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Stanford, Packard nurses reject 'final' contract
Original post made
on Apr 8, 2010
Nurses at Stanford and Lucile Packard Children's hospitals have soundly rejected a contract the hospitals have called their "last, best and final" offer.
Read the full story here Web Link
posted Thursday, April 8, 2010, 12:04 PM
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Posted by CaliNurse
a resident of Stanford
on Apr 14, 2010 at 12:58 pm
The Stanford nurses were presented with the "Last, best, and final offer" and rejected it. This is true.
As far as I know it was really the ONLY offer. The Hospitals rejected everything the nurses (represented by CRONA or Committee for the Recognition Of Nursing Achievement... which is the Union comprised of Nurses that work at Stanford) placed on the bargaining table. So in essence there was not any negotiating to speak of.
What I don't understand is how so many people interpret what is going on between the Nurses and the Hospital(s) and there is such vast discrepancies in so many of the interpretations. I've read many of the comments on some of the major news sites and can clearly see that people don't have all the facts and then do not truly understand the information they do have.
Below is an attempt to help people understand what is happening. It is long. But it is factual and I hope that after reading it you will have a better understanding that the nurses are not acting out of greed. It's really more of an issue of FAIRNESS and RESPECT.
A Magnet hospital is one that has embarked on an extensive review and systematic evaluation of its nursing practice by the American Nurses Credentialing Center (ANCC). They must meet stringent quantitative and qualitative standards that define the highest quality of nursing practice and patient care. Becoming a Magnet hospital means that the organization must meet over 65 standards developed by the ANCC. Those standards must be demonstrated in a very extensive written document and validated and confirmed by site visits. A small percentage of hospitals nationwide have achieved this noteworthy status. Stanford is a "Magnet Hospital".
For those that do not understand why Stanford nurses are upset about the contract proposal offered to them by the hospital administration please try and picture yourself as a patient with a serious illness requiring inpatient hospitalization.
Would you want old Florence Nightingale to be your nurse or would you want an experienced, dedicated Stanford nurse? What is the difference, you might ask? A mere 3 or 4 decades ago nurses were just short of hand maidens. They took care of custodial needs, reported observations to the doctors and carried out tasks ordered doctors. Today's nurses have evolved into a much more intricate position in the health care system.
Nursing is a PROCESS, not a set job that can be accomplished by routine tasks. There are no correct building codes to adhere to, no absolutes in structural configurations, no bonuses for making more profit on an individual case, no guarantee that the outcome will be the same each time even if the calculations are done correctly. A human being is a complex structure and no two are the same. Not even identical twins.
Nursing assistants (aides) are being phased out. Primary care, where the nurse takes care of everything, is becoming the norm (especially on the night shift.) Thus, the nurse in most instances will ultimately be responsible for all aspects of the patients "care" when hospitalized. Unlike years ago, nurses ARE held accountable for everything they do. They must be familiar with all the medications they are giving, the correct dosing, the mechanisms of actions, the adverse reaction and side effects, and the course of action to take in the event of problems. They not only follow the doctors orders they must know if they are correct. They are the link between positive and negative patient outcomes.
In a teaching hospital especially, it is imperative that the nurses be constantly aware of every aspect of everything that is happening. One mistake can be the demise of the entire treatment plan. The doctors are the diagnosticians and are wonderful at Stanford but the nurses are their bridge to success.
I can say this with certainty since I have worked at Stanford for 30 years. I have been witness to many situations that if it were not for the keen skills of the bedside nurse the outcome would not be positive.
Nurses deal with the physical, psychological, and material aspects of a hospitalized patient. They deal with bodily fluids (excrement, blood, vomit, sputum etc), infectious diseases, hazardous chemicals and radiation, emotional distress, heavy lifting, mechanical instrumentation and troubleshooting and a myriad of other situations on daily basis. Nursing is not a simple task oriented job. Not only does it require knowledge, observation and assessment skills, physical endurance and compassion, it also requires a high degree of intuitive perceptive skills that comes from experience. Stanford has a very high proportion of very experienced nurses. It is because of those nurses that the teaching is fostered and the level of service is maximized.
We are not Stanford nurses because of the wages. We are Stanford nurses because it is our calling, our niche, our abilities to provide optimal care to people that need it because we've developed those skills through years of dedication and teamwork in practice and commitment to the nursing profession and to Stanford.
