Workplace safety is a basic human right

Workers deserve certain things.
They deserve to be treated with dignity and respect, they deserve a living wage and basic benefits, and they deserve a save workplace and the ability to return home safely to their families after their work day.
This holds true in Sandy Hook Elementary School, in West Texas, and in Bangladesh.
This holds true because they are basic human rights, upheld by religions and philosophies.
They are a part of the basic human work contract.
A worker has an obligation to provide a good days work and an employer has an obligation to treat that worker with respect and dignity, and to provide a living wage, basic benefits, and a safe workplace.
Too often, in pursuit of greater profits, employers do not fulfill their ethical obligations.
This past Sunday, and every April 28, we celebrated Workers Memorial Day, honoring workers who have died on the job or as a result of job related illness, and rededicating ourselves to worker's safety.
I attended a moving celebration at Memorial Park in Groton, CT.
Labor Council President Wayne Burgess led the ceremony and closed with a quote from labor leader Mother Jones that sums up what we must all do.
"Pray for the dead and fight like hell for the living".   Mary Harris Jones (Mother Jones)

We're not a contract, we're a Union

What happens when you no longer have a contract, do you still have a union?
So asked Candice Owley, President of the Wisconsin Federation of Nurses and Health Professionals yesterday.
In Wisconsin, public employees have lost their right to collective bargaining, the same right that I and my colleges at Backus have recently fought for and gained. But while they may no longer work under a contract, they are still a union, because a union isn't a contract, it is a collection of workers joined together for the common good.
We signed our first contract last May, but we formed our union before that.
We formed our union when we started gathering together, discussing common concerns, and coming to a mutual feeling, that we were all in this together and that the way to improve our work lives, the lives of our families and most important, the lives of our patients, was to stand together and advocate together.
It happened slowly, gradually spreading from person to person, department to department, and it continues still.
In the ED it happened one morning at change of shift,
When we walked out to the floor and one of our third shift nurses was having a discussion with the VP of Nursing.  The VP was trying to convince her that we didn't need to join together.  5 or 6 of us went and stood with our sister and before long the VP retreated to her office and a union had been formed.
We had no contract, no officers, no labor/management committee, no collective bargaining rights, no protection of a grievance procedure, but make no mistake, we were a union.
Now we have a contract, and with that certain legal protections concerning wages, benefits and working conditions.  I do not want to minimize their importance, but the contract does not make us a union.
What makes us a union is members using their new found voice, to advocate in the workplace, the community and the capital.
Our union is not limited to the 400 RNs of Backus, it is, and needs to be so much more.
We are a voice for the non union workers, our patients, and our community, and they are part of us.

The AFT Joint Healthcare/Public Employee Professional Issues Conference has been a great opportunity to learn and grow.
Late today we will head home, knowing that we have MANY brothers and sisters, all united in the belief that the workers of this country are what made it great and that we remain the voice for those who have none.
This belief is what makes us a union.

Maybe it IS a vacation

My last blog was about vacations, which was timely because....
Well, I'm on vacation.

I have 2 weeks off and I'll be doing some traveling.
You know the old question, "business or pleasure?"
I think there should be a third choice.
Today I head for Baltimore with our Vice President, our Political Liaison, and our A4 delegate for 3 days of meetings and classes as representatives of the Backus Nurses. These gatherings provide education and networking that are critical when we need to reach out to other locals or our state or national leadership for assistance.
I cannot tell you what a blessing it is to be able to call Washington and ask for Mary McDonald, the directer of AFT Healthcare, and hear,

"AFT, good morning, how can I help you?"
"Good morning, is Mary McDonald in?"
"Whom can I say is calling?"
"John Brady, from the Backus Nurses"
"Hello John, I'll put you though"
"Hi John, it's Mary, how are things in Connecticut?"

I'll be back in time for a workers memorial service in Groton on Sunday and an executive board meeting on Wednesday and then it's off to Florida for 3 days for a niece's college graduation.

