The NLRB blew-it!

Not so long ago the NLRB ruled that Nurses Allysha Shin (Almada) and Vicki Lin were wrongly terminated and determined in their decision that Huntington Memorial Hospital (HMH) was required to rehire and repay back wages. In the same decision the NLRB also allowed HMH to in essence “black ball” the same two nurses from ever working at any HMH facility.

The issue I had with the NLRB’s decision was that the NLRB appeared to be making a decision on whether or not HMH had the right to terminate a registered nurse for violating the nurse practice act and/hospital policy and protocols. It was the failure of the HMH RN’s to follow both our state’s nurse practice act and hospital policy and protocols that were the grounds that HMH argued that they fired the two RNs and not because of these two RN’s involvement in unionizing activities (The CNA was trying to unionize HMH; a fight that the CNA lost with 539 nurses voting no compared to 445 nurses voting yes with pretty much every single eligible nurse casting a ballot). The NLRB, which we all know are experts on how nurses should perform their duties, decided in favor of the two HMH RNs.

However, on March 2018 our California Board of Registered Nursing placed a Public Reproval on both Nurse Shin (Almada) and Lin’s licenses, which will remain in affect for three years. In both nurses’ document they agree as follows: “Respondent admits the truth of each and every charge and allegation in Accusation Respondent agrees that her Registered Nurse License is subject to discipline and she agrees to be bound by the Disciplinary Order below… ” (Allysha Almada-Final Vicki Lin – Final).

What I concluded from the outcome is simple: the NLRB had no place in deciding the original case since it applied to nursing practice. The NLRB has no expertise in judging whether a nurse has acted within his/her scope of practice or followed hospital policy and protocols.   Perhaps in the future when confronted with such an issue where a nurse is terminated due to an alleged failure to conduct themselves within their scope of practice and said nurse has been reported to their licensing board for such behavior the NLRB should wait for said licensing board to conclude their investigation. If the licensing board finds that the nurse acted within their scope of practice and didn’t violate hospital policy or protocols – then the NLRB can step in and render their decision.

In the future the NLRB should stick to adjudicating labor issues and stay out of the business of licensing boards, such as the Board of Registered Nursing, whose mission is to decide whether or not a nurse has failed to adhere to his/her nurse practice act.

You may recall that in May I reported that two former Huntington Memorial Hospital (HMH) RNs were being investigated by our state Board of Registered Nursing (BRN). The two nurses in question are: Allysha Rae (Almada) Shin and Vicki Lin. They were terminated by HMH for violating hospital policies, they and the California Nurses Association (CNA) argued that they were fired for their unionizing activity at the hospital. Long story short the nurses with the help of the CNA filed a complaint with the National Labor Relations Board (NLRB). The NLRB concluded that HMH inappropriately terminated the RNs and ruled that they were owed back pay and so forth, but HMH got the NLRB to agree that neither (Almada) Shin or Lin were eligible to work at HMH in the future.

Meanwhile the BRN began to investigate (Almada) Shin and Lin, I learned this from nurses that had been interviewed by BRN investigators regarding the incident. It would appear that the BRN investigator found the complaint to be substantiated and thus an “accusation” has been formally submitted. The accusations can be found by searching the license of both Allysha Almada and Vicki Lin.

Nurse (Almada) Shin is being cited for two causes for discipline from the BRN. They are:

  • FIRST CAUSE FOR DISCIPLINE – (Unprofessional Conduct- Incompetence)

Respondent is subject to disciplinary action under section 2761, subdivision (a)(1), as defined in California Code of Regulations, title 16, sections 1443 and 1443.5(2), on the grounds of incompetence in that Respondent breached the Confidentiality Agreement, aided and abetted in the falsification of a medical record, and failed to comply with the double-check process for administering insulin. Complainant refers to and incorporates all the facts and allegations contained in Paragraphs 11 through 20, as though set forth fully.

  • SECOND CAUSE FOR DISCIPLINE – (Unprofessional Conduct- Violation of Nursing Practice Act)

Respondent is subject to disciplinary action under· section 2761, subdivisions (a) and (d), as defined in California Code of Regulations, title 16, sections 1443 and 1443.5(2), for general unprofessional conduct and/or violating or attempting to violate, any provision or term of the Nursing Practice Act. Complainant refers to and incorporates all the facts and allegations contained in Paragraphs 11 through 20, as though set forth fully.

