Sunday, October 30, 2011

When it snows in October!

I woke Sunday morning to no power. Seems like we just got over hurricane Irene with it's 7 day outage. Now, a snowstorm in October?
Unusual weather for unusual times.
If you had asked a year ago if we'd have a hurricane knocking out power for a week or a snowstorm in October, most would have laughed. Similarly, had you asked if Backus nurses would be sitting at the negotiations table, most would have laughed.

“Some men see things as they are and say why. I dream things that never were and say why not.” -Robert Francis Kennedy

We started a year ago, talking in small groups. In May we formed a local. Now we sit at the negotiations table.
How did it happen?
We dreamed things that never were and said why not.
Why not a hospital that puts patients before profits?
Why not a hospital that treats patients and employees with respect?
Why not a hospital that engages patients, employees, and the community in decision making?
We asked "why not?" and then set out to answer the question.
The road ahead is not smooth, change will not come easy or fast, but it will come.
It will come because we have the strength, courage and will to ask why not.
It took 118 years of Backus history for this to happen. I'm sure some thought it would only happen when pigs flew or when hell froze over. Maybe some even said, "when we have snowstorms in October."

Thursday, October 27, 2011

Sometimes, we do make a difference

The other day, after yet another frustrating shift, I gave blood at a bloodmobile at the hospital.
After donating I sat in the canteen to have a drink before driving home and the volunteer asked me if I worked in the ER. She said "I was in on Sunday with my husband, he had a heart attack." Not knowing how he had made out I wasn't sure how to respond. Then she said, "You were all so kind and did such a great job, he ended up going to Yale and getting 3 stents, he came home Tuesday."
A breath of relief from me. I thanked her and we talked about it.
I think I remember the case. It wasn't too busy at the time and we had enough help to provide the resources needed at the moment. This is when we are at our best in the ED.
We see enough chest pain to be well practiced. If we have enough staff available it is like a symphony. Techs, medics, nurses, doctors, xray,registration, unit coordinator, all working simultaneously in harmony.
In 15 minutes we can have the patient undressed, on the monitor and oxygen, aspirin and nitro given, chest xray done, 2 IV lines, blood to the lab, a troponin done in the ED (a cardiac specific blood test), history and medications entered into the record, a STEMI kit with life saving meds started if appropriate and Life Star ready to fly. During this time someone will be comforting explaining to the patient and family.
This is what happens when you have the needed resources, experience, and practice.
Truly it is the ED at it's best.
It is why we come back day after day and put up with the abuse we do, because sometimes, what we do really makes a difference.
At times like this I am proud of what I do and proud of my coworkers.

Sunday, October 23, 2011

Rabies and Afib (study shows no link)

Not long ago I wrote a blog about a patient who came in in rapid Afib, a rapid irregular heart rhythm.
Lisa Currier, sent me the following email.
"Rabid Afib- a rapid, irregular heart rhythm characterized by foaming at the mouth".
You see, I had written "rabid" not rapid.
I've admitted before that spelling is not a strong point for me. In nursing school my advisor said I was going to be a good nurse but that if my spelling didn't improve I wouldn't get the credit I deserve because people would look at my charting and go????????
Computerized charting, with it's many check off boxes has helped. Spell check has been a godsend. However, "rabid", being a legitimate word, isn't picked up by spell check.
I want to thank Lisa for pointing out my error. It allowed me to go back and correct my mistake and also showed me someone was paying attention to what I type. I'm glad that I have friends like Lisa who are comfortable enough to kid me about my mistakes. What God didn't give me in spelling ability He made up for in the ability to laugh at myself.
Also, and very importantly, I want to assure you that we have seen no increase in the number of cardiac patients presenting with rabies. The last thing we need is a bunch of worried people showing up with palpitations and looking for rabies vaccine.

