On Monday, August 24, 2015, the California Nurses Association (CNA) held yet one more of their dog and pony shows. This time the subject of their display was the firing of two Huntington Memorial Hospital RN’s.   The nurses, Allysha Almada (CA RN License #802190) and Vicki Lin (RN License #832090), claim that they were fired by Huntington administration for being vocal about their support for a nursing union, a union that if the nurses voted in favor of (which they didn’t) would have been represented by the CNA. Want to check an RN’s license all you have to do is go to the California Board of Registered Nursing (BRN) website here – http://www.rn.ca.gov/online_services/perm-verif.shtml and click the big grey button marked “click to verify a license” and you can check not only if a RN is licensed but pretty much any health/medical profession that is licensed in our state.

Depending on which newspaper you read somewhere between two dozen to 50 nurses/people came out in support of the reinstatement of Almada and Lin. However, if my many years of experience (all up and down the nursing career ladder) has taught me anything, its that sometimes there’s more to the story than what meets the eye – and that would appear to be the case with Almada and Lin.

I’ve learned that at least one complaint has been filed against Almada and Lin. The complaint has been sent to the BRN, the licensing body in our state that has oversight of nearly 400,000 licensed RNs and is responsible for investigating allegations of misdeeds, accusations, etc., lodged against a California RN. So, what pray tell could the complaint be – well it’s not about Almada and Lin’s support of a nursing union for darn sure!

The complaint alleges the following:

  • Nurse Almada provided her username and password to Nurse Lin
  • Nurse Almada provided this in the form of a note, which was later found in a patient’s medical record, and perhaps the most serious of charges
  • Nurse Almada did this so that Nurse Lin could use Nurse Almada’s username and password to confirm as a second “signatory” that Nurse Almada had double-checked a medication that required two nurses to check-off, without Nurse Almada actually being present and having actually verified that she had indeed confirmed that the appropriate amount of medication had been titrated/drawn by Nurse Lin.

If indeed, Nurse Almada did as alleged and Nurse Lin “signed” as Nurse Almada as alleged in the complaint then it would appear to this nurse that they clearly violated our nurse practice act, not to mention potentially placing a patient in harms way – because the medication that was being administered could be deadly – which is why our nursing protocols call for the first nurse to draw the medication and check that the amount is appropriate and for a second nurse to come and verify that indeed the medication is the appropriate medication and that the appropriate amount is about to be administered. Remember the “rights” — the right patient, at the right time, and so forth.

What’s the big deal about requiring two or more nurses to verify that the appropriate medication is about to be administered to a patient, simple some of the medications that a nurse administers can KILL their patient and nurses are only human and can make a calculation error, inadvertently draw too much medication, misread an order and so forth, so nursing protocols require that certain medications such as insulin, heparin and others require a two nurse protocol. Because too much insulin can kill and too much heparin and your patient can bleed out of every orifice of their body. So the two-nurse protocol protects both patient and nurse and to circumvent this safety protocol is unconscionable.

The question that now begs to be asked is how come the CNA is demanding the reinstatement of two nurses that allegedly engaged in acts of what would appear to be not only the falsification of a medical record and the possibility that these two nurses engaged in an act of patient endangerment? I guess, when the rubber hits the road patient safety isn’t what concerns them as much as holding press conferences that continue to spread their propaganda and accuse Huntington Memorial Hospital of being a “bad” hospital that’s mean to its RNs on staff.

A lot’s been “said” in print about the recent vote to unionize/not-unionize the RNs at Huntington Memorial Hospital (HMH). If you’d listened to the California Nurses Association (CNA) and many of their vociferous supporters you’d think that it was HMH management that was trying to suppress the vote, but you’d be wrong. You may wonder how I came to this conclusion, simple by looking at the outcome of the NLRB-led and supervised April 15th – 16th election. The unofficial outcome of the vote was as follows – 539 No to 445 Yes with 176 Challenged ballots. There are 176 ballots left to be counted and were challenged by either HMH or the CNA, which is their prerogative. However, if you’re a “true believer” of the CNA party line you might assume that it’s HMH that has challenged the lion’s share of the 176 ballots, but you’d be wrong. It’s my understanding that HMH has challenged only five that’s right five of the 176 challenged ballots, leaving 171 votes challenged by the CNA, that’s right the CNA is the side that has chosen to challenge the largest number of ballots. On the bright side, it looks like pretty much every eligible RN who was entitled to vote did just that with only about 40 nurses abstaining. This, in my humble opinion, is proof that contrary to the heated rhetoric of the past several months show that the HMH RN’s felt free to vote! Now why would the CNA, the nursing union that kept spewing the “just let the nurses vote” mantra at every media source they could find and painting HMH as some kind of boogey man when it came to the nurses voting on the issue of whether or not to unionize, challenge so many ballots? Why, because they feared that the majority of these 171 ballots were not in favor of the union and thus their strategy was to challenge these ballots, thus hopefully swinging the outcome of the vote in their favor. However it would appear that this strategy might have backfired. We should know the final results on April 27th and if the NO votes win the day the CNA will of course respect the nurses will – NOT! They’ve already made it clear (just take a peek at their newest flyer handed out the very next day – CNA Flyer) that they plan to continue their campaign to unionize the RNs at HMH – so much for “just let the nurses vote”. Hypocrite, thy name is the CNA.

