The Nurse Unchained
One nurse’s unabashed opinion on all things nursing.

Nurses throughout California either have already received or will be receiving a flyer from the C.N.A. that, in this RN’s opinion, as usual has more misstatements and lies than truth.  Today, I received a copy of their flyer “Why is CEO Meg Whitman at War with California Nurses?”  Of course, in true C.N.A. style this statement is more fiction than truth, since Whitman is not at war with California nurses, but the C.N.A., which represents less than 80,000 of California’s nearly 400,000 RNs threw the first punch and is peeved because Whitman refuses to kowtow to them.  Instead she’s chosen to engage all of California’s RNs in an open and free manner letting the RN decide for herself/himself.

Which brings me to the other misrepresentations and lies that the leadership of C.N.A., has decided to hurl at me, simply because I refuse to allow the C.N.A. to speak for me and because I make it clear at every opportunity that the C.N.A. can only speak for their members and not for every nurse in California.  So in return the leadership of C.N.A. placed my picture on their recent attack piece.  Of course this vile practice is commonplace when it comes to the leadership of C.N.A., but their false statements will not silence me, and as I’ve done before I will address their attack piece with the facts.

First, they state that I’m Whitman’s “Nurse Advisor”, handpicked by Whitman.  Well this is news to me, since though I’ve been happy to answer questions from members of the Whitman team as well as make suggestions this is something I’m happy to do for any person, candidate, politician, nurse, citizen, etc.  Based on the leadership of the C.N.A.’s logic this would make me Senator Dianne Feinstein’s “nurse advisor” as well since I often meet with her staff or her when I travel to DC to participate in our wonderful democracy.

Second, yes I’m a former Director of Nursing, as I’m a former nurse educator, head nurse and more importantly a former NICU/PICU nurse.  But of course the leadership of the C.N.A. loves to stir the pot and prefers to diminish my qualifications as a bedside nurse because as we all know management is inherently evil – I wonder if Deborah Burger and her co-presidents of the C.N.A./N.N.U. know that they are also members of this elite group, since they are after all part of management as is Rose Ann DeMoro.

Third, I never endorsed Schwarzenegger’s bid to “rollback” the ratio law since he never asked the ratio law to be rolled back, simple to delay the implementation of phase two.  What I advocated, which was the same message the Schwarzenegger attempted to communicate, was that California should hold off implementing the Phase II of the ratio until we had studied the impact of Phase I.  Considering that we had one side claiming gloom and doom because of the ratio and the other side claiming that all of nursing ills had somehow been cured because of the ratio I thought it made sense to see what the studies bore out.  And as we were to learn most of the studies have shown mixed results, and don’t even get me started on Aiken’s apples vs. oranges study that was published claiming that if only New Jersey and New York had the same ratio law a percentage of patients would have survived.  I wonder why she didn’t simply compare a set of California hospitals pre and post ratio law?  I think those results would have been much more interesting and a better indicator on the impact of the law.

Fourth, I never campaigned against nurses, just because the leadership of the C.N.A. didn’t like the fact that there were nurses that didn’t cleave to their party line doesn’t mean we campaigned against nurses.  It simply means we were exercising our constitutional guaranteed rights, just as the C.N.A.

Fifth, worked as a consultant for the hospital industry on restructuring and downsizing, yes and I also worked with the hospital industry on such things as developing acuity systems, recruitment and retention of nurses and other hospital/nursing issues.  Restructuring and downsizing aren’t always bad things, if restructuring allows the nursing department and its team to become better managers so that they are more responsive and supportive of the nursing team –this is a good thing, and I would hardly call downsizing the registry pool to zero and replacing those slots with all permanent staff nurses a bad thing since every hospital’s goal should be to have little to no reliance of registry/travel nurses.

Sixth, not sure why the C.N.A. thinks I’ve travelled around the U.S. fighting RN ratios because I haven’t, I ‘ve exercised my right of freedom of speech to write letters to the editor when the issue of nurse/patient ratios have come up.  Of course when I’ve been physically up to travelling to DC I’m sure I’ve shared with my elected officials my opinions on the cookie-cutter ratio versus the acuity system.

However, the biggest misstatement/lie of the leadership of the C.N.A. comes near the end of their presentation.  They present the following, labeling it “in her own words”.  “Forced overtime is one way for hospitals to work around staffing shortfalls”. – Working Nurse magazine, Feb. 5, 2007.  What they fail to do, which is yet another example of how the leadership of the C.N.A. chooses to spread it misinformation and lies about those they see as threats to their mission, is to provide to the reader/recipient the whole sentence, let alone the whole quote from my Feb. 5, 2007 column entitled “Mandatory Overtime?” (the whole article can be found at http://www.solutionsoutsidethebox.net/2007-From-the-Floor-Archive.php).  The actual and whole quote is as follows “Forced overtime is one way for hospitals to work around shortfalls, which probably happens all too often.  The constant use of overtime may be symptomatic of substandard management.  An extremely capable Chief Nursing Officer (CNO), Director of Nursing (DON), and even charge nurse does not need to rely upon a continuous use of overtime because where there is good and solid nursing management, you’ll find happy nurses, and as a rule, a complete nursing staff.  Therefore, there will be less reliance on registry and overtime to compensate for the staffing shortfalls.” Of course providing the sentence in its entirety or the full quote wouldn’t have served the leadership of the C.N.A.’s purpose, which was of course to paint me as some kind of hospital’s hatchet woman, but as those who know me can attest I’m no man’s (woman’s) hatchet person – which is why I think the C.N.A. leadership fears me as they do.

