Senior News November, 2004 Vol. 25. No. 11

 

Published by the Humboldt Senior Resource Center in Eureka, California. HSRC is a non-profit community-based organization offering services for senior citizens, multi-generational families and caregivers.

Memories in the making taps into always-present creativity

Last chance to get $600 credit for Rx costs

Think About It - Not driving

CSL decides priorities

CNA cites judicial decision about covering patients

Media Q&A regarding the Informational Picketing

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Media Q&A regarding the Informational Picketing, October 14, 2004

Q. The union claims St. Joseph is hiring traveling nurses instead of qualified local nurses. Is this accurate?

A. No, this is not correct. The hospital's preference is always to hire qualified local nurses for both full time and part time positions. However, in order to comply with mandated staff ratios, particularly in specialty areas, it has been necessary, as it is with all hospitals, to supplement existing staff with travelers.

Q. The union says that the hospital is experiencing an exodus of nurses. Is this true? How many nursing positions are currently open?

A. The hospital has experienced turnover, as does every hospital, but the number of nurses recruited in each of the past three years has exceeded the number who have left. The statement that there is an exodus is simply a fabrication.

St. Joseph Hospital's vacancy rate has consistently been below the state and national averages, which is pretty good considering that we are in a rural area during a national and state nursing shortage.

Currently St. Joseph Hospital has 25 Full Time Equivalent (FTE) RN posted vacancies, and 11 part-time openings for RNs. This represents a current vacancy rate of 10.2 percent, below the state and national average. The national average is currently above 15 percent according to the California Healthcare Association's Special Report, June 2004.

Q. How many nurses have been hired from CR or HSU nursing programs this year? How many last year?

A. Over the past two years, St. Joseph Hospital has hired 26 graduates from CR and HSU.
 
Q. How many traveling nurses are employed by St. Joseph?
 
A. The number of travelers is a moving target but it varies with demand, which is a function of the Hospital census, vacation schedules and other variables. On average, travelers account for 13.8 percent of staff.

Q. Is it true that nurses routinely work eight to 14 hours without a break?

A.It is true that nursing is an incredibly demanding profession, regardless of the hospital. The calling to be a licensed care giver is one that comes with long hours and stressful conditions.

Many nurses at St. Joseph Hospital and most other hospitals work 12-hour shifts. Others work 8 hours shifts. We strive to balance assignments so there is always adequate staff on the job for everyone to take their breaks. St. Joseph Hospital follows all federal and state laws providing break time for employees, including nurses. We discourage nurses from working without a break because a rested nurse is a more effective nurse.

At the same time, there are moments in the life of every hospital when sudden or unanticipated spikes in patient demand require not only nurses but medical staff and others to attend to patients or perform other services during their breaks or extend their shift. In a hospital, you just can't punch out at five o'clock, turn off the light to your office and go home.

Q. Are any nurses being threatened or targeted by disciplinary action for
being on the picket line?
 
A.No. St. Joseph nurses are not being threatened or targeted by disciplinary action for being on the picket line or any other appropriate union-related activity. It would be inconsistent with the law, with our policies but most important with St. Joseph Hospital's values to discipline an employee for exercising their right to picket or to speak freely.

The Hospital will not tolerate threatening behavior of any kind. Nor will the union, which may file grievances with the National Labor Relations Board if it believes an employee has been threatened or targeted for legitimate union activity.

Regrettably, sometimes an employee who is being disciplined for other reasons attempts to use this as a smokescreen.

Q. What is St. Joseph Hospital's position on the CNA informational picket?

A. First and foremost, we support and appreciate our nurses for their hard work and dedication.

This is just an informational picket and there will be no interruption to the quality of health care. This is a one day event only. It is not a strike.

We believe that informational picketing is unnecessary and potentially unsettling to our patients. We wish the nurses would have first exhausted the processes already in place to resolve their issues, including continuing to use a facilitator in problem solving meetings.

Q. What are the RNs issues?

A. The Hospital gained better understanding of the union's concerns late last week when Bob Sampson, VP of Human Resources and Mary Anne McCrea met with the CNA representative and a group of our nurses. The discussion was frank and open.

The nurses raised issues that the Hospital has been working collaboratively with staff to address for some months. These include:

Interpretation of the CNA contract
Staffing changes required to implement state mandated ratios Communication to explain these changes and ongoing efforts to recruit new nurses.

Related issues of local recruitment and RN education:

The RNs shared complaint was that the Hospital is moving too slowly to resolve issues and concerns in these areas, therefore it is appropriate to do informational picketing.

