As a RN with decades of experience at various nursing disciplines; I find myself conflicted as I watch my fellow health professionals, in particular nurses, protesting outside their respective hospitals. I fully support nurses who advocate for the patients and for themselves. It’s enshrined in our Nurse Practice Act – we, the nurse, are the patient’s advocate and we can’t cede that responsibility to another “agency”.
During this healthcare crisis our nurses claim to find that they’re lacking the appropriate protection to safeguard their patients, their families, and most importantly themselves. In order to bring light on these issues nurses have taken to the streets to protest with their state goal being to bring pressure to bear on hospital administrators to provide the appropriate safety materials, such as N95 masks, face shields, and other PPE. In turn, many of these same hospital administrators have claimed that these materials have been made available – so why the disconnect?
My experience has taught me that all too often when nurses claim that their concerns are being ignored that it happens for two reasons. The first, administration is either not listening to the nurses or ignoring the nurses’ concerns. The second, the nurses are failing to use their chain of command and thus there’s an appearance that administration isn’t being responsive to the nurses’ concerns. The first garners a great deal of press on behalf of the “beleaguered” nurse, and the second just reinforces the failure of the nursing staff to appropriately use their chain of command – which leads to the same sad result – a feeling that administration isn’t listening. One of my favorite things to do whenever I go to a hospital either to work as a nurse, consultant, or patient is to ask the nurses around me to tell me the name of their Chief Nursing Officer (CNO) and you’d be surprised how many can’t tell me that individual’s name.
COVID-19 has shown us the many weak points in our healthcare network. It’s also shown us that our healthcare community is willing to answer the call to serve in many cases putting aside their own needs. However, I’d like to recommend that the next time nurses chose to protest the failure of their hospital administration to provide appropriate PPE that those same nurses aren’t photographed failing to practice social distancing or not wearing face masks while outside – this somewhat undercuts their claim that requests for safety protocols are being ignored when they can’t practice basic safety protocols during their protest.
Not so long ago the NLRB ruled that Nurses Allysha Shin (Almada) and Vicki Lin were wrongly terminated and determined in their decision that Huntington Memorial Hospital (HMH) was required to rehire and repay back wages. In the same decision the NLRB also allowed HMH to in essence “black ball” the same two nurses from ever working at any HMH facility.
The issue I had with the NLRB’s decision was that the NLRB appeared to be making a decision on whether or not HMH had the right to terminate a registered nurse for violating the nurse practice act and/hospital policy and protocols. It was the failure of the HMH RN’s to follow both our state’s nurse practice act and hospital policy and protocols that were the grounds that HMH argued that they fired the two RNs and not because of these two RN’s involvement in unionizing activities (The CNA was trying to unionize HMH; a fight that the CNA lost with 539 nurses voting no compared to 445 nurses voting yes with pretty much every single eligible nurse casting a ballot). The NLRB, which we all know are experts on how nurses should perform their duties, decided in favor of the two HMH RNs.
However, on March 2018 our California Board of Registered Nursing placed a Public Reproval on both Nurse Shin (Almada) and Lin’s licenses, which will remain in affect for three years. In both nurses’ document they agree as follows: “Respondent admits the truth of each and every charge and allegation in Accusation Respondent agrees that her Registered Nurse License is subject to discipline and she agrees to be bound by the Disciplinary Order below… ” (Allysha Almada-Final Vicki Lin – Final).
What I concluded from the outcome is simple: the NLRB had no place in deciding the original case since it applied to nursing practice. The NLRB has no expertise in judging whether a nurse has acted within his/her scope of practice or followed hospital policy and protocols. Perhaps in the future when confronted with such an issue where a nurse is terminated due to an alleged failure to conduct themselves within their scope of practice and said nurse has been reported to their licensing board for such behavior the NLRB should wait for said licensing board to conclude their investigation. If the licensing board finds that the nurse acted within their scope of practice and didn’t violate hospital policy or protocols – then the NLRB can step in and render their decision.
In the future the NLRB should stick to adjudicating labor issues and stay out of the business of licensing boards, such as the Board of Registered Nursing, whose mission is to decide whether or not a nurse has failed to adhere to his/her nurse practice act.
