Julia RN

Looking at it objectively- it is an interesting case. The staff's union, USW, contends that the employer, NYSNA, used the interval of time when the workers were trying to get their union recognized, to change their terms and conditions. The employer refusal voluntary recognition but entered into a quick mail ballot election with no notable anti-union campaign other than these changes. USW refers to this as a "novel type of interference" in their exceptions to the decision. Makes sense that an employer that is also a union would not want to engage in a typical anti-union campaign- so perhaps they found another way... A hearing at the NLRB seems to be the next step that will determine if the rights of these workers were violated. Something all unionists should pay attention to -IMO- if the facts are accurate, I wouldn't want an employer to be able to lawfully do this.

Searched on the NLRB and there's a link to the case: http://www.nlrb.gov/case/03-CA-027723 It seems the staff's union filed a Unfair Labor Practice charge against nysna. A judge issued a decision in favor of nysna for the larger part of the complaint but found nysna did commit a unfair labor practice (over cell phone use- it looks like). The staff's union- USW- filed an appeal and it looks like general counsel for the NLRB agrees with them that the judge was wrong in finding in favor of nysna on the larger part of the complaint- that nysna did commit a ULP when it threw out the staff's contract during an organizing campaign. Don't know what the next step in the process is but maybe if this gets settled a strike can be averted??

So they all joined CNA/NNOC- not that I think this is a bad thing. I do believe we are stronger together. This looks more like a new constitution for NNOC with an expanded leadership body, than a "new union". I don't see PSNAP listed as an affiliate on the NNU website yet, but they participated in the convention. I wonder if they will be considered "an affiliate" in their own right, or a "CNA/NNOC affiliate" under NNOC. http://www.nationalnursesunited.org/about/who-we-are.html Anyway, I wish my state was in it. Maybe someday....

Exciting news - congratulations! I see the UAN website no longer exists- does the UAN no longer exist?

The New York State Department of Health adpoted this as an emergency regulation on August 13- see: http://www.health.state.ny.us/diseases/communicable/influenza/seasonal/providers/health_care_personnel_influenza_immunization_requirements.htm The power to implement mandatory vaccination rests with the states, not the federal government and there are no religious exemptions in NYS for this rule (only a few specific medical exemptions). This is an emergency rule, good for 90 days and will expire on 11/10 but the state intends to mke it a permanent rule. This process will require a hearing. No hearing date is set as of now, so public comments are not being actively solicited. However, you can and should still write or call the commissioner of the NYSDOH with your concerns. The rule can be modified or reversed through the adoption of an additional emergency rule. Contact the Commissioner- Richard Daines, MD New York State Department of Health Corning Tower Empire State Plaza, Albany, NY 12237 518-474-2011 You should cc the governor : David A. Paterson State Capitol Albany, NY 12224 518-474-8390 And also be sure to cc the Office of Regulatory Reform (GORR) by email [email protected] Put the ID # of the Rule - I.D. No. HLT-35-09-00007-E in the subject line of the email

your topic is a great choice for your lobby day. if you are lobbying as part of a group or organization, you will likely be provided with the specific legislation or bill that they support. most of the state staffing ratio bills seek to set a maximum number of patients that an rn can be assigned to care for in a given unit, and require facilities to establish a staffing plan that meets those requirements. in addition, the plan must provide for adjustments of patient assignments based on factors like acuity, availability of support services, level of competency, etc. the adjustments would be to have less patients per nurse under certain conditions. the bill should provide that direct care nurses participate in formulating the staffing plan for the facility. some additional resources for you: http://www.nysna.org/advocacy/activity.htm a2264 would establish minimum nurse-to-patient ratios in all healthcare facilities. this bill was agreed upon by labor unions in new york state that represent registered nurses. memorandum of support http://www.massnurses.org/legislation-and-politics/safe-staffing http://www.protectmasspatients.org/ wish you success at lobbying and your chosen profession!

