Expect the Unexpected?
Our Bargaining Team meets with the hospital in April to start bargaining. This year we are once again prepared to defend our contract. Hospital management has initiated discussions over the Clinical Ladder and it was announced at Charge RN meetings that Tarzana RNs earn more than RNs at other Providence facilities… stated as if this is a problem.
We are not just waiting for bargaining to make our needs known. Since our hospital was purchased by Providence, we have helped our hospital meet the benchmarks expected by Providence. We now provide even better care and we have eased our budget strains by limiting length of stay, which is much healthier for our patients. However, improving patient care has not been an easy task especially when we are doing more with less. During the last few months, RNs in Women’s Services, Med Surg and CVU have been working out of ratio, and on many floors, Charge RNs have patient care assignments. In response, our Union has requested that the hospital initiate an immediate extra shift bonus program which will once again encourage nurses to work extra shifts at the hospital. This will likely be an issue during negotiations.
From the Desk of Jim Owen
President, Providence Tarzana 121RN Chapter
In previous years, I spent quite a bit of time with 121RN learning about the Affordable Care Act, including testifying at the Obama town hall meeting on healthcare in Los Angeles. That work in support of the Affordable Care Act has really helped me better understand our new Providence healthcare plan.
According to the Affordable Care Act, all new policies must include coverage for multiple preventive services and screenings with no co-pay, deductible or co-insurance payment by the insured. Because the new Tarzana health plan began after the ACA’s September 23, 2010 effective date for preventive care, these services must be included.
Late last year, I was speaking to a Tarzana pharmacist who had a list of medications that were listed as “preventive” under the Affordable Care Act. I knew that "preventive" office visits were to be covered at 100% and that my $60 a month Diovan should be covered at 100% though our new Providence healthcare plan. However, this was last December and just before the new plan went into effect. I did not have complete faith in our “new” Providence insurance, so I made sure to order my Diovan before Jan. 1 and paid the usual $60.
Every February I see my internist and he changes my prescription, if necessary. When I went to Providence St. Joseph pharmacy to pick up the Rx, I was told that the pharmacy would be charging me a co-payment. Remembering my conversation with the Tarzana pharmacist and the list of medications considered “preventive,” I informed the Providence clerk that the Rx is preventive and should be covered at 100 percent.
Employees have had all sorts of concerns over the new Providence plan. As we go into bargaining, we need to know what has happened to you. If you have a question about whether your medication or doctor’s visit is covered, question it. If the card doesn’t work, question it. If you cannot get results, inform a steward.
{Congratulations to US!}
New Tarzana CEO Gerald Clute sent out an email announcing that we won the President’s Award for Excellence in improving clinical, quality and financial outcomes. The email said that from January 2009 to December 2012, our results were notable, including:
- Reducing Medicare Average Length of Stay by 14.3%
- Reducing ER Median Length of Stay by 17.6%
- Reducing Overall Observed/Expected Mortality Rate by 18.4%
- Reducing Sepsis Observed / Expected Mortality Rate by 30.6% (from 2010-2012)
- Increasing Net Operating Income so our operating income exceeds expenses
- Increasing the monthly average number of ambulance runs by 9.5%
- Increasing Clinical Reliability Index Scores by 9.8%
Grievance Wins
In-Lieu of Benefits
The contract allows employees the right to waive health benefits and receive $35 per pay period in exchange starting Jan. 1 of this year. Providence has not paid these employees this money. Human Resources has worked for two months on this issue with Providence Corporate and finally notified us that they believe the issue has been resolved. If you were impacted, you will receive money owed from Jan. 1 and start receiving the $35 with each paycheck.
Grievance Issues
Our contract says that management shall use best efforts to avoid adding mandatory classes after the final work schedule has been posted. This issue was grieved last year because of all the last-minute classes scheduled during the December holiday season and grieved again this year because of four classes being required after the schedule was put out: phones, PCA Pumps, Strokes, and Mask Fitting. In addition, employees who came to class were not able to attend because of attendance limits causing employees to be required to return at another time.
In regard to the PCA Pump class, if you cannot take the class during your working hours because of patient care needs, advise your manager. Request to take the class from a home computer or after work on a hospital computer. If overtime is not authorized, talk with a steward. If you have already taken the class at home, submit paperwork to your manager asking for payment. If necessary, talk with a steward.
Bargaining Paid Sick Leave
One issue raised in member bargaining surveys is access to paid sick leave. Employees earn up to 48 hours a year depending on status, but then must be out for 7 consecutive days before reserve sick time may be used.
ACROSS THE COUNTRY, there have been TWO LANDMARK WINS regarding the use of sick time, one in Portland, OR, and the other in Philadelphia.
Portland: Portland’s City Council passed the Earned Sick Time policy. Effective January 1, 2014, private employers must give employees up to 40 hours of job-protected sick leave each year. Both full- and part-time employees will earn one hour of sick leave for every 30 hours worked and be able to access it after 90 days on the job. For employers with five or fewer employees, the time will be job-protected but not paid.
Philadelphia: The city council voted to adopt a law that would require most employers to provide some paid sick leave. Under this law, workers earn one hour of sick leave for every 40 hours worked. Large employers will have to provide up to seven earned sick days a year. Smaller businesses, with between 6 and 20 workers, will provide up to four sick days a year.
Daily Unit Cleaning Assignment?
Nurses on the fourth floor have been told they are expected to participate in a daily unit cleaning assignment. Many of the tasks identified are actually job duties of other job classifications or tasks that each RN should handle on his or her own. Steward Julia Clare says, “The unit is a team and we all should work together, help each other out and clean up after ourselves. When we RNs are assigned to four or five patients, our primary focus should be patient care. Our Charge RNs should talk to us individually if we are not doing what we are supposed to be doing.”
Examples of Required Tasks
- Clear hallways, get rid of extra beds and equipment. Round floor and turn lights off in unused rooms. How long will this take?
- WOWs 1-4 make sure that the storage area is clean and that the WOW is wiped down and operational. No saline, syringes, angiocaths or medications should be present. Shouldn’t each of us take responsibility for keeping our workstations clean? It is usually the job of our Charge RN to talk with us if we don’t.
- Kitchen: Make sure that every drawer, cupboard, microwave and refrigerator are clean; no open milk containers. Really? Is this a good use of an RN’s time and expertise?