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.

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.

Nursing unions are quick to praise RNs when they vote to bring in a union and often characterize these nurses and their actions to join a union as brave or groundbreaking. However when RNs chose to deny a union foothold into their ranks suddenly these same RNs are now somehow victims of intimidation by the “evil” hospital administration, or somehow too weak to resist the management propaganda and thus hoodwinked into voting against unionization.

Case in point, the recent failure of the C.N.A. to organize the RNs at St. Agnes Medical Center in Fresno, California. The S.E.I.U. put out a “call for union unity” and used this recent loss (452 voted no while 327 voted yes with a margin of 125), which was the second failed attempt to unionize the St. Agnes RNs by the C.N.A. In the S.E.I.U. press release they clearly argued that the RNs were somehow manipulated by the hospital management and thus somehow incapable of making a decision of their own volition. Meanwhile, the S.E.I.U. conveniently failed to acknowledge the St. Agnes coalition of RNs “Our Voice-Our Choice” that lead an independent grassroots efforts to provide the “other-side” of the discussion to the RNs. This action was completely independent and to my knowledge unfunded by the management or administration of St. Agnes. So I find it rather ironic that a union that claims it’s all about empowering RNs to speak up for themselves would fail to acknowledge that these RNs did just that – oh I know it must not count if it’s not a union-led effort.

Too bad that nursing unions often show themselves to be no better than the hospital management that they label unresponsive to RNs wants and desires. In the case of St. Agnes the no vote appears rather decisive, but instead of giving kudos to the RNs for expressing themselves and exercising their collective will the C.N.A. has decided to fight the outcome of the vote and the S.E.I.U. chooses to characterize St. Agnes RNs as some kind of dupe to the hospital administration. In my opinion if the nursing unions were all about empowering the nurses, they should be celebrating that the St. Agnes nurses came together and that they made their will so clearly known, but then again it only counts when RNs chose to unionize versus affiliate as professionals. Why else do you think 85% of all RNs in the USA continue to choose to eschew the nursing unions, and over the past several decades or so nursing unions have basically been playing a zero sum game when it comes to membership?

In short, if we are expected to celebrate when RNs chose to vote in a union, we should equally celebrate when they chose to “self-represent” and be union-free. Otherwise, if we are to believe the union propaganda that RNs are somehow so feeble-minded that they fall under the “mind-control” of hospital administration or allow themselves to be so easily frightened and intimidated then you have to ask yourself do you want such a weak and feeble-minded RN caring for your loved-one, caring for your patient, or working on your team. For far too long nursing unions have denigrated RNs that resist their siren lure; it’s time that they show the same respect for RNs that chose to remain union-free as those who chose union membership.

Dateline Dearborn, Michigan – Nurses alleged that nurses attack them!

Yes, you read correctly, the nurses and other members of the California Nurses Association/National Nurses Organizing Committee (C.N.A./N.N.O.C.) alleged that during their convention in Dearborn that members of the Service Employee International Union (S.E.I.U.), a rival nursing union, barged into their event and began to harass and attack their members. C.N.A./N.N.O.C representatives have alleged that at least one woman was injured during this altercation and had to be treated at a local hospital for her injuries.

When I read this report in my e-mail and later in my local newspaper I thought what a sad, sad day for the nursing profession; and a sense of déjà vu came over me. Since several years ago I was very nearly “that” woman who had to be taken to the hospital after being accosted by a male RN who was a C.N.A. member.

During a special election that had been called by our Governor the C.N.A., S.E.I.U. took issue with a request from the Governor to delay the implementation of phase two of the California mandated nurse/patient ratio law, asking that a review and report of the impact of phase one first; this request seemed reasonable to me since many hospitals were claiming the law had been at the heart of a series of hospital closure and the nurses were arguing that it had “solved” our state’s nursing shortage. A review of what phase one had or had not done seemed reasonable however some chose to interpret that to mean a rollback of the law. So the C.N.A. started its now famous campaign where it dogged the Governor and many other elected officials to various events throughout the state holding loud and boisterous demonstrations and even interrupting the “non-political” annual Governor’s Conference on Women. Historically this conference has placed a focus on women and women issues with little to no political agenda, a rare venue where divergent groups could gather for an open exchange of ideas – no more because since that day the conference has become like so many public meetings have become susceptible to “hijacking” by one group or another for its own political agenda.

