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.”
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