We are not complaining about our wages. Granted we do need our sustenance to survive thus we do need a paycheck. What the problem is, goes beyond that. Someone else had commented that should a General in the Armed Forces be demoted to a Corporal to save money that they would have a right to be upset. Well, that is what the hospital administrators are effectively proposing to do in a round about way and it is very demoralizing to the vast majority of experienced nurses that have been working at Stanford for most of their career. The hospital wants to change the "Clinical Ladder" that essentially ranks nurses by their skills and productivity and make it so difficult to achieve the highest rank that most of the nurses that have been promoted to the higher levels would be reduced to the same level as a brand new nurse. Like saying the only way to stay a General is if you can serve in two different wars at one time in two different countries. What the hospital has proposed in order for the nurse to remain at the highest level would require a time expenditure nearly equivalent to having a second job only it is on your own time. The requirements and point system for their proposal is exhausting even to read (it's over 35 pages in length). The process for application is tedious plus the 45 points needed in 4 different areas (every year) are in many ways not even connected to what a bedside nurse does. Like 5 points for writing journal article, 3 points for taking a semester course. And a whooping 15 points if you write an original research article. And that doesn't include the 27 annual continuing education units needed (12 units/year over the 30 every 2 years required to maintain an RN's license.) This process also includes rewriting a resume every year and presenting your completed application packet in presentation form to a panel. It like reapplying for your job every year.
Nursing is stressful enough. The rate of burnout is high. The long-term physical ailments bedside nurses end up with are quite significant. So all that being said, is it unreasonable for the nurses to want adequate retirement benefits. To have reasonable Health Insurance with reasonable co-pays for medication. To be able to save their PTO (paid time off) to use at a later date should they need to take a medical leave of absence. To have their medical insurance continue while on a medical leave for 6 months (as it stands now) instead of having it cut back to 12 weeks and then having to pay the inflated COBRA rates. (As well as not being able to save or use the PTO to pay for it).
What the hospital has offered looks good to the lay person. They have offered us wage increases. Or so it seems. But if you look at the entire package it is actually full of reductions. In the long run the amount of PTO( sick leave/vacation pay/holiday pay) is actually decreased. The ability to save it up is reduced. The medical insurance drug co-pays will be increased. (The insurance premiums have already been increased for the HMO.) The retirement plan is not in line with what other institutions offer. And the medical retirement plan still requires out of pocket payment's and if you have to retire early before Social Security kicks in how do you do that if you aren't able to work because you're just to physically exhausted and weakened to do what you've been doing for 30 + years as a bedside nurse. Who's going to take care of the nurses that have always done the care-giving. We need to be thinking about that. We need to feel that if we give 30+ years of our lives to making Stanford one of the best Hospitals in the country (even the world) that we aren't forgotten. That we deserve better. That it is not right to take away things that we have planned our lives around. And to be placed in a situation that devalues the scope of what the nurses have given to Stanford over the course of the past 30 to 40 years, well that's of significant issue.
It's not about the wages....it about our lives, our healthcare , our retirement benefits and it's also about our dignity. To be respected as the TEAM PLAYERS that we have been. Working at the hospital, FOR the hospital, WITH the hospital, to assure that it is the BEST it can be. That is what we were told when the Hospital was awarded "Magnet Status". "We were the Best." Now, however, we are not good enough.
Most nurses do not work a full 40 hour week. A few may, but most do not, can not, it's just too much. And after working in a stress filled healthcare setting for a very long period of time it can take a toll on your health. So, many older nurses cut back even further. So the figures you see posted as to annual salaries are not as accurate as you might think. And think about it, wouldn't you want the person taking care of you to be healthy. Nurses are exposed to the worst of the worst and are risking there own health on a consistent basis in order to do their job. Sometimes a patient is admitted to the hospital before they know what is wrong. H1N1, RSV, TB, meningitis, c-diff, Herpes Zoster, just to name a few of the infectious diseases a nurse may be exposed to before it is diagnosed and isolation protocols are implemented. Nurses place their own lives at risk on a daily basis for the people they want to help.
The changes the hospital proposes are not truly for the betterment of the hospital and the nurses. It is for the betterment of the hospital's budget. That's the bottom line. And they are NOT in a deficit either. They boasted of the profit they made in 2009 that was well over 100 million dollars. Keep in mind that Stanford is a non-profit institution. So what you see on the surface, what stands out for most out in the public sector is that Stanford offered the nurses a generous wage increase and that nurses have plenty of paid vacation time. That nurses make a lot of money and that they are greedy for not accepting what the hospital so graciously offered. That is just not accurate. It is not true. It is just plain wrong.
The hospitals contract proposal, with all of it's take-a-ways will save the hospital 20 million dollars a year. How on earth could that possibly be offering the nurses any type of INCREASE?
So when I read some of the other news sites comments and see statements like "nurses are an abomination" or "nurses are greedy", I feel that I must respond and say that in all my 32 years as a nurse I have never felt so demoralized and humiliated as I do now. And all along I thought I was helping people live, be comfortable, feel safe, saving lives or helping them die with dignity.
Was I wrong?