Thursday, October 20, 2011

Nursing shortage

For a moment I'd like to share some thoughts on the nursing shortage. There are many reasons that have been studied, the aging workforce of baby boomers beginning to retire, more opertunities for women in the work force than previous generations, a shortage of educators. These and others have been studied exhaustively.
What I'd like to address is something that I believe has not been given enough attention. Perhaps nowhere is the shortage as severe as at the bedside.
Because bedside nursing is hard!
Bedside nurses work under extreme stress, physical and emotional, hour after hour, day after day, without lunch breaks, without bathroom breaks, with little control over their practice. They are subjected to abuse from patients, families, and doctors, and administration. It's no wonder so many leave the bedside for other work. Because of their unique skill set they are recruited to management, teaching, consulting and more.
They are encouraged to further their education to higher degrees, a worthy goal, but then they are taken away from the bed side. A nurse enters the profession, works their tail off, continues their schooling, and is rewarded with a job that takes them away from the patients, with increased pay, time for lunch and bathroom, better parking and other perks, control over other nurse's practice, ect.
One big problem,
who's going to take care of the patients?
What can be done?
First, we must elevate the status of the bedside nurse. There is a similar thing happening with doctors. There are so many advantages to being a specialist that we lack primary care. The bedside nurse and the primary care physician should considered the top of their professions.
The bedside nurse should be the highest paid, they should have control over their practice, they should get any perks, they should be staffed to allow breaks.
Crazy ideas?
What's crazy is our treatment of the bedside nurse. If we do not change our way of thinking and acting there will be no one left to do the actual work of caring for the patients.

Tuesday, October 18, 2011

Occupy Wall Street

The Tea Party movement, the Arab Spring, the Wisconsin state capital, Occupy Wall Street, they all have something in common.  They are all populist movements.  In all of them the common man and woman is speaking out, no shouting out, I'm mad as hell and I'm not going to take it anymore!
The worldwide economic downturn has magnified a problem that has long been there.  It's like autumn leaves, that when stressed by cooler nights and shorter days, lose the chlorophyll that makes them green and allows the underlying colors that have been there all summer long to show through.
There is a wide gap between the haves and the have nots. The 1% and the 99%.
This spring the people of northern Africa and the Middle East said ENOUGH! 
The people of Wisconsin and Ohio said ENOUGH!
Even the nurses of Backus Hospital said ENOUGH! 
Enough to the CEOs getting 28% salary increases while we had pay and benefits slashed, our LPNs dismissed,  and our patients diverted to other hospitals, held over 24 hours in the ED and PACU due to poor staffing, and their peanut butter taken away.
AFL-CIO president Rich Trumka states it this way: 
"Occupy Wall Street has captured the imagination and passion of millions of Americans who have lost hope that our nation's policymakers are speaking for them. We support the protesters in their determination to hold Wall Street accountable and create good jobs.    We are proud that today on Wall Street, bus drivers, painters, nurses and utility workers are joining students and homeowners, the unemployed and the underemployed to call for fundamental change.  Across America, working people are turning out with their friends and neighbors in parks, congregations and union halls to express their frustration – and anger -- about our country's staggering wealth gap, the lack of work for people who want to work and the corrupting of our politics by business and financial elites.  The people who do the work to keep our great country running are being robbed not only of income, but of a voice.  It is time for all of us—the 99 percent—to be heard. 
We will open our union halls and community centers as well as our arms and our hearts to those with the courage to stand up and demand a better America."

AFT president Randi Weingarten said:
"All over this country, there are young people who have done everything that was asked of them—they went to school, worked hard and prepared to meet their responsibilities as they pursue their dreams.
We need to listen to what the individuals camped out in Liberty Plaza for Occupy Wall Street—and those marching in the streets from Boston to Denver to Los Angeles—have to say. And then we need to get serious as a nation about working together to create economic opportunities for all Americans, including young people, so we can get our country back on the right track."

I stand with the Occupy Wall St movement.  It has a vitality that the working man and women have been waiting for.  The movement has been said to be lacking leadership, I disagree.  It is a new form of leadership, a leadership that says I'm here in the trenches with you brother and sister.  Movements like we see in Wisconsin, Ohio, Norwich, New York, and across our country have shown what is possible when working men and women come together and say ENOUGH!
In the halls of Backus  and in the streets of New York we strive for the same goals, a voice for the 99% of Americans who work hard each day to make this country great.

Be proud of what you have accomplished so far, you are the Backus Federation of Nurses!
You stand up together, proudly advocating for yourself, your patients, your families, and your community.  And you are not alone, you are part of the 99%.

I urge you to use the voice you now have.  Get involved in your union.  Come to meetings whenever you can. Talk to the leadership and liaisons about your concerns.  Register and vote in the upcoming elections, I guarantee you, the 1% will.

This movement has been called a democratic awakening. 
Let's not watch it, let's live it!

