Hello Uniontalkers, I believe that I have posted before about this subject
matter. But this time I will put in the question framework. I know that any
negotiations between ANA/UAN and AFLCIO are secret at this point and no news
has come out as to this new relationship, but we do know that raids have now
ceased.
Are we now headed towards one union for nurses? Oh yes, there are
non-ANA/UAN/AFLCIO unions, please let's not forget. Teamsters, Calif. Nurses
Assoc., Pasnap and other independent unions like CRONA, etc who are currently
representing nurses at work.
Now more than ever it will become important for us to examine those unions
which have been the most effective in representing nurses across our nation.
We continue to critique unions, examine history closely, and make decisions
about who we want to represent us as we continue to challenge the corporate
health care industry where we work! We seemingly agree that we need to be
unionized to become empowered and have a voice both in terms of our rights at
work as well as address safe patient care.
Mandatory overtime and understaffing are serious conditions we deal with at
work, as is the lack of respect, and deskilling within our profession. I no
longer believe that nurses face "ethical" dilemmas at work, but rather, as
Suzanne Gordon puts it, "political dilemmas" which have very serious
consequences both for us as health care professionals and the safety of
Americans who deserve safe care.
There are many frontline nurses who have taken the bull by the horns and gone
ahead with organizing and voting for representation at work. We know that
this is the only way possible for us to have a seat with management and
contract both for our own good and patients too. We hear cries for "unity"
amongst nurses!! But at the heart of this cry is also the matter of dues and
payment for services - again we get back to power and money matters when we
get involved with another system, ie. unions. On Uniontalk, we have nurses
who are standing firm that this is about nurse empowerment and nurses' voices
being heard! Many are actively involved in making not only changes at work
thru contracts, but also changes within our culture of nursing as well. Many
claim that we can ill afford to be dominated or become dependent upon
patriarchal, authoritarian systems or structures which could or would render
us back in "our places" so to speak! ... Beth
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Toward a national organization for nurses
by Rose Ann DeMoro, CNA Executive Director
The California Nurse, October-November, 2000
Amidst the public discussion of HMO reform and proposals for a patient's bill
of rights, there is a very big healthcare story that much of the media
continues to miss.
Nurses are up in arms across this nation. In unprecedented numbers they are
seeking union representation, insisting their hospitals improve unsafe
hospital conditions, demanding their legislators enact nursing care reforms,
and electing pro-nurse candidates to office.
And, for the first time, many are searching for a single, unified, national
voice of direct care RNs acting on their own behalf in their own interest.
While increasing numbers of nurses share this dream, achieving the goal is a
challenging process.
In the past few weeks, a majority of nurses who are members of the
Massachusetts Nurses Association and the Maine State Nurses Association voted
to disaffiliate from the American Nurses Association (ANA) and become
independent organizations.
But, due to arcane organizational bylaws requiring a two-thirds vote by
anyone who shows up, the staff nurses narrowly fell short, even though in
Massachusetts 62 percent favored independence. ANA used retirees, academics,
and nurse administrators to thwart the will of the direct care nurses. For
now, but I suspect not for long, they remain captives within an ANA framework
that the majority of their members have determined to be stifling and
unworkable.
There remains overwhelming interest among staff nurses in Massachusetts and
Maine to work together with CNA and the Pennsylvania Association of Staff
Nurses and Allied Professionals (PASNAP) to establishing a national staff
nurse organization.
Similarly, at the School for Nurse Activists and Patient Advocates held in
Oakland in September, attended by 350 representatives of more than 20 very
diverse groups, there was a strong sentiment for the building of a national
and international organization of direct care RNs. "I realize now more than
ever how much a national voice for the bedside nurse is needed."
As PASNAP Vice President Pearl Kolbosky put it, "sometimes I feel like the
nurses in Pennsylvania are the only ones fighting mandatory overtime, short
staffing and increasing responsibilities, but these are the issues facing all
nurses. I realize now more than ever how much a national voice for the
bedside nurse is needed."
Issues discussed at the School crystallized why so many nurses have embraced
this view. Increasing numbers of RNs no longer feel they can safely practice
their profession. An alarming number, especially in unrepresented hospitals,
have responded by refusing to continue to work in the hospital setting,
fueling the new industry-manufactured national nursing shortage.