And finally my letter to the editor to the Boston Globe which I wrote in response to an editorial by Suzanne Gordon (which can be found here http://www.solutionsoutsidethebox.net/Nursing.php).  In my letter, which the Globe titled “California’s experience raises questions”, I shared my first hand experience and concerns about California’s nurse/patient ratio law.  I did so because as a NICU/PICU nurse I never treated my patients with cookie-cutter nursing care and I don’t believe that the nurse/patient ratio law’s cookie-cutter approach is in the best interest of our patients or of the nursing team.  Many RNs and I support the acuity system, which allows the nursing team to assess the patient, the illness, its severity and complexity of treatment and then match that with a nurse’s skill sets.  I prefer this because I firmly believe that as nurses we treat patients not numbers.

Of course its my personal belief that the main reason the leadership of the C.N.A. attacked Whitman, even before she received the Republican nomination was because they had already decided to support Jerry Brown and the fight for the Governor’s office would go much easier if Brown had to face Steve Poizner, so they pulled out all the stops to help defeat Whitman in the primary – but things didn’t go their way and so like petulant children they’ve decided to throw mud and vile accusations at nurses who dare support Whitman.  But I won’t support Brown because I haven’t forgotten Project Iatrogenesis also known as SB 666.  For my readers who may not remember, or don’t know what SB 666 entailed (attached is some background).  But to make a long story short, Project Iatrogenesis which was a key component of SB 666 and the brainchild of then Gov. Brown and carried by then State Senator Watson, would’ve allowed for a nurses aides to accumulate a number of hours at the bedside and with no additional educational requirements take a test and if passed become a LVN, a LVN could accumulate a number of hours at the bedside and with no additional educational requirements take a test and if passed become a RN, and so forth following this same path a RN could even become a physician.  The leadership of the C.N.A. may have forgotten about this little episode under then Governor Brown, but this RN hasn’t.

The leadership of the C.N.A. appears happy to provide its nursing membership, the media and public at large with information that at best are twisted to fit a message, ask yourself this if this nursing organization is willing to provide false and misleading information to the public in order to advance its cause, what stops one of its RN members from doing the same to a patient’s medical record or during report?  There’s a French proverb “qui vole un œuf vole un bœuf”, loosely translated it means, “if one can steal and egg, one can steal a cow”.

SB 666

Several days ago, Sherry Bebitch-Jeffe was quoted in an AP release.  Her quote was in reference to the ongoing push and pull between the Whitman Campaign and the California Nurses Association (C.N.A.).  She posited the following,  “While it’s common for Republican candidates to attack public employee unions, she said the public generally has goodwill toward nurses and does not equate their union with “big labor.” She went on to state “I would not have singled out the nurses association, even if they were making fun of me”.   Of course this is the same Bebitch-Jeffe that was adamant that the recall of Gray Davis would fail, so sure was she of her prediction that she made a bet with me that this would be the outcome and the loser would buy the winner dinner.  I’m still waiting on her to make good on her debt.

As a nurse I admire Whitman for defending her campaign and herself from the C.N.A.’s baseless attacks.  Unlike the C.N.A. nurses Whitman has been the professional while C.N.A. nurses have acted like spoiled children throwing tantrums.  The “march on the Whitman’s private home in Atherton” being the most recent tantrum.  I’m all for the freedom to demonstrate but we also need to respect certain social boundaries and one of these boundaries has been an individuals’ home.  Of course this seems to mean nothing to members of the C.N.A.  If they wanted to demonstrate they could’ve chosen the Whitman campaign headquarters or event; instead they chose to disrupt the serenity of an entire community, violating not only Whitman’s peace and tranquility but also that of all her neighbors in her Atherton community.  One would think nurses who take an oath to advocate for some of our communities most vulnerable and fragile members would at least respect some personal boundaries, but not the C.N.A. they have now joined the ranks of such disreputable groups as the Phelps/Westboro Baptist Church and if you don’t know who these folks are just head over to Wikipedia (http://en.wikipedia.org/wiki/Westboro_Baptist_Church).

