the union, which represents 1,500 nurses and other workers at the north philadelphia hospital, is threatening to hold a three-day strike starting oct. 2 if a new contract is not reached by the time the current agreement expires sept. 30
we have worked many hours at the bargaining table, but the hospital seems intent on ignoring the needs of patients and the dedicated staff here at temple," said maureen may, president of the nurses' union. "nobody wants a strike, but we are concerned about the future of patient care and the retention of professional staff."
union officials said the health system wants to increase employee health-care costs and forgo its promise to cover dependents' tuition at temple university. pasnap officials said staffing levels also remain a "serious concern."...
...temple said its nurses are paid "among the highest rates" in the delaware valley, making an average hourly rate of $39.80."
it proposal for the next three years is for no increase in the first year, followed by 2 percent increases in each of the following two years. for allied health professionals, the offer is no increase this year, following by 2 percent increases in the second and third years and 2.5 percent in the fourth....
Specializes in Critical care, tele, Medical-Surgical.
the first two studies are attached. the others are easy to find.
up to 20,000 preventable patient deaths each year can be linked to low rn staffing. for each additional patient assigned to an rn, the likelihood of death within 30 days increased by seven percent. four additional patients increased the risk of death by 31 percent. -- journal of the american medical association, october 22, 2002
[color=#191919][color=#191919]if all hospitals increased rn staffing to match the top 25% best staffed hospitals, more than 6,700 in-hospital patient deaths, and, overall 60,000 adverse outcomes could be avoided. the findings do not include the ancillary value to families of reduced morbidity, such as decreased pain and suffering and days lost from work, and huge economic savings for the hospitals-health affairs, january/february 2006
cutting rn-to-patient ratios to 1:4 nationally could save as many as 72,000 lives annually, and is less costly than many other basic safety interventions common in hospitals, including clot-busting medications for heart attack and pap tests for cervical cancer.-medical care, journal of the american public health association, august 2005
[color=#191919][color=#191919]patients cared for in hospitals with higher rn staffing levels were 68% less likely to acquire a preventable infection, a[color=#191919][color=#191919]ccording to a review of outcome data of 15,000 patients in 51 u.s. hospitals-medical care, june 2007.
[color=#191919][color=#191919]improved rn staffing ratios are associated with a reduction in hospital-related mortality, failure to rescue, and lengths of stay. every additional patient assigned to an rn is associated with a 7% increase in the risk of hospital acquired pneumonia, a 53% increase in respiratory failure, and a 17% increase in medical complications-agency for healthcare research and quality, may 2007.
[color=#191919][color=#191919]patients hospitalized for heart attacks, congestive heart failure, and pneumonia are more likely to receive high quality care in hospitals with better rn staffing ratios-archives of internal medicine, december 11/25, 2006.
[color=#191919][color=#191919]if all hospitals increased rn staffing to match the top 25% best staffed hospitals, more than 6,700 in-hospital patient deaths, and, overall 60,000 adverse outcomes could be avoided. the findings do not include the ancillary value to families of reduced morbidity, such as decreased pain and suffering and days lost from work, and huge economic savings for the hospitals-health affairs, january/february 2006.
[color=#191919][color=#191919]cancer surgery patients are safer in hospitals with better rn-to-patient ratios. a study of 1,300 texas patients undergoing a common surgery for bladder cancer documented a cut in patient mortality rates of more than 50%.
[color=#191919][color=#191919]hospitals with low volume on cancer procedures can match standards of high volume urban medical centers just by increasing their rn ratios-cancer, journal of the american cancer society, september 2005.
[color=#191919][color=#191919]cutting rn-to-patient ratios to 1:4 nationally could save as many as 72,000 lives annually, and is less costly than many other basic safety interventions common in hospitals, including clot-busting medications for heart attacks and pap tests for cervical cancer-medical care, journal of the american public health association, august 2005.
[color=#191919][color=#191919]chances of a hospital patient surviving cardiac arrest are lower during the night shift because staffing is usually lower at night, even though cardiac arrest occurs at all times of day or night-according to a report on 17,991 cardiac cases from 250 hospitals-annual meeting, american heart association, november 2003.
[color=#191919][color=#191919]the institutes of medicine of the national academy of sciences reports that "nurse staffing levels affect patient outcomes and safety." insufficient monitoring of patients, caused by poor working conditions and the assignment of too few rns, increases the likelihood of patient deaths and injuries-iom, november 4, 2003.