I would hope that Professor Dreier is a better fact checker of his instructional material than he is of his columns, because in his above entitled column he failed to fact check the statements about me provided to him in all likelihood by the California Nurses Association (CAN).

Not only does he mangle the name of my company (it’s Solutions Outside the Box, not Outside the Box Solutions), he also falsely accuses me of having been hired by Huntington Memorial Hospital (HMH) to as he puts it “to harass and intimidate nurses and undermine their organizing efforts”. I’ve not received, been paid, promised, etc., a single red cent by Huntington Memorial Hospital. I’ve also not engaged in any way shape or form to harass or intimidate any HMH nurse. The CNA (whose leadership fears me as well as any nurse willing to stand up to their machinations) is always happy to spread lies and untruths – in short they know that I’m not being compensated but they are happy to say I am because more often then not the folks that support them (like Prof. Dreier) don’t bother to fact check the information that the CNA spoon feeds them.

Prof. Dreier goes on in his column to illustrate, as so often happens when ideologues from either side of the political spectrum get their “panties in a wad” to tell the tale of woe of their favorite side and ignore the experiences from the other side of the discussion. So, since Prof. Dreier’s fact checking is lacking let me set a few things straight.

First, I was contacted by several HMH nurses that wanted to learn what their options were to avoid a union. In that spirit, I met with a group who came on their own time and dime to learn what resources and recourses they had to provide a counter-point to the “let’s join a nursing union” advocates. They didn’t pay me a red cent. I did however secure the domain name of their group, IStandWithHuntington.com to ensure that it couldn’t be co-opted for other uses, but it’s the IStandWithHuntington nurses that run it and moderate it.

Second, I know that many of the “we don’t need or want to join the union” nurses have shared stories of being followed, tires being slashed, secure areas (key-card accessible only areas) doors of the hospital being propped opened with orange traffic cones bearing the name of hospitals other than HMH have been reported. One nurse who has vocally opposed the CNA returned to her station to find that someone had left feces on her chair. In case you think she imagined such a disgusting act, a third party observed a pro-union nurse committing the act. As for the incident that Prof. Dreier states occurred in the HMH cafeteria, I understand that there is a video of the event and from what has been described to me the pro-CNA nurses weren’t just sitting politely at a table, but instead were blocking egress to the cafeteria and one of their supporters went so far as to go over to the IStandWithHuntington group in a confrontational manner to verbal abuse the nurses for not coming along with the program. So it would appear that there might be bad actors on both sides, which is why such a campaign often leaves open wounds in its wake regardless of which side prevails.

Third, Prof. Dreier parrots the plea for “just let the nurses vote”, but what he fails to inform his readers is that the CNA doesn’t want to let all eligible nurses vote, they want to pick and chose which nurses can vote and they do this by challenging a particular nurses’ vote. When the NLRB called the election the first thing the CNA did was challenge the right of the Patient Flow Coordinators (PFC) to cast a ballot. The NLRB didn’t agree and said the PFC’s could vote but that their ballot would be a different color (a Scarlet letter so to speak), segregated from the other ballots and only counted if the vote was close. Then the CNA, not happy with this, made it clear they planned to “challenge” some of but not all of the PFC ballots – guess which one they didn’t want counted. Finally, the CNA declared that they didn’t want any PFC ballot counted, even though theses nurses if the CNA prevailed would fall under the CNA representation. So I guess when the CNA stomps their feet and shout “just let all the eligible nurses vote” what they really meant to say was “Just let the ones we say have the right to vote, cast a ballot”.

Back in the day when I was a professor of Nursing the need to fact check our information was considered paramount. Perhaps the same exacting standards aren’t required for Prof. Dreier’s department of Urban & Environmental Policy or Occidental College – one would hope not.

You can read Dreier’s column here – http://www.huffingtonpost.com/peter-dreier/huntington-hospital-nurses-defy-union-busting-campaign_b_7051072.html

Tornek for Mayor!

It takes a strong person to admit a mistake.

Yeah, I know – didn’t I blog all that long ago to not vote for Terry Tornek for Mayor, and you’d be right. Except, two things happened since then. The first being that my candidate of choice back then was Dan Morgan and after the general election he came in third leaving only the top two vote getters to move to the April 21st run-off. And second of the two remaining candidates, Terry Tornek and Jacque Robinson, Tornek in my opinion is the better candidate.

During the run-off period I and several other individuals had the opportunity to met with both candidates, on different days of course. The reason for the meetings was an item of concern to us as a group, and Tornek when asked agreed immediately, emailing me by the next day with dates and times that worked for him, while Robinson appeared to take her time deciding whether or not she would grace us with her presence, but at the last moment emailed a day and time that she could meet with less than a 24-hour window in which to let everyone else know. The topic of our discussion would be the concerns of the nurses from the other side of the whether or not to form a nursing union at our local hospital, Huntington Memorial.