I think Bebitch-Jeffe is dead wrong to think and publically state that Whitman should do nothing when groups try to bully her.  The C.N.A. threw the first salvo, long before Whitman was even the Republican candidate for Governor.  They did this not so much because of Whitman’s stance, but because their candidate of choice stands a very good chance of losing to Whitman in the General Election; which is why they tried to influence the Republican Primary in hopes that Poizner would win the nomination and failing that the C.N.A. has decided to pull out all the stops.  This strategy could very well back fire on the members of the C.N.A. because even though nurses are held in high regards by the public at large this is due mainly to the public’s vision that nurses behave in a more “ethical” behavior than many of us regular folks.  There are limits to what kind of “bad” behavior the public will tolerate even from nurses.  To date Whitman has appeared to have taken the high road, while the C.N.A. and many of its members have chosen to take the low road.

In this nurse’s opinion the California Nurses Association (C.N.A.) membership hit an all time low this afternoon in Atherton, California.  You may wonder what could be worse than threatening opposition nurses, their children, and pets, or stalking opposition nurses, showing up at their relatives homes and calling family members at all hours of the night and day under the pretext of “convincing” the recalcitrant nurse that the C.N.A. is a great organization to join is low  — you weren’t in Atherton.  Today, low behavior was when hundreds of C.N.A. members and supporters descended on this quiet neighborhood so they could hold a demonstration at the private residence of California gubernatorial candidate, Meg Whitman.

Of course this demonstration was accompanied by all the usual hyperbole and misrepresentations that are part of the C.N.A.’s usual arsenal.  But to come to a person’s private home is truly above the pale. I’m sure Ms. DeMoro, Nurse Burger and company wouldn’t appreciate say the S.E.I.U. coming to their private homes and demonstrating to illustrate how the C.N.A. has engaged in raiding their nursing unions.  But common decency, and socially appropriate behavior seems to be lacking in the C.N.A. leadership DNA.

But what this nurse liked best was that in the C.N.A.’s attempt to garner media attention a nurse delivered a letter to Ms. Whitman by placing said letter in Whitman’s residential mailbox. In doing so this nurse may have engaged in a federal offense.  What federal offense, why the law that states only authorized letter carriers may insert mail into a residential mailbox.  Oh my!  The rule making and rule toting C.N.A. broke a rule themselves – color me surprised! …. More to come.

They’re at it again, those prevaricating leaders of the ANA, misrepresenting their membership numbers and of course the media that seems more concerned with regurgitating a press release then actually fact checking what the ANA spoon feeds them and then writing their own story instead they are complicit in perpetuating the ANA’s lie.  If not for the media aiding and abetting the ANA in their fabrication, the ANA would have long ago stopped their prevaricating ways (or at least some of them) and not pretend that they represent the interest of nurses that aren’t even members of their organization.

President Obama (a man, I think, that’s never met a misstatement that he hasn’t liked) stands before the American people and tells us that his “plan” for health care reform which is not even his own (the plan actually belongs to Congress and in particular the Democratic-controlled Congress) has the backing of the nurses, as if all 2.9 million of us have held a convention and come to an agreement on his “vision” and we’re unanimous about our support of his “plan” when we are far from an agreement on his or any other plan being floated out there.  What he means to say is that the ANA, a nursing organization that reportedly represents somewhere between 180,000 to 190,000 thousand RNs out of the almost 3 million RNs that are active in this country, is behind him when the reality is that just a little over 15% (and that’s assuming that all of the ANA’s members agree) of America’s RNs are behind him and his efforts when he refers to the support of the nurses and the ANA.

All the while they’re in their white lab coats and scrubs in neat little lines behind the President using the illusion of the organization’s large membership to provide him with credibility, just like the American Medical Association right before their membership blew the lid off of their charade of being the voice of the American doctor; and yet few have questioned the validity of the ANA’s claim of representing the interest of 2.9 million RNs.  What’s truly ironic is that a membership of nearly 200,000 is a respectable number by nearly any standard, especially for nurses who can be as hard as herding cats when it comes to getting them to join a group.  But no the nursing leadership of the ANA can’t help themselves and they have to pretend that they represent all of “nursingdom”, and I know I’m not the only one who’s grown tired of their lies and misrepresentations.

In their latest press release they have the gall to open their press release citing the statistic that nurses, once again, are ranked as one of our nation’s most trusted professions, and yet they think nothing of misrepresenting the facts when it comes to their membership and it’s a slippery slope because as the saying goes little lie, big lie.  The ANA doesn’t nor has it ever even come close to represent the interest of all of America’s RNs, they as a membership organization can only represent their members and unless you pay the ANA cold cash you’re not a member thus limiting their sphere of representation to those nurses who consent to be members of the ANA.  But the ANA like the AMA has long held an over inflated sense of self-worth and this has caused them to misrepresent their membership base just so they can have a seat at the table.  It’s time for the ANA to come clean and cite their actual membership numbers and leave the rest of the 2,710,000 of us alone because we didn’t appoint them our spokesperson or spokes organization.