A while back I published several articles on pain and opioid use. I wrote these article to shed light on the other side of the pain and opioid use debate that seemed to me to be very one-sided. And while opioid abuse has undoubtedly destroyed many lives, what concerned me most was the focus on opioid abuse without equal time being given to the estimate 25.3 million Americans suffering from chronic pain (8/11/15 NIH press release).
That said you can find my articles on the issue here
Nov. 2011 – Working Nurse Magazine – Chronic Pain: What nurses don’t know about pain management WNM Chronic Pain1 copy
Sept. 2012 – Working Nurse Magazine – The Great Opioid Debate: Balancing the need for pain management with the potential for abuse — WNM The Great Opioid Debate1 copy
May – Apr. 2014 – Working Nurse Magazine — The Opioid “Epidemic”: Why we need to dial back the sensationalism and find common-sense solutions — WNM Opioid Epidemic1 copy
Since April of last year there has been the constant drone from the California Nurses’ Association (CNA) and their supporters of “just let the Huntington Memorial Hospital (HMH) nurses vote”. Elected officials such as Congresswoman Judy Chu, Pasadena City Councilpersons, Gordo and Tornek, former Pasadena City Councilperson Robinson, various “community leaders” and others have picketed the hospital, held rallies, written letters to the editor and what not echoing this simple plea. However, when the vote which was held in April 2015 showed that a majority of HMH nurses voted no to having union representation these same individuals who claimed they were only interested in the HMH nurses getting to vote suddenly had a change of heart and cried foul, demanding that the vote be stricken and a new vote taken even though well over 90% of eligible HMH RNs came out to cast their vote.
As expected both the CNA and HMH leadership filed charges with the National Labor Relations Board (NLRB), each claiming that the other side had made one type of violation or another. The NLRB rendered numerous decisions, some in upholding the CNA claims and dismissing others. In the meantime the campaign to disparage the care at HMH continued unabated. Even after the CNA and HMH agreed to set aside the vote and hold a new election there were those CNA supporters who seemed unable to control themselves and continued their attempts to vilify HMH and its leadership.
One such person is an individual named John Grula, PhD who writes a column for the Pasadena Weekly. He’s most recent diatribe against HMH can be found here – http://www.pasadenaweekly.com/cms/story/detail/outbreak_of_truth/16130/.
He makes many claims in his article, which on their face sound absolutely outrageous. Claims such as CNA-affiliated RNs provide the best patient care in our state. To bolster this claim he brings up the Olympus scope and how the failure to properly clean them lead to bad consequences for many patients. He goes into great detail about these incidents that occurred at HMH, but failed to mention that there were at least two other LA-area hospitals that had similar outbreaks and breeches in reporting such outbreaks. One such hospital was UCLA Ronald Reagan Medical Center, which ironically he cites as having CNA-affiliated RNs that provide the best care in our state.
At the beginning of Grula’s article he cites a June 1, 2016 LA Times article which if you don’t read beyond the first paragraph paints a dim picture about how HMH handled the drug-resistant Pseudomonas aeruginosa. However, if you read the full article, which you can find here — http://www.latimes.com/business/la-fi-huntington-hospital-scopes-20160601-snap-story.html, a slightly different picture emerges. The article lays out the problem was not just at HMH, but at hospitals across our nation, it also lays out the steps HMH took to correct the matter.
His article goes on to mention the firing of two HMH nurses, which the CNA and their supporters claimed was in response to the nurses’ pro-union stance and unionizing activities. He then writes that the NLRB agreement rescinded their termination, removing any mention of termination from their employment record, that they received back pay and that one nurse had returned to HMH. While some of his statement is correct, he fails to mention that while any mention of their termination was removed from their employment files notating instead that they had voluntarily resigned. Grula goes on to claim that one of these nurses chose to return, but my research shows that the nurse he claims returned to work at HMH, hasn’t. The reason for this appears to be related to the NLRB agreement, which bars both nurses from ever working at or having any business with HMH now or in the future. Not to mention that I know that at least one complaint has been filed with the California Board of Registered Nursing (BRN) about the nurses and the possible violation of our nurse practice act. Several weeks ago, I learned that several HMH nurses have admitted to being questioned by the BRN. Now whether this goes anywhere remains to be seen.