Nurse Vicki Lin is being cited for two causes for discipline from the BRN. They are:

  • FIRST CAUSE FOR DISCIPLINE – (Unprofessional Conduct- Incompetence)

Respondent is subject to disciplinary action under section 2761, subdivision (a)(l), as defined in California Code of Regulations, title 16, sections 1443 and 1443.5(2), on the grounds of incompetence in that Respondent breached the Confidentiality Agreement, violated hospital policy by falsifying medical documentation and failing to comply with the double-check process for administering insulin. Complainant refers to and incorporates all the facts and allegations contained in Paragraphs 10 through 17, as though set forth fully.

  • SECOND CAUSE FOR DISCIPLINE – (Unprofessional Conduct- Violations of Nursing Practice Act)

Respondent is subject to disciplinary action under section 2761, subdivisions (a) and (d), as defined in California Code of Regulations, title 16, sections 1443 and 1443.5(2), for general unprofessional conduct and/or violating or attempting to violate, any provision or term of the Nursing Practice Act. Complainant refers to and incorporates all the facts and allegations contained in Paragraphs 10 through 17, as though set forth fully.

There may be some who think, and the NLRB is one, that what (Almada) Shin and Lin did isn’t worthy of an investigation by the BRN. However we are talking about the standard of care as it applies to “double-checking specific medication” and insulin is one of these. I’ve worked NICU/PICU almost my entire career, and I can never recall a time when any nurse I worked with was “too busy” to come and go through this very basic nursing practice – perhaps that’s because I prefer not to place my patients at risk because of a calculation error in how much insulin needs to be titrated.

I also found their comments as it relates to how they handle their passwords rather cavalier, especially in today’s environment where hospitals are being locked out of their systems due to ransomware, the over 1 million Equifax customers who’s personal information that may be at risk due to a security breech and so forth. So not leaving your passwords written down and left out willy-nilly where anyone can pick it up is actually quite significant and important to maintaining security, confidentiality, and patient privacy.

What I find interesting is the following scenario, what happens if the BRN prevails and one or both (Almada) Shin or Lin is found “guilty” as per the accusations. Does this then vindicate the HMH management for their original decision to terminate these two nurses? Does this mean that perhaps the NLRB made a rush to judgment about the facts of the case? Perhaps in the future the NLRB shouldn’t attempt to dictate nursing practice and leave it to the BRN, whose mission is to do just that!

For the past several years the California Nurses Association (CNA) have launched what can only be described as a smear campaign against Huntington Memorial Hospital (HMH), its management, and ironically against many of the very nurses they purported they wanted to protect. The CNA held rallies and protests outside the hospital and of course many politicians, such as Congresswoman Chu and numerous members of the Pasadena City Council calling for HMH to “just let the nurses vote”.

So when time came for the HMH RNs to vote on the matter the RNs turnout in unprecedented numbers something that rarely happens. The outcome, which was no surprise to this RN, was that the CNA lost. The unofficial tally of the NLRB-led and supervised April 15th – 16th election was as follows – 539 No to 445 Yes with 176 challenged votes. Did the CNA honor the will of the HMH RNs, of course not? Instead they cried foul, filed complaints and demanded an opportunity to have a brand new election. The NLRB, which is not known for being all that fair and heavily favoring “unions” no matter how egregious their actions are – don’t believe me just ask the RNs from Cedar-Sinai that had to endure threats of violence against their children and pets if they opposed the CNA coming into Cedars. Threats which at first the local NLRB folks stated were no big deal, but at least the DC office disagreed and made the final decision that CNA employees have indeed made threats in order to chill the NO-vote.

The NLRB decided that HMH had made errors and that the CNA deserved another bite at the apple, and so another vote was scheduled. As the new date approached the CNA filed additional complaints further delaying the vote. Then about two months ago an interesting rumor began to spread through many of the HMH nursing units. The rumor was that the CNA had abandoned their efforts to unionize the HMH RNs, but no official announcement was made until April 26th when I received word from several of my sources that the CNA had withdrawn their petition – effectively ending the fight to unionize the HMH RNs.

So after all the wringing of hands and gnashing of teeth and stories from the so-called down-trodden RNs that the CNA were going to save from the “evil” machinations of the hospital administration – the CNA quietly pulled up stakes and left.

