participants focused on the principal factors that have contributed to the shortage, the growing threat of the nursing shortage to patient safety, and the priority solutions most likely to provide for a stable nursing workforce in the future.

based on those discussions, the following recommendations are proposed for transforming the workplace, aligning nursing education and clinical experience, and providing financial incentives for health care organizations to invest in high quality nursing care.

*create organizational cultures of retention

adopt the characteristics of "magnet" hospitals to foster a workplace that empowers and is respectful of nursing staff.

provide management training, as well as support, to nurse executives.

positively transform nursing work through the use of information and ergonomic technologies.

set staffing levels based on nurse competency and skill mix relative to patient mix and acuity.

adopt zero-tolerance policies for abusive behaviors by health care practitioners who work with nurses.

diversify the nursing workforce to broaden the base of potential caregivers.

*bolster the nursing educational infrastructure

increase funding for nursing education, including endowments, scholarships and federal appropriations.

establish a standardized, post-graduate nursing residency program.

emphasize team-training in nursing education.

enhance support of nursing orientation in-service and continuing education in hospitals.

create nursing career ladders commensurate with educational level and experience.

*establish financial incentives for investing in nursing

make new federal monies available for health care organizations to invest in nursing services.

condition continued receipt of these monies on achievement of quantifiable, evidence-based, nursing sensitive goals.

align private payer and federal reimbursement incentives to reward effective nurse staffing

_______________________________

RN-PA, RN · Nov 22, 2003

Thanks again. -jt and NRSKaren, too. I've copied all of your links and will be bringing them to hand out at our next Retention committee meting in early December. I will also consider making copies of some of the articles to give to management. I haven't had a chance to read much of it yet, but JCAHO's own report: "Health Care at the Crossroads: Strategies for Addressing the Evolving Nursing Crisis" looks EXCELLENT!

-jt · Nov 22, 2003

We printed out all the articles for each member of managements negotiating team, sent copies to the news reporters who were following our story, the Board of Directors, and community organizations, and leaders --- and asked why our hospital could insist on ignoring all this data and refuse to provide safer staffing, when all the proof points to the fact that their pts lives depended on it. And the community started asking that question too.

I wrote a letter to the reporter who did that pro-RN article in the Philly Daily News which was linked in a post above. She wrote back asking for more info, so I sent her all those links too. :)

She's doing a follow-up story Mon or Tues. Please post the link to it when it comes out!

Good luck.

Hellllllo Nurse, BSN, RN · Nov 23, 2003

I wrote to the reporter of this article:

http://www.philly.com/mld/philly/news/columnists/7281135.htm

(Thanks for posting it, fab4fan).

Here is a copy of the reply I got, plus my letter:

Hi XXXXXXX,

Well, great minds must think alike, because I'm doing a follow-up column for Monday's paper about just the things you've written here! ( hope it's not too arrogant, calling our minds "great," but what the heck, right?). Nurses from all over the country have written me to say that they've LEFT nursing in hospitals because of crappy conditions. But they terribly miss bedside care, because it's what they got into nursing to do ! Thanks for alerting me to your facts and figures, which correspond precisely with the stats I'm finding and reflect precisely the anecdotes I'm hearing.

Thanks for taking the time to write. By the way, fyi, I am a Ms. not a Mr. - "Ronnie" is a nickname for "Veronica," my beloved grandma's name, may she rest in peace!

take care,

Ronnie P.

-----Original Message-----

From:

To: [email protected]

Cc:

Sent: 11/20/2003 10:45 PM

Subject: re: your article MCP nurses' strike

Dear Sir,

I loved your article about the strike. So supportive of the nurses!

I am an RN in Texas, a right-to-work state where "union" is a dirty

word. We face the same horrific working conditions as do nurses in

Philly and all over the U.S. Unfortunately, no nursing unions in Texas.

No one wants to hear us.

I wanted to address with you the myth of a "nursing shortage". I have

been reasearching the topic for months, and I, like many other nurses,

are totally convinced: there is NO nursing shortage. The real shortage

lies in jobs that nurses are able to tolerate, due to poor working

conditions and terrible nurse-to-patient ratios.

Here is some info I've found:

Almost 500,000 licensed registered nurses were not employed as nurses in

2000.*

Data from the Health Resources and Services Administration's (HRSA's)

2000 national sample survey of RNs shows that more than 500,000 licensed

nurses (more than 18% of the national nurse workforce) have chosen not

to work in nursing. This available labor pool could be drawn back into

nursing if they found the employment opportunities attractive enough**

The ANA maintains that the deterioration in the working conditions for

nurses is the primary cause for the staff vacancies being reported by

hospitals and nursing facilities - not a systemic nursing shortage.