We also use a protest of assignment (POA) form in my union. The professional association cautions nurses who are not covered by the union that using the form may put their job at risk. Our form states that the nurse is notifying management that the assignment is unsafe. There is a place on the form where the nurse can indicate whether she is accepting or refusing the assignment. I have seen situations where the nurse has refused the assignment and still kept their job- but I wouldn't think this is possible without a union behind you. My contract provides the process that must be followed: -the nurse must notify management that they are protesting the unsafe assignment -management must respond either in person or by phone if unable to get to the unit -management must sign the form (then copies go to the union, administration, and the nurse keeps one) -POAs are reveiwed and discussed by the union and management -a nurse cannot be discouraged from filling one out or suffer any reprisal for doing so Ultimately, the nurse is responsible for the care they give, but my state board of nursing has put in writing that they will consider the circumstances if there is a practice issue that arises during the carrying out of such an assignment and the nurse had submitted a POA at the time. So, the POA does offer some protection here. It also helps management share in the responsibility for the given situation. In my state, inappropriate delegation of an assignment to an RN is considered misconduct by the BON. We also use the information from completed POA forms when negotiating for staffing and lobbying legislators for staffing ratios.

Congratulations to all who are members of these organizations! This opens up a new realm of possibilities- the opportunity to realize a dream of unity for staff nurses that we have all often spoken of. Now, all I have to do is get my state to see the light....

i think this is a really important discussion for everyone involved in the labor movement especially at this time. in the broad view, this is not just about two unions- it is about the importance of union democracy and what that means for workers. professor clyde summers, one of the authors of the landrum-griffin act or lmrda said, "workers gain no voice in the decisions of their working life if they have no voice in the decisions of the union which represents them." [color=#608686]union democracy, the basis of rank and file unionism, makes the union strong by ensuring the members are driving the direction of the union and are thereby encouraged to fully participate. it protects members' freedom of speech and gives them the ability to fight corruption in their union if that becomes neccessary. i have read the articles about this issue with interest and if seiu leadership is behind this deception they have sunk to a new low, imo. it is one thing to fight someone head-on, to say who you are and why you disagree. it is another thing to impersonate a member and imply that you are part of a dissident group within a competing organization. we would expect this kind of behavior from union busters, not from a labor union. union democracy and the rights of union members to speak freely are critical to the labor movement, and if these principles are being exploited in this manner, every rank and file unionist should be calling for andy stern's ( and anyone involved in this deception's) immediate resignation. this campaign crosses a sacred line, in my mind. the op's comments remind all of us about the needs of the membership- to understand, to have transparency and ongoing communication. the issues and structures are complicated and confusion can be exploited weaken to solidarity among us. i'd offer another resouce for objective info at: http://www.uniondemocracy.org/index.htm

If I may- No one here is saying anything like that. Many brothers and sisters risked life and limb struggling for democracy against corrupt union bosses rather than give up the right to have union representation. Their sacrafices helped toughen up laws and stengthened the labor movement. We honor their memory no matter who reminds us about their legacy.

educated union members know that the antidote for corruption in the labor movement is union democracy. lessons of our forefathers have taught us well. dedicated union activists know that "watchdog" is as an important part of their function as nurses do- (ask tdu-teamsters for a democratic union and ny nurses united -a new group or better yet check out: http://uniondemocracy.org/ ) democracy is never won without a struggle, whether in a union or in a nation, (for some of the reasons already citied- greed, power lust) but is well worth the fight. i'm thinking of the many examples in "utopian" literature- should we give up our freedoms because man is imperfect and corrupt? what kind of society would we be left with?

Agree with your analysis. Unfortunately, many union staff nurses (and their dues $) remain tied to ANA through mandated membership. I do think the "ratio fight", as well as the management influences of the AHA and AONE, have a lot to do with what has transpired on the national scene. Most of the founding states of this proposed new ANA union work in concert with these management organizations on their sham staffing legislation. This "new" national union will undoubtedly pursue organizing in the ANA states that do not have collective bargaining programs, especially states where the NNOC/CNA has become a presence. (NY, OH, WA, AZ and TX giving a joint presentation at a recent ANA meeting on the national labor environment was foretelling.) Their motivation is not to organize the unorganized, but to keep staff nurses out of those "other" unions. The UAN was badly damaged by the split, but is finally free of any affiliation with the ANA. As UAN states struggle to free themselves from the tryanny of ANA, their conviction to the struggles of the bedside nurse grows all the more stronger. That conviction will hopefully unite us all, and bring staff nurses together in a new way, to fight for real reforms in our practice and in our health care system.