Imagine finding flyers posted all over a hospital sounding the “alert that a professional union buster was on site”, and that flyer used to identify a nearly 70 year old great grandmother who has to use an electric scooter to get around.  What power this person must have to send the California Nurses Association (C.N.A.) in paroxysm’s of fear and panic and to engage in their usually tactics of lies and misinformation.  I was met with just such exhibitions fear-mongering and hysteria by C.N.A. recruiters, representatives and supporters when I made a recent visit at the invitation of a fellow nurse from Cy-Fair Hospital in Houston.

Their flyer identified me as a professional union buster, which I guess is a recognition of how much they fear my presence; but truth be told I’m not a professional union buster, and in particular I’m not a nursing union buster.  The C.N.A. and many other pro-union people love to use the word union-buster since it tends to invoke images of a Simon LeGreed character replete with requisite black hat and cloak and evil laugh.

I have nothing against unions for the blue-collar worker, but I’m far from convinced that professionals such as registered nurses need unions to represent them.   So when nurses contact me for my opinion and advise about how to speak for themselves I am always happy to help my fellow RN in advocating for our profession and for themselves.  I’m happy to help in the effort of showing nurses that they can and do have a strong voice as both an individuals and as a group without paying a nursing union dues of upwards to $80.00 a month for the favor.

In the case of two recent nursing union attempts, one nursing staffs’ attempt to stay free from the C.N.A. and one nursing staffs’ attempt to decertify from the C.N.A.  As fate would have it, I was in a position where I could help both in spirit and in person so I did.  At the first hospital my fellow nurse and I found C.N.A. representatives playing shenanigans with hospital elevators so that the floor where a “No to the C.N.A.” nurse had been given a meeting room was locked out.  This malfunction only affected the one floor that we had to reach on both days, what a coincidence.  You may wonder why I think C.N.A. representatives capable of such underhanded techniques.  Simple, I still haven’t forgotten a C.N.A. strike in the San Fernando Valley where pro-C.N.A. nurses locked out much need medical equipment, hiding/destroying manuals, etc., so that the relief nurses were hard pressed to provided nursing care to patients many of whom were in intensive care; and the C.N.A. strike was suppose to be all about their concern for patient safety  — go figure!  And at the second hospital I got treated to the experience of being stalked by not one, not two, but upwards to three C.NA. representatives at a time.  The situation became of such concern that hospital HR and security had to become involved; but I guess I should feel honored that the C.N.A. felt the need to have so many people watching my every move.

Whether or not nurses chose a union to represent them or not should be up to the nurses themselves but this seems to rarely be the case these days.  As in the case of the Tenet Healthcare/C.N.A. neutrality agreement Houston nurses that had opposing views to the C.N.A. material, propaganda or message had no one to turn to; at least that’s what the C.N.A. representatives thought, except they overlooked a grassroots network of informed RNs that were available for these nurses to reach out to; which they did and we responded.  One would think that the C.N.A. representatives would be excited to learn that nurses were empowering one another, oh that’s right it only counts if the nursing unions are doing the empowering.    So sorry, we didn’t get that memo. One would also think that the C.N.A. would invite and encourage an open and lively discussion about the benefits of a nursing union, but they couldn’t be bothered to even accept the invitation extended by one group of nurses to present their viewpoint in an open debate.  Instead they skulked about passing out flyers full of misstatements and lies since it so much easier to insult the intelligence of nurses rather than respect them.

In the case of the flyer (see a copy here at http://clavreul.org/Gallery.php) they suggested that the nurses ask me a set of questions, and I responded with an open letter (see a copy here at http://clavreul.org/Gallery.php).  One pro-C.N.A. nurse chose to mark up my open letter with graffiti instead of addressing me nurse to nurse.  But then again it’s become common practice for pro-nursing union nurses to engage in such childish behavior.  It’s a sad day when our honorable profession is marred by such immature behavior.  However, I see these as indicators of how much the organizational structure of the C.N.A. fears nurses who chose to take back or carry on with their own voice.  In the past several years their membership has been declining (their last official report in 2008 has their membership at just over 72,000 almost a full 8,000 or 13,000 drop depending on which C.N.A. official report you read).  I think it’s this drop that has them scrambling for new members in the other 49 states.

But in some parts of our country nurses don’t want anything to do with them, and even when Tenet handed the C.N.A. the proverbial keys to the kingdom providing C.N.A. organizers unfettered and unprecedented access to RNs on the floor, scheduling information and even home addresses and telephone numbers; the C.N.A. has found resistance to their siren song.  They couldn’t even gather enough cards at Park Plaza and Northwest Hospitals in Houston to even call an election and they slunk out of Houston so quietly that few even knew they had abandoned their organizational efforts.  They accused one, that’s right ONE, nurse of trying to take away the union at Cy-Fair Hospital.  What power this one nurse must have, I guess the well over 30% of eligible nurses that signed decertification cards meant nothing, it was all that one nurse’s fault.  And this morning we learned that Hahnemann Hospital (another victim of the nefarious Tenet/C.N.A. neutrality agreement) had rejected the union.  The C.N.A. had such access to the RNs at Hahnemann that nurses that opposed the C.N.A. had to get the NLRB to intervene just so they could get a meeting room in the bowels of the hospital and finally a table in the cafeteria (shortly before election day) and the union spokespeople whined that this was unfair.