I was with a group of nurses who decided that we had had enough with members of the C.N.A. disrupting events through-out our state and when the C.N.A. decided to hold their post-election night event at the same venue as ours we decided to take our signs and hold a low-key, peaceful demonstration outside their room; since of course what’s good for the goose is good for the gander – no? As we stood outside the door of their event with our signs; members of the C.N.A. came out to demand that we leave, when that failed they tried to drown us out and when that didn’t work they tried kicking my cane out from under me so I’d fall.

So, while I found it very distressing that nurses would resort to physically assaulting one another (as if they don’t experience this type of bullying enough in the workplace) I found it rather ironic that Rose Ann DeMoro would yell “foul” when treated to some of the same tactics she and some members of the C.N.A./N.N.O.C. was infamous for – talk about the pot calling the kettle black. This recent event also helps highlight what happens when people are intentionally “radicalized”, allowed to funnel all their frustration (both real and imagined) into a perceived “foe”, and then let lose to vent. The past several years have seen the C.N.A./N.N.O.C. aggressively recruiting for new nurse members throughout the country. In many of these recruitment activities there have been accusations made that the C.N.A./N.N.O.C. has engaged in union raiding, the use of State Board of Nursing mailing lists to recruit (this is usually prohibited), and even the attempt to recruit under the guise of emergency response, etc.

There is little doubt that the C.N.A./N.N.O.C. has developed a reputation for “bare-knuckle” fighting and not being shy at calling out those that they perceive are hampering their agenda. Most organization members would welcome such aggressive “protection”, however sometimes when a group behaves in a way that is very much outside the societal norm and don’t face consequences then the groundwork is laid for the potential of even more outrageous behavior in the future and where does the line get drawn?

Time for disclosure, for those who may be unaware of my personal bias let me make it clear I am not one who supports or promotes the idea of unions for nurses. I am however a firm believer that nurses should seek out, participate and join professional associations, but NOT unions. Strikes and the behavior exhibited by the rival nursing unions in Michigan are a good example of what happens when nurses adopt the no-holds barred mentality of unions.

Another thing that has concerned me about the recent confrontations in Michigan is the silence from organizations that claim to be professional nursing associations and advocacy groups on the alleged nurse on nurse violence that was reported to have occurred in Dearborn, MI. You’d think that they would at least issued a statement denouncing such unprofessional, let alone poor human behavior. Of course, I’m sure that if this had been an episode of E.R. or House maybe we’d have received a denouncement.

I’m also concerned at the fall-out from this violent encounter, since the S.E.I.U. and C.N.A./N.N.O.C. confrontation over the stalled unionization in Ohio I have received numerous mailers from the S.E.I.U. about the transgression; and now with the events in Dearborn one wonder if there will be an intervention or will things continue to escalate? However, Ms. DeMoro shouldn’t be allowed to cry wolf about the S.E.I.U. members “stalking” C.N.A./N.N.O.C. members since it has been my experience that the C.N.A./N.N.O.C. has engaged in this behavior, usually meant to coerce uncooperative nurses at hospitals targeted by the C.N.A./N.N.O.C. for union organizing. Don’t believe me just read the testimony of nurses from Cedars-Sinai hospital that describe what they experienced at the hands of C.N.A. representatives when they opposed unionization; as well as the documented threats made to some nurses’ families. This does not mean I believe such behavior is justifiable or acceptable but it is interesting that when C.N.A./N.N.O.C. members experience such hostility it is suddenly not so palatable. Maybe this might be a significant emotional event for both groups to step back and take a look at what has happened and what is happening and maybe alter the collision course they are both on. Of course there are some observers who also see this as an opportunity to expose the darker side of nursing unions, and it very well maybe but the question remaining is will the media report and investigate, or will they take their usual role of union sympathizer and sweep it under the rug?
Meanwhile, this morning a brief news article revealed that a court official had lifted the temporary restraining order that had been granted to the C.N.A./N.N.O.C. against the S.E.I.U. The court official ruled that the restraining order was “not supported” by the evidence filed by the C.N.A./N.N.O.C. (source Los Angeles Times, April 23, 2008)

For those who may not have heard the news, and don’t be surprised if you haven’t since the California Nurses Association (C.N.A.) is not likely to advertise their loss of the certification vote at Mt. Sinai Hospital in Chicago. Why, because when you loss by a vote of 152 in favor and 293 opposed (that’s a 141 vote difference) and only 11 challenges you don’t go issuing any press releases!