In the end, I find it ironic that the CNA and their supporters continue to rant and rave about giving the HMH RNs a voice, but seem to ignore that their “victory” at having the HMH vote overturn effectively gaged the voice of the 539 HMH RNs that voted no to union representation. Throughout this entire contested voting period the CNA and their supporters seem to only advocate for the 445 HMH RNs that voted for union representation and minimize the fact that a majority voted not to unionize.
Where are the CNA and their supporters speaking out in support of these nurses? Nowhere I guess, because it would appear to me that the CNA and many of their supporters appear ethically and morally challenged to acknowledging that these RNs might actually feel that they don’t need a nursing union to speak for them.
Update – California Board of Registered Nursing Investigating Two Huntington Memorial Hospital NursesAuthor: raconte
You may recall that back in September of last year I blogged about at least one complaint being filed against Nurse Allysha Almada and Vicki Lin with our Board of Nursing (BRN). It’s come to my attention that BRN investigators have interviewed several Huntington Memorial Hospital (HMH) nurses regarding the Almada/Lin affair.
At this point I have no idea what these nurses told the BRN investigators or what questions that the BRN investigators had for the nurses. However, as I learn more I’ll be sure to share the information on The Nurse Unchained. Of course the BRN investigators may conclude that there wasn’t a violation of our nurse practice act in which case the allegation can be closed with or without merit. However if its decided that the allegation is substantiated then the allegation can be refer to the Attorney General for formal disciplinary action or refer to cite and fine. This is call an accusation and if a nurse has an accusation filed against him/her it will show up on a license search.
You can learn more about the complaint process by pointing your browser here
Also point you browser here for my article on the California BRN WNM California BRN1
CNA up to its old tricks — claim nurses terminated for union activity — but there’s more to the storyAuthor: raconte
Our local paper recently published an article about two Huntington Memorial Hospitals with the claim made by the nurses that they were fired due to their union activity. However there’s more to the story and below you’ll find both the link to the above mentioned article and my letter to the editor — that the Star News chose not to publish. I think they were afraid to encourage their readers to think beyond the pablum the union was spoon feeding to both the paper and its readers.
Nurses Almada and Lin with the help of the California Nurses Association (CNA) held a rally to demand that Huntington reinstates the two nurses. The claim is that these two nurses were unfairly terminated due to their support of the recent failed unionization effort at Huntington Memorial. If what they claim is factual, then shame on Huntington Memorial.
However, as a nurse with more than 40 years of experience at all levels of the nursing ladder I’m somewhat hesitant to take their tale at blind faith. Why? Because the hospital is bound by confidentiality in all personnel matters and Almada, Lin, and the CNA know that and are counting on Huntington to adhere to this code. Meanwhile, they can sling all the mud that they want, which they’ve been doing over a year now with support from much of the local media and many local officials who enjoy union support.
I’d prefer to wait and see, because something tells me that there’s more to the tale of the firing of these two nurses than just their involvement in the failed unionization attempt. My nursing instinct tells me that these two nurses may have failed to adhere to our nurse practice act and if this were the case then firing them would’ve been the appropriate action. I also think it is interesting that they’ve made a big deal about going to the NLRB, but said nothing about filing a complaint with our state’s labor board. Not to mention it’d be an act of ultimate stupidity on the part of Huntington to fire any nurse at this time except for cause.
On Monday, August 24, 2015, the California Nurses Association (CNA) held yet one more of their dog and pony shows. This time the subject of their display was the firing of two Huntington Memorial Hospital RN’s. The nurses, Allysha Almada (CA RN License #802190) and Vicki Lin (RN License #832090), claim that they were fired by Huntington administration for being vocal about their support for a nursing union, a union that if the nurses voted in favor of (which they didn’t) would have been represented by the CNA. Want to check an RN’s license all you have to do is go to the California Board of Registered Nursing (BRN) website here – http://www.rn.ca.gov/online_services/perm-verif.shtml and click the big grey button marked “click to verify a license” and you can check not only if a RN is licensed but pretty much any health/medical profession that is licensed in our state.