So if our network of nurses, and me, in particular can help our fellow nurses when confronted with such behavior and that makes us professional nursing union busters in the eyes of the union then I guess that’s a cross we’ll just have to bear.  I see it as the desperate actions of an organization that knows that people have begun to look behind the curtain that is the California Nurses Association/National Nurses Organizing Committee and they don’t like what they see.  The more they howl about RNs empowering each other the more I know that I’m their bête noire and that’s a role I think I shall relish.

The nurse’s of Hahnemann University Hospital in Philadelphia just got the news — they won in their election fight against the California Nurses Association (C.N.A.)!  The vote count was 309 RNs against to 267 RNs in favor of unionization.

I wonder how the C.N.A. and their supporters will spin this election loss.  No doubt they’ll issue a press release touting the narrow loss and I’m sure the press will parrot this statement.  Just like when the C.N.A. won the vote at Cy-Fair in Houston by a margin of 8 (now that was a slim victory), but the C.N.A. touted the vote as though it was a resounding victory for nurses across Texas.  So if we use their own reasoning then we can only conclude that if an 8-vote margin is a resounding win; then a 42-vote margin is one major whooping on behalf of the nurses in their rejection of the C.N.A.  Maybe the Pennsylvania nurses might’ve been more receptive to the idea a nursing union if it had been a local nursing union that was courting their vote and not the carpet bagging C.N.A. and their well-known bullying tactics that was courting them?

To put things into perspective for folks, the nurses that weren’t keen on a nursing union had a very hard row to hoe.  Like in Houston they found that their hospital and nursing management were in essence prohibited from offering them assistance thanks to a so-called neutrality agreement (for more one this agreement see “Like Thieves in the Night”) that had been signed between Tenet and the C.N.A.  The agreement gave all the cards to the C.N.A. and their representatives to spread their message, but withheld equal support for the nurses that wanted to get their counter-message out.  Things were so blatantly unfair that the NLRB actually intervened on behalf of the No to the C.N.A. nurses and granted these nurses a couple concessions: such as a meeting room that was somewhere in the “bowels” of the hospital so that only the most stalwart of nurses could find the meeting room and of course finally a table in the cafeteria.  Throughout the process nurses, such as Nurse Hummel were stalked, photographed, and pilloried by the C.N.A. representatives.  The C.N.A. pulled out all the stops even going so far as to paying for a pro-C.N.A. nurse from Cy-Fair hospital to come out and make the rounds through the hospital and producing a flyer depicting Hahnemann nurses attending a big pro-union rally in DC organized by the C.N.A.  The only problem with the flyer was that the nurses pictured from Hahnemann Hospital never attended that event and had been plucked out of another photograph and pasted into this C.N.A. propaganda material.  Nurse Hummel even made sure to invite the C.N.A. to attend a debate so that interested nurses could have an open discussion, but the C.N.A. was a no-show, which seems to be par for the course when it comes to dealing with the C.N.A.

I think that the C.N.A. finally met their match when RNs from several other states came out to offer their support, expertise and knowledge with those who simply wanted to be able to have their side of the story heard.  I know that several nurses came out on their own dime and time; and as one of those nurses, I found the time I spent at Hahnemann enlightening and enjoyable.  I was both pleased and honored to have met with not only Nurse Hummel (after so many telephone conversations) and the countless other RNs that came to our table or met us in the hallways and meeting rooms to share their story and to give me an opportunity to answer their questions.

So hats off to all the nurses (both anti & pro nursing union) of Hahnemann who turned out to vote (from what I’ve been told about 592 eligible nurses voted) that means nearly 60% of the eligible nurses voted in this election.  I can only hope that the media fairly reports the outcome of the election and assuming that they even chose to report the vote outcome.  For more information I invite you to visit the Hahnemann nurses website at: http://www.thepronurse.com/

Newspapers across the country are suffering from declining readership, and many have either closed or are facing impending closure – most place the lion’s share of the blame on the Internet.  Pundits claim the instant access offered by the Internet is driving people from the printed word to the electronic word.  I’m not sure if I’m ready to buy into this conclusion, simply because I think there’s also a growing lack of confidence in the “objectivity” of newspapers among the reading public.