Many of nurses, both non-union and union, have been following the machinations of the C.N.A. and their national organizing arm N.N.O.C. Nurses have watched as the C.N.A. was accused of raiding another nursing union, the take over of the Hawaii Nursing Association and the attempt to undermine the Louisiana Nursing Association during their Hurricane Katrina Recovery period and wondered when nurses would say enough. It looks as though this may have just occurred in Chicago with the Mt. Sinai nurses overwhelmingly voting to remain free to speak with their own voices.

All too often nurses become so “war weary” of the join a union/don’t join a union pushme pullme circus that when the certification election is held more stay home failing to cast their vote, leaving the margin of victory for either side so slim that which ever side looses can easily launch a challenge. Not so in the case of Mt. Sinai Hospital with only 11 challenges and a 141 vote difference the victory in this matters lies clearly with nurses choosing to exercise their “advocacy muscles” for themselves and their cohorts.

You can read the official announcement here.

Freedom of the press is critical to the foundations of our democracy, however accuracy of the press is also equally important!  For when the press reports erroneous information or moves from reporting the news to acting as a “public relations” agent for a person, group, organization, etc then the press fails to keep its promise to the people it purports to serve.

Recently the California Nurses Association (a nursing union) has garnered some press for their antics and outspoken “activism”.  This is all well and good since we do live in a free society, however it is imperative that when the press covers actions of the C.N.A. that they do so with accuracy.  It is my opinion that this was not the case in a recent San Francisco Chronicle article, “The Rabble-Rouser” published on May 6, 2007 and written by Kathleen Sharp.  After reading the article, I felt compelled to respond, since I felt it was more a free public relations article then news article; and that there were numerous inaccuracies and mischaracterizations that needed to be addressed.  You will find my response to the article as well as the article archived here.

Why, you may ask, have I posted this letter as well as copies of the letter and article to the NRNPA website?  Since it would seem that the San Francisco Chronicle editorial staff has chosen not to run my letter nor answer three separate phone calls, I persevered and tried a fourth time and on May 7th I spoke with Ms. Greene.  At her request I e-mailed a copy of my letter directly to her, she was kind enough to acknowledge the receipt of my email and informed me to whom she had forwarded copies of my email.  Meanwhile I waited and surmised the SF Chronicle would not print my letter since I strongly believe that they had an unadvertised “support” for unions and the C.N.A., in particular.  So I am not completely surprised that they have yet to run my response, though I had hoped they would have presented another viewpoint.

And this is why I have decided to run it.  I encourage you to read both my letter and the article to which it is in response to and to formulate your own opinion and if you feel so incline share it with me at clavreul@nrnpa.org.

May 10, 2007

Letters to the Editor
San Francisco Chronicle
901 Mission Street
San Francisco, CA 94103

Re: The Rabble-rouser

Dear Editor:

I read the above article, or should I say PR piece, with interest and concern.  Your reporter made several errors in the article; according to the C.N.A.’s own website they have approx. 75,000 members not the 80,000 your reporter cited and Ms. DeMoro is no modern day Florence Nightingale – in fact she is no RN and her actions are an insult to the memory of Florence Nightingale!
Finally, RNs across this country (both in unions and not) have not exactly jumped on the C.N.A.’s bandwagon.  Nurses represented by other nursing unions have decried DeMoro and the C.N.A.’s tactics since they often play fast and loose with the facts in order to push their agenda; they have received at least one written warning from the Calif. Board of Registered Nursing for violating the Continuing Education program – all which often runs counter to the oaths we as nurses take when we become licensed.  And finally before you paint them as though they represent a large portion of RNs in this country please remember that we are almost 3 million RNs compared to 75,000 RNs in the C.N.A.
For the record I am one of the 290,000 California RNs that has chosen not to let the C.N.A represent nor speak for me and who despises the deceptive tactics that their organization employs.

Sincerely,
Geneviève M. Clavreul, RN, Ph.D.

The link to the article is here: http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/05/06/CMGJIP6QD41.DTL

Well here we go again, many readers in Texas were subjected to a lengthy, though already rather worn, tale of the triumph of the C.N.A over to evil hospital corporations/ However for those of us, many who are RNs, this story was yet another pubic relations tall tale about the C.N.A. and its non-nurse executive director DeMoro. Early this month the San Francisco Chronicle tried to portray DeMoro as some kind of modern day Florence Nightingale and now the Texas Observer would want us to believe that she is a modern day Wonder Woman. The problem with both analogies is that they are incorrect. First, as so many of us know DeMoro is not nor has she ever been a licensed RN and her actions and behavior would shame the woman credited with founding modern nursing. As for being a Wonder Woman, those of us who grew up with Wonder Woman recognize that the reference to the nurse members of the C.N.A. as her (DeMoro’s) nurses is an insult to the Wonder Woman myth. Wonder Woman would have never tolerate anyone referring to people as “hers” as if they are owned by DeMoro.