Friday, October 14, 2011

Brandii Grace, Advocate for the Worker

I met Brandii Grace this summer in Washington DC. We were invited, along with David Linton, a college professor from New York, by our national union AFT and the AFL-CIO to speak before the National Labor Relations Board and the AFL-CIO about our experiences in organizing our union locals.

Brandii is an accomplished "game designer", she designs and develops video games. She is also a highly respected teacher of this craft.

I know her as a young, energetic unionist who when she met resistance in organizing her school did not back down but instead fought back and now speaks out for others. She has started a blog to help others more effectively assert their rights. I have places a link to the right, "From the Trenches" and I'll let Brandii tell you more....

In the beginning of 2010, I was the leader for a union movement of the faculty at the Los Angeles Film School. Over the course of a month, we did everything necessary to file for a union election. During that same month, I was promoted, threatened, suspended, put on probation, and fired. It was a busy month.

Before this whole thing began, I was actually anti-union. Being raised by my grandmother in a single parent household, we were terribly stressed when she unfairly lost her job due to a flawed union policy. I grew up thinking unions were bad and caused families to struggle the way mine did.

Now I know the truth: unions are not bad, but they do require good leadership. A bad or ineffective leader will create an ineffective union. In part, I have started this blog in the hopes of creating better union leaders.

My experiences have taught me a lot about unions, unionizing, and the government policies intended to protect our right to unionize. While I believe I did the right thing, and would do it all again if necessary, there are lots of things I wish I had known before I started. This blog is about sharing the lessons I've learned and the stories that taught them to me.

Tuesday, October 11, 2011

The bare necessities

Recently I cared for a patient who came to the ED in rapid afib (an irregular heartbeat). We started them on a cardizem IV drip to slow the rate. It work but they started to have short pauses in their heartbeat so, after consulting with the doctor, we stopped the drip.
I stayed close to the patient and about 5 minutes later their heart stopped and they passed out.
I called for help and was just about to do my first chest compression when they gasped, came to, and had a heart beat, and a nice rythm at that!

The pause lasted 6-10 seconds, it felt like 6-10 minutes!

It was yet another reminder of what an amazing thing the human body is. The heart basically "rebooted" itself. It was beating irregular, it stopped.......paused.......and started again, this time in a regular rythm.
It's also a reminder of how fragile human life is.
This patient had no heartbeat for 6-10 seconds!
Some people would classify that as deceased. And yet, this patient lives.
I work in a job that reminds me daily to be amazed at life and that we are not guaranteed a certain number of years or a certain number of heartbeats. The only guarantee is that someday our heart will stop.
We seek a balance, to make a difference in the world while at the same time not becoming enslaved to the things of this world.
As the great philosopher Baloo said, we "look for the bare necessity" of life.

Friday, October 7, 2011

Thank you LPNs

This is my second attempt at writing this blog entry. The first attempt was OK. It was full of newspaper quotes from the past year. But it didn't capture the feelings I am experiencing.
You all already know the facts.

In January, management announced that the 15 LPNs of Backus Hospital would be eliminated by the end of the year.  They were promised that management would do everything it could to find them other jobs in the hospital.  Since then, some of them have found their own new jobs.

On September 30, the 10 LPNs still at Backus were called into meetings and, one by one, they were walked out.

They were not allowed to return to the floor to say goodbye to their coworkers, there was no retirement tea, they were not even allowed to retrieve their own belongings from their lockers.

After up to 40 years of dedicated service they were, as on newspaper heading stated, "put on the shelf".


Nursing is not a job, it is a way of life.  Being a nurse does not end at the door, we carry it with us to the market and the ball field.  When someone needs us, we are there. Our patients are not "customers", they are as our children, our siblings, our parents and grandparents.


Some people don't get this.


That is the problem.

Kathy Claussen RN sent an open letter to the New London Day and it really captures what we are feeling.

To my friends and colleagues at Backus Hospital, I'm sorry we didn't get to say goodbye. When I came to work you were gone. I can only imagine how you feel. I feel sad, angry, embarrassed, helpless.

I appreciated working beside you all these years. The dedication, compassion, loyalty, competence and professionalism you exhibited is unsurpassed in my eyes.

I will miss you all. I already do. You all deserve the best in your next endeavors

To all the LPNs of Backus, past and present, God bless your for your dedicated service to the hospital and your patients know that we love you, we respect you, and that no decision can erase what you have done and what you have meant to all of us.

God speed, your are our colleagues and you are in our hearts.