The CNA had played their usual dirty PR game, demonizing the hospital management, accusing the hospital of providing poor care and of course getting local elected officials, religious leaders and community members to come out to these “demonstrations” and calling for “fair elections” and “just let the nurses vote”. Of course both Robinson and Tornek came out to one or more of these demonstrations, so for the nurses coming to the meetings with Robinson and Tornek it was very significant because until that time no nurse who didn’t want a union had had the opportunity to speak to either Tornek or Robinson so they were anxious to have their voices and concerns heard.

As luck would have it we met with Robinson first, the meeting was brief and it was apparent from her body posture that the meeting was pro-forma. Robinson listened but parroted the “just let the nurses vote” line, ignoring that the vote was already tainted with all the demonstrations and that the CNA had already challenged the right of some of the nurses to vote – so much for a fair election and letting the nurses vote. In short she might have appeared to listen to our concerns but most of our group came away with the impression that her side was picked and her decision well made, and we shouldn’t burden her with new information. After one of her patented just let them vote,” I finally told her that she was being flippant. I told her that as an elected official her duty is to represent union as well as non-union constituents. So strong was this vibe that a couple folks from our group said it wasn’t even worth their time to meet with Tornek.

Our meeting with Tornek followed many days later and where Robinson seemed stiff and distant, Tornek appeared relaxed and engaged. He gave us nearly an hour of his time and seemed to be taking great interest in our concerns – this didn’t necessarily mean that he supported our point of view, but it didn’t leave us with the feeling that we were beating our heads against a brick wall.

At a recent debate Robinson kept telling the audience that she was willing to have difficult conversations, but when asked by one of the panelist how she could (and let me paraphrase) on the one hand be endorsed and supported by the police union when it had sued to block the release of the independent review of the police shooting of McDade an unarmed teenager from our community. She never did answer the panelist’s question – I guess this was one difficult discussion she wasn’t willing to have.

I like to think that I’m capable of integrating new information and adjusting my conclusions based on that information which is why tonight my daughters and I are going to complete our mail in ballots – selecting Tornek for Mayor of Pasadena. I hope that all my Pasadena friends that are registered to vote will do the same as well, because we need an individual who can and is willing to represent all Pasadena residents!

Hard Facts? Whose Facts?

Once again John Grula has published yet another attack (“Hard Facts” – http://www.pasadenaweekly.com/cms/story/detail/hard_facts/14291/) against Huntington Memorial Hospital (HMH), and argues that somehow a nursing union (in this case the California Nurses Association – CNA) is the panacea for all the ills that he lays at the doors of HMH. His source for his damning accusations of poor quality of care is the September 2013 issue of Consumer Reports article – “Your safer-surgery survival guide.” which in his article he cites as “the gold standard when it comes to providing trustworthy evaluations of consumer products and services.” Such reports might serve you well for a dishwasher, vacuum cleaner, car and so on, but maybe not so much for a hospital. Perhaps he and others may believe that Consumer Reports is the “gold standard”, but this nurse and health care professional prefers to rely on reports from sources such as the Joint Commission – www.qualitycheck.org and the Centers for Medicare and Medicaid Services (CMS) – www.hospitalcompare.hhs.gov, State and County Department of Health Services ratings when it comes to accessing the overall “quality” of a hospital.

I also had a good laugh at his reference to the recent Leapfrog scores where HMH received a grade of “C”. He made a great deal out of HMH’s C-grade while extolling Kaiser (a unionized hospital chain), but fails to point out that UCLA Medical Center (a unionized hospital) also received a “C” from Leapfrog. Grula also goes on to rave about how of the four hospitals designated by the CDC to provide care for Ebola patients were all in Northern California – oh and unionized. However, Grula should be well aware that in all likelihood these hospitals were selected more for meeting specific qualities and criteria that the CDC setup more than anything else. But then again Grula’s facts seem somewhat weak on this issue, because in his article he makes the following claim “A hospital really has to have its act together to be designated an Ebola treatment center by the CDC, and in the case of California, the four hospitals that achieved this mark of excellence are all in the northern part of the state.   Those four hospitals are:  Kaiser Oakland Medical Center, Kaiser South Sacramento Medical Center, the UC Davis Medical Center and the UC San Francisco Medical Center. No hospital in Southern California, including HMH, made the grade with the CDC.” However, a quick glance at this CDC page – http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/current-treatment-centers.html, and you’ll see all 55 hospitals with Ebola treatment centers including the four Southern California area hospitals overlooked by Grula that hold this designation. I guess Grula and the Pasadena Weekly editors need to be more thorough with their fact checking – but perhaps the facts don’t matter for Grula and the Pasadena Weekly when it comes to their campaign to denigrate HMH. And for the curious among you this CDC link details the process for being designated an Ebola treatment center – http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/treatment-centers.html.