[color=#191919][color=#191919]inadequate staffing precipitated one-fourth of all sentinel events-unexpected occurrences that led to patient deaths, injuries, or permanent loss of function-reported to jcaho, the joint commission on accreditation of hospital organizations, from 1997 to 2002-jcaho, august 7, 2002.
[color=#191919][color=#191919]improved rn-to-patient ratios reduce rates of pneumonia, urinary infections, shock, cardiac arrest, gastrointestinal bleeding, and other adverse outcomes-new england journal of medicine, may 30, 2002.
nurses from units with low staffing and poor organizational climates were generally twice as likely as nurses on well-staffed and better-organized units to report risk factors, needlestick injuries, and near misses. -- american journal of public health (july 2002, vol 92, no. 7 ) sean p. clarke, phd, rn, douglas m. sloane, phd, and linda h. aiken, phd, rn
hospitals seeking to improve safety outcomes should put a premium on adequate nurse staffing.--quality safe health care 2006; more nursing, fewer deaths, s p clarke, l h aiken
[color=#333333][color=#333333]in a canadian study, tourangeau et al found that hospitals with a higher registered nurse staff mix had significantly lower mortality rates. specifically, they found the mean risk adjusted 30 day mortality rate for acute medical patients was 15% but that a 10% increase in registered nurse staff mix caring for acute medical patients was associated with five fewer deaths in 1000 discharged patients -- nursing-related determinants of 30-day mortality for hospitalized patients. canadian journal nursing res 2002, tourangeau ae, giovannetti p, tu jv, et al.
I don't need to be convinced that better staffing ratios lead to better outcomes. What I am wondering is what specifically the Temple nurses are asking for in relationship to better staffing. I haven't seen anything specific.
Cabanaboy , I beleive PASNAP is affiliated to NNU , so the probability is the staffing ratio they desire would be those that California has in law .which can be seen on this link :-
I believe , from what has ben posted / links , the offer to withdraw the gag order clause , was dependant upon the nurses accepting the rest of Temples offer .
As I have heard many administrators say re. their pay you only get what you pay for , ie. if you pay well you'll get a good administrator , same goe in nursing , so although 90% may accept something doesn't mean its right .
Re. the tuition , surely as a recent / present student , don't you think if you had this bensfit you would not want to lose it ( I am sure it is the reason a number of employees choose to work at Temple ). It is not something the hospital owes the employees it is the fulfilment of an obligation the made their staff .
use the above link for a table with th proposed ratios in the pasnap supported bill.
minimum staffing requirements of pennsylvania's safe staffing act
the ratios shown in the box are the minimums that each hospital must follow in its staffing plan and must be adjusted upwards to reflect actual patient acuity.
click here for text of current bill, currently in the pennsylvania's house of representatives health and human services committee. ...
Cabanaboy , I beleive PASNAP is affiliated to NNU , so the probability is the staffing ratio they desire would be those that California has in law .which can be seen on this link :-
I believe , from what has ben posted / links , the offer to withdraw the gag order clause , was dependant upon the nurses accepting the rest of Temples offer .
As I have heard many administrators say re. their pay you only get what you pay for , ie. if you pay well you'll get a good administrator , same goe in nursing , so although 90% may accept something doesn't mean its right .
Re. the tuition , surely as a recent / present student , don't you think if you had this bensfit you would not want to lose it ( I am sure it is the reason a number of employees choose to work at Temple ). It is not something the hospital owes the employees it is the fulfilment of an obligation the made their staff .
Of course I would want tuition bennies for myself and children. That sure would be a nice perk, but not something I would expect or hold against my employer if they decided not to do it when almost no other employer does. And they did live up to their obligation. The issue is about the contract going forward.
You said, "As I have heard many administrators say re. their pay you only get what you pay for , ie. if you pay well you'll get a good administrator , same goe in nursing , so although 90% may accept something doesn't mean its right ."
We don't have nursing unions here, and I can say that 98% of the nurses I have worked with as a sstudent are downright awesome! Although I'm not a RN yet, my research suggests that I will make a very fair wage.
