Behavior has consequences
On September 30, 2011, the San Francisco Chronicle ran an op-ed penned by two California Nurses Association (C.N.A. and affiliated with the AFL-CIO) members. They were identified as Genel Morgan and Rita LaBarge, RNs at Mills-Peninsula Hospital and Alta Bates Summit Medical Center respectfully. They wrote this op-ed in response to what they viewed as a growing black lash against their public theatre held in the name of Judith Ming, a patient that died due to a nursing error that occurred at Alta Bates Summit Medical Center in the early morning hours after the C.N.A. organized one-day strike.
They begin their op-ed, entitled “C.N.A. members: Nurses protect patients”, with the following statement “To suggest that nurses who fight to provide safe care every minute of every day are using the death of one of our patients for our own gain is genuinely disturbing. One only has to view the video of the candlelight vigil held honoring Judith Ming to recognize the palpable grief in all our faces as we honored the life of a patient caught in the crosshairs of a system gone awry.”
This statement just about says it all when it comes to why so many nurses like myself and the public-at-large haven’t exactly been singing the C.N.A. praises about their behavior during the one-day strike and subsequent four-day lock out. A patient, a human being, died a tragic death and the C.N.A. nurses and their leadership
- First, call for an investigation via a press release,
- Second, hold a candlelight vigil in the name of the patient, announcing this “exhibition” of sorrow through yet another press release and then for good measure videotape and post it for all the world to see, and
- Third, begin a campaign to vilify the nurse that made the nursing error because we all know that “replacement” nurses aren’t real nurses just like substitute teachers aren’t real teachers, and doctors covering another doctor’s shift aren’t real doctors and so on.
Stay at the bedside long enough, and I have a couple of decades under my belt, and you see your share of nursing and medical mistakes. I’ve even stopped similar mistakes as the one reported to have occurred at Alta Bates Summit Medical Center. My readers may also recall the heparin overdoes that occurred in a number of pediatric patients not that long ago at Cedars-Sinai Medical Center. Then there was the nursing error at St. Mary’s Hospital in Madison, WI that lead to the death of a 16-year old mother who was at the hospital to deliver her child. In this case Nurse Thao, an experienced Labor & Delivery nurse, gave the mother an epidural anesthetic via IV causing the mother the have seizures and eventually die. Our nursing literature is rife with cautionary tales of nursing errors narrowly avoided or of those not caught that ended in tragic outcomes. Which is why, I found the C.N.A.’s crocodile tears about this tragic event so repugnant, because just when you think they can’t stoop any lower, they do. One must ask oneself have they no shame – apparently not!
Like falling dominos, the C.N.A. and their members set in motion a series of events when they walked away from their assignments to hold their one-day strike. They did so fully informed that should they hold their one-day strike those that didn’t report to work would face an additional four-day lockout so the hospital could meet its commitment to the 500 nurses that had been hired to cover the shifts of the striking nurses. Neither party was engage in any thing nefarious. The nurses, aggrieved with the state of the contract negotiations issued an intent to strike and when strides weren’t made (in their opinion) they held their strike – all legal and above board. Alta Bates Summit Medical Center in turn, unlike a grocery store or office couldn’t just close up shop and send the patients home for a day. Their only option was to hire registry/travel nurses to cover the one-day strike. However it’s not realistic that the hospital bring 500 nurses from across California and the country just for one-day so they did what most hospitals in the same situation would do, they gave these nurses a five-day contract. In turn they informed the nurses that walked away from their assigned shifts that they wouldn’t be allowed to return for an additional four-days, this rule didn’t apply to nurses that weren’t scheduled to work the day of the strike -- all legal and above board.
Whether what happened at Alta Bates Summit Medical Center was a case of catheter confusion, some other nursing oversight, human error, or negligence we’ll have to wait for the conclusions of the various investigations that are ongoing. The C.N.A. instead of vilifying the hospital or offending nurse should be actually asking how they can help ensure that nursing errors such as the one that occurred never happen again. Instead they chose to publish op-eds about their anguish, or issue quotes about “if only I had been allowed to return to work my shift the day after the walk-out, and posting videos of candlelight vigils to the web, giving lip service to patient advocacy. I think it’s important to note that this is the same group that has reportedly held 100 strikes over the past three years. Which makes it all the more important to remind the C.N.A. and their nurse members that behavior has consequences.
What’s going on at Henry Mayo Newhall Memorial Hospital?