Q. What is the hospital's message to the RNs?

A. We are committed to work with our RNs honestly and respectfully to build confidence and teamwork. We want them to succeed.

We believe that some of their concerns are based on lack of understanding of the Hospital's success and sincerity at resolving their issues.

But the Hospital also shares some of the nurses' frustrations. The past year has been one of enormous change in health care in California, and particularly at St. Joseph Hospital.

For example, we successfully implemented a first time union contract, a process that almost inevitably creates confusion because many existing practices must be changed to comply with the contract. To meet mandated ratios, the Hospital moved to an all RN model of care - as did many hospitals in the state - which required reducing Nursing Assistant positions in order to create more RN positions.

Many of these issues are to be expected, and exist in Hospitals throughout California. Union contracts often can be interpreted differently, particularly where there is a first time contract as we have here. Typically, these differences are resolved through informal discussion or formal grievances, as opposed to picketing.

Similarly, every Hospital in the state continues to grapple with the state mandated ratios. We have done our best to deal with the situation via an all RN model of care, but the complexity of the subject invites differences and disagreements. We have been and are already committed to further discussion on this complicated issue

Q. Some nurses allege the Hospital has been violating mandatory RN staffing ratios, and that this creates unsafe work conditions. Is this accurate?

A. We are proud of the Hospital's record of patient safety. Our compliance with mandatory staff ratios has been validated twice this year by the Department of Health Services (DHS), which is the agency responsible for monitoring and enforcement. On two separate visits, DHS surveyed St. Joseph Hospital, confirmed that we are in compliance, and even said that we are substantially above the requirements in several areas.

Q. The union alleges the Hospital is seriously understaffed, and is not doing enough to recruit RNs from the community.

A The union is wrong on the staffing and recruitment issue as well. St. Joseph Hospital's vacancy rates have been well below both the national and state averages for the past two years, even though we are in a rural area which makes recruiting difficult.

And while the Hospital has experienced turnover, as does every hospital, the number of nurses recruited in each of the past three years has exceeded the number who have left. This is a continuing trend. In fiscal 2003 we had a net gain of 12 RNs, in 2004 a net gain of 20 RNs, and so far this year we have had a net gain of 20 RNs.

Additionally, we have a partnership with the local school of nursing and in fact will be providing a _ time instructor to HSU so they can increase the number of nursing students they accept. We have hired 15 to 20 graduates each year and have had a minimal turnover rate.

Q. The nurses say they are concerned about reductions in ancillary staff. They say the number of certified nursing assistants has decreased since the beginning of the year.

A. When ratios went into effect the Hospital moved to an all RN model of care and created more RN positions in order to meet the ratios. We then reduced the number of nursing assistants so as not to be overbalanced. If anything this improved patient safety because we were replacing less qualified staff with more highly qualified individuals.

Q. The union says there is a "growing exodus" of highly skilled RNs because of unsafe staffing, working without breaks and mandatory overtime.

A. The Hospital has experienced turnover, as does every hospital, but the number of nurses recruited in each of the past three years has exceeded the number who have left. This is a continuing trend. In fiscal 2003 we had a net gain of 12 RNs, in 2004 a net gain of 20 RNs, and so far this year we have had a net gain of 20 RNs. This is the opposite of an exodus.

Moreover, St. Joseph Hospital's vacancy rate has consistently be below the state and national averages, which is pretty good considering that we are in a rural area during a national and state nursing shortage.

Q. Some of the RNs say they have lost confidence in Mary Anne McCrea, and they feel she is punishing them for voting to join the union. What is Mary Anne's reply?

A. Mary Anne has said the following: "I'm a nurse. I understand the long hours and sacrifices nurses make every day. We are dealing with significant challenges in health care in California. Many of these issues are to be expected, and exist in Hospitals throughout California.

We've had to make difficult decision, some of which have been unpopular. I can understand that. Because of my position I'm a convenient lightening rod. Frankly, we share some of the nurses' frustration at the pace of resolving many of these issues.

Working with our nurses, with medical staff and with others, the Hospital has made effective progress clarifying misunderstandings and resolving many real concerns in all the above areas. I am personally committed to helping our nurses to succeed."

Q&A provided by Mary Ann McCrea, Chief Operating Officer, St. Joseph Health Systems. See St. Joseph's and Redwood Memorial Hospital's web sites at www.stjosepheureka.org and www.redwoodmemorial.org.