For example several weeks ago the LA Times ran an article, “Many Nursing jobs, but only the strong need apply” (http://articles.latimes.com/2009/apr/27/health/he-nurses27).  The article was available in its entirety on line nearly two days before it ran in the print version of the Los Angeles Times, and upon reading it I found that it appeared to have more in common with a PR piece for the C.N.A. rather than an unbiased, objective piece of reporting.   I took issue with several parts of the article, and submitted a letter to the editor and one to the Reader’s Representative.  I wasn’t sure if they’d run it, but I thought that at the very least they’d print a correction.  They did neither, but after some persistent follow-up on my part; including several telephone calls to Ms. Gold, the reader representative which remain unanswered, and two calls to Mr. Newton, A Sr. VP at the LA Times who communicated with me that he ask the reporter to call me which she never did, and a lengthy conversation with someone named Maria they quietly ran my letter on the “Health” page in their internet edition.  A copy of my letter can be found here (http://www.latimes.com/features/health/la-hew-letters18-2009may18,0,3851881,full.story).

I felt compelled to address several shortcomings that I found in the article.  The first and most obvious was the number of new licenses issued that the C.N.A. representatives tout to prove the success of the California Nurse/Patient ratio law that they helped push into law.  Though it’s correct that there have been nearly 100,000 new licenses issued since the law was passed five years ago, a nearly equal number of licenses have been lost, so it’s been a wash.  The reporter had an obligation to report the fact, not just the rhetoric.  The reporter also appeared unable or unwilling to interview a variety of nurses, since the three nurses she interviewed were all from C.N.A.-represented hospitals, and if this was to be a pro-union piece she should have at least interviewed nurses from the S.E.I.U. and U.N.A.C.; better yet she should have interviewed two non-union nurses and one union nurse as this would have been a fairer representation of nurses.  But the worst offense, in my opinion, was her failure to identify one of the nurses she interviewed as a member of the C.N.A./N.N.O.C. Council of Presidents.

It’s reporting and editing such as this that’s caused the reading public to loose faith on the ability of their local newspaper to report, rather than make, the news.  Just like the LA Times refused to cover the recent “Anti-Tax” parties attended by thousands in LA based on the excuse that these were manufactured events; but would show up to cover a couple of hundred people who showed up at a recent LA School Board meeting to protest impending lay-offs.  As anyone who has ever organized an event, protest or rally in this city knows, it’s all “manufactured” because as a rule you have to get permits, put out press releases, etc.  So if events being organized and manufactured is the LA Times threshold then they shouldn’t cover any such event but of course they cover those that they seem sympathetic to.  And this is one of the primary reasons, this citizen, thinks that people are turning to the Internet because more often than not we know the bias of blogs, forums and other “news sources” from these sites.

They came like thieves in the night, their goal simple to “steal” their way into one or more of the Tenet-run Houston hospitals.  Their arrival wasn’t completely unexpected, it’s just that the Registered Nurses at CyFair, Northwest and Park Plaza, weren’t the ones that had invited them.  Instead, the California Nurses Association/National Nurses Organizing Committee (C.N.A./N.N.O.C.) came under a rather notorious agreement known as a “neutrality agreement” and as the only union option.  There would be those that might argue that a neutrality agreement isn’t such a bad thing, and it wouldn’t be if such an agreement were actually neutral.  Most reasonable people would understand the term “neutral” to mean having no personal preference or not supporting or favoring either side in a war, dispute, or contest; but the agreement that the C.N.A./N.N.O.C. came in under, with the consent of Tenet management was far from neutral.

When I first learned of the neutrality agreement I asked for a copy and it wasn’t long before a copy appeared in my mail, and after reading the lengthy document it was clear that Tenet and the C.N.A./N.N.O.C. had entered into an agreement that benefited not the nurses but the union leadership of C.N.A./N.N.O.C.  One could easily blame the leadership of C.N.A./N.N.O.C. for crafting such a one-sided contract, but the fault for agreeing to the overly restrictive terms lay firmly in the lap of Tenet management.  As any good contract negotiator will tell you, its not uncommon for one party or the other to present a tough or one-sided agreement, they do this to see what kind of or how much push back they will get from the other party; and it’s assumed that the other party will present a counter offer – hence the term contract negotiation.  But if Tenet offered any counter offer to the C.N.A./N.N.O.C. agreement then I can only conclude it was a half hearted counter offer, because the contract heavily favored C.N.A./N.N.O.C., to the point of disadvantaging Tenet’s very own nurses themselves.