It would appear that the California Nurses Association (C.N.A.) has set its “sights” on Henry Mayo Newhall Memorial Hospital. Now by setting their “sights” on Henry Mayo Newhall, I don’t mean that they’re planning to try and unionize the hospital, because the C.N.A. already represents the RNs at Henry Mayo Newhall. What I mean is that I think they’re laying the groundwork for some serious arm-twisting in advance of the next contract negations. What? Pray tell would lead me to think such a thing. Simply put, an article that I believe the C.N.A. had planted in The Signal, the area’s local paper this past March.
The article was entitled “Nurses challenge staffing” laid out for all to read that the C.N.A.-represented nurses were accusing the hospital for failing to meet our state mandate nurse-patient ratio and this action as reported in the paper “poses a danger to patients”. Oh my! I find it interesting that nursing unions always seem to be quick to cry “poses a danger to patients” whenever they want to get in the paper or on TV and this cry makes sense because everyone’s ears perks up when they hear that something or someone “poses a danger to patients”.
As I read the paper I began to suspect a more choreographed press release rather than an article for several reasons.
- The first being that the reporter incorrectly reported that RN’s receive a college degree in Registered Nursing, and when I reported this error to the paper’s editor there appeared no attempt to correct the error, didn’t publish my letter to the editor dealing with the error and the reporter (for whom I left several messages) never responded to my phone call.
- The second, and perhaps most interesting, was the statement that the RNs came to The Signal to discuss what they “saw as the dangers of team nursing” on the condition on anonymity but brought along their C.N.A. representative to vouch for their credentials. Why did they need the C.N.A. representative to vouch for their credentials, since all they needed to produce was their valid California RN license and their Henry Mayo Newhall identification, and if necessary proof they were C.N.A. members. I think that the C.N.A. representative was there to ensure that the nurses stuck to the script, and The Signal fell for it hook, line, and sinker.
All in all, the article painted a grim picture of brave and overworked nurses struggling to do their job and provide appropriate care for their patients. However as a nurse with almost four decades of experience under my belt I found it hard to buy some of their “poor me” stories. Such as the one “Helen” tells of “I don’t know any of the meds my patient got today. Because all the thousands of medications we give to patients each day.” Really? Thousands of medications each day – how many patients does she have each day? 100? I’m a NICU/PCIU nurse and in some cases I’ve had to deliver complicated medication regimes and in my entire career I’ve never had to administer thousands of medications to my patients every day – come on! And even if a nurse did have to deliver thousands of medications to their patients every day no one would expect them to remember, but they would be expected to be able to report from the patient’s medical records what had been administered during their shift. This is why we record our actions in the patient’s medical chart, and in some of the more technologically up to date hospitals we simply scan the medication barcode and the patient’s id barcode and the computer updates the record.
In all likelihood there are underlying nursing management issues at Henry Mayo Newhall, especially when I learned that Mr. Larry Kidd, RN was the Chief Nursing Officer (CNO) and Vice-President for Patient Care Services. He was brought in by the Camden Group as their CNO in their failed attempt to help the Los Angeles County Department of Health Services to turn around and save King/Drew Medical Center (KDMC) – and we all know how that story ended. So I wouldn’t be surprised if competent and experienced nurses had issues with his management of the nursing department. Even I had issues with his management of the nursing department during the failed turn-around of KDMC, so no surprise there. I can also empathize with their dislike of team nursing, because I’ve never been a fan of team nursing. I’ve always found that team-nursing without clear lines of communication and strong management often devolved into chaos with no nurse stepping up to take leadership responsibility and everyone pointing to the other with the explanation that I thought it was their job?
You can find a copy of The Signal article and my response LTE TS Henry Mayo
Did C.N.A.’s Demonstration at Whitman Home Result in a Federal Offense?
In this nurse’s opinion the California Nurses Association (C.N.A.) membership hit an all time low this afternoon in Atherton, California. You may wonder what could be worse than threatening opposition nurses, their children, and pets, or stalking opposition nurses, showing up at their relatives homes and calling family members at all hours of the night and day under the pretext of “convincing” the recalcitrant nurse that the C.N.A. is a great organization to join is low -- you weren’t in Atherton. Today, low behavior was when hundreds of C.N.A. members and supporters descended on this quiet neighborhood so they could hold a demonstration at the private residence of California gubernatorial candidate, Meg Whitman.
Of course this demonstration was accompanied by all the usual hyperbole and misrepresentations that are part of the C.N.A.’s usual arsenal. But to come to a person’s private home is truly above the pale. I’m sure Ms. DeMoro, Nurse Burger and company wouldn’t appreciate say the S.E.I.U. coming to their private homes and demonstrating to illustrate how the C.N.A. has engaged in raiding their nursing unions. But common decency, and socially appropriate behavior seems to be lacking in the C.N.A. leadership DNA.