Why? You may ask did the CNA give up the battle for the hearts and souls and most importantly the dues of the HMH RNs because apparently in the end they did their math and figured that they would lose this election as well. And of course they could risk a news story about them losing an election, they only want news stories about their triumphs.   So kudos to the IStandWithHuntington nurses and their supporters for being the voice of the opposition and it was due in large part to this opposition that HMH RNs got the opportunity to stand up to the CNA.

I do wonder where are all those community leaders, religious leaders and politicians, like Chu, Tornek, Gordo and others now? They rallied with the CNA endorsing the CNA line but failed to rally to show their support when the HMH RNs won the day. The silence is deafening!

Congratulations HMH RNs for making your choice known, now its time to rebuild many of the bridges and bonds with your co-workers that the CNA had no trouble breaking. It’s time to reunite once again for the good of your nursing team, the hospital, the community and most importantly for the very patients you have committed to serve.

Enough is enough

Since April of last year there has been the constant drone from the California Nurses’ Association (CNA) and their supporters of “just let the Huntington Memorial Hospital (HMH) nurses vote”. Elected officials such as Congresswoman Judy Chu, Pasadena City Councilpersons, Gordo and Tornek, former Pasadena City Councilperson Robinson, various “community leaders” and others have picketed the hospital, held rallies, written letters to the editor and what not echoing this simple plea. However, when the vote which was held in April 2015 showed that a majority of HMH nurses voted no to having union representation these same individuals who claimed they were only interested in the HMH nurses getting to vote suddenly had a change of heart and cried foul, demanding that the vote be stricken and a new vote taken even though well over 90% of eligible HMH RNs came out to cast their vote.

As expected both the CNA and HMH leadership filed charges with the National Labor Relations Board (NLRB), each claiming that the other side had made one type of violation or another. The NLRB rendered numerous decisions, some in upholding the CNA claims and dismissing others. In the meantime the campaign to disparage the care at HMH continued unabated. Even after the CNA and HMH agreed to set aside the vote and hold a new election there were those CNA supporters who seemed unable to control themselves and continued their attempts to vilify HMH and its leadership.

One such person is an individual named John Grula, PhD who writes a column for the Pasadena Weekly. He’s most recent diatribe against HMH can be found here – http://www.pasadenaweekly.com/cms/story/detail/outbreak_of_truth/16130/.

He makes many claims in his article, which on their face sound absolutely outrageous. Claims such as CNA-affiliated RNs provide the best patient care in our state. To bolster this claim he brings up the Olympus scope and how the failure to properly clean them lead to bad consequences for many patients. He goes into great detail about these incidents that occurred at HMH, but failed to mention that there were at least two other LA-area hospitals that had similar outbreaks and breeches in reporting such outbreaks. One such hospital was UCLA Ronald Reagan Medical Center, which ironically he cites as having CNA-affiliated RNs that provide the best care in our state.

At the beginning of Grula’s article he cites a June 1, 2016 LA Times article which if you don’t read beyond the first paragraph paints a dim picture about how HMH handled the drug-resistant Pseudomonas aeruginosa. However, if you read the full article, which you can find here — http://www.latimes.com/business/la-fi-huntington-hospital-scopes-20160601-snap-story.html, a slightly different picture emerges. The article lays out the problem was not just at HMH, but at hospitals across our nation, it also lays out the steps HMH took to correct the matter.

His article goes on to mention the firing of two HMH nurses, which the CNA and their supporters claimed was in response to the nurses’ pro-union stance and unionizing activities. He then writes that the NLRB agreement rescinded their termination, removing any mention of termination from their employment record, that they received back pay and that one nurse had returned to HMH. While some of his statement is correct, he fails to mention that while any mention of their termination was removed from their employment files notating instead that they had voluntarily resigned. Grula goes on to claim that one of these nurses chose to return, but my research shows that the nurse he claims returned to work at HMH, hasn’t. The reason for this appears to be related to the NLRB agreement, which bars both nurses from ever working at or having any business with HMH now or in the future. Not to mention that I know that at least one complaint has been filed with the California Board of Registered Nursing (BRN) about the nurses and the possible violation of our nurse practice act. Several weeks ago, I learned that several HMH nurses have admitted to being questioned by the BRN. Now whether this goes anywhere remains to be seen.

In the end, I find it ironic that the CNA and their supporters continue to rant and rave about giving the HMH RNs a voice, but seem to ignore that their “victory” at having the HMH vote overturn effectively gaged the voice of the 539 HMH RNs that voted no to union representation. Throughout this entire contested voting period the CNA and their supporters seem to only advocate for the 445 HMH RNs that voted for union representation and minimize the fact that a majority voted not to unionize.