One place where I do run into union employees often is the grocery store. I stopped going to one chain because their highly paid checkers don't bother to stop their converstion amongst themselves to acknowledge your business or even say thank-you. In big part because they know how hard it is for them to be fired. Better pay doesn't always equal better employees.
use the above link for a table with th proposed ratios in the pasnap supported bill.
minimum staffing requirements of pennsylvania's safe staffing act
the ratios shown in the box are the minimums that each hospital must follow in its staffing plan and must be adjusted upwards to reflect actual patient acuity.
click here for text of current bill, currently in the pennsylvania's house of representatives health and human services committee. ...
thanks for that info. where i'm at, these proposed ratios seem to be about what the hospitals i have been in seem to have. med/surg sometimes has 5 patients. i believe most hospitals have looked at the research you included above and know what staffing is needed for best patient outcomes and thus less expense.
what are the ratios at temple? since the union is pretty vague about that when they are so vocal about other less important issues, i am guessing that their ratios probably aren't too much different. anyone know?
earlier i said with a union with whatever gain you make you are going to lose somewhere else. after contemplating it for about 7 seconds, the problem i see with this proposed legislation is that it doesn't address cna staffing. if a mandatory nursing ratio is implemented, you will have less cna's. personally, i would rather have 5 patients and enough cna's to handle the cna stuff than 4 patients and do it all by myself!
of course i would want tuition bennies for myself and children. that sure would be a nice perk, but not something i would expect or hold against my employer if they decided not to do it when almost no other employer does. and they did live up to their obligation. the issue is about the contract going forward.
they did live up to there obligation , but because they renaged upon that agreement and flouted a legal decision to reinstate their obligation , the industrial action came about .it's very convenient to look forward and miss seeing the crash behind you ( methinks you will be a good administrator one day and may have ben in the past )
you said, "as i have heard many administrators say re. their pay you only get what you pay for , ie. if you pay well you'll get a good administrator , same goe in nursing , so although 90% may accept something doesn't mean its right ."
we don't have nursing unions here, and i can say that 98% of the nurses i have worked with as a sstudent are downright awesome! although i'm not a rn yet, my research suggests that i will make a very fair wage.
one place where i do run into union employees often is the grocery store. i stopped going to one chain because their highly paid checkers don't bother to stop their converstion amongst themselves to acknowledge your business or even say thank-you. in big part because they know how hard it is for them to be fired. better pay doesn't always equal better employees.
it is poor management that cannot fire a poor employee , unions can only make an employer follow their policies and applicable law . if the management has complied with its own policies and the applicable law the union cannot stop an employee from being fired .
staffing on-med/surg 1:7,ICU1:3 and one pt could be fresh open heart(doesn't happen all the time, but frequently has been the case). most of our pt when admitted have multi system problems, so we usually have more than 1 disease process going on. we do occassionally have a cna covering the whole unit .(20-30pt),often being pulled to other units to cover the 1:1.(pts that are AA andO,but require close observation). Not sure what the pt.acuity will be at the institution you will be employed at when you have to walk the walk, but in our institution acuity levels are high. Gone are the days where the insurance pays for a hospital admission for Mrs.X to get a rest.Insurance will not pay for Mr.Z to be admitted to the hospital the day before surgery to get pre-admission testing done. We love our cna's and believe they are a valuable part of the team, however they can only practice within their knowledge base. In the real world of being a REGISTERED NURSE, it is the RN that is responsible for the pt. I would really encourage you to ask your wife or another nurse what are the capibilities of a cna vs the obligations of a RN. The only way for a nurse to develope a nurse/pt relationship is to spend time with the pt.Cabana boy, cna's cannot and should not be doing YOUR job. ie. pt. assessments anywhere from once a shift to as frequently as every 30 minutes. IV site assessments, medication administration and effectiveness or lack there of, explanation of procedures that were not fully comprehended when explained by M.D., admission and/or discharge instructions, bedside rounds ,comforting a family member who just lost a loved one. The list goes on and on......The RN has many responsibilities in the course of her shift,knowing what duties he/she can deligate to cna is only one, but a very important one.