It's no vacation

It was 2:30 in the morning when we finished up.
Most of us had been up since 5 am and worked all day.
It's a 42 page contract with 61 articles, all from scratch.
So yes, there are some mistakes.
One of those was the language on vacations. The contract says we submit for vacations 4 weeks before the schedule.
What we agreed to was a MINIMUM of 4 weeks.
When this happens, you rely on the negotiation notes to clarify. I want to thank Carol Cote, who took notes for us, because if not for those notes, we would be in a pickle.
You'll remember that last fall we reached an agreement that full week vacations would be submitted up to 6 months in advance. We could not agree on partial week vacations.
Then this year, it was said that summer vacations needed to be submitted in January or it would be too late.
We filed 2 grievances and the first one had an arbitration date of May 29.
I am pleased to announce that we have an agreement that I believe covers most of our concerns.
Vacation can be submitted until 4 weeks before the schedule.
Non prime time vacations will have a one month period for full week requests and then be open for full or partial weeks. They will not depend on seniority, the will be first submit/first granted.
Prime time will have a one month submittal period, in which preference will be given to full weeks and seniority, and after that it will be first submit/ first granted.
Also, "full week" will be defined as 24 hours, so, if you need Thursday through the next week (10 days), you could conceivably get it without burning up 64 or 80 hours of vacation time.
Naturally, all requests are dependent on patient care needs.
It's complicated, and you'll have questions. Please talk to your delegates and officers.

Hello....God..???

Bombings and manhunts in Boston.
Explosions in Texas.
Floods in Chicago.
And that was just this week!

Add to that sickness in our families, the economy.....need I go on?

It makes a person want to post on facebook, "Hello.....God.......are you still there?"

I've been told by someone at sometime, that if I can't see God it's not because He has moved away, it's because I have.
OK, if you say so.
I do know that some people seem to go though some pretty horrible things but do alright, emotionally and spiritually, if not physically, and it seems to be related to their believe and dependence on some form of a higher power in their life.

Listen, if you're looking for answers to life's great questions, don't look here, I'm just trying to do my best.  But maybe if we all stop running, stop trying to do it all alone.  Maybe if we stand still and ask for help.....
Maybe God, or some higher power, will find us, and we'll all be a little bit better.
In the meantime, give someone a hug, it'll heal the both of you.

I cry with Boston

I wish I were a good enough writer to make some sense of times like this.
I wish my words could heal the wounds in Boston, in Sandy Hook, in natural disasters.
I wish I could say the right thing to comfort a grieving mother in the emergency room.
I can't.
The best I can do is listen.
I am reminded of the story of Susie, who returned late from school to a worried father.
"Susie, I was worried, why are you late?"
"I had to help my friend Stephanie. She lost her favorite doll."
"Did you find the doll?"
"No Daddy, we couldn't find it."
"So how did you help her."
"I held her hand and helped her cry."

My words will not make sense of this, they will not heal the wounds.
So tonight, I cry with Boston, tonight our country cries with Boston, tonight the world cries with Boston."

Rick Olson RN

There's a saying, "a man's man."
Loosely, it means a man who women want to be with and men want to be like. A man who is confident but not coincided, polite but speaks his mind, his own person but accepting of all others.
Rick Olson RN is a nurse's nurse.
He's an ER nurse whom other nurses admire. He understands his patients and his coworkers, whatever their background and treats all with respect. At the same time, he expects patients and coworkers to accept personal responsibility for their own health and their own nursing practice.
Not always a nurse, he has spent his time working with his hands and working out in the bad weather.  He understands hard work and never shirks form it, nor does he expect others to.  Yet he understands the less fortunate in society and has empathy for them.
He has a respect for our EMS bothers and sisters that comes from being one of them, a respect that we should all imitate.
Whether working the floor or being in charge, Rick seldom sits.  He is always ready to lend a hand.  His knowledge is a benefit to all under his care and all working with him.
Never could he be accused of not speaking his mind, yet he is open minded enough to listen to other augments and judge them fairly.
It's been my privilege to work with him for 12 years.  He is a source of support, advice, and friendship.
This year Rick is being honored as a Nightingale nurse, it's about time.

A Culture of Safety

I was standing at the counter when it hit me.
I became nauseous, my knees buckled, and I almost fell to the floor.
I had been uncomfortable mixing the IV magnesium.  It just seemed like too many vials.  Then there was the conversion from milliequivalents to milliliters and all.  I checked with another nurse, but like me, she was inexperienced.
It was a busy second shift in the ED.  The more experienced nurses were involved in a bad trauma.
My patient was breathing poorly, the result of years of smoking.  The magnesium was designed to improve his breathing, but instead he got worse.  We had stopped the IV and intubated him and he was now "stable".

Then, out of the blue, it hit me.
I had mixed the IV at 10 times the concentration!
My preceptor was out of the trauma by now.  I told her and then the admitting doctor, who set her pen on the counter, turned to me, and said, "it will be alright".

I have told this story to many a new nurse.  This week I told it to the Quality of Care Advisory Committee at the Connecticut Department of Public Health.  It was my first meeting on that committee as a representative of the AFL-CIO.

My point was this.
If we want to establish a Culture of Safety in health care, and I believe we should, then we need to have non punitive reporting.
The airline industry has adopted this philosophy and as a result "near misses" have decreased because systems have improved.