But what this nurse liked best was that in the C.N.A.’s attempt to garner media attention a nurse delivered a letter to Ms. Whitman by placing said letter in Whitman’s residential mailbox. In doing so this nurse may have engaged in a federal offense. What federal offense, why the law that states only authorized letter carriers may insert mail into a residential mailbox. Oh my! The rule making and rule toting C.N.A. broke a rule themselves – color me surprised! …. More to come.
And the LA Times wonders why their readership continues to shrink. . .
Newspapers across the country are suffering from declining readership, and many have either closed or are facing impending closure – most place the lion’s share of the blame on the Internet. Pundits claim the instant access offered by the Internet is driving people from the printed word to the electronic word. I’m not sure if I’m ready to buy into this conclusion, simply because I think there’s also a growing lack of confidence in the “objectivity” of newspapers among the reading public.
For example several weeks ago the LA Times ran an article, “Many Nursing jobs, but only the strong need apply (http://articles.latimes.com/2009/apr/27/health/he-nurses27)” . The article was available in its entirety on line nearly two days before it ran in the print version of the Los Angeles Times, and upon reading it I found that it appeared to have more in common with a PR piece for the C.N.A. rather than an unbiased, objective piece of reporting. I took issue with several parts of the article, and submitted a letter to the editor and one to the Reader’s Representative. I wasn’t sure if they’d run it, but I thought that at the very least they’d print a correction. They did neither, but after some persistent follow-up on my part; including several telephone calls to Ms. Gold, the reader representative which remain unanswered, and two calls to Mr. Newton, A Sr. VP at the LA Times who communicated with me that he ask the reporter to call me which she never did, and a lengthy conversation with someone named Maria they quietly ran my letter on the “Health” page in their internet edition. A copy of my letter can be found here (http://www.latimes.com/features/health/la-hew-letters18-2009may18,0,3851881,full.story).
I felt compelled to address several shortcomings that I found in the article. The first and most obvious was the number of new licenses issued that the C.N.A. representatives tout to prove the success of the California Nurse/Patient ratio law that they helped push into law. Though it’s correct that there have been nearly 100,000 new licenses issued since the law was passed five years ago, a nearly equal number of licenses have been lost, so it’s been a wash. The reporter had an obligation to report the fact, not just the rhetoric. The reporter also appeared unable or unwilling to interview a variety of nurses, since the three nurses she interviewed were all from C.N.A.-represented hospitals, and if this was to be a pro-union piece she should have at least interviewed nurses from the S.E.I.U. and U.N.A.C.; better yet she should have interviewed two non-union nurses and one union nurse as this would have been a fairer representation of nurses. But the worst offense, in my opinion, was her failure to identify one of the nurses she interviewed as a member of the C.N.A./N.N.O.C. Council of Presidents.
It’s reporting and editing such as this that’s caused the reading public to loose faith on the ability of their local newspaper to report, rather than make, the news. Just like the LA Times refused to cover the recent “Anti-Tax” parties attended by thousands in LA based on the excuse that these were manufactured events; but would show up to cover a couple of hundred people who showed up at a recent LA School Board meeting to protest impending lay-offs. As anyone who has ever organized an event, protest or rally in this city knows, it’s all “manufactured” because as a rule you have to get permits, put out press releases, etc. So if events being organized and manufactured is the LA Times threshold then they shouldn’t cover any such event but of course they cover those that they seem sympathetic to. And this is one of the primary reasons, this citizen, thinks that people are turning to the Internet because more often than not we know the bias of blogs, forums and other “news sources” from these sites.
The Myth of the Employee Free Choice Act
As the New Year dawn’s unions and their supporters, many of whom are legislators that owe their elections to the vast sums of money unions donated to their campaign, are gearing up to tackle the “Employee Free Choice Act”, also known as the “Card Check Bill”. As with so much legislation the words that were chosen to describe the bill don’t necessarily provide an accurate picture of the intent of the bill. Oh sure -- free choice – everyone is in favor of free choice. Unfortunately this bill isn’t so much about free choice as it is about weighing the fight to unionize in favor of one group over the other.
Unions contend that employers impede their ability to unionize under the current system and thus are pushing for what they describe as a more streamline approach, which is the card check. Simply put if a union can gather a majority or set number of employees to sign cards indicating that they want union representation then voila the union “wins”, and if the employer drags their feet then the employer can face sanctions and fines. Now to some this may seem a simplified and fuss free approach to what can often be a long drawn out procedure to union recognition for employees who want such representation.