Grula, even went so far as to pull a quote from one of my blog posts “Myth of the Magnet Hospital”, but was unable to even correctly spell my name or include my credentials, where I state that I believe the Magnet designation is a dubious one. I stand by this statement primarily because unlike receiving Joint Commission accreditation that can be pulled by the Joint Commission. A “Magnet” hospital rarely if ever stands to loose its Magnet designation when their nursing staff truly fails. A Magnet hospital might not be able to renew their status, but to my knowledge UC Davis (it has since regained its Magnet designation) is the only Magnet hospital to lose its Magnet status ironically due to all the nursing conflict created by their nursing union. No other Magnet hospital has had it Magnet designation, not even Cedars lost their Magnet designation when their NICU nurses nearly killed several infants due to heparin overdosing due to nurses failing to read the vial and to follow the procedure to double-check the medication. So my philosophy is that the Magnet designation can serve a purpose to help distinguish excellence in nursing, but only if the organization behind that designation is willing to remove or place a hospital in a probationary status when the nursing team makes an egregious error. Just as the Joint Commission will come back to re-inspect a hospital when problems arise and if necessary remove their seal of approval until corrections are made, so too should the ANCC for the Magnet designation.

Grula is so enamored with Leapfrog and his conclusion that unionized hospitals provide the best of care he still hasn’t explained why Antelope Valley (a CNA-represented hospital) was the only hospital in LA County to receive a F from Leapfrog. Could he be engaging in the practice of ignoring information that might unfavorably skew his results? Just asking?

It would appear his love for Kaiser knows no bounds, because as he extolls Kaiser’s virtues he fails to acknowledge the recent 28 million, that’s right 28 million, dollar judgment against Kaiser for their failure to promptly MRI a patient, costing that patient the loss of her leg, and fines imposed against Kaiser for their failure to provide appropriate mental health services to their patients, this is the second year where they still have deficiencies and not made all the corrections required. This is a common willful blindness problem on the part of the rabid pro-union advocates. They pick apart organizations and individuals that they perceive as opposing their unions and views at the expense of some obvious truths. Many years ago the CNA tried to get the California legislature to pass a card-check law for nurses. If passed this law would simply require a union gather enough qualified signatures from nurses at a particular hospital and that hospital’s nursing staff would automatically be represented by a union, no election, no opportunity to present any other side of the discussion. I attended one of the hearings in Sacramento where unionized nurses presented their tale of woe to the committee. They argued that without a nursing union nurses couldn’t stand up to hospital administrators and appropriately advocate for the patient. Their tales were vivid and pulled at your heartstrings they even invoked the example of a Tenet hospital in Redding, CA that was accused, at that time, of excessive cardiac surgery. Their claim was simple, if only those nurses had been in a union they would’ve felt safe to speak up; the only problem with their argument was that it was the nurses, the non-union nurses that blew the whistle on this practice. As I listened to their rationale, I wondered where were all the union nurses blowing the whistle on the IVF scandal at UC Irvine so many years ago? And because I had my ducks in a row and all the evidence, I like to think it was this last minute effort by a handful of nurses and myself that helped get the bill pulled by its sponsor and it eventually died. If there’s one-thing legislators don’t like, its being lied to and made a fool.

And while we’re at it if unions are so great for nurses why are the CNA and another nursing union, UNAC/AFSCME embroiled in a fight at Kaiser – Los Angeles Medical Center to hold an election so the nurses can leave UNAC for the CNA. Ironically, the CNA has also accused UNAC and Kaiser of engaging in practices that are blocking the nurses from this vote. Here’s a copy of an Open Letter to UNAC members_Sigs2 sent to UNAC members sent by CNA-supporting nurses regarding this very matter. In their letter they plead that people should call “UNAC at 800-762-5874 and tell them to withdraw all blocking charges, charges that are preventing your nurse colleagues at LAMC from a fair and democratic election that will finally allow us to choose our union”. Sounds familiar doesn’t it, I guess “evil” hospitals aren’t the only ones that seem to cause the CNA problems, unionized nurses cause the CNA problems as well – how ironic!

So Grula I call your September 2013 issue of Consumer Reports article and raise you my 2014- 2015 US News & World Report Best Regional Hospitals (http://health.usnews.com/best-hospitals/area/ca/huntington-memorial-hospital-6932350).

Terry Tornek for Mayor — NOT!

Not that long ago the Pasadena Star News announced that it endorsed Councilman Terry Tornek for mayor. In their editorial they characterized his running as mayor, as being brave. They came to this conclusion that he was brave by throwing his hat in the ring, before Mayor Boggard (our current mayor) had announced whether or not he’d seek another term. I don’t know about you but I would hardly call what Tornek did as brave, especially since he didn’t resign his council seat – that’s right. He’s currently an elected member of our city council, so if he loses his bid for mayor he can finish out his term. In my book that’s not called being brave, it’s called hedging your bets. At least, Jacque Robinson resigned her council seat to run for mayor – not that’s definitely showing more courage that Tornek – but still not enough to earn my vote.