I don't characterize the power of collective action as a "crutch". It's great that you are able to be a strong advocate for your patients. Could you agree that your voice would be even stronger, carry more weight, if all the nurses in the institution stood with you? Not all nurses have your ability. We all excel in different areas. When we come together as a union, we can help those nurses develop their voice- so that all patients benefit- not just those lucky enough to have strong advocates. We're in this together. I don't understand the benefit of the "you're on your own" approach in nursing.

Looks like a do-over. From The Pulse, the official publication of the Montana Nurses Association at http://nursingald.com/uploads/newsletters/MT122008.pdf Excerpt from executive director, Robert Allen, Address to the House of Delegates- October 2, 2008: "So what does the future hold?... The eight states who disaffiliated from the UAN have found some significant support in one another and, as the coalition continues talks, to keep each state informed of important issues, advances in advocacy, and through that, the dream of bringing forth a national entity which could unify the labor voice of the eight states and those who might follow.... I see Montana being a founding member of a new national union of federated states who share core values and a unified long term vision for nursing--a federation of states who take direction from the membership and who promote a strong ANA and strong CMAs." BTW- I'm a member of one of these "states" and this is the first I'm hearing of this plan... At one time, I believed it could be done, but experience has shown me that "ANA Union" is an oxymoron.

This ANA position is a revison to replace the 1995 statement. While any nurse can file an objection to an assignment, the consequences may be severe without union protection- was true in 1995 and still true today (and acknowledged by ANA). You can certainly use this process when you lack the education/experience needed for the assignment as well as when you are given too many patients or the acuity is too high for one nurse. What happens to the pt in the meantime? They stay safe- hopefully a supervisor finds a solution. I've seen managers stay and take assignments, elective procedures canceled, patients diverted- all things you would expect in an emergency. One of the key points, I believe, is treating this as a patient safety emergency.

I had posted about this previously in a different thread- https://allnurses.com/forums/f8/safe-staffing-saves-lives-ana-has-started-campaign-us-288904-20.html#post3164301 The 1995 document that this proposed revision would replace is attached there. I think it would be important to compare the two documents when making comments on the revision. The comparison is interesting, from a historical perspective as well as a nursing practice viewpoint. The Massachusetts Nurses Association was cited in the 1995 version: "In 1984, the American Nurses Association House of Delegates directed that ANA issue a position statement on mechanisms to support nurses' abilities to exercise their right to accept or reject an assignment. The position statement was to be based on a Massachusetts Nurses Association 1981 Resolution and later the Position Statement on Mechanisms to Support Nurses' Abilities to Accept or Reject an Assignment. This action was referred to the ANA Cabinet on Economic and General Welfare." That bit of history is left out of this draft- perhaps it is deemed no longer relevant as Mass. has since left ANA. The current version cites Texas as an example of having a process to address this issue- no mention of California's law- not surprising. ANA finds a way, even in this document, to decry staffing ratios- around line 81. Another change in the current version is in the role of the state nurses association. In the 1995 version: "SNAs are encouraged to develop an ADO form to document unexpected or inadequate staffing. SNAs also should develop appropriate follow-up measures for nurses to take after filing the ADO form in order to fully document the extent of the nurse's protest. An SNA that distributes an ADO form must be prepared to review and act on information from these forms. Data about quality issues and facts related to risk in patient care because of substitution of registered nurses by others or understaffing of registered nurses have been hard for the SNAs to compile. With the ADO forms the SNAs can gather the anecdotal information to report to the public as well as the proper authorities." That's been replaced or rather watered down with: "ANA’s Constituent Member Associations should establish a mechanism to assist nurses’ in expressing objections to unsafe patient assignments." Don't see much help for staff nurses in this document.