However, I wonder if those who support this approach would be willing to allow for the same approach to decertification? As it stands now decertify is an onerous and tedious task, and for good reason. Just as one should not approach unionizing without thought, full disclosure and discussion one should not decertify without full and complete discussion for all involved. Both the act of unionizing and decertifying can and often has far reaching implications, not only for the employees who are seeking this action but also for the employer and community at large.
Here is a link to information about the Employee Free Choice Act -- http://www.sourcewatch.org/index.php?title=Employee_Free_Choice_Act. However, I propose to my fellow pro-union and “Employee Free Choice Act” supporters, allow the same rules that the Employee Free Choice Act will invoke to those wish to decertify, because those who want to ride themselves of a union should have the same “free choice” as those who wish to bring in a union, n’est pas?
Of course they may argue that the Free Choice Act may subject employees who wish to decertify to undue influence and intimidation and therefore a secret ballot is called for, but the same can be said for those who wish to unionize. A secret ballot protects all individuals and organizations from undue influence, intimidation and tampering. And yes unions are equally culpable of the same bad behavior they often accuse employers of perpetrating. Don’t just take my word for it, you need only look up the hearing transcripts of the NLRB hearing that involved Cedars-Sinai and the C.N.A. where non-union supporters (nurses) were threatened by C.N.A. representatives: Threats such as we know where your children go to school, and where you walk your little doggies (authors emphasis added).
So before you give the Employee Free Choice Act a pass, remember that if the same rules cannot be applied to those who wish to remove a union then the bill/law is flawed and is not deserving of support.
Is the San Francisco Chronicle providing free PR for the C.N.A.?
Freedom of the press is critical to the foundations of our democracy, however accuracy of the press is also equally important! For when the press reports erroneous information or moves from reporting the news to acting as a "public relations" agent for a person, group, organization, etc then the press fails to keep its promise to the people it purports to serve.
Recently the California Nurses Association (a nursing union) has garnered some press for their antics and outspoken "activism". This is all well and good since we do live in a free society, however it is imperative that when the press covers actions of the C.N.A. that they do so with accuracy. It is my opinion that this was not the case in a recent San Francisco Chronicle article, "The Rabble-Rouser" published on May 6, 2007 and written by Kathleen Sharp. After reading the article, I felt compelled to respond, since I felt it was more a free public relations article then news article; and that there were numerous inaccuracies and mischaracterizations that needed to be addressed. You will find my response to the article as well as the article archived here.
Why, you may ask, have I posted this letter as well as copies of the letter and article to the NRNPA website? Since it would seem that the San Francisco Chronicle editorial staff has chosen not to run my letter nor answer three separate phone calls, I persevered and tried a fourth time and on May 7th I spoke with Ms. Greene. At her request I e-mailed a copy of my letter directly to her, she was kind enough to acknowledge the receipt of my email and informed me to whom she had forwarded copies of my email. Meanwhile I waited and surmised the SF Chronicle would not print my letter since I strongly believe that they had an unadvertised "support" for unions and the C.N.A., in particular. So I am not completely surprised that they have yet to run my response, though I had hoped they would have presented another viewpoint.
And this is why I have decided to run it. I encourage you to read both my letter and the article to which it is in response to and to formulate your own opinion and if you feel so incline share it with me at clavreul@nrnpa.org.
May 10, 2007
Letters to the Editor
San Francisco Chronicle
901 Mission Street
San Francisco, CA 94103
Re: The Rabble-rouser
Dear Editor:
I read the above article, or should I say PR piece, with interest and concern. Your reporter made several errors in the article; according to the C.N.A.'s own website they have approx. 75,000 members not the 80,000 your reporter cited and Ms. DeMoro is no modern day Florence Nightingale - in fact she is no RN and her actions are an insult to the memory of Florence Nightingale!
Finally, RNs across this country (both in unions and not) have not exactly jumped on the C.N.A.'s bandwagon. Nurses represented by other nursing unions have decried DeMoro and the C.N.A.'s tactics since they often play fast and loose with the facts in order to push their agenda; they have received at least one written warning from the Calif. Board of Registered Nursing for violating the Continuing Education program - all which often runs counter to the oaths we as nurses take when we become licensed. And finally before you paint them as though they represent a large portion of RNs in this country please remember that we are almost 3 million RNs compared to 75,000 RNs in the C.N.A.
For the record I am one of the 290,000 California RNs that has chosen not to let the C.N.A represent nor speak for me and who despises the deceptive tactics that their organization employs.
Sincerely,
Geneviève M. Clavreul, RN, Ph.D.
The link to the article is here: http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/05/06/CMGJIP6QD41.DTL