At first, I was supportive of Robinson in her run for mayor, but as time would reveal she, like her fellow councilmember Tornek, were way too beholding to their union cronies. I was able to come to this conclusion because these two, like Victor Gordo and Judy Chu were only open to listening to the handful of pro-California Nurses Association (CNA) nurses from Huntington Hospital and chose to ignore the requests of the we-don’t-need the CNA nurses from Huntington Hospital (they call themselves IStandWithHuntington). It took 30 or so IStandWithHuntington nurses swarming the CNA sponsored press conference before Robinson, Tornek, et al to even acknowledge that there nurses that had a differing opinion on the issue of whether or not to unionize.

So when I took in account both Tornek and Robinson’s lack of fairness to the IStandWithHuntington nurses and that these two individuals were also sitting councilmembers during at least part of the time a city employee was able to embezzle an estimated 6.4 million of Pasadena taxpayer money – I made the decision that it was time to support a different candidate. So from among the remaining four candidates, I decided that I’d support and vote for Don Morgan.

Your can read my letter here – (LTE PSN Tonrek for Mayor2a) that I sent to the Pasadena Star News, which they have failed, refused — call it what you may. I hope you’ll consider voting for Don Morgan. I think he would be a welcomed change.

So for those who may or may not have read Mr. Grula’s latest attempt to convince the Pasadena Weekly reader’s that the California Nurses’ Association (CNA) should be given free reign at Huntington Memorial Hospital (HMH), by “just let the nurses vote” – what a disingenuous piece of tripe.

He begins by heralding that the LA region of the National Labor Relations Board (NLRB) has found “probable cause to believe the HMH has engaged in unfair labor practices against the nurses wanting to form a union”. That might be the case, but let me remind my readers that this is the same regional board of the NLRB that found that the threats made from the offices of the CNA against two Cedars’s nurses that opposed the union weren’t threats at all. However the DC NLRB (and final say on the matter) decided that threats made to one nurses children and another’s nurse’s pets were indeed threats and thus were enough to invalidate the vote – and to this day Cedar nurses remain union-free. In short, just because the regional branch feels there’s probably (i.e. a reasonable belief) cause it doesn’t mean that in the end it will be substantiated.

But what really galls me is this attempt by Grula to somehow equate union representation with the recently released “Leapfrog scores” published in a recent LA Times article — http://graphics.latimes.com/california-hospital-scores/. Granted HMH gets a rank of “C”, but so did 69 other hospitals, including such venerable institutions such as UCLA Medical Center, Loma Linda (which got a D believe it or not) and Stanford Hospital. Grula goes on, in his article to make it appear as though HMH is the only LA County hospital with such a low score – not true! He also goes on to pontificate that Kaiser (a CNA-represented hospital network) has a rank of “A”, which is true, but what he fails to disclose is many other CNA-represented hospitals that scored “C”, “D” and “F” grades– yes “F”.

So, Antelope Valley Hospital is the only LA County area hospital to receive a big fat F and is a CNA-represented hospital! California Hospital Medical Center, Citrus Valley Medical Center Inter-Community, Glendale Memorial Hospital, Good Samaritan Hospital, Henry Mayo Newhall Memorial, and UCLA Medical Center all receiving a C grade are all CNA-represented hospitals. So while HMH receiving a C-grade might provide fodder for Grula and the CNA to say that hospitals with unionized hospital staff get better grades from Leapfrog is a very weak assumption to make (I think they’re kind of leapfrogging to that assumption). It would appear that Grula is following in the footsteps of the CNA in not allowing the facts to get in his way.

The problem, in my opinion, lies with the CNA-campaign to gather enough valid RN signatures to call for a vote – and it would appear that they might be falling short of this goal. So now the CNA is trying to pressure HMH management into just giving the CNA the “keys to the kingdom” and allow a vote to go forward without showing via signed cards that a majority of HMH RNs want the union. The feedback that I’ve gotten from HMH nurses on the ground is that most have been rebuffing the CNA’s advances. So this will have to make the CNA representatives work all that much harder for the votes – oh boo hoo. The CNA likes to paint nurses that are pro-union as somehow being brave and self-determined all the while painting nurses that oppose the union as somehow misguided, naïve or shills for management. They accuse yours truly of interfering because I’m giving “aid and comfort” to those RNs standing up to the CNA union machine all the while the CNA applauds local politicians, church and community leaders who support the CNA. Their message if you support the CNA you are somehow brave and community minded, and if you don’t you’re weak minded and interfering; their logic boggles the mind.

The CNA tried this same tactic many years ago when they tried to get our state legislators to pass legislation that would bypass a vote entirely and simply allowing gathering enough signed cards to install a union. They testified that nurses were really too weak to “speak up for themselves” thus they needed this card check legislation. Union representatives even went so far as to tearfully testify that if only the nurses at that “Tenet hospital in Redding” had been unionized the RNs would have felt safe to come forward to blow the whistle on all the unnecessary cardiac surgery that was being performed. There was just one problem with that scenario. It was the nurses, themselves, that blew the whistle – the very non-unionized nurses that the union deemed to weak to speak for themselves. Meanwhile they never explained why the union represented nurses at UC Irvine never blew the whistle on the problems with the IVF program.