A quick look at the Oncology Nursing Society website did not offer much in the way of help with this issue. From what I see, they do not take a position on staffing ratios and their legislative advocacy program does not mention any staffing bills which they support. Hmm... the variations in staffing evident in the responses suggests to me that the professional specialty organization needs to take a look at the issue of staffing. You could still try to write to them- are you a member? Contact them here: http://www.ons.org/contact.shtml I see you are in NY. You might want to contact the New York State Nurses Associaiton. Here's a link to one of their position papers (2007) related to chemotherapy/oncology nursing- the contact number and email for the nursing practice dept is at the bottom of the page. http://www.nysna.org/practice/positions/position23.htm The staffing legislation that NYSNA supports has a 1:3 ratio in tele and 1:4 in med/surg. http://assembly.state.ny.us/leg/?bn=A06119&sh=t You say your fall rate is the highest in the hospital. That should be a red flag to your administration- they should be listening to you! Hope this is helpful. Let us know how you make out.

Glad to see this thread is still active- agree with the advice that we must keep the pressure on our reps to do what must be done. Safe staffing will save lives and healthcare $$ as well by improving quality and delivery of effective care. However, I advocate for different legislation than that proposed by ANA. I choose to support HR 2123- for REAL safe staffing. You can read about it on the American Association of Critical Care Nurses legislative action center and send a letter of support from here: http://www.aacn.org/WD/Practice/Content/PublicPolicy/legislativeactioncenter.pcms?menu=Practice#LEGISLATIVE I feel ANA does not go far enough (actually, not very far at all) to provide real strategies that staff nurses can use to face the challenges of their practice as it is today. As I read the experiences of nurses in this thread, their need for support is overwhelming. For what it's worth, ANA is asking for public comment on a position paper: Patient Safety: The Rights of Registered Nurses When Considering a Patient Assignment. This will replace a previous position paper which was called: The Right to Accept or Reject an Assignment. (the title change is notable in and of itself IMO) Let them know they need to do better by us as well- maybe someone over there will see the light! http://www.nursingworld.org/HomepageCategory/Announcements/PositionStatementCommentsPatientSafety.aspx I'm attaching the document that they are revising so you can compare them ANA right to reject assignment 1995.pdf

I think it's more than that- each way of negotiating has its advantages.

cheu looks to have about 2500 members- a lot less than the rn membership of cna. sorry- but at least for now, it looks like a different union only on paper- a division of cna created to represent workers other than rns. different staff might be assigned to the "healthcare workers", but they are employed by cna. cheu lists no employees, only unpaid officers and shows no assets of its own. wonder who retains the power to hire or fire the staff that services these members- cna or the officers of cheu? setting it up this way enables cna to negotiate with the employer separately for each group....interesting

Wanted to post an update- On Sept 8, 2008, ANA and a former president of the Michigan Nurses Association jointly filed a lawsuit against the Michigan Nurses Association. Apparently, ANA is attemptng to enforce its bylaws in court. After California left, a bylaw was passed by the ANA House of Delegates requiring a two-thirds vote of a state's entire membership (not just those that vote) before any state can leave ANA. Talk about holding members hostage- yikes!! No way you can even get one third of any state to even participate in a vote- it just doesn't happen. Wondering if CNA and Mass will show some support for these Michigan Nurses... Wondering how other ANA members feel about their dues being used this way... but then the vast majority don't even know, do they? ANA has reached a new low- IMO

So this I don't get... Being curious, I looked up CHEU. It doesn't look like an "affiliate". Rather, it looks like it is CNA- same address, all money goes to CNA for representation, no staff of its own, etc. (go to www.cheu.org and you land at CNA) So what gives? Does CNA really represent other healthcare workers besides RNs?

