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

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

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but no official announcement was made until April 26th when I received word from several of my sources that the CNA had withdrawn their petition – effectively ending the fight to unionize the HMH RNs.

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

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

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

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

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

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

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

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

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

eMail HMH v CNA Settlement

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

Hard Facts? Whose Facts?

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

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

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

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

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

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

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

 

If one were to believe the C.N.A. (based on the quote from their official spokesperson) that was written up in the August 12th issue of the Houston Chronicle (read the story here — http://www.chron.com/disp/story.mpl/business/5940099.html) an eight vote difference is a “majority” and thus an overwhelming endorsement for union representation and anyone that questions this vote is undemocratic. Contrary to the C.N.A. allegations, what the National Right to Work Foundation has (www.nrtw.org) done is file an unfair labor practice allegation against both the C.N.A. and Tenet (you can read the press release here – www.nrtw.org/print/3156). They allege is that the neutrality agreement that was signed between Tenet and the C.N.A. was the first “wrong” action in the C.N.A. attempt to gain a foothold in Texas. In addition, the nurses have alleged that this neutrality agreement was so one-sided it provided the Houston-area Tenet nurses no choice in which union the nurses could join, so in essence the C.N.A. was foisted on them. To make matters worse the so-called neutrality agreement also gagged the managers from speaking or answering questions raised by the nurses, leaving the nurses very little access to information that wasn’t either provided by the C.N.A. or vetted and approved by the C.N.A. – talk about a raw deal. Not to mention the agreement gave the C.N.A. access to the private home addresses and telephone numbers of the nurses without the nurses’ knowledge or permission. It’s also my understanding that a neutrality agreement is generally not introduced or signed until the prospective union can demonstrate that there’s an interest expressed by the nurses to be represented by that union, which I understand never happened in this case.

Something tells me that if the roles were reversed the C.N.A. would have been screaming “bloody murder” and Congressman Henry “I’ve never met a congressional hearing I didn’t like” Waxman would have been chairing hearings on such outlandish behavior. So the nurses have had to rely on themselves and a network of management/union-savvy nurses from around the country to get answers and information to then share among themselves. But then again we are talking about the world according to the union, so we shouldn’t expect things to appear logical. I feel confident in making such a bold statement because a couple of months back a Fresno-area hospital rejected the C.N.A. for the second time by a 125 vote margin, and guess what the C.N.A. has contested the outcome. How come the C.N.A. cries undemocratic to question a neutrality agreement that results in an eight-vote margin win for the union, but when another hospital’s nurses vote to stay union-free this is worthy of being contested by the C.N.A., which that claims that all it wants to do is let the nurses have a voice?

I guess it just another example of a union talking the talk but not walking the walk – why am I not surprised.

Did Tenet “sell” its nurses out?

For the past year or so the National Nurses Organizing Committee (N.N.O.C.), a spin-off of the California Nurses Association (C.N.A.) has been aggressively trying to recruit and add nurses from across the country to their union. At present N.N.O.C. has Texas-area nurses in their sights and they are currently in Houston (under a neutrality agreement) trying to recruit nurses from three Tenet-owned, Houston-area hospitals; the three hospitals are: Cy-Fair, Houston-Northwest, and Park-Plaza.

 

 

When I learned of the N.N.O.C. activities in these hospitals I reached out to some of my contacts in Houston as well as at least one of the nurses who had been identified as leading a nurse-driven opposition to the unionization attempt. Several conversations and emails later my daughters and I found ourselves taking a short trip to Houston and meeting with the various nurses from all three hospitals. Even though I had received a great deal of background information from these nurses prior to arriving in Houston the sheer scope of the nurses’ abandonment and betrayal by their employer only became clear after I read the Tenet/C.N.A.-N.N.O.C. neutrality agreement and listened to the personal stories of the RNs that I met during my stay.

 

 

I thought how odd that a neutrality agreement would be signed even before the union presented any authorization cards showing that there was an interest from the nurses to call for a vote. Neutrality agreements are often controversial, but in short a well-written one (i.e. one that favors the union at the expense of employer rights) can make unionizing efforts much easier for the union and its representative. The Tenet/C.N.A.-N.N.O.C. agreement is heavily weighted in favor of the union, even going so far as requiring that the hospital have any of its opposition information which was to be neutral-language based preapproved by the C.N.A./N.N.O.C before it could be distributed; and the part that I thought even more interesting was the part where the hospital would provide the union with the names of “eligible” RNs personal contact information. The nurses didn’t even know their private, confidential contact information had been provided to this third party until nurses began receiving calls at home from union representatives; it was only after numerous complaints from nurses that the nurses were given an opportunity to opt-out but of course by then the union already had the complete list. One nurse shared that she discovered her contact information had been released to the union, without her knowledge, when union representatives contacted her at home and used her given name not the “nickname” that she normally goes by even at work.