So when I read this what I can only characterize as a publicity stunt I responded with a letter to the Texas Observer, and a follow up phone call. Again no response except the request to resend the email to another individual at the Texas Observer, which I did. Still no response so up on the “Nurse Unchained” it goes. Below you will find my letter and the link to the article it is in response.

Enjoy.

May 18, 2007

Letters to the Editor
The Texas Observer
Austin, TX 78701

Re: An Ounce of Dissension

Dear Editor:

When I read the above article I was struck with a strong sense of déjà vu? Why, because I had read a strikingly similar article a week earlier in a local California newspaper. There is a term in journalism for this kind of reporting and its called planting a story. I wasn’t surprised to discover the California newspaper had engaged in such a practice – it’s common in a state that makes its business in the marketing of illusions – but to see it being excepted in the Texas press is very saddening.

As for the Texas nurses taking a stand for nurses and patients rights I say kudos, though I’m not sure the NNOC is the way to go. I find Sharp’s reference to nurses as “her (DeMoro’s) nurses” tacky – since they are not her nurses! As a nurse who has worked at the bedside in many states, including Texas (Bexar County Hospital) and now lives in California I can proudly state that I am no nurse of DeMoro; and I am one of the more than 250,000 active California RNs that have said no to the antics of the C.N.A. and DeMoro. I also find it intriguing that no mention was made of Deborah Burger, who is a RN, and the president of the organization. But what should I expect of an organization that pays its executive director (who is not a RN) almost three times what they pay their president (who is a RN). Sounds to me like DeMoro has more in common with the hospital/healthcare corporations she so adamantly denounces than she knows.

Sincerely,
Geneviève M. Clavreul, RN, Ph.D.

The link to the article is here: http://www.texasobserver.org/article.php?aid=2495

Question: What can one person or a small group accomplish? Answer: A lot, if they are committed, determined and perseverant.

Defeat of AB 1201 – Related to Collective Bargaining, is or should I say was a bill in the California Legislature (you can find text of the amended bill here:
http://www.nrnpa.org/legislation). Today, May 31, 2007 at 16:26, I learned that AB 1201 was left held in the Suspense File, which means that it is for all intents and purposes inactive for the remainder of this legislative session. This is welcomed news since the bill, in my opinion, characterized nurses as so weak as to require legislative intervention in order to perform their responsibilities. I know several nurses that shared my concerns and that I encouraged them to contact AB 1201′s author (Assemblyman Leno) and their Assemblyperson. I know that Suzanne Geimer, RN, not only wrote to Assemblyman Leno but that she also took the time to contact her elected Assemblyman and meet with one of his field representatives to share with him her opinion and experiences (I joined her in this meeting as per her invitation). To all those who took the time to contact their elected representatives I want to say THANK YOU. The NRNPA is all about getting information both professional and legislative that affects and effects our chosen profession and then encouraging them to inform and educate their elected officials about how they feel this will impact them.

You can read a copy of my letter of opposition that I emailed to Assemblyman Leno, and my elected representatives at the end of this post. The attachment that is referred to in the letter can be emailed upon request (it is in PDF and easily attached to this blog entry). In the meantime, until AB 1201 is withdrawn, not passed or vetoed it can be resurrected in the next or future legislative session so it will be important to be vigilant.

May 29, 2007

The Honorable Mark Leno
13th Assembly District
State of California
P.O. Box 942849
Sacramento, CA 94249-0013

Re: Opposition to AB 1201

Dear Assemblyman Leno:

I have long been an outspoken advocate on issues that affect and effect nursing and a nurse’s ability to deliver quality of care. It is this concern that has spurred me to make my opposition to AB 1201 clear. AB 1201 is not a bill that enhances a nurse’s ability to deliver quality of care to their patients, contrary to the statements of its sponsor even though I believe they think it does. The language used in AB 1201 denigrates nurses and our profession; its chauvinistic language makes nurses out to be so weak as to be unable to stand up for their rights let alone the rights of their patients. In truth if a nurse is this weak I would not want this person caring for me or a loved one.

