union nurse vs nonunion non-nurse

Chico David, BSN, RN · Apr 21, 2008

There are layers that are a bit hard to figure here, so I'm having to make assumptions.

I'll assume that the reason nurses are doing the job now is that you are analysing medical info and it requires your knowledge background to do it properly.

Depending on your contract, the fact that there is a past practice of having this be a nurse job may give some leverage for a grievance against hiring a non-nurse for the job.

In our union, we'd probably file the grievance to preserve the right to while we were deciding whether or not to proceed with it - you can always withdraw a grievance, but there are time limits on filing them.

if there are several nurses with similar job - it sounds like that's the case? - then consider a campaign via petition, asking for meeting with your manager, etc.

There is almost certainly no legal barrier to this, since you aren't performing actual patient care activities, it's your nursing knowledge that's needed, not your nursing license. So likely no regulatory angle to pursue.

In all your actions, important to de-personalize: not against an individual, but for a principle.

In general, outright refusal to orient the person is a bad idea. Once you venture into the area of insubordination, you can create a situation that's hard to defend. I never advise nurses to outright refuse something, unless there is real danger to a patient. Better to do it while documenting the reasons you believe it is wrong.

ponds · Apr 21, 2008

Thank you, Analyses of the job shows the data percentage is a lot higher if done by a nurse. We have all RN's except 1 employee in a different building. She does abstract but not the same data base as we do. Our manager is very new to this position. She worked for 2 months before becoming a manager. The job posting use to require a RN. This past one did not. As our manager has been in her new role I assume she has taken the RN lable off in order to cut costs.

As soon as the posting went up our Rep from our area meet with the hospital along with all attorneys. They we allowed to hire a non nurse but it was understood that the new person would work and orientate with a person close to her level. We meet again with human resources ect on thurs.

I was by the rep that we are not required to train her nor is the new person allowed to work on our data bases. We do have a nurse on leave that looks as if she may not return. I was told they must replace with a nurse. Is this true?

We do data abstraction for mandatory data bases required by CMS.

I am just unsure about what is right and when to file a grievance. We are put in a tricky spot right now. Also there is concern they might take us out of the union if the job does not require a nurse. some of the data bases require a nurse but not all. I myself was off on workcomp injury when the data abstracting job posting came up and I applied. Most of us have had injuries but we all applied and got through the normal process.

So I am saying most of us are not able to go back to work on the floor. Thanks for all the info you have given.

RN Power Ohio · Apr 22, 2008

What is the data used for? Is this person a qualified researcher but missing a medical background?

I would think that if the data is to be applied to patient care that an RN should be collecting it. To be sure the data is accurate.

ponds · Apr 23, 2008

She is not an abstractor. The data is required for medcaid/medicare reimbursement. Every quarter 5 charts are checked for validation to make sure they are abstracted correctly. Average must be greater than 80 percent a year or it affects the reimbursement. It is required by all acute care hospitals but not critical access hospitals yet. The data is compared nationally and many core measure questions are publicly reported on hospital compare website.

CMS gives you a list and you choose which database you want to collect. They might give a list of 10-15 and you need to collect for 1 or 2 of them.

For example surgery. They collect for antibiotic to be given within an hour of incision. For this you need to have all elements of correct ABX for surgery, date, route, and military time. If any of these are not complete you fail the measure. Getting anesthsia to document IV has been difficult.

This is an example of 1 of the measures. They are many. It is very surprising how the insurance companies and CMS dictate everything you do.

Then quarterly we present the data amd explain why they fail. It is actually a very intersting job. The definitions change or add every 6 months. 1 data base of definitions to abstract is over 300 pages not counting all the appendix's. Sorry if I explained too much.

This is why it would be so difficult to train a lay person. They would not realize the impact and accuracy the core measure elements are. Thanks for listening