Noticed they do not mention New York or Michigan- and only a passing mention to Minnesota. Those state Nurses Association's unions are proposing ratio legislation with mandated minimum numbers that are upwardly adjustable for acuity and other factors. I do not have any experience with the various forms of the staffing committee/hospital association endorsed legislation which has been passed in a number of states, but can comment on my experiences with this issue in collective bargaining. I have participated in many labor/management staffing committees that were mandated by contract and found them to be minimally effective at improving staffing. The first problem is just getting the staff nurses to be able to attend the meetings as part of their workday. Many meetings are cancelled, because of- you guessed it- short staffing. These meetings never seem to be a priority when the staffing decisions are made. Management often expects the staff nurses to attend them on their own time and/or days off- now that's empowering! The accuracy of the information often becomes a focus of disagreement. Management says there were 6 nurses and the staff reports that there were five. By the time the information is sorted out- it doesn't matter anymore- the damage has been done. Management usually seeks a "range" or "staffing guidelines" type of agreement and will consistently staff to the lowest of number of nurses allowable- or violate the agreement altogether. Again, you can file a grievance and go all the way to arbitration- which may be heard 6 months to a year from when the "unsafe" conditions occurred. If you do succeed at getting numbers in a contract- even a range- just agreeing on numbers for the staffing can take up many negotiating sessions- I don't think a year is an unusual amount of time. But we still persist- because any improvement, no matter how small is still worth it. So unless the minimum numbers are spelled out in the legislation, the process, as this article points out will take a very long time. And in some states, including Washington, management can still get out of staffing according to the plan they agreed to. Seems like a big waste of time and effort in my opinion- and more importantly- a lot of time that unsafe conditions continue for nurses and the patients they care for. Legislation, must have the ratios spelled out, and be upwardly adjustable, in order to really address the issue of staffing. I've had my fill of stall tactics- and so have my patients- thanks AHA and ANA!

Another quote from the article: "Even in states with no staffing legislation in the works, Dodge urges hospitals to pay attention to the trend. She recommends that all hospitals start staffing plan committees with nurse input. "Staffing committees are a great opportunity for hospitals to engage their nurses. Get them involved in the process and the solution on individual units," Dodge says. "You'll make your nurses happy, remain competitive, be better able to recruit nurses. And a union is not likely to come knocking if your nurses are touting your hospital." Apparently, Dodge's law firm, Drinker Biddle, helps hospitals "avoid" unions- I know I am restating the obvious- but Dodge's interest as well as the AHA's interest in this issue is not improving quality or patient care- it's about avoiding staffing ratios and unions. Interesting that the "map" concerning staffing legislation is from the American Nurses Association- I recognized it from their website, and if you look really closely at the small print, you'll see it. ANA had to have given permission for the AHA to reprint this data for the article. Imagine that- ANA- the supposed champion of the staff nurse- a bona-fide "labor organization" itself- helping the AHA avoid ratios and unions. So what else is new?

This bill, H.R. 2123, has mandated minimum ratios and staffing by acuity. If adopted, every hospital would have to develop a staffing plan "on the basis of input from direct care registered nurses at the hospital." If the nurses are represented for collective bargaining, their union must have input as well. The staffing plan has to meet the minimum ratio set in the bill- for each shift, a direct care registered nurse may not be assigned to more than the number of patients specified for that unit. In addition, the staffing plan must provide for direct care registered nurse-to-patient ratios above the minimum based upon consideration of the following: (A) The number of patients and acuity level of patients as determined by the application of an acuity system on a shift-by-shift basis. (B) The anticipated admissions, discharges, and transfers of patients during each shift that impacts direct patient care. © Specialized experience required of direct care registered nurses on a particular unit. (D) Staffing levels and services provided by other health care personnel in meeting direct patient care needs not required by a direct care registered nurse. (E) The level of technology available that affects the delivery of direct patient care. (F) The level of familiarity with hospital practices, policies, and procedures by temporary agency direct care registered nurses used during a shift. (G) Obstacles to efficiency in the delivery of patient care presented by physical layout. The term acuity system is defined in the bill as an established measurement tool that-- (A) predicts nursing care requirements for individual patients based on severity of patient illness, need for specialized equipment and technology, intensity of nursing interventions required, and the complexity of clinical nursing judgment needed to design, implement, and evaluate the patient's nursing care plan; (B) details the amount of nursing care needed, both in number of nurses and in skill mix of nursing personnel required, on a daily basis, for each patient in a nursing department or unit; © takes into consideration the patient care services provided not only by registered nurses but also by direct care licensed practical nurses and other health care personnel; and (D) is stated in terms that can be readily used and understood by nurses.