For example the C.N.A./N.N.O.C. representatives were given access to the employee list, including personal contact information, of all the RNs at the three hospitals (CyFair, Northwest, and Park Plaza).  Keep in mind that prior to this all three hospitals were non-union shops, thus the C.N.A./N.N.O.C. were not yet recognized as a bargaining unit for any of the RNs at these hospitals; so these strangers were given free access to this personal information and RNs discovered this only after they started receiving calls, visits and mail from C.N.A./N.N.O.C.  Tenet also sold the rights of the RNs to any non-approved C.N.A./N.N.O.C. messages or information, because they agreed to a clause that required C.N.A./N.N.O.C. approval of any flyer that the hospital management would post regarding the unionizing efforts with their hospitals (keep in mind C.N.A./N.N.O.C. were not yet a recognized bargaining unit at any of these hospitals). C.N.A./N.N.O.C. representatives were given meeting space and permission to have information booths in employee areas; but when a group of Tenet nurses (many of whom were already members of the state’s professional nurses association, the Texas Nurses’ Association) requested the same privilege they were denied by hospital administration.  So instead the nurses were expected to, and did run their own information campaign on their own dime and time.  These nurses organized a truth-a-thon (photo below) to provide interested nurses with another side of the “union/non-union” story; C.N.A./N.N.O.C. were so fearful that these nurses had decided to provide an alternate voice that C.N.A./N.N.O.C. representatives took photographs of the no- C.N.A. nurses and those nurses that requested information at the truth-a-thon.   Which is why I’m always skeptical at unions that whine about the harsh tactics of management when they often engage in the very same tactics that they accuse management.

In the end CyFair nurses voted to accept the union, the margin was very small but of course C.N.A./N.N.O.C. declared an outright victory and a that a new day was dawning for the nurses of Texas, because soon C.N.A./N.N.O.C. would release all RNs in Texas from the shackles of “servitude” and “oppression”.  But wait; there was still Northwest and Park Plaza, what happened to the union vote at these two institutions?  Well, just as C.N.A./N.N.O.C. came into Houston like thieves in the night on April 14th they formally withdrew their petition and they slunk out of Park Plaza and Northwest, once they realized that the RNs at Northwest and Park Plaza with help from CyFair nurses were not about to abdicate their professional voices without full disclosure.  These nurses launched, again on their own time and dime, an information campaign and as luck would have it they got to observe how C.N.A./N.N.O.C. representatives acted and for every pro-union button that was being worn, two no thanks C.N.A. button were being worn as well. The Park Plaza nurses mounted such excellent information campaigning that C.N.A./N.N.O.C. representatives demanded additional time to campaign and of course their request was granted – but even the additional time couldn’t turn the tide.  Ironically the C.N.A./N.N.O.C. accused the two Tenet Hospitals with colluding with the NRTW Foundation as to why their organizing effort failed.  Let me get this straight Tenet gives C.N.A./N.N.O.C.  complete access to employee personnel records, unfettered access to nurses while at work, in the units, break rooms and wherever else nurses gathered in the hospital and denied nurses who opposed the C.N.A./N.N.O.C. message even the opportunity to provide their side of the story, except when those nurses did all the work themselves on their own dime and the C.N.A./N.N.O.C. whines, stomps their feet and cry “FOUL”?  This is just one more reason that I oppose unions for nurses, because this is not the kind of behavior I want to see exhibit by nurse professionals.

Where is the Texas media to report the withdrawal?  All the while C.N.A./N.N.O.C. was actively organizing the newspapers could barely contain themselves and happily reported on the C.N.A./N.N.O.C. progress; but now that C.N.A./N.N.O.C. have withdrawn there has been nary a peep.

Of course, I know why C.N.A./N.N.O.C. doesn’t want it known that the nurses of Northwest and Park Plaza rejected their overtures; because God forbid should nurses be lead to believe that they can speak for themselves since the C.N.A./N.N.O.C. campaign is based heavily on “nurses are so weak, disenfranchised and oppressed” that only a union can adequately represent them.  So when nurses reject the C.N.A./N.N.O.C. either by voting them down as recently happened in Fresno, or decertify as in the San Diego area, or stand-up and don’t even let them get their foot in the door as in Houston then the mythos created by C.N.A./N.N.O.C. is damaged and thus makes their propaganda much less affective.

With little fanfare this past week, nurses from Centerpoint Hospital of Independence, MO held a decertification vote.  The results 226 to 78 with 24 opting not to vote at all, and the Nurses United Local 5126 (part of the American Federation of Teachers) were ousted as representatives for the RNs at the hospital.  The vote took place over two days (April 23 and 24) last week, and the results were a celebrated outcome to a small core group of professional nurses that had coalesced to further professionalism versus unionism for nurses.

I learned about the nurses of Just Let Us Vote, JLUV, and emailed the contact for JLUV, Jerilyn McDermed.  She responded to my email with her telephone number and I called her and we chatted.  She gave the “quick and dirty” version of the history of the unionization of Centerpoint and why she chose to launch a decertification effort.  Their path to decertification wasn’t an easy one, they were targeted by members of Nurses United Local 5126, labeled the “misinformed minority”, demeaned by some of the more vociferous pro-union nurses on staff, and found little support in the local media to get their side of the story out.  Yet, they persevered and after many months of foot-dragging from the union they got the green light for a decertification vote.  Of course the union machine spun the story as if they had been the ones instrumental in allowing the nurses the opportunity to have the vote; and in a way that was true since the union had filed numerous complaints with the NLRB that caused the vote delay.  So when the union removed their objections the vote was green lighted, but then again if the union hadn’t initially objected the vote would have taken place much, much sooner.