As was evident in the high level of discussion at the School, nurses have
clearly identified the source of the current crisis - the corporate takeover
and monopolization of our healthcare resources, care for profit, our health
for sale.
That corporate consolidation has hastened the restructuring that has degraded
patient care conditions and threatened the nursing profession. It also
translates into unprecedented clout in what healthcare reform legislation is,
and is not, enacted in state capitols and Congress.
More nurses than ever believe that an increasingly monolithic corporate
healthcare industry can only be effectively challenged by a unified national
voice of direct care RNs, in alliance with patients, other healthcare
employees, and RN organizations beyond our borders such as the Canadian
Federation of Nurses Unions.
Across the US, RNs are learning why they need an independent, staff nurse-led
voice as the most effective representative for nurses.
One reason is to ensure the maximum use of resources in the critical battles
we face.
In 1995, CNA convention delegates voted to establish an independent
organization and end our affiliation with the ANA. Concurrent with the vote,
the delegates also adopted a detailed plan outlining our programmatic
direction. Among its highlights, we projected:
Increased resources - including internal organizing, community support, and
research - to support collective bargaining goals. Dramatic intensification
of efforts to organize unrepresented nurses. Expanded membership educational
programs on nursing practice, strengthening clinical expertise, and patient
advocacy. Increased legislative, regulatory and ballot initiatives to promote
health care reform, support for direct care nurses, and patient protections.
We also projected a stepped up public awareness campaign on the dangers
inherent in the corporate healthcare system and establishment of strategic
links with patients, consumers and national and international nurses'
organizations that were similarly committed to these goals. Five years later,
we can proudly say that we have accomplished many of our goals, though much
more work lies ahead.
Our achievements would not have been possible without the professionalism of
our staff nurse leadership. Experience shows why. As nurses grapple with the
search for a new national nurses' movement, there are two other paths some
have chosen, both with considerable pitfalls.
First, there are those who remain a part of the ANA. Despite some recent
efforts to address staff nurse concerns, the ANA remains controlled by nurse
administrators and educators.
At the School, PASNAP's Pearl Kolbosky gave an example of the inherent
contradictions in such a structure.
"ANA," Kolbosky noted "has many nurse leaders in management positions. If
we're taking a stand on mandatory overtime, these managers have a conflict of
interest. Management is concerned with the corporate end of the hospital and
not concerned with patient care issues and the bedside nurse. It's your nurse
manager who will mandate your overtime."
Similarly other, non-nurse unions are desperately seeking to organize RNs
around the U.S. Again, growing numbers of RNs have found that arrangement to
be unsatisfactory.
A large teachers' union, for example, has many RN members. Essentially, it is
a single craft organization that has provided fine representation for its teac
her members, based on its expertise involving education issues and its
experience with the teaching profession. But it has far less experience and
success representing nurses in state legislatures or at the bedside.
Additionally, some other unions that have RN members have signed agreements
that compromise the interests of nurses and patients, including
labor-management partnership pacts that promote deskilling and
de-professionalization, and acceptance of "morbidity" bonuses that link
economic compensation to reductions in care.
On some healthcare and labor issues, we can continue to find common ground
with the ANA and other unions, and we continue to seek cooperation and unity
where possible.
But it is readily apparent to CNA, and thousands of other nurses across the
US today, that nurse executives or other occupational groups are not the most
effective voice for direct care RNs.
It is staff nurses themselves whose daily decisions most directly affect the
lives of their patients, as well as the professional practice and economic
well being of their colleagues. It's called self-determination, and for
nurses, it's long overdue.
--------------------------------------------
Harried nurses act to stem staffing woes
Plea to protect patients becomes national effort
by Michael J. Berens, Chicago Tribune
December 20, 2000
Faces drawn from fatigue, eyes droopy, swollen and red, the 50 registered
nurses gathered in the sparse meeting room, coffee cups tipped for yet
another caffeine rush.
They came to share stories and console each other about how their critically
ill patients are all too often victims of substandard nursing care, resulting
in unnecessary pain or injury.
"I feel so guilty," said a newly hired nurse in her early 30s, lowering her
head and closing her eyes. "We're so short-staffed. Every time I go home I
wonder if someone is going to die because I wasn't there."