The nurses that strongly opposed the union quickly formed two ad-hoc groups, UB-144 and Informed RN (http://informedrn.googlepages.com/) to reach out and provide an alternative source of information then the one being provided by C.N.A./N.N.O.C.   Though one cannot necessarily blame the C.N.A./N.N.O.C. for drafting a contract that favors them and their cause so heavily, I wonder why the administration at Tenet was so willing to pretty much just roll over and take it. The first rule of contract negotiation is to make the tough demands up front and then negotiate, negotiate, negotiate. But there is little give and take in this agreement since it binds Tenet in such a way they have pretty much left the nurses that want non-union information out in the cold with no support from any Tenet official. However, these nurses showing a great deal of initiative have reached out and garnered answers and support from other nurses in Texas and across this nation – because of the little known fact that nursing unions and most of the main-stream media fail to clarify is that nursing unions do not represent the voice of nurses, since most nurses (either 89% or 80% depending on which statistic you pick) choose to speak with their own voice – not a union voice.

 

 

However, what concerns this nurse and citizen most is what, in my opinion, is a very undemocratic and almost draconian tact that the C.N.A./N.N.O.C has demanded of the three Tenet hospitals. For example C.N.A./N.N.O.C. can and does get meeting space at all three of these hospital – this is fair; but when Tenet-nurses wanted to get their “we are professionals and don’t need a union to represent us” message out the C.N.A./N.N.O.C. demanded that the hospital refuse a room to these nurses. Even though these nurses were doing everything on their own time and dime and the only thing they asked for was the same courtesy that C.N.A./N.N.O.C. had demanded – a room to meet in. The C.N.A./N.N.O.C. demanded and got a confidential employee list with the private home contact information of all the eligible RNs; when the nurses of Informed RN asked for the same courtesy they were denied access to the list. So next time when the C.N.A./N.N.O.C. (or any union for that matter) pontificates about democracy and rages against special interest groups – remember the above example because if C.N.A./N.N.O.C. was all about informing and empowering nurses then they wouldn’t fear a grass-action group such as Informed RN. But of course the C.N.A./N.N.O.C. does fear such groups because groups such as Informed RN are all about empowering RNs to be informed and to take action on what they know – all without having to pay dues to the union machine. To me how C.N.A./N.N.O.C. has dealt with the Houston RNs, coupled with the language that they crafted for a California Assembly Bill 1201 (thankfully killed in committee) shows what their union leadership really think of nurses.

 

 

Meanwhile, I hear that these buttons (see below) are so popular that Informed RN can hardly make enough to meet with the demands. Way to go Informed RN!

Hubris

A short while ago I was invited by some nurses from Houston, Texas to pay them a visit. Since my daughters and I had been discussing taking a short vacation for some time the invitation provided us with an opportunity to take a road trip to Texas. I let the nurses in Houston know that I’d be happy to pay them a visit and chat with them about their experiences with the California Nurses Association/National Nurses Organizing Committee. Which is why after just a few days in Houston, my daughters and I found us in Austin having lunch at the Sheraton Hotel and under the watchful eye of C.N.A./N.N.O.C. officials. We had personal business to attend to in Austin, and since the C.N.A./N.N.O.C. has planned a strategy session with HCA nurses to discuss “unionizing” I thought it would be a perfect opportunity for me to observe them in action, so to speak.

As I walked down the hallway between the conference rooms and the restaurant where my daughters waited for me, a C.NA. representative recognized me and quickly left the meeting room so he could follow me. And follow me he did, stopping short of the restaurant entrance where he then stood for 10 – 15 minutes, in plain sight, observing us as we ordered our meal and while he busily spoke to someone on his cell or text messaged. A little while later he motioned for someone to join him and appear to direct him to continue the vigil while he went back upstairs. After finishing our lunch we made plans to complete our errand and found it most amusing to see that we were still being “watched”; oh to have such power.

Which brings me to my point of hubris. Why the officials of the C.N.A./N.N.O.C. would think that I would plan to disrupt their activities or meetings is interesting – but of course they would think this is how people behave since they think nothing of disrupting a meeting, stalking or harassing those they perceive as “threats” or even raiding other unions – so of course they would believe this behavior to be the norm and thus everyone else would exhibit the same deplorable behavior. Which is why they made a point of observing and stalking my daughters and I while we were having our lunch and then made sure we were “observed” during our entire stay at the hotel. If they had only come up and introduced themselves perhaps they would have learned my intent and thus not wasted their time on looking the fool.

Nonetheless when I shared this experience with my fellow nurses from Texas and California everyone had a good laugh at the actions of the C.N.A. and commented on how this made for a memorable experience for this Texas road-trip. Of course one would think that the C.N.A./N.N.O.C. exercise in hubris would end there, but have no fear the day after my return I received an email from an N.N.O.C. nurse from Tennessee. Nurse Chapman chose to send me an email regarding a very popular article I wrote, “To Unionize or Not to Unionize, that is the Question?” Apparently he was under the impression that he was my editor or significant other because he attempted to “deconstruct” my article throwing around such words as nurses need strong union representation (just see what such strong unionization has wrought the nurses of Great Britain, Australia and Canada), research and studies have shown. . . without providing a single citation for his conclusions, and my favorite “I request that you change the title of your article. . ”. Of course my response to him was NO, I would not change the title of my article, as I like it very much the way it is now. I also reminded him that this article, as all my articles and blog postings reflect my opinion and experience and thus not subject to his approval. Of course he chose to ignore the underpinnings of all my articles which that my readers should always do their due diligence, which by the tone and context of his letter I think he preferred that nurses just remain as sheep and that they should follow his piped piper. “N.N.O.C.”.

Oh the hubris of the C.N.A. and their operatives to think that they can intimidate nurses so easily, and me in particular.