A few weeks after my med error, my boss, Sue Davis, called me to the office.  We talked about the error and she said,   " I know this will never happen again".  It never has.  But more important, system changes were put into place to decrease the chance that this or other errors would happen in the future.

No health care provider intends for an error to happen.
The incidences of suicide increase after a nurse makes an error.
Increased reporting of errors or near errors will improve the safety of all patients.
That is why, in my opinion, health care workers need to be encouraged to self report and know that it will not be held against them. This is not always the case.

My patient, he survived.
I am sure that many others have been and continue to be safer, because of the many system changes that followed.
This nurse, I survived too.

Seeing is beliving

People feel sorry for Thomas.
Like if you were there, and your friends said they had seen the risen Lord, you wouldn't have said,
"ya right!"?
It's sometimes easier to believe with blind faith then to question and then believe.
Thomas wanted to believe....it's just hard.
Lots of things in life are like that.
A couple of years ago when we met Ole in a coffee house and he told us that we could join together with our fellow nurses, form a union, and make a difference,....I wanted to believe.
I DID believe.  Yet a part of me was asking why we met in a coffee house far from the hospital like secret agents.
Looking back, I can see that Ole did a masterful job in giving us enough information for the day, but not too much.  He once showed me a video of a mock meeting between management and a worker where the manager tried to scare the worker into submission.  He stated that he couldn't show it to everyone because not everyone was ready to see it.
I thought, what makes him think I'm ready?
But when I came up against a similar situation, I was ready, I had been prepared.
So my belief that we could be successful was based on my "seeing" that I was being prepared.
When we started reaching out to others at work, some people and some departments were reluctant to believe that we could be successful, that we could make a difference, that THEY could make a difference.
Now we have delegates in every large unit, we have filed grievances, reversed or modified some discipline and will soon argue our first arbitration. We have the ear of our congressman, senators, governor and state and local legislators, We are well known at our state and national federation and to other labor unions, and we have partnered with non profits to benefit the community.
So yes, many of us, like Thomas, have to see to fully believe, but, like Thomas, we can do great things once we see.

Cooked, but not Done

Stick a fork in me, I'm Cooked, I'm done!

How many times have you thought that at the end of a shift?

It's not just nurses, it's ALL health care workers.

I've included an email I received from Katherine Kany, the assistant director of AFT Healthcare division, on just this issue.

What can we do about it?

Connecticut has a law that says every hospital must have a safe staffing committee, that this committee must be at least 50% bedside RNs, and that this committee must report to the state when requested as to the staff to patient ratio. We have been pushing a bill in Hartford that would make this reporting a regular occurrence, not only when requested, and would publish the results on a public website.  Many of you have written testimony in favor of this.  The Connecticut Hospital Association is opposing this bill and it looks like they may win this round, but this does not mean defeat.  We need to continue to write and speak to legislators and propose it again next year.  In addition, we are working to ensure that the hospital is in fact complying with the current law by having real meetings and including real nurses.  I also hope that my recent appointment to the Department of Public Health quality of care advisory committee can help.

I want to urge you to visit a new AFT CT web site, SafeStaffingCT.org, and share your stories.

Yes, it's a battle.

There are those who want to continue to short staff to save a buck, hoping that it doesn't hurt patients or staff, in pursuit of larger profits. 

But we are many, and together we can ensure our patients safety and

ours, and we know there are better ways to save, that don't put people at risk.

We may be cooked, but we're not done.

 

What you have always known, now captured and broadcast by the American Organization of Nurse Executives. Highlighting below is from me (Katherine Kany).

 

Survey: Nurse understaffing, fatigue threatens patient safety

March 21, 2013 | By Julie Bird

Fatigue leaves a majority of nurses concerned about their ability to perform safely, with two-thirds of nurses reporting they had nearly made a mistake at work because of fatigue and more than a quarter saying they had made a fatigue-related error, according to a survey commissioned by Kronos Incorporated.

The "Nurse Staffing Strategy,"  released this week at the American Organization of Nurse Executives conference in Denver, found nurse fatigue also can negatively affect operational costs, as well as patient and employee satisfaction, according to the research announcement.

Among the findings:

·         39 percent of respondents found current staffing levels inadequate, while 38 percent found them unsatisfactory

·         57 percent said workloads were not distributed evenly in the previous year, with 54 percent saying they had an excessive workload

·         77 percent said their organization had 12-hour nursing shifts

·         96 percent reported feeling tired at the beginning of their shift, and 92 percent while driving home after work

·         63 percent said vacancies affected scheduling and overtime staffing "more often than anticipated"

·         56 percent said their hospitals disregard required rest periods, and 65 percent said their hospitals do not have policies regarding cumulative days of extended shifts

Separate research recently published in JAMA Pediatrics found that nurse understaffing in neonatal intensive care units (NICU) leads to higher infection rates among very low-birth-weight babies.

