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Chico David

Chico David BSN, RN

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Love my work. Love my play, love my activism

Chico David's Latest Activity

  1. Chico David

    New national nurses union forms

    Short form update: both on the organizing front and on the political/social movement front, NNU has been pretty active. More members in more states, including places like Texas and Florida that have hardly been hotbeds of union activity. Making substantial inroads into some of the big for-profit hospital chains, which is important, both because they are widespread and because they tend to oppress their nurses pretty badly. I'd say the biggest disappointment is that the progress toward true unity and integration have come a little slower than I might have hoped. While we are unified in many ways, there is still an understanable reluctance of some states to give up autonomy and move toward true integration. It will come, but not as fast as some of us might have dreamed.
  2. Chico David

    Old union, new union or no union

    Several quick thoughts: it sounds to me, if I understand correctly, that people at your hospital are trying to set up an entirely independent union, not affiliated with any larger organization There are places with single-bargaining-unit unions that are fairly successful CRONA at Standord University Hospital being an example. But they are the exception. for the most part, a larger union with more power and more structure behind it will be more effective. But not always. In some places the absence of collective bargaining by state nurses associations has led a variety of non-nurse unions - Teamsters, Laborers, Steelworkers and others - into representing nurses. Not always too successfully. As a board member of a nurse union, I can tell you that the complexity of running a union - just in complying with reporting requirements and such - is immense. A big challenge for a new independent organization. I'd be leary of that idea. And, in response to another comment further up: No state can prohibit nurses unions, at least in the private sector. Some states have so called "right to work" laws, which prohibit a contract that makes union membership mandatory for a particular workplace. In those states, unions tend to be small and weak and not common. But there are no states where unions are illegal - even though a lot of managers will lie about that and love for you to think they are illegal.
  3. Chico David

    Can I get out?

    By federal law, you can not be required to be a member of a union. But, depending on your state law and the contract where you are, you may be required to pay a fee for the benefits of the union contract. If you are in a so called "right to work" state, that would not be the case. Both membership and dues are voluntary in those states. If you are in a state, like California, that allows agency shop contracts, then you can choose to be what is called a "Beck objector" in which case you are not a member of the union and pay the portion of dues that goes to pay for collective bargaining costs but not the part that goes to pay for political activity. That's usually in the ballpark of 90% of full dues and, since you are choosing not to be a full member you don't have a vote in anything like contract ratification.
  4. Chico David

    Why is unionization a subject of taboo??

    I really like your spirit. I have the strong impression - again, I'm not an expert - that there are rules on who can be classified as exempt and that staff nurses are not generally one of them. But it's a subject loaded with grey areas. Back in the 90s we got new corporate oriented, bottom-line oriented management at our place. Lots of things changed for the worse. Their constantly repeated mantra was "if you don't like it, so somewhere else". Some did, but some of us stayed and organized instead. Now we're still here and all that management team are gone - every last one of the top level people that forced us to unionize. Outlast 'em.
  5. Chico David

    Why is unionization a subject of taboo??

    I don't know wage and hour law inside out or anything, but I am just sure that the staffing/pay practices you describe are in fact illegal. A phone call to the state department of labor might be a start or, if you live in one of the Southern states where the state government thinks workers have no rights, going to the US department of Labor might be worthwhile. Here is a link: http://www.dol.gov/whd/overtime_pay.htm You'll find a fair bit on info there on overtime and also how to contact them. This just sounds like absolute garbage to me.
  6. Chico David

    Why is unionization a subject of taboo??

    Men are not so into the sacrificial thing that so many nurses seem to have bought into. Accepting poor wages and absurd working conditions "for the good of the patients" - even though management may be making fat salaries and/or big profits while cutting the nursing care and the nurses wages. What's really for the good of the patients is to demand decent staffing levels and good enough wages to draw top people into the field. Back when we were negotiating our first contract I was on the bargaining team and I was the one who wrote most of the bargaining updates we sent out to nurses. The lawyer who was negotiating for management was a (several words I can't use here) and they were doing everything possible to prevent us getting a contract at all, let alone a decent one. So that information was in the updates. At one of our membership meetings a nurse got up and said "I don't like to read those updates because sometimes they say things about managment that aren't very nice". I remember thinking "I'll bet you'd never hear that at a meeting of a mostly male union".
  7. Chico David

    Why is unionization a subject of taboo??

    I might add that healthcare in general and nursing in particular is one of the few areas in the US where union membership is growing. A lot of union shrinkage has been due to the offshoring of various kinds of work that were unionized. Harder to do that with hospitals.
  8. Chico David

    Nurse to Patient Ratio

    I don't know them all off the top of my head - it varies by unit, but here are some samples: ICU - 1:2 stepdown unit - 1:3 specialty unit (peds, tele, oncology) 1:4 Med/surg 1:5 Emergency 1:4 (unless a patient is heading for an ICU - then the ICU ratio applies) A couple of other items that can be just as important as the numerical ratios: These ratios are in effect "at all times" which means days and nights and includes break and meal periods - in other words, to be legal there should be designated people to relieve you during meals and breaks - not just another nurse "watching" your patients. And these ratios are supposed to be floors, not ceilings - hospitals legally should staff up from that for high acuity patients. Both of those issues are not complied with as often as the basic numbers - a lot of hospitals try to fudge it in various ways and enforcement is uneven - it's always a work in progress.
  9. Chico David

    Any good funnies in medical transcriptions?