Below are some of the key points made in AB 1201 that I believe are erroneous and incorrect assumptions made by the bill’s sponsor:

1) Only nurses in unions can effectively advocate for safe patient care — NOT:

a) In your testimony before the Assembly Labor and Employment committee you testified that California is facing a critical nursing shortage. However you must ask AB 1201′s sponsor why then did their representatives when interviewed by the Pasadena Star News editorial board on April 5, 2004 say that there is not a shortage? They asserted that the nursing shortage was manufactured and was now no longer a major issue. (See attached). Also, the bill’s sponsor testified at this same committee meeting that if the nurses’ at the Tenet run hospital in Redding had only been unionized that somehow the scandal involving unnecessary cardiac surgery would not have occurred. However more recently at two Southland hospitals there have been transplant scandals where no nurse came forward to blow the whistle, and yet the sponsors of AB 1201 represent both of these hospital’s nurses.

2) The card check protects the nurse — NOT:

a) AB 1201 also attempts to establish a card-check or petition system over the secret balloting system now in place. I find this very concerning since during unionization or decertification attempts “feelings” from both sides can be very volatile and a secret balloting system permits the individual at least the security of being the only one who knows how they chose to vote. I would like to share with you several examples of what can only be described as efforts to intimidate that I personally know of having occurred.

i) After a failed attempt by the C.N.A. to organize at a local southland hospital, a particularly outspoken anti-union nurse had all their employment records, including time cards, as well as all the patients’ records (of patients that the nurse had cared for) subpoenaed. The C.N.A. only relented after that nurse engaged a private attorney to fight the release of the records.

ii) A nurse had her picture prominently displayed on a flyer, along with a picture of her husband who was running for elective office. The flyer tried to characterize her husband as being less than honest. One wonders what his campaign had to do with the union’s attempt to unionize a hospital, especially since the candidate was not at all involved in healthcare except for being married to a nurse.

iii) Two other nurses received numerous telephone calls that threatened the two dogs that the one owned and the daughters of the other. The threats though vague (we know where you and your daughters live) were worded in such a way that a reasonable person could interpret them as being of a threatening nature.

b) All the examples provided above can be found in the public records. These are clear examples that unions can at times be found to play fast and loose with the rules. I think you must ask yourself this, if hospitals were the ones pushing for the legislation of a card check/petition system rather than the secret balloting system would you be as quick to support them in this legislative endeavor.

3) The NLRB was wrong — NOT:

a) Lastly, the sponsor of AB 1201 argues that the recent NLRB decision somehow diminishes the charge nurses ability to effectively advocate for nurses and patients. Personally, as an RN with over thirty years at both the bedside and in nursing management I believe that the NLRB decision was a sound decision based on good management principles. One of the main complaint nurses cite for their dissatisfaction and for leaving the profession is often poor nursing management. If we are ever going to address this issue our profession must develop strong and competent pathways into nursing management and the charge nurse is the entry level into this pathway. The NLRB decision made it clear that its ruling applied only to the full time charge nurse and not the rotating charge nurse position, and thus making it clear that the rotating charge nurse is not in a position of management. It is important to remember that in California the highest nursing position in a hospital, often referred to as the Chief Nursing Officer, is required by law to hold an active California RN license. The reason for this is to make it clear that even at the highest level of nursing management the individual is still a nurse first and therefore bound by our nursing rules, regulations and oath and remains first and foremost a patient advocate. It is my personal and professional belief that AB 1201 undermines this since its language clearly defines the nurse as being incapable of fulfilling this requirement without legislative intervention. In my 30 years I have never felt that my ability to properly advocate for my patients has ever been prevented by “administration”.

I hold licenses in three states and the District of Columbia and I have practiced as a nurse (either as a LVN or RN) in Kansas, Texas, Georgia, South Dakota and of course California – so you can see my experience is vast. Perhaps my success is in knowing and understanding the nursing regulations as well as I do, which is one of the reasons that I share my skills and talents with the almost 200,000 RNs in Southern California and Arizona who read my monthly column, “From the Floor”.

In closing I ask that you place my letter and name in firm opposition to AB 1201 in the official record.

Respectfully submitted,
Geneviève M. Clavreul, RN, Ph.D.

Cc: State Senator J. Scott
Assemblyman A. Portantino

For a copy of the attachment referenced in the letter email me at clavreul@nrnpa.org