Meanwhile, Democratic lawmakers in Michigan are joining a nurses' union in calling for a state law requiring hospitals to maintain lower nurse-to-patient ratios so they are adequately staffed without mandatory overtime, Michigan Radio reported.

Sixteen states have rules regarding staff-to-patient ratios, but California is the only  state setting minimum hospital staffing levels, according to the report.

"I don't think people realize that when your nurse is handling far too many patients, or working a double-shift or been mandated to stay over, it's probably because the hospital wants it that way," Scott Nesbit, R.N., told Michigan Radio.

The Michigan Health and Hospitals Association opposes the legislation, according to the report.

The nurse staffing survey was conducted by HealthLeaders Media.

To learn more:
- read the survey findings
- here's the Michigan Radio report

Read more: Survey: Nurse understaffing, fatigue threatens patient safety - FierceHealthcare http://www.fiercehealthcare.com/story/survey-nurse-understaffing-fatigue-threatens-patient-safety/2013-03-21#ixzz2OCR9qn7J 
Subscribe: http://www.fiercehealthcare.com/signup?sourceform=Viral-Tynt-FierceHealthcare-FierceHealthcare

 

 

Katherine Kany, MSN, BS, RN

Assistant Director | AFT Healthcare 

State Budget Cuts and Hospitals

There has been much talk about the state budget cuts to hospitals. 
It's confusing.
When I asked State Rep Betsy Ritter about it a month ago, she said even the experts aren't sure what the final impact will be.
In a nutshell, the Affordable Care Act (Obama Care), calls for an increase in the number of patients who will have insurance and a decrease in the compensation hospitals get to treat uninsured patients. (DSH payments)  In theory, they balance.  The real question, and disagreement, is in whether or not they balance.
To make matters more complicated, part of the equation includes an increase in people on Medicaid, and last summer, the Supreme Court ruled that the federal government could not force states to do this.
In states that have decided not to expand Medicaid, the hospitals will see a decrease in funds for uninsured, and no increase in the number of people on Medicaid, a double whammy.
Luckily, Connecticut is in the forefront of both expanding Medicaid and setting up a "health exchange" where people who make too much for Medicaid will be able to purchase insurance with premiums based on income.
The "Healthy Chats" that you see advertised are information sessions and information gathering sessions on just this.  I have attended 2 of these, have learned a lot, and have made contact with the people on the exchange.
OK, maybe it's not a "nutshell". 
I said it was confusing.
Bottom line, hospitals will get less money for uninsured patients but will see less uninsured and whether they balance is the million dollar question.
I have included the conclusion of a study on this issue from the
Urban Institute’s Health Policy Center, funded by the Robert Wood Johnson Foundation. If you would like to see the entire study, I am happy to email it to you.

Conclusion
 Federal lawmakers who passed the ACA offered hospitals an implicit bargain: help fund the ACA’s coverage expansions by giving up some Medicaid and Medicare reimbursement, and in return receive new revenue when formerly uninsured patients enroll in Medicaid or private coverage.

Last June, the Supreme Court placed the fate of this implicit bargain in state hands. Regardless of what each state decides, its hospitals will help pay for the ACA. But whether hospitals receive the ACA’s promised financial rewards depends on state decisions about Medicaid expansion. Although expansion would reduce hospitals’ private payments, the accompanying boost to Medicaid revenue is over 2.5 times the size of those losses in the average state, even without considering the potentially significant benefits of hospital-based presumptive eligibility in further reducing uncompensated care burdens.

Put simply, hospitals’ financial pain from the ACA remains mandatory. But the extent of their offsetting gains now depends significantly on whether state leaders decide to expand Medicaid.

There is "buying" power in a union

There's an old song, "There is power in a union"
As it turns out, there is "buying power" in a union too.
So, when the presidents of AFT Locals 5049, 5051, 5123, and 5149 (L+M and Backus hospitals) visited Bob Veleti of Velenti Automall in Mystic, CT with our field rep, we were representing the united buying power of 2,000 people.
As a result, any member or spouce of the 4 locals who visits Velenti will be given preferential pricing on the three big American brands, Chevrolet, Ford, and Chrysler, Dodge, Jeep, Ram.
I'm told this can be a savings or $2,000-$3,000 off the list price.
Details of this benefit and other member benefits are on our web page under "member Benefits" @
http://backusunited.ct.aft.org/member-benefits