Replacement-Nurse Company: Undermines Progress

Indy, LPN, LVN · Sep 10, 2006

I did look into what was being asked for, the company offered to reduce co-pays and make some changes to the plan to increase doctor participation. The union, turned it down.
But I think I kept my comments in this thread to the subject at hand: because they bleed managment, replacement workers are not only not, by definition, scabs: they are beneficial to strikers.
~faith,
Timothy.

I think there's room for debate here on the value of what the replacement nurses are "giving", versus what they are getting. What they get is money, and not much else. The striking nurse, prior to the strike, got to work in the community and not have to travel and be away from family and friends in order to work.

I think also that what is being "given" in this case is the care of another human being and it is priceless. Neither the local nurse nor the replacement nurse is being paid enough, ever. Charity and concern for the human condition were the emotional background and basis for the formation of our profession. As such it has run contrary, for the most part, to our desire to make a good living. We allow ourselves, collectively, to live less well in order to help our fellow human beings.

That's all nice and sweet, but you know what? Our fellow human beings don't recognize it, our bosses don't care and the only one who's got your back, in the end, is you, and possibly your family. I think there's nothing wrong with reminding a spoiled set of CEO's, and a rather spoiled american public, that if it were not for the excellent health care they receive now by understaffed, underpaid nurses, a whole lot of 'em would be looking the grim reaper in the eyes a heck of a lot earlier than they are prepared to.

Now, as to the details. I don't know the details. I live in a right to work state and haven't grown the balls to do much other than vent on a bulletin board. I don't want to be a travel nurse. I don't like the willingness of the hospital I work for, to employ agency nurses at the rate they do, when I'm working there for less. Would I go to another state to work a strike? Heck no, not under current conditions; my job is okay and there's no incentive to go there. What they pay won't make up for being away from my family.

My manager tried recently to "motivate" her nurses to "work harder," I guess, to get all the JCAHO stuff done for the mock surveys so that "we can pass this thing without a hitch." She says, "if we do this it will be a really wonderful accomplishment." Yes, I'm sure the hospital CEO thinks it will be a wonderful accomplishment. He told his department managers that "after all the money spent on passing this inspection, if we don't pass it's because we [the staff] don't care."

The above paragraph is off topic, sure, but I'm illustrating that the employer that for me is local, pays decently (I like my pay and I'm relatively new), and has half-decent benefits, still has an administration that acts like a donkey's behind and betrays their commitment to the almighty dollar more than to the patient when faced with something like a JCAHO inspection. I think the CEO forgot that it's his responsibility to spend some more of his salary staffing the hospital in such a way that the nurses will have the ability to do the dumbsh*t things that the surveyors demand, in the name of patient safety. Oh, but I forgot. They don't intend for such things to be done all the time, just when the surveyors come. So, they demand that the nurses work harder so the hospital can get paid the current amount.

Now did our brilliant CEO think for one second that it would be a good motivator to promise a raise if the survey goes off without a hitch? Oh heck no! So I'm to do a sh*tton more paperwork and annoy the snot out of my patients (name and birthdate please, even though you know I've seen you enough to know who you are... yes, I know you already answered me two hours ago... ), so that the hospital can do absolutely nothing more for me than they already do.

Sorry. My form of response to this has not been to organize, but simply to not do the extra work. If I have a slow night, which may be once a month, I may do some things that weren't doable on other nights. As it is, if all the physician orders are carried out, and all the patients doing well, and nobody's in pain or having some acute problem, and my charting is done, I'm satisfied. Most of the stuff you have to do to please JCAHO is centered around one point, in my opinion: the nurse is either too stupid or too understaffed to know what on earth he/she is doing from one minute to the next, and thus, is prone to all sorts of errors. Since the government doesn't value life enough to mandate safe staffing, they mandate instead that the hospitals who want their money pay people in suits to come around and insist that nurses act like wild-eyed three year olds with their memorized scripts, checking armbands 16 times a shift, and never letting a pill out of their sight for a second, and locking up things like normal saline from whatever boogeyman may want the saline. The hospitals could get a clue and staff well enough, but instead they talk down to the people that they need to get past this inspection: the nurses.

Sorry for the ramble. I am slowly talking myself into being some sort of activist here. I don't go for people who think it's ok to abuse others when under stress; and that's what I think our administration does. I am pretty sure each and every administration would take all the advantage they can of their employees, given the opportunity. As such, I think agency nurses who do choose to work a strike ought to be asking a lot more than $60/hour. If they couldn't afford their nurses they ought to not be in business; if you're gonna go work in that atmosphere then bleed 'em dry. Take your advantage, because rest assured, they have been taking advantage of others for a long time; given the opportunity, they will take advantage of the travel nurses. So if they are willing to pay $60/hour, ask for $100. See what happens.

Sorry for the ramble... wow I didn't know all that was going to come out.

caroladybelle, BSN, RN · Sep 11, 2006

Has anyone worked when these replacement nurses were imported in? How quickly did management get back to negotiating in good faith?

One thing to keep in mind, that some of the replacement nurses often have jobs/life issues, where they can take 1-4 weeks off to work a strike, or can commit to a few weeks, but not a long term strike. This means that there often is turnovers in staffing every week or two, with NO continuity in care.

Thus the administration, is forced to orient...and reorient...and orient again. This is expensive and a pain in the tuchis, and can lead to more focus on negotiating with the strikers.

(I know of a few staffers in some facilities that use their PTO time to work strikes....not something that I believe in, but to each their own...)