This is one of my fundamental issues with nursing unions, which is they all too often resort to mud slinging, fact mangling and sometimes out right lies to grow their ranks. Nursing is a profession and should be treated as such. All too often unions in their mad dash to unionize the RN workforce resort to tactics that leave a mark on our time honored profession. I say if they want to convince nurses to unionize do so with the facts, with well supported arguments and leave the bullying and threats out of it. And as I always say “if nurses are too weak and incapable to advocate for themselves (as the CNA purports) how can these same nurses advocate for their patient as they are require by The California Nursing Practice Act.

But back to the “C” grade awarded to HMH and many other hospitals. It’s important to keep in mind that there several different hospital safety “report cards” available. Leapfrog – www.hospitalsafetyscore.org- is but one of many that are recognized and used. You can also see how your local hospital stacks up by using the Joint Commission Quality Check – www.qualitycheck.org; CMS Hospital Compare – www.hospitalcompare.hhs.gov; and Consumer Reports Hospital Safety Ratings – www.consumerreports.org/health/doctors-hospitals/doctors-and-hospitals.htm to name a few.

In Grula’s opinion piece “Huntington Hospital is Ill” that ran in the November 6, 2014 edition of the Pasadena Weekly, he attempted to paint Huntington Hospital as some kind of sub-par hospital and it’s administration (calling out its CEO Steve Ralphs) as somehow cruel and uncaring of their nursing staff – all this, in my opinion, at the beck and call of the California Nurses Association (CNA).

Why? You may ask, because the CNA has been trying unsuccessfully, to date, to unionize the 1,100 RN workforce that ply their craft at Huntington Hospital. As expected, the CNA was up to its usual shenanigans, they held a rally where they claimed hundreds of supporters attended lining the length of Pasadena Avenue, when in reality somewhere about 80 – 100 people showed up, of which only a handful were actual Huntington RNs. Their theme for the rally, “restore quality patient care”.  As a RN and Pasadena resident it really irked me that the pro-CNA nurses at Huntington would allow the CNA to spread such a despicable message, because to restore something implies that something, in this case quality patient care, is missing which isn’t the case with Huntington Hospital. However, the CNA isn’t one to let the facts get in their way and neither it appears is Grula or the editors at the Pasadena Weekly.

I make this bold statement, because in Grula’s piece he tries to convince his readers that somehow it makes sense to allow the Huntington nurses to unionize because 60% of California nurses already belong to unions. He bases these numbers on two statistics both provided by, you guessed it, the CNA. The first statistic he provides is that there are 200,000 RNs in California and that 120,000 are in unions. So when you use these figures its easy to see how one might conclude that about 60% of all California RNs are in unions, but there’s one small problem. What, pray tell, might that be? All it takes is a quick telephone call to the California Board of Registered Nursing (BRN) to learn that there are currently 398,134 actively licensed California RNs with another 16,025 holding an inactive license for a total of 414,159 California RNs. It’s that quick and easy. Not sure you can look it up on line at http://www.rn.ca.gov/about_us/stats.shtml or for the most up to date figures you can call the BRN at (916) 574-7699. So with more accurate figures the 60% of all nurses belonging to unions becomes more like 30% with the majority of California nurses (about 70%) choosing to remain union-free.

Gurla also tried to make a point of Huntington’s CEO Ralphs’ salary, but failed to note how much money the CNA will make yearly off the backs of the RNs in the way of dues if they are successful in unionizing the Huntington RN workforce. Think the number one followed by six zeroes and then some. His entire piece supports solely the goal of the CNA and the Huntington RNs that support the CNA, but fails to mention that the greatest opposition comes from within the very Huntington RN family – from members who don’t want the union to represent them as they feel they don’t need an additional layer between them and management. Of course, if Grula even mentioned that opposition was coming from Huntington nurses, themselves, then the CNA’s and his argument that it’s the “evil” management that’s fighting the CNA — falls to pieces and blows the “we’re poor weak nurses who can’t speak for ourselves so we need the CNA to fight our battles for us” theory out of the water.

So when Grula’s piece was published, wrong statistics and all, I submitted a letter to the editor to both correct the erroneous statistics and to provide my two cents on what’s happening at Huntington, which is that the CNA is facing resistance, not from hospital management but from the very nurses they are attempting to organize. Some of the nurses who didn’t want a union reached out to me and asked for advice and guidance, which I was happy to give them. Something the CNA hates, because they like to portray themselves as the protector of the hard working nurse who is somehow so downtrodden by management that they can’t stand on their on two feet. So when the very nurses they want to represent, fight them and spurn the CNA overtures, the leadership of the CNA becomes practically apoplectic.

After emailing my letter to the editor I followed it up with a phone call to the editor, Kevin, and had a nice chat with him and received a promise that he’d run my letter in the November 20th edition. So when November 20th rolled around I picked a copy of the Pasadena Weekly and found that my letter to the editor hadn’t been printed as promised. I called Kevin and imagine my surprise when he informed me that he gave my letter to Grula so he could “respond”. Why? Because somehow the statistics I provided from the BRN were an “opinion”, or as he so quaintly put it “my contention”. I’d say that the Pasadena Weekly editorial staff has egg on its face for failing to fact check Grula’s stats and now their trying to find a way to save face and to dig themselves out of this fiasco of Grula’s and their making.