staffing on-med/surg 1:7,ICU1:3 and one pt could be fresh open heart(doesn't happen all the time, but frequently has been the case). most of our pt when admitted have multi system problems, so we usually have more than 1 disease process going on. we do occassionally have a cna covering the whole unit .(20-30pt),often being pulled to other units to cover the 1:1.(pts that are AA andO,but require close observation). Not sure what the pt.acuity will be at the institution you will be employed at when you have to walk the walk, but in our institution acuity levels are high. Gone are the days where the insurance pays for a hospital admission for Mrs.X to get a rest.Insurance will not pay for Mr.Z to be admitted to the hospital the day before surgery to get pre-admission testing done. We love our cna's and believe they are a valuable part of the team, however they can only practice within their knowledge base. In the real world of being a REGISTERED NURSE, it is the RN that is responsible for the pt. I would really encourage you to ask your wife or another nurse what are the capibilities of a cna vs the obligations of a RN. The only way for a nurse to develope a nurse/pt relationship is to spend time with the pt.Cabana boy, cna's cannot and should not be doing YOUR job. ie. pt. assessments anywhere from once a shift to as frequently as every 30 minutes. IV site assessments, medication administration and effectiveness or lack there of, explanation of procedures that were not fully comprehended when explained by M.D., admission and/or discharge instructions, bedside rounds ,comforting a family member who just lost a loved one. The list goes on and on......The RN has many responsibilities in the course of her shift,knowing what duties he/she can deligate to cna is only one, but a very important one.
I'll ignore the personal tone in your responses, RNICUME.
Maybe I worded my thoughts wrong, because you misunderstood what I was saying about CNA's. I'm well aware they can't do the job of RN's. However, RN's can do the jobs of CNA's. And if an institution has to hire more RN's, and each RN takes care of fewer patients, what is to keep them from deciding not to use as many CNA's? You will have fewer patients, but potentially you will be doing more work with each of them. I don't know that will happen, it just seems like a likely possibility.
I will agree, it does sound like your staffing is not right. Are those maximum allowed or typical patient to nurse ratios? And your message is lost when you go on strike because you are for better patient safety. You reps have been saying the patients are in danger with the replacement workers. At the least, the striking workers bear some of that responsibility.
Anyway, the bigger point I have been trying to make with all of this is that you don't need unions to get the right policies into place. Good hospitals understand what it takes to operate a successful business. A healthy administration to staff relationship, correct patient to nurse ratios, and having satisfied employees are all part of that. Unions make you believe that you need them in order for those things to happen, and that the administration is your enemy.
If you don't want to respect my opinion as a nurse, fine. It would probably be good for you to respect me as a member of the public, however. I can gurantee you there are many out there who share the same thoughts I do. You don't have to agree with it, but you should probably respect it.
I've only been following this story for a day, so I wasn't aware of any renegging on a past agreement. Maybe I will be a good administrator someday. Is that bad? You make it sound like it is. You further make my point that unions foster a bad relationship between administration and employees.
cabana boy no hard feelings at all. i do wish you all the luck in the world with your becoming a nurse. i do respect your opinion and i know without a doubt there are alot of people who share the same opinion you do. i do find that most people that express your opinion tend not to be in the nursing profession. i am not saying that all nurses believe in unions. as always there are 3 sides to every story,and everyone is entitled to their opinion.( freedom of speech) .glad to have had this discussion with you and hopefully will have more. there's always topics in nursing open for debate:)
Firstly as the previous poster said in these threads there is back and forth , sometimes as we are not gifted writers comments appear harsher than was their writters intent , we all enjoy participaring in these threads and while we may disagree with a differing opinion , It is great to have this forum .
"Anyway, the bigger point I have been trying to make with all of this is that you don't need unions to get the right policies into place. Good hospitals understand what it takes to operate a successful business. A healthy administration to staff relationship, correct patient to nurse ratios, and having satisfied employees are all part of that. Unions make you believe that you need them in order for those things to happen, and that the administration is your enemy."Cabanaboy quote .
While it is true you don't need a union in all places to get the right policies etc.in place , you do need one where you have management who do not respond to patient and labor needs . In the situation where management runs the facility like a feudal manor an opening is made for a union to get in , the relationships in that situation are already adverserial , the union will and can only enforce the contract and applicable law , it is usually when management transgresses from that , that relationships deteriorate to both camps being in conflict .
Simply to clarify re . renegging . The contract between Temple and PASNAP had a clause that gave tuition to staff and their famillies , Temple took this away , that to me is renegging upon a contract .
As to you being a good future administrator ,if you reach that position I hope you will care more for how bedside nurses view their employer , than what the bottom line is ( unfortunately too many administrators care for the bottom line and nothing else ) , if you do I wish you good luck and the nurses under you will be lucky to have you .
herring_RN, ASN, BSN
3,651 Posts
the first two studies are attached. the others are easy to find.