Nurses are opting not to take these nursing jobs because they are not

attracted to positions where they will be confronted by mandatory

overtime and short staffing. **

76.6% (of) Licensed RNs (in The U.S. are) Employed in Nursing***

* Projected Supply, Demand and Shortages of Registered Nurses: 2000-2020

(released on 7/30/03 by the National Center for Health Workforce

Analysis, Bureau of Health Professions, Health Resources and Services

Administration, U.S. Department of Health and Human Services). The

Bureau of Labor Statistics, in an earlier report, predicted that that we

will need one million new nurses by 2010 (Monthly Labor Review -

November 2001) to cover new positions and replace the nurses who have

retired.

**

http://www.nursingworld.org/gova/fe.../107/ovrtme.htm

*** https://www.aacn.org/aacn/practice....a6?OpenDocument>

https://www.aacn.org/aacn/practice....a6?OpenDocument

I suggest you wisit the nursing web community of http://www.allnurses.com

http://www.allnurses.com>

This web community has thousand of nurses members. Please browse the

posts, do a search on the topic of the "nursing shortage". Nurses know

that the "shortage" is a myth. We wish that the public and polititinas

knew it, too!

Again, thank you for your article. Keep up the good work-telling the

truth!

Sincerely,

XXXXXX XXXXXXX, RN

-jt · Nov 24, 2003

No big surprise there. It seems to be their MO. They are participating in conducting seminars all over California to train hospital executives in how to evade and reverse the new staffing ratio law. The tactic you mention is right there in the "playbook" they give out these seminars.

excerpt:

* 'Close beds and cry wolf'

Voluntarily close or downsize beds or units, citing an inability to "find" sufficient RNs to meet the ratios. The goal is to fan hysteria in hopes of softening public support for the ratios, winning regulatory exemptions to compliance, and generating political support for legislation to repeal or suspend the ratios.

* Delay elective surgeries, declare healthcare "emergencies," - both to force RNs on staff to work more hours and to engage in a PR war to subvert the ratios. To ratchet up public pressure, some hospitals may close units or suspend operations every day, and will meet with legislators to place the blame on the ratio law. The officials concede that hospitals may, in some cases, have difficulty receiving permission to reopen beds or units that have been temporarily or permanently shut down.

Seminar packets provide:

1. Detailed information on temporary and permanent closures of units and suspensions of beds

2. Sample letter to DHS requesting bed suspension

3. Sample letter to employees and medical staff announcing unit closures

4. Sample press release for participants headlined "(Facility/System Name) Closes XXXX Unit Because of Lack of Nurses. Despite Recruitment Efforts, Hospital Unable to Hire Enough Nurses to Meet New State Law.">>

Full article: http://www.calnurse.org/102103/hospindustry.html

MORE INFO AT:

http://www.calnurses.org/cna/watch/tenet/

and

http://www.calnurses.org/cna/watch/tenet/tenarch.html

RNangelER · Nov 25, 2003

Hey Everyone, WE (MCP nurses) had our big Rally and today everyone is meeting at the table. Keep your fingers crossed and say your prayers for us. The rally turn out was excellent.

We had many other Unions also out their fighting for our cause. We even seen Rich Freeman's face (CEO of MCP) behind the Hospital gate for a brief moment until he ran back into the hospital to hide!! Below is a link for the follow up story from Ronnie Polaneczky in The Philadelphia Daily News

http://www.philly.com/mld/dailynews/7344078.htm

I am also attaching some links to our local news and video clips that I found this AM. I don't think the links will work for too long due to the news being updated daily.

http://abclocal.go.com/wpvi/news/11252003_nw_nursestrike.html

Click here: WPVI.com:

http://kyw.com/news/local_story_328174640.html

Click here: CBS 3 Video Viewer

http://www.philly.com/mld/dailynews/7344078.htm

If anyone finds more please send them. Thanks!:kiss

RN-PA, RN · Nov 25, 2003

RNangelER, prayers and best wishes to you and your colleagues! Another great article by Ronnie Polaneczky-- I just finished emailing and thanking her.

ohioln, RN · Nov 26, 2003

I don't think they can ask you to work manditory overtime and then not pay you. Are the nurses there salaried or payed an hourly wage? If they're salaried, they can, but not if they're payed an hourly wage.

RNangelER · Nov 26, 2003

I didn't post #19 but I will try to answer the question Ohioln. TENET does not ASK us to stay. . . . . They tell us we are MANDATED! The Union nurses are paid hourly. Alot of us work 12 hours shifts. So, if we were to be mandated we would have worked 16 hours for straight time pay. In the old contract we were allowed to refuse up to six times then the next nurse on the list would be mandated and so on with the last person not being able to refuse. According to the contract that TENET has offered, we can be mandated with an hour and 45 minute notice. On top of the safety issues of being exhausted and errors occuring, what about family obligations. TENET (at MCP hospital) has 75 RN openings at the time of our stike. We would be mandated a heck of alot. We are attempting to get mandation completely strickend from our contract.

I hope this answered your question Ohioln :confused: Take care