Thursday, October 6, 2011

Understanding our Role

A few years ago I took over the household chore of vacuuming after my wife said her doctor felt she should no longer do it because of some cervical disc issues.  I never checked with her doctor about the validity of this claim but I figured fair is fair, she had done it for the first 25 or so years, it was probably my turn.I do have one rule, I won't do it when she's home.  The reason is that she micromanages my work and I can never do it well enough.  It's not her fault, she has this obsessive-compulsive streak at times.
I used to feel sorry for her about this and to be honest, slightly superior, till I realized that I too can be obsessive-compulsive. (Just not about cleaning).  I first recognized it in myself, after therapy and joining a support group, as it pertains to my adult children.  They were making choices that I felt were not in their best interest and I could not stop myself from interfering in their lives.  I'm getting better but it remains a struggle and always will be.  I think it's natural for parents to fall into this, but it's not healthy, for the children or the parent.
In my recovery process I have realized that I have always leaned toward being obsessive-compulsive, often in one area of my life at a time.  I have had times when I obsessed over our family budget (whether money was tight or not), running (5 marathons, 1 ultra), school ( up all night before clinicals preparing) and other things.
The past 12 months I have poured myself into this fight for a union at work.  It' a fight worth fighting, the outcome will benefit coworkers and patients now and for years to come.  I could not have continued day after day if I wasn't the way I am.
I'll share a great prayer that helps me:
God grant me the serenity
to accept the things I cannot change:
courage to change the things I can;
and wisdom to know the difference.

One of the lessons I have learned with my children is that I can lead and teach them by my example, but I cannot choose for them. 
For the past 12 months our organizing committee and now or negotiations committee have led us in our effort to gain a voice at work. Our officers and stewards will one day fill that role.The "wisdom to know the difference" tells me that their role is not to "lead", not "carry".  It is the role of each and every member to become involved and do what we can. 
For those in a leadership role to "carry" the membership would be like me trying to make life choices for my children or my wife trying to micromanage my house cleaning, it just doesn't work.
So, if you notice me bugging you less about coming to negotiations, or becoming otherwise involved, it is not because it has become less important, it is only me trying to do my part and leave your choices in your hands. 
This is not me saying I'm tired, or I'm done fighting.  Ironically, in the past, whenever I have decided to back off and let others decide for themselves, I experience a renewed vitality and energy.  My goal is, and will always be, to fight for a Backus Hospital that puts patients first and respects it's employees.

The question I would like you to ask yourself is this:
What's my goal, what's my role?

Monday, October 3, 2011

Which side are you on?

If you missed the last contract negotiations you missed a great presentation on our wages proposal to management.  We presented it first to our members and then to management.  There were great questions from our members and a great opportunity for conversations with your 18 member negotiating committee. I have included a link to the power point proposal at the right.

This Wednesday, Oct 5, from 5:15 - 10, at the Holiday Inn in Norwich, we will meet again.  Management has promised a response to our proposal.

That should be interesting.

All are invited and encouraged to join us.

We have spent and continue to spend many hours in thoughtful conversations among the committee and with all members on our proposals and hours at the negotiating table with management.

We do it  because we believe in a better Backus Hospital.  We are proud to represent all the RNs.

Your committee is looking for help.  Without your help, the greatest proposals, the most logical arguments, will not get us the contract we deserve.  We know management does not approach these negotiations looking for the most sensible proposal and putting together a contract that does right by the nurses and best serves the patients. 

When I see ten experienced, trusted and loyal nurses walked out - in spite of record high census just before the flu season begins - I know we have a management that doesn't get it.  It makes me realize that it will not be about putting together reasonable positions and asking politely to have them considered.  I know it is about power.  I know we must stand together and say in one clear voice that WE will not accept a contract that holds back our families or our ability to provide the best possible care to our patients.

We are at the table to negotiate and we are ready to be reasonable and helpful but we will not be patient forever.  We want to bargain but we will not beg.   

This is the turning point.

Your committee is ready to lead, but they are nothing without you.

Our strength comes from the unity of our members.  When management sees sees us united that will be our turning point.  That is when we get the contract our hospital needs, the contract our families need, the contract our community needs.

Many have already come out to negotiations, join them!

I know you are busy, I know you have other obligations, I can appreciate that.  Come when you can, come at any time, come for as long or as short as possible.  Children and other family members are welcome.

                                                  Which side are you on?