Depending on which newspaper you read somewhere between two dozen to 50 nurses/people came out in support of the reinstatement of Almada and Lin. However, if my many years of experience (all up and down the nursing career ladder) has taught me anything, its that sometimes there’s more to the story than what meets the eye – and that would appear to be the case with Almada and Lin.
I’ve learned that at least one complaint has been filed against Almada and Lin. The complaint has been sent to the BRN, the licensing body in our state that has oversight of nearly 400,000 licensed RNs and is responsible for investigating allegations of misdeeds, accusations, etc., lodged against a California RN. So, what pray tell could the complaint be – well it’s not about Almada and Lin’s support of a nursing union for darn sure!
The complaint alleges the following:
- Nurse Almada provided her username and password to Nurse Lin
- Nurse Almada provided this in the form of a note, which was later found in a patient’s medical record, and perhaps the most serious of charges
- Nurse Almada did this so that Nurse Lin could use Nurse Almada’s username and password to confirm as a second “signatory” that Nurse Almada had double-checked a medication that required two nurses to check-off, without Nurse Almada actually being present and having actually verified that she had indeed confirmed that the appropriate amount of medication had been titrated/drawn by Nurse Lin.
If indeed, Nurse Almada did as alleged and Nurse Lin “signed” as Nurse Almada as alleged in the complaint then it would appear to this nurse that they clearly violated our nurse practice act, not to mention potentially placing a patient in harms way – because the medication that was being administered could be deadly – which is why our nursing protocols call for the first nurse to draw the medication and check that the amount is appropriate and for a second nurse to come and verify that indeed the medication is the appropriate medication and that the appropriate amount is about to be administered. Remember the “rights” — the right patient, at the right time, and so forth.
What’s the big deal about requiring two or more nurses to verify that the appropriate medication is about to be administered to a patient, simple some of the medications that a nurse administers can KILL their patient and nurses are only human and can make a calculation error, inadvertently draw too much medication, misread an order and so forth, so nursing protocols require that certain medications such as insulin, heparin and others require a two nurse protocol. Because too much insulin can kill and too much heparin and your patient can bleed out of every orifice of their body. So the two-nurse protocol protects both patient and nurse and to circumvent this safety protocol is unconscionable.
The question that now begs to be asked is how come the CNA is demanding the reinstatement of two nurses that allegedly engaged in acts of what would appear to be not only the falsification of a medical record and the possibility that these two nurses engaged in an act of patient endangerment? I guess, when the rubber hits the road patient safety isn’t what concerns them as much as holding press conferences that continue to spread their propaganda and accuse Huntington Memorial Hospital of being a “bad” hospital that’s mean to its RNs on staff.
A lot’s been “said” in print about the recent vote to unionize/not-unionize the RNs at Huntington Memorial Hospital (HMH). If you’d listened to the California Nurses Association (CNA) and many of their vociferous supporters you’d think that it was HMH management that was trying to suppress the vote, but you’d be wrong. You may wonder how I came to this conclusion, simple by looking at the outcome of the NLRB-led and supervised April 15th – 16th election. The unofficial outcome of the vote was as follows – 539 No to 445 Yes with 176 Challenged ballots. There are 176 ballots left to be counted and were challenged by either HMH or the CNA, which is their prerogative. However, if you’re a “true believer” of the CNA party line you might assume that it’s HMH that has challenged the lion’s share of the 176 ballots, but you’d be wrong. It’s my understanding that HMH has challenged only five that’s right five of the 176 challenged ballots, leaving 171 votes challenged by the CNA, that’s right the CNA is the side that has chosen to challenge the largest number of ballots. On the bright side, it looks like pretty much every eligible RN who was entitled to vote did just that with only about 40 nurses abstaining. This, in my humble opinion, is proof that contrary to the heated rhetoric of the past several months show that the HMH RN’s felt free to vote! Now why would the CNA, the nursing union that kept spewing the “just let the nurses vote” mantra at every media source they could find and painting HMH as some kind of boogey man when it came to the nurses voting on the issue of whether or not to unionize, challenge so many ballots? Why, because they feared that the majority of these 171 ballots were not in favor of the union and thus their strategy was to challenge these ballots, thus hopefully swinging the outcome of the vote in their favor. However it would appear that this strategy might have backfired. We should know the final results on April 27th and if the NO votes win the day the CNA will of course respect the nurses will – NOT! They’ve already made it clear (just take a peek at their newest flyer handed out the very next day – ) that they plan to continue their campaign to unionize the RNs at HMH – so much for “just let the nurses vote”. Hypocrite, thy name is the CNA.