So, I say to the Pasadena Weekly do the math, show some journalistic integrity, make the correction, print the letter, and let your readers know that it isn’t the management resisting the CNA, but many of the Huntington nurses themselves.

You can read Grula’s “hit piece” on Huntington Hospital here

Here we go again, the C.N.A. has spent their members’ hard earned money that they take in as dues to produce (CNA Flyer1) a high-gloss hit piece on yours truly. My oh my how I must frighten the C.N.A., this handicapped, little old lady from Pasadena.

So when I saw the piece that they’re passing out at Huntington Memorial Hospital I felt compelled to respond – since as so many nurses have come to learn from past experience, many members of the C.N.A. like to play fast and loose with not just the rules, but with the truth as well.

First – IStandWithHuntington (ISWH) are the Huntington Memorial Hospital nurses that feel that they don’t need the C.N.A. to represent them. The IStandWithHuntington blog is an alternative voice to the C.N.A. message/propaganda. Nurses whose opinions differ from those backed by the C.N.A. have the right to speak their mind and get their message out and they have chosen to do so – even though it means fending often scurrilous attacks from the C.N.A. “war machine”. They express their opinions, viewpoints and so forth on their blog.

Second – Did I help the ISWH nurses – darn tooting. I contributed to their cause by securing the IStandWithHuntington domain name and offered it to them for their use. They run and have full control over their blog. This isn’t illegal, the ISWH nurses have the right to freedom of speech, just as the C.N.A. members have and for the record Huntington Memorial Hospital hasn’t spent a dime in securing, purchasing or hosting this blog.

Third – The C.N.A. really does need to go back to school if they think I’m a professional union buster. Professional is defined as – a person engaged in a specified activity as one’s main paid occupation rather than as a pastime. I’m not paid to help nurses who want to get their union-free message out. Nurses call, write and email me when they want advice on how to get their message out, on how they can even the playing field and what not. I listen to them and if I think I can help I do what I can do, there’s a whole network of us who believe that nurses can effectively advocate for themselves, without union representation.

Fourth – They’re great about listing my administrative positions that I’ve held over the years, but conveniently leave out that I’m a RN and that I’ve spent more years at the beside as first a Pediatric nurse and then a PICU/NICU nurse than I have in administration. But then again if they did that they might actually provide folks with the impression that I’m a nurse and not some boogey man “union buster”, because nurse = good and union buster = evil, don’t you know.

Fifth – It’s no secret that I don’t support the RN-to-patient ratio, because I support the far superior patient acuity system. Title 22 and Joint Commission mandates an acuity-based system because nurses aren’t workers on an assembly line and patients aren’t widgets. I believe that nurses give the best care when patients are assessed based on the complexity of their illness, care needs and so forth and then matched to the nurse that has the skills, education and training to best meet those care needs – after all that’s why I became a nurse. And I think that’s why most of you became nurses, as well.

Ask yourselves this why does the C.N.A. feel the need to play so fast and loose with the truth, why do they resort to innuendoes, and cast aspersions? This is the union that says they want to represent you and yet they appear to show utter contempt of your fellow co-workers who chose to exercise their to freedom of speech and simply put their message out as well. The ISWH nurses have spent their hard earned money on their effort and whether you agree or not about joining or not joining a union the ISWH nurses are deserving of some modicum of respect. I think their blog has strived to keep their tone civil and information fact based. So just to be clear I’m not about union busting, as the C.N.A. likes to suggest, but I’m am about making sure that these nurses who want to have their message heard get the opportunity to be heard.

The C.N.A. loves the scorched earth technique in dealing with those who disagree with or oppose their viewpoint; do you? Do you want to be associated with a group that feels entitled to denigrate others in our profession because we don’t chose to follow their rhetoric? As nurses we are charged with advocating for our patients, so how can we be expected to advocate for our patients if we can’t even advocate for ourselves? I’m proud to be a RN. You’re welcome to call, write or email me.

By Genevieve M. Clavreul, RN, Ph.D.

Working Nurse Magazine

I know that for a lot of nurses, talking about politics is about as appealing as going to the dentist. However, legislation and policy decisions can shape the way we practice at every level, sometimes dramatically. That’s why it’s important for nurses to pay close attention to proposed laws or new regulations affecting our profession.

Let’s take a look at some current healthcare-related measures and what they could mean to you.

Opioid Restrictions

If you or any of your patients suffer chronic pain and have a liver condition that contraindicates acetaminophen (the active ingredient in Tylenol), you should be very alarmed by S.2134 and H.R.4241.

These bills, prompted by the recent fear-mongering about prescription opioid abuse, would ban Zohydro ER, the only FDA-approved opioid that doesn’t contain acetaminophen. The legislation would also prohibit the FDA from re-approving Zohydro “unless it is formulated to prevent abuse.”

Aside from its impact on chronic pain sufferers, this attempt by some members of Congress to usurp the function of the FDA would set a frightening precedent. If Congress can summarily ban a drug that’s already passed the FDA’s approval process, what’s to prevent legislators from banning other approved drugs, like contraceptives, in hopes of scoring political points? I shudder at the potential consequences.