Where are the CNA and their supporters speaking out in support of these nurses? Nowhere I guess, because it would appear to me that the CNA and many of their supporters appear ethically and morally challenged to acknowledging that these RNs might actually feel that they don’t need a nursing union to speak for them.

Here we go again, at the begin of June, just 4 days shy of the scheduled NLRB hearing regarding Huntington Memorial Hospital (HMH) and the California Nurses Association (CNA); the news broke that HMH and the CNA had come to an agreement. The papers spun it as if it was a victory for the CNA and the two nurses that had been fired, over the “evil” HMH and its management.  HMH reportedly terminated Alysha Almada and Vicki Lin for violating hospital policy, however Almada, Lin, their supporters and the CNA argued that they had instead been fired for their activity in trying to unionize the HMH registered nurses. An attempt that failed with 539 HMH nurses voting NO to 445 HMH nurses voting YES (with 171 additional votes being challenged by one side or the other).

Our local media herald the “rehiring” of Almada and Lin, even going so far as quoting Almada that she had “decided to decline returning to work at HMH because for the past six months I’ve been working at Keck USC, a hospital where RNs enjoy a CNA contract”. However I received an email (which you can find attached at the end of this post) that tells a slightly different tale. Yes, Almada and Lin’s termination was rescinded, but this termination was replaced with voluntary resignations. However what struck me as odd was that part of the agreement assured that neither Almada nor Lin would never be permitted to obtain employment or have any other business relationship with HMH; a caveat that I found very interesting.

Still unresolved through all this is what is happening with the complaint (at least one that I know for a fact was filed, and another that has been filed which I cannot confirm) about Almada and Lin’s action that were filed with the California Board of Nursing (BRN). I’m not sure if the BRN is moving forward with the complaint, but if they do and if the BRN does decide that their action was indeed a violation of our nurse practice act then an accusation will in all likelihood follow. I wonder if that indeed happens will our media report on this or just ignore it? Only time will tell.

Meanwhile, various newpapers, including the Pasadena Star News, Pasadena Weekly and Pasadena Independent spun the agreement as some sort of victory for the HMH nurses, but never once interviewing a single one of the 539 nurses who voted no to CNA representation. Not a single reporter asked them what they thought about their votes being thrown out at the request of, ironically enough, the very nurses union that Almada and Lin argued were all about giving nurses a voice. I guess the only nurses deserving a voice in their opinion are those that favor a nurses’ union and the rest be damned.

As promised below is a copy of the email that nurses forwarded to me, and though I have confirmed that it wasn’t a confidential internal memo, I’ve redacted private and contact information to protect my sources.

eMail HMH v CNA Settlement

Our local paper recently published an article about two Huntington Memorial Hospitals with the claim made by the nurses that they were fired due to their union activity.  However there’s more to the story and below you’ll find both the link to the above mentioned article and my letter to the editor — that the Star News chose not to publish.  I think they were afraid to encourage their readers to think beyond the pablum the union was spoon feeding to both the paper and its readers.

Huntington Memorial terminated 2 nurses; both claim retaliation for efforts to unionize

Dear Editor:

Nurses Almada and Lin with the help of the California Nurses Association (CNA) held a rally to demand that Huntington reinstates the two nurses. The claim is that these two nurses were unfairly terminated due to their support of the recent failed unionization effort at Huntington Memorial. If what they claim is factual, then shame on Huntington Memorial.

However, as a nurse with more than 40 years of experience at all levels of the nursing ladder I’m somewhat hesitant to take their tale at blind faith. Why? Because the hospital is bound by confidentiality in all personnel matters and Almada, Lin, and the CNA know that and are counting on Huntington to adhere to this code. Meanwhile, they can sling all the mud that they want, which they’ve been doing over a year now with support from much of the local media and many local officials who enjoy union support.

I’d prefer to wait and see, because something tells me that there’s more to the tale of the firing of these two nurses than just their involvement in the failed unionization attempt. My nursing instinct tells me that these two nurses may have failed to adhere to our nurse practice act and if this were the case then firing them would’ve been the appropriate action. I also think it is interesting that they’ve made a big deal about going to the NLRB, but said nothing about filing a complaint with our state’s labor board. Not to mention it’d be an act of ultimate stupidity on the part of Huntington to fire any nurse at this time except for cause.

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 (CNA).

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

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).