Tag Archives: safe staffing

Should Supervisors Perform Bargaining Unit Work?

15 Jan

Mat Keller headshot

By Mathew Keller RN JD, Regulatory and Policy Nursing Specialist

It’s happened to just about every RN at some point or another. Your unit is short staffed, and you’re doing the best you can — but you’re stretched too thin, and your patients aren’t getting the care they’re paying for and deserve. So you call your nurse manager. What happens?

Staff-nurse supportive nurse managers do their best to avoid these situations in the first place by staffing appropriately. However, sometimes it’s just not possible to prepare for unexpected events and changes in acuity. That’s why top nurse managers, when confronted with these situations, advocate for their units in order to get another bedside RN called in to lend a hand.

Some nurse managers may also offer to help out themselves. In limited circumstances, this may be acceptable. If the nurse manager is competent to perform the work, if there was no way the nurse manager could have anticipated the staffing needs in advance, and if the nurse manager is performing the work only in limited emergency circumstances, then MNA is unlikely to pursue a grievance for a supervisor performing bargaining unit work.[1] In such instances, the needs of our patients come first.

If, however, the nurse manager precipitated the staffing crisis through purposeful unsafe staffing, if the nurse manager is not competent to perform bedside RN care, or if there is a continuous pattern of unsafe staffing and supervisors performing bargaining unit work, then MNA can and will take action. As above, in such instances, the needs of our patients come first.[2]

A continuous pattern of supervisors performing bargaining unit work indicates a greater underlying problem—unsafe staffing. As Carrie Mortrud, RN, MNA Safe Patient Staffing Specialist, puts it:

We appreciate nurse managers who step up to the plate and help the team in emergency circumstances that could not have been anticipated. When nurse managers continuously do this, however, they are covering up a larger systemic and often chronic problem — unsafe staffing. They are putting a Band-Aid on an arterial bleed. Clearly a tourniquet is needed — with a temporary Band-Aid.

In those instances, nurse managers need to step up to the plate in another way: by staffing appropriately and hiring more nurses. This protects our licenses, our jobs, and more importantly, our patients.”

Are you experiencing a situation where your nurse manager is continuously performing bargaining unit work? We want to know!  Please let your steward, labor representative, or MNA’s Regulatory and Policy Nursing Specialist Mathew Keller know right away.

 


 

[1] See, for example, Essentia Health Virginia Contract p. 4: “Except in cases of emergency (an unplanned immediate need) or an unavoidable situation where patients would be deprived of needed nursing care, non-bargaining unit personnel shall not be used to perform bargaining unit work.”

[2] Please note that, in rare instances, smaller hospitals have negotiated language allowing supervisors to perform bargaining unit work.  See, for example, Deer River Contract Article 3.1: “Due to the relatively small number of RNs employed at the HealthCare Center and the relatively small size of the facility, the HealthCare Center has working managers who perform bargaining unit work in addition to their management duties.  Any significant expansion of managers doing bargaining unit work beyond that typically done at present shall be open to negotiations between the parties.  The minimum staffing for acute care at the facility will include two bargaining unit RNs if one RN is ER capable and one RN is charge capable.”

When RNs speak, policymakers listen

30 Jan

 

In response to recent attacks on nurses’ safety and their ability to provide safe, quality care for their patients, MNA members are speaking to legislators about safe patient staffing levels and workplace safety in 2015.

Nurses visited the Capitol January 28 to speak to legislators about the need for a Safe Patient Standard. They told lawmakers that patients are at risk when nurses have too many to care for at one time, and urged legislators to create a standard for nurse staffing that protects patient safety.

Nurses from North Memorial Medical Center “adopted” the day to talk specifically about the serious staffing issues facing the nurses and patients there. North Memorial management has unilaterally implemented new staffing grids hospital-wide, which add to the already large assignments of Registered Nurses as well as ancillary staff.

North Memorial RNs told legislators stories about how the new grids are limiting the care they’re able to provide patients and how concerned they are about their patients’ welfare.

“Are patients allowed water, turning, help to go to the bathroom only once a day?” asked one North Memorial RN. She said she’s gone through all the channels to alert management to the problem without success. “I can’t deliver a gold standard of care without support.”

Rep.  Joe Atkins (DFL-Inver Grove Heights) told the nurses how influential their advocacy is on legislators. Atkins said he and his fellow state representatives are lobbied on hundreds of issues, which makes it difficult to keep up, but they start to take notice when they see numerous emails about the same issue. What really breaks through the noise, he said, is when constituents visit them in person and they can put a real name and face to a story. Atkins encouraged nurses to continue coming to the Capitol to advocate for their patients and profession as often as possible.