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As a traveler, with excellent references from some very good facilities, I can tell that it takes more temporary nurses to do the job of "local" nurses, and the work output is lower and poorer. I could be the most doggone intelligent chemo nurse in the nation (and I most certainly, am not), I still am going to be slower than the locals, because I do not have all the important phone numbers memorized, have no clue as to the best stick on duty, I don't know that Dr. X likes Y product for her central line placements, I haven't a clue about the idiosyncrasies of your "crack" pharmacy (which in my current top hospital assignment...is the absolutely, worst one that I have dealt with), that there are "standing" orders for Z antiemetic, I don't where the calculator is and I need, and every blooming shift I have to get three different new codes to work the three different pyxis/omnicells that are not interconnected. Which means every stinkin day, I have three silly pieces of paper that I have to keep with everthing else in my pockets, to dial in a code....to get out.....a spit basin.... if I can find it in all those shelves and cubbies, or figure out what it is listed under.

(you learn quickly brains don't mean Jack, when it takes you 10-15 minutes to get a basin from the omnicell for your vomiting patient).

After nurse managers have to deal with: What's the phone number, who is on IV team today, I've never put in an NG tube, and the complaints of.."It took that stupid nurse 15 minutes to get me a spit basin", they will want you to come back.

lindarn · Sep 12, 2006

One thing to keep in mind, that some of the replacement nurses often have jobs/life issues, where they can take 1-4 weeks off to work a strike, or can commit to a few weeks, but not a long term strike. This means that there often is turnovers in staffing every week or two, with NO continuity in care.
Thus the administration, is forced to orient...and reorient...and orient again. This is expensive and a pain in the tuchis, and can lead to more focus on negotiating with the strikers.
(I know of a few staffers in some facilities that use their PTO time to work strikes....not something that I believe in, but to each their own...)
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As a traveler, with excellent references from some very good facilities, I can tell that it takes more temporary nurses to do the job of "local" nurses, and the work output is lower and poorer. I could be the most doggone intelligent chemo nurse in the nation (and I most certainly, am not), I still am going to be slower than the locals, because I do not have all the important phone numbers memorized, have no clue as to the best stick on duty, I don't know that Dr. X likes Y product for her central line placements, I haven't a clue about the idiosyncrasies of your "crack" pharmacy (which in my current top hospital assignment...is the absolutely, worst one that I have dealt with), that there are "standing" orders for Z antiemetic, I don't where the calculator is and I need, and every blooming shift I have to get three different new codes to work the three different pyxis/omnicells that are not interconnected. Which means every stinkin day, I have three silly pieces of paper that I have to keep with everthing else in my pockets, to dial in a code....to get out.....a spit basin.... if I can find it in all those shelves and cubbies, or figure out what it is listed under.
(you learn quickly brains don't mean Jack, when it takes you 10-15 minutes to get a basin from the omnicell for your vomiting patient).
After nurse managers have to deal with: What's the phone number, who is on IV team today, I've never put in an NG tube, and the complaints of.."It took that stupid nurse 15 minutes to get me a spit basin", they will want you to come back.

I think that many of you are missing the point that the hospital is making. Their concern is more of control over health care, and the nurses as employees, rather than the strike. They don't care how much more it costs them to hire replacement nurses. They have insurance to cover the cost of hiring replacement workers, and losses from employee strikes. Their main goal and issue, is CONTROL OVER THE NURSES. Even if they ultimately settle, and the nurses get the contract that they want, the hospital has proven that they still control the hospital and the nursing staff. They have exerted dominance over the 'lower class". These are not my feelings, but what I truly think is the game that is being played out all over the country. JMHO, and my NY $0.02.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Hospitals live in fear, of nurses finally connecting the dots, coming together, and AS A BLOCK, fight the forces that are being exerted in hospitals all over the country, and take control of their own profession, and health care.

The lose sleep at night worrying about nurses taking control over hospitals, and health care in general. Can you imagine 200, 000 pissed off nurses taking over? I can.

caroladybelle, BSN, RN · Sep 21, 2006

I think that many of you are missing the point that the hospital is making. Their concern is more of control over health care, and the nurses as employees, rather than the strike. They don't care how much more it costs them to hire replacement nurses. They have insurance to cover the cost of hiring replacement workers, and losses from employee strikes. Their main goal and issue, is CONTROL OVER THE NURSES. Even if they ultimately settle, and the nurses get the contract that they want, the hospital has proven that they still control the hospital and the nursing staff.

And you obviously miss the point that is being made .....by nurses. Both "scabs" and picketing staff members.

Nurses are not interchangeable. They are not one size fits all. You cannot just take one off the street, plug him/her into a position, pay them scab wages, and get the same quality of work that your vested longterm employees give you.

The POB may try to do so...but patients/MDs/middle management WILL notice the difference and complain loudly.

MDs, employees and patients are customers. If MDs cannot get the tests they need or there are undue delays in treatment, because the rent-a-nurse couldn't the right equipment to the patient, transfer them to the right place or they take too long, they will complain and take their business elsewhere. If patients get lousy care during a strike, because rent-a-nurse, couldn't find things, didn't know how to get things....the patients will complain to the facility, their friends, the news, the MDs and/or insurance carriers. If tests/treatment get delayed, because the rent-a-nurse is being oriented (or the fourth or fifth one), insurance will not pay for that delay. And if middle management has to spend all their time being tortured by rent-a-nurses asking a million questions, patients and MDs upset about delays and problems, their lives will be miserable and they will put pressure to bear.

Financial costs are only a small part of the damage of a strike. The longterm damage will last longer.