    I suspect you have that one right - I had no idea you folks used such sophisticated technology. I come from a bygone era and I sort of pictured earphones and a keyboard just typing it out - but it does make sense in today's world there would be technical aids for the volume of stuff that gets done.
  10. Chico David

    Magnet Hospitals

    I think you get the gist of most of the replies so far. magnet status is primarily three things: 1. A marketing tool for the hospital. 2. A money-maker for the agency that confers magnet status. 3. A way to distract nurses by giving them some of the trappings of power and influence through phony committees so they don't go seeking real power and influence through unionization. Some of us have taken to calling it "maggot status". I'd also add that, on average, the difference between for-profit and non-profit is probably greater - though even there, too many supposedly non-profit hospitals have taken to acting more and for like for-profits. See this item for an example: http://www.beyondchron.org/articles/New_Study_Finds_CPMC_Profits_Not_Matched_by_Charity_Care_9753.html
  11. We've all heard doctors dictating H&Ps, discharge summaries and the like. And we all know they rush and mumble. Add in the increasing number of foreign-born docs, and it's amazing that transcriptionists get it right as much as they do. That said, I've seen some pretty odd things crop up in charts lately. I'm hoping some of you can add to my list, but I'll throw out a few to start off. "frequent MSS" - I thought about that one a while - couldn't imagine what "MSS" stood for. But the context made it clear: emesis. Here's one I still don't know what the doctor actually dictated: among the findings of a study was "benign prostatic hypertrophy" - the study was an echocardiogram and the patient was female. Any ideas? My personal favorite: under social history: "the patient is a warrant here at Citrus School" That puzzled me for a while - but the doctor is from India and I mentally heard it in his voice and accent - he had said "volunteer"
  12. From the standpoint of policy and planning, we really are in a bind right now. On the one hand, we probably do have a long term structural shortage of nurses brought about by the retirement and aging of the Baby Boom generation. On the other hand, we have an acute over supply right now. It seems highly likely that the oversupply in the short run will discourage people from going into the field and worsen the shortage in the long run. It also seems apparant that the source of the article - AACN - is the organization for people in the business of educating nurses and they are desperately anxious not to cut their business by allowing people to understand how severe the current oversupply really is - their desire to talk up long term shortage is clearly in their own self-interest. The best answer is a real, broad based economic recovery as fast as possible, but with neither party having a real plan to promote that and one party doing all they can to prevent it, I can't see that happening any time soon. It's important to understand that the nursing glut is not quite the same as unemployment in other fields. In other lines of work there are actually fewer jobs. That's not the case in nursing - the number of nurses employed is about the same as before the recession. What has created the glut is people coming back into the nursing work force who were (or would like to be) out of it: Nurses who were working in another field and lost their jobs, Nurses who were being supported by a spouse and went back to work when the spouse lost their job, Nurses who were retired or on the point of retirement who were forced to delay retirement or come back to work because their retirement funds were decimated, Nurses who were working part-time who went to full time when a spouse lost their job.
  13. Chico David

    Are there many health educators in medical facilities

    The LCSW is one of those jobs that varies immensely depending on the setting. Some are primarily psyco-therapists in effect. Others do work that is very bureaucratic. The clinical social workers at our hospital actually have fascinating jobs, if very challenging. I kid them regularly that when I encounter a patient with a totally intractable set of life issues - homeless, no money, no insurance, needing expensive drugs to survive, or needing a stable situation to manage their illness and no hope of getting it, bizarre family issues: living with someone who has threatened to kill them, or the patient is threatening suicide themselves - for any of the above, my first thought is "I know, call the Social Worker!" They never get any easy ones. for the right person, this kind of challenge can actually be fun. But it's not for everybody.
  14. Chico David

    Obama calls morning-after pill call `common sense'

    Sudafed's a pretty silly example - the one and only reason you need an ID to purchase that is because it can be used as an ingredient in the making of methamphetamine. It's a drug enforcement issue, nothing to do with the safety of the medication.
  15. Chico David

    Nurse to Patient Ratio

    Wow! For some reason I had not looked at this thread before and am pretty blown away at what some nurses - and patients! - are enduring in many parts of the country. We know we are lucky in California to have legal ratios, but I had not fully grasped how much worse some places can be. I think it's worth throwing out a few things to think about: 1. Our ratio law and its implementation did not just happen - it took a long fight by a strong union that engaged thousands of nurses and pushed legislators to do that right thing. And it was not an easy push, by any means. 2. The ANA - the organization that many still (erroneously) think of as the voice for nursing has consistently fought against real ratio laws, working with the hospital industry to derail them everywhere. 3. Ratios don't just make our lives better, they save our patients lives - solid studies show that too many patients per nurse produces significantly more patient mortality. 4. Management will push us as far as we will put up with. When enough nurses stand together and say no, these staffing practices will change - and not until then. 5. Ratio laws have been introduced in legislatures in a number of states: Ohio, Illinois, Massachusetts, Texas, Florida, and probably more I don't know about. But we won't see those laws pass until enough nurses come together and take action to support them.
  16. Chico David

    Obama calls morning-after pill call `common sense'

    I'm afraid I have to think it was a fundamentally political decision - regardless of whether one agrees on the substance, I thing the President and his advisors pretty much envisioned the barrage of Republican attack ads about him encouraging teen sex by making birth control more available (as if teens need encouragement!) and decided this was the easier route to go. Just picture the sort of attack ads that would have been made. Maybe with African drum sounds in the background to remind everyone that he's a scary black man scheming to make all your babies have sex in 3rd grade. Just too much political downside. On the substance, I'm of slightly mixed minds about it, but I ultimately come down on the side of these facts: 1. This is the only OTC medicine, as far as I know, with an age limit. 2. Lots of OTC medicines have at least as much danger associated with them. 3. The FDA, based on the advice of its expert panels had decided to remove the age limit. 4. It is very nearly unprecedented for the FDA decision to be overruled like this. So, on balance I think it was the wrong decision for the wrong reasons, but I can understand the opposite point of view too.