It’s behavior such as this that makes me suspect the true motivations behind the union’s push for the “Employee Free Choice Act”, better known as EFCA.  They extol the virtues of having a majority of employees signing cards to bring in union representation, but when the tables are turned and people sign cards to end union representation then the union fights it tooth and nail.  So, it’s apparent to folks like me that the union likes to make full use of the process when it serves them, but they don’t want their opponents to have the same opportunities.  Maybe this simple fact is why polls show that up to 80% of union members themselves oppose the passage of EFCA.  But, back to Centerpoint.

So, when I came across an article in the Independence Examiner about the upcoming vote I wrote a letter to the editor and it was published on March 31st and distributed throughout the hospital by nurses.  Jerilyn shared with me that a pro-union nurse had defaced one of the letters that had been posted, and her response was to place a post-it note by the defaced flyer that asked folks not to write on her flyers, since no one wrote or defaced their flyers.  Of course, she wasn’t shocked by such churlish behavior since all too often pro-union nurses will engage in such behavior with the full support of their union local – another reason why professional nurse often eschew unionization.

As the date of the vote approached the Kansas City Star did a write up and its lean was so pro-union that was more of a advertisement then a news story, so I was compelled to write a letter to the editor (which can be found at the end of this post) and contact the Reader’s Representative.  He was very nice and said he would have the reporter call me, which I’m sure he did but as of the writing of this post the reporter has yet to call me. I had also left a message in his voice mail myself.  Additionally, the letter to the editor reader had still not read my letter nearly three days after submission.  In the end, the professional nurses of Centerpoint were able to overcome a pro-union local media and a well funded union local from the AFT to get their message out and the nurses responded with an overwhelming vote of 226 to leave the AFT with only 78 voting to remain with the AFT.  Stories covering the recent decertification vote can be found at the Kansas City Star here and the Independence Examiner here.

One more victory in a growing movement by professional nurses to decertify from union representation and retake their voice and right to self-representation.

April 9, 2009

It’s unfortunate that your paper seems to prefer to regurgitate the union story line rather then to report the complete story and let your readers form their own opinions.

I’ve got a pretty good track record in getting letters to the editor published – if I say so myself.  Every now and then I send a letter that I think is particularly important, especially when it is correcting misinformation, doesn’t seem to make the “cut”.  When this happens I sometimes decide to post it on my blog, and this is what I’ve done with a copy of the letter to the editor that I sent in response to an Pasadena Star News editorial piece they published on the nursing education and nursing shortage challenge.  Though overall the article made a valiant attempt to present solutions, I also found at least one glaring error and many of the same old-same old problems and solutions that the nursing talking heads have been nattering about for almost as long as I’ve been a registered nurse.  However, the Pasadena Star News paper letter to the editor person felt that my response was too long to print and after he suggested that I might want to consider editing it down and “tightening” it up I should resend it, which I did.  Alas, neither letter has been published to date.  So below you’ll find both versions of my letter to the editor the first is the original followed by the much revised and edited down version of the second submission.

September 22, 2008

As someone who has written extensively on the issue of the nursing shortage and an outspoken advocate for nursing I have called on a “Flexner-like” study of our nation’s nursing programs.  In the early 1900s our Nation’s medical schools and the very structure of medicine received an overhaul of sorts in the form of a nation-wide study that is often referred to as the Flexner-study.  This study provided a framework from which all medical schools now design their program around which has allowed for a maximization of available “seats” in medical schools, the facilitation of transfers within and outside school systems all the while maintaining a high level of quality.  I think nursing, too, could benefit from a similar review.  This does not necessarily mean that I think nursing should be forced to adopt the same study tool, but perhaps nursing could use a top to bottom review from a core group of experts that could then provide recommendations on everything from what the entry-level of nursing should be to how we should structure the complete nursing career ladder, to how to design our nursing programs to maximize the available and often limited seats and so forth.

October 3, 2008

Many external factors impact our nursing education pipeline, some of which you noted in your article.  However your editorial failed to address issues such as the low student to instructor ratio which is mandated (in some cases as low as 8:1) which often makes colleges and universities hesitant to launch, expand or maintain nursing programs.  Many of our nursing schools have a high attrition rate; contributing factors are due in great part to poorly prepared students specifically in areas of science, math and yes English-language skills.  Nursing programs are also plagued by a great deal of “individuality” which often makes transferring from one nursing program to another problematic.  Not to mention that the average nursing school educator can make more money as a staff nurse. These are just a few of the issues that place a strain on our nursing pipeline, and while these problems are partially addressed, all too often they’re being addressed piece-meal with very little county, state or nation-wide coordination.

psn-room-for-nurses