Safe Staffing Ratios

There’s brighter news in the area of nurse staffing requirements. As most of us know, California has had mandatory nurse-patient staffing ratios for the past decade and Congress is now considering national requirements.

The federal Registered Nurse Safe Staffing Act (H.R.1821 and S.2353), which would apply to all Medicare-participating hospitals, is quite different from California’s rules, which mandate specific ratios for each type of unit. Instead, the proposed federal law would require each hospital to establish a committee — at least 55 percent of which must be RNs providing direct patient care — that will create staffing plans based on patient acuity, staff experience and other factors.

Longtime readers know that I’m very critical of California’s “one size fits all” approach to staffing ratios. I strongly believe that an acuity-based system makes more sense, allowing managers to match nurses to patients based on the nurse’s skills and training rather than arbitrary legislative dictates. The federal law would also give nurses a greater voice in those decisions.

Unfortunately, these bills wouldn’t change California’s current requirements. If this law passes, Medicare hospitals in our state would still need to organize the required committees and create staffing plans, but those plans would have to comply with existing state laws.

Lab Result Reporting

Till now, patients have always been told, “The doctor will call you when your test results come back.” However, in February, the Center for Medicare and Medicaid Services amended the Clinical Laboratory Improvement Amendments of 1988 (CLIA) to give patients the right to request test results directly from the laboratory. All entities subject to HIPAA must comply with the regulation by October 6.

It will be interesting to see how the new rule will affect the patient-provider relationship. Will patients be better informed or will they be panic-stricken after trying to interpret their test results based on Internet searches? Will patients even be informed of the new rule? (I know my and my daughter’s providers have yet to say anything about it.)

If your facility’s lab is subject to CLIA, have you been educated about the new regulation? How do you feel it’s working so far? Drop me a line and let me know.

MRSA and Worker’s Comp

If you’re unlucky enough to contract a methicillin-resistant Staphylococcus aureus (MRSA) skin infection while working in patient care, a proposed state law (AB 2616) would make it easier for you to file a workers’ compensation claim. The bill, which is supported by the  California Nurses Association and National Nurses United, passed both houses of the Legislature in August and now awaits the governor’s signature.

AB 2616 states that MRSA skin infections contracted while providing direct patient care will now be presumed to be work-related unless there’s specific evidence to the contrary. That means if you file an MRSA-related claim, the burden of proof will no longer be on you, which is good news.

Workplace Violence

Workplace violence is an ongoing concern for nurses and other healthcare workers. There’s been some progress since Napa State Hospital psychiatric technician Donna Gross was strangled to death by a patient in 2010, but nursing organizations and unions have been calling for more.

SB 1299, which went to the governor’s office on August 28, is intended to light a fire under the state Occupational Safety and Health Standards Board and push state hospitals to take action. The bill would require acute care and acute psychiatric hospitals to establish plans to prevent workplace violence in both inpatient and outpatient settings.

The plans must include training and education for workers, procedures for investigating incidents, and policies for documenting and reporting incidents to the Division of Occupational Safety and Health, which would be required to post anonymized reports online starting in 2017.

Quicker Licensure

Too many new RNs have passed the NCLEX, graduated from nursing school and started applying for work — only to wait and wait for the BRN to issue their licenses. A bill in the Assembly, AB 2165, seeks to address that problem by giving professional licensing boards a 45-day deadline to issue licenses to candidates who’ve completed all the requirements.

The 45-day clock wouldn’t start ticking until you have completed all the application requirements, so this law wouldn’t help if you had missing paperwork or problems with your background check. The point is to keep qualified applicants from being held up by bureaucratic backlog.

Using our Power

This list is by no means comprehensive. New measures come up all the time, including ones that aren’t specific to nursing, but may still affect our work.

The good news is that we don’t have to sit back and watch idly. With almost 400,000 active RNs in California alone, we have more political power than many of us realize. However, for us to use that power, we have to be aware of what’s going on and willing to get involved. We can’t afford to let politics be a spectator sport.

 

How to Stay Informed

If you want to find out more about these bills and others like them, check out the following links:

•  The Library of Congress THOMAS database allows you to look up information about federal bills.

•  GovTrack.us  is another option for keeping track of happenings in Washington. It requires registration.

•  The Official California Legislative Information webpage includes information on current state laws and proposed legislation.

•  LegTrack is another search engine for state measures. It requires registration.

•  Ballotpedia is “an interactive almanac of U.S. politics,” including neutral descriptions of federal and state measures.

•  The Board of Registered Nursing (BRN) website often provides useful information on pending legislation. The BRN’s legislative committee examines all measures and decides whether the board should support, oppose or watch each measure.

•  Professional organizations and unions such as the American Nurses Association, California and the California Nurses Association/National Nurses Organizing Committee also monitor relevant legislation, although these organizations’ information may be available only to members.

Some professional organizations also organize “lobby days,” which are a great opportunity for nurses to learn about important current issues and the political process in general.

Working Nurse Magazine – Issue