The nurses at Kaiser Permanente Medical Center talked of being so overwhelmed
they delivered too much medicine to patients. They complained that care was
delayed to gurney-bound patients wheeled into hallways instead of rooms
because too few nurses were on duty.
"What should we do?" a veteran nurse asked Kay McVay, president of the
California Nurses Association, one of the nation's most aggressive nurses
unions.
McVay told the anxious nurses to create a daily report of every case of bad
or delayed care linked to insufficient staffing levels. "We'll take your
experiences to the public," she said.
Besieged by inadequate staffing, nurses are pushing their calls for reform
into the public spotlight. From raucous street rallies to private meetings,
the primarily female profession is circumventing a code of silence that, in
some hospitals, still mandates that nurses should not speak to a superior
unless spoken to first.
California is ground zero for this new, aggressive activism. This fall, the
California Nurses Association, based in Oakland, about 30 miles north of
Hayward, held the nation's first training school to teach nurses and patients
how to become activists.
The Tribune reported in a three-day series in September that a majority of
hospitals nationally have significantly reduced registered-nurse staffs.
Since 1995, at least 1,720 patients have died and 9,584 others were injured
in cases linked to overwhelmed or inadequately trained nurses.
Pushed by activist nurses, California lawmakers this year adopted an
unprecedented law that will require hospitals to maintain minimum levels of
nurse staffing.
Though a majority of nursing advocates generally recommend a ratio of one
nurse for eight patients on general hospital floors, hospitals routinely
order nurses to care for 15 patients or more, according to U.S. Department of
Health and Human Services records. The California law represents the first
government mandate to dictate staffing decisions within privately operated
hospitals.
Hospital officials say patients receive the highest standard of care and that
staffing is maintained at safe levels.
In a testament to the growing influence of the nation's 2.6 million
registered nurses, legislators in two dozen states, including Illinois, have
begun to draft similar staffing laws. Recently published research has found
evidence that patients suffer fewer complications when more nurses are on
duty.
"I don't know a nurse who would leave anyone they love in a hospital alone,"
said Tricia Hunter, executive director of the California branch of the
American Nurses Association. She said nurses in dozens of states have formed
volunteer "buddy groups" to maintain 24-hour vigils for their families and
friends.
At some Chicago-area hospitals, registered nurses sometimes implore families
to stay overnight with sick relatives because they cannot guarantee patient
safety amid inadequate staffing on some shifts.
In Rhode Island, dozens of nurses marched in the streets this year-not for
more money but for more nurses to be added to hospital staffs and an end to
mandatory 16-hour shifts, which they say have resulted in sloppy, reckless
care.
"In every city there is a momentous battle being waged for patient safety,"
McVay said. "Nurses are witnessing unnecessary death and injury because
hospitals want to save a few dollars by eliminating patients' lifelines:
registered nurses."
The activism is spreading. More than 350 nurses, including three
representatives of the Illinois Nurses Association, gathered for four days of
workshops and panel discussions at a new School for Nurse Activists and
Patient Advocates, organized by the California nurses group.
Nurses and patients were shown how the 32,000 members of the California
Nurses Association encouraged patients to publicly recount their experiences.
Additionally, the association set up a 24-hour public hotline. The strategy
is being copied by at least a dozen other nurses associations.
At the nurses meeting at the Kaiser Permanente Medical Center, Jim Ryder, a
California Nurses Association leader, outlined a strategy that is as
unorthodox as it is controversial: Nurses agreed to fill out brief, daily
reports involving every instance of substandard care linked to inadequate
staffing. The cases, which will not reveal patient names or any other
identifier, will be put into a database and released next year, Ryder said.
The nurses allowed the Tribune to attend the meeting at Kaiser Permanente
with a condition that the identities of those quoted would be protected.
The nation's largest nurses' associations maintain that a majority of
facilities have unnecessarily squeezed staffs in pursuit of higher profits.
Even the upper ranks of the traditionally staid American Nurses Association
have been spurred into a more demonstrative form of protest. Last month,
association President Mary Foley was arrested after blocking the entrance to
a hospital in Washington, D.C., where nurses were on strike to end what they
said was excessive, mandatory overtime used to compensate for inadequate
nurse staffing.
At the heart of the dispute: How many patients can be assigned to a
registered nurse before safety is compromised?
California lawmakers have been the first to attempt an answer, earlier this
year passing the nation's first law to establish nurse-to-patient r