MNA’s February 9-10 Nurses Day on the Hill is a great opportunity to learn about MNA’s legislative priorities and how to advocate for them. We’ll give you training on how to navigate the political process and will make appointments for you to meet your legislators. For more information or to sign up, visit the Day on the Hill page on MNA’s website.

We will continue taking small groups of nurses to the Capitol on Wednesdays during the legislative session. The next opportunities are Feb. 4 and 18. We will meet at 10 a.m. at the MNA office in St. Paul for a briefing and then head to the Capitol to talk to our state representatives and senators.

To sign up or to see if your hospital can “adopt” a day to meet legislators from your region, please contact Geri Katz at 651-414-2855 or email Geri.Katz@mnnurses.org.

North Memorial Medical Center nurses protest unsafe staffing plan

11 Jun
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Nurses at North Memorial Hospital in Robbinsdale are on the front lines of a battle for safe staffing and safe care that could have a major impact on MNA members and patients throughout the state.

North Memorial management wants to cut nursing staff to dangerously low levels by increasing the number of patients each nurse cares for in the majority of units in the hospital. Nurses are fighting the plan at every step of the way.

“Our patients deserve the best possible care,” said North Memorial MNA Co-Chair Mary Turner. “In our professional judgment, this plan could increase the number of patients to unsafe levels.”

Initial discussions with management were challenging enough to spur North Memorial MNA nurses to the next level – informational picketing on June 24.

“It’s critical to raise the public’s awareness about threats to safe staffing and patient care at North Memorial – and at hospitals throughout Minnesota,” Turner said. “North Memorial is not alone in putting the bottom line ahead of patient care and safe staffing. It is up to nurses at the bedside to advocate for our patients by opposing this dangerous plan now and every time – and everywhere – management attempts something similar.”

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All-nurse meetings at North Memorial to discuss the situation have been packed. While clearly expressing overwhelming solidarity to oppose the proposals, members also shared disturbing experiences about current staffing and patient safety levels. Nurses are being told – or required – to care for more patients and work more hours, even before the new plan is implemented. Nurses have been routinely telling management that the staffing situation is unsafe, but managers respond by telling nurses to “flex up” or “make do.”

“In the last five weeks, there’s been intense pressure to flex up, flex up, flex up,” said RN Dee Anderson. Her geriatric patients take more time than younger people, so Anderson can’t give the kind of care she’s used to.

“It makes me feel pressured and inadequate in my nursing,” she said. “If I feel I have to do more than I know I can, patients are cheated of the care they deserve – and that really hurts me.”

Floating charge nurse Melissa Hayes filed a Concern for Safe Staffing form after a recent night where she was required to care for extra patients and getting no response to her requests for staffing from management.

“Lights are going off, phones are ringing, it’s not okay to leave patients hanging like that,” she said. “I want people to be honest about what’s expected and answer our calls. We really need the support.”

North Memorial nurses are proud of their hospital and want it to “provide the gold standard of care” it always has, but cited other recent concerns:

  • Floors that are short of nurses are required to take patients who have not been assigned.
  • Nurses are working dangerously long shifts – and then expected to stay longer. One nurse worked three 12-hour shifts with only a short break and then was asked to work even longer.
  • Nurses are so worried about their patients that they stay by the telephone when others are on break to make sure people are cared for.
  • Patients are often “stacked up in the lobby” because there are no rooms for them.
  • Nurses frequently find themselves taking care of six patients or more at one time, which doesn’t give them enough time to properly care for anyone.

“In 2010, North Memorial and other area hospitals agreed to work with nurses on staffing,” said North Memorial MNA co-chair Trent Burns. “If the hospitals don’t live up to their promises to nurses, how can the public trust hospitals to live up to their promises to deliver quality care?”

The June 24 informational picketing will show management that nurses are united against the plan – and that there is widespread public opposition.

RN Kate Drusch said hospital leadership needs to hear a message: “It’s a collaboration of compassion and care to serve our patients and communities so nurses provide safe care,” she said. “We’re all partners together in patient care.”

MNA nurses throughout the state are encouraged to join the picketing to not only halt the plan’s implementation at North Memorial, but prevent other hospitals from attempting a similar ploy.

SEIU Healthcare MN, which also represents North Memorial staff,  is partnering with MNA on this event.

Nurses and supporters will picket from 8 a.m. to 6 p.m. on public sidewalks surrounding the hospital.  Volunteer to join the informational picketing.