I would hope that Professor Dreier is a better fact checker of his instructional material than he is of his columns, because in his above entitled column he failed to fact check the statements about me provided to him in all likelihood by the California Nurses Association (CNA).
Not only does he mangle the name of my company (it’s Solutions Outside the Box, not Outside the Box Solutions), he also falsely accuses me of having been hired by Huntington Memorial Hospital (HMH) to as he puts it “to harass and intimidate nurses and undermine their organizing efforts”. I’ve not received, been paid, promised, etc., a single red cent by Huntington Memorial Hospital. I’ve also not engaged in any way shape or form to harass or intimidate any HMH nurse. The CNA (whose leadership fears me as well as any nurse willing to stand up to their machinations) is always happy to spread lies and untruths – in short they know that I’m not being compensated but they are happy to say I am because more often then not the folks that support them (like Prof. Dreier) don’t bother to fact check the information that the CNA spoon feeds them.
Prof. Dreier goes on in his column to illustrate, as so often happens when ideologues from either side of the political spectrum get their “panties in a wad” to tell the tale of woe of their favorite side and ignore the experiences from the other side of the discussion. So, since Prof. Dreier’s fact checking is lacking let me set a few things straight.
First, I was contacted by several HMH nurses that wanted to learn what their options were to avoid a union. In that spirit, I met with a group who came on their own time and dime to learn what resources and recourses they had to provide a counter-point to the “let’s join a nursing union” advocates. They didn’t pay me a red cent. I did however secure the domain name of their group, IStandWithHuntington.com to ensure that it couldn’t be co-opted for other uses, but it’s the IStandWithHuntington nurses that run it and moderate it.
Second, I know that many of the “we don’t need or want to join the union” nurses have shared stories of being followed, tires being slashed, secure areas (key-card accessible only areas) doors of the hospital being propped opened with orange traffic cones bearing the name of hospitals other than HMH have been reported. One nurse who has vocally opposed the CNA returned to her station to find that someone had left feces on her chair. In case you think she imagined such a disgusting act, a third party observed a pro-union nurse committing the act. As for the incident that Prof. Dreier states occurred in the HMH cafeteria, I understand that there is a video of the event and from what has been described to me the pro-CNA nurses weren’t just sitting politely at a table, but instead were blocking egress to the cafeteria and one of their supporters went so far as to go over to the IStandWithHuntington group in a confrontational manner to verbal abuse the nurses for not coming along with the program. So it would appear that there might be bad actors on both sides, which is why such a campaign often leaves open wounds in its wake regardless of which side prevails.
Third, Prof. Dreier parrots the plea for “just let the nurses vote”, but what he fails to inform his readers is that the CNA doesn’t want to let all eligible nurses vote, they want to pick and chose which nurses can vote and they do this by challenging a particular nurses’ vote. When the NLRB called the election the first thing the CNA did was challenge the right of the Patient Flow Coordinators (PFC) to cast a ballot. The NLRB didn’t agree and said the PFC’s could vote but that their ballot would be a different color (a Scarlet letter so to speak), segregated from the other ballots and only counted if the vote was close. Then the CNA, not happy with this, made it clear they planned to “challenge” some of but not all of the PFC ballots – guess which one they didn’t want counted. Finally, the CNA declared that they didn’t want any PFC ballot counted, even though theses nurses if the CNA prevailed would fall under the CNA representation. So I guess when the CNA stomps their feet and shout “just let all the eligible nurses vote” what they really meant to say was “Just let the ones we say have the right to vote, cast a ballot”.
Back in the day when I was a professor of Nursing the need to fact check our information was considered paramount. Perhaps the same exacting standards aren’t required for Prof. Dreier’s department of Urban & Environmental Policy or Occidental College – one would hope not.
You can read Dreier’s column here – http://www.huffingtonpost.com/peter-dreier/huntington-hospital-nurses-defy-union-busting-campaign_b_7051072.html