NY Nurse December 2013/January 2014

New York

nurse Dec 2013 / jan 2014

the official publication of the new york state nurses association

CARING KNOWs NO BOUNDS NYSNA RNs volunteer in the Philippines

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New York Nurse dec 2013 / Jan 2014

A day in the life of a nurse

Joys and sorrows herald the holidays

By Judy Sheridan-Gonzalez, RN, NYSNA President

A

ny nurse will tell you about the bittersweet nature of December. The holidays tend to bring out the best and the worst in people and situations. It’s a time when people shock us with their generosity – or sadden us with the overwhelming depression or tragic events that seem to escalate at this time of year. As nurses, we are often the lifeline for our patients, neighbors, and families when there is no one else.

It takes its toll upon us – and yet we continue to be there for people no matter what. I think that this is the tie that binds us to one another, as a community of caregivers; a role we never seem to shed.

Responding to tragedy

Advocating for patients. Advancing the profession.SM

Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP First Vice President Patricia DiLillo, RN, MEd Second Vice President Marva Wade, RN Secretary Anne Bové, RN, MSN, BC, CCRN, ANP Treasurer Patricia Kane, RN Directors at Large Anthony Ciampa, RN Ingred Denny-Boyce, RN, BSN, MSN Shirley Hunter, RN, MS Tracey Kavanagh, RN, BSN Colleen B. Murphy, RN, MS Grace Otto, RN, BA, BSN Sean Petty, RN, CPEN Karine M. Raymond, RN, MSN Veronica Richardson, RN Verginia Stewart, RN Regional Directors Southeastern Michael Healy, RN Southern Gwen Lancaster, RN, CCRN, MSN/Ed Central Carol Ann Lemon, RN Lower Hudson/NJ Eileen Letzeiser, RN, BSN, MPH Eastern Martha Wilcox, RN Western Kris Powell, RN Executive Editor Jill Furillo, RN, BSN, PHN Executive Director Editorial offices located at: 131 W 33rd. St., New York, NY 10001 Phone: 212-785-0157 x 159 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2013, All rights reserved

The incomprehensible devastation in the Philippines has horrified the world with its wide swath of destruction as the massive Typhoon Haiyan, called Yolanda in the Philippines, finds a place in the growing list of calamities related to climate change.

As the corporate Nero’s of today’s world continue to fiddle while Rome burns, greenhouse gases escape into the atmosphere, wreaking havoc with our ecosystems and severely impacting those with the most to lose: the agricultural workers of impoverished nations suffering

In our thoughts Four people were killed – among them RN Kisook Ahn, who had worked at Kings County and Woodhull hospitals and who was on her way home from working nights at the Sunshine Children’s Home and Rehab Center in Ossining – and dozens were injured in the Metro-North train derailment on December 1. The injured were treated at HHC trauma centers at Jacobi, Lincoln, and Elmhurst, as well as at Columbia-Presbyterian, Montefiore, and other area hospitals. Our hearts go out to everyone affected by this tragic accident.

from storms in Asia and drought in Africa, coastal dwellers from Staten Island to New Orleans, urban dwellers eking out an existence in Haiti.

The list goes on and on.

But nurses rise to meet the challenges. As we go to press, at least 250 New York nurses have already volunteered to go on relief missions to the

brave nurses of Bellevue Woman’s Center near Schenectady threw that fear on its head in early December when they voted in huge numbers to become the newest members of our NYSNA family. They were outraged when the hospital unilaterally changed the way they deliver care, setting in motion a

Everything we do makes a difference.

We need to celebrate this important truth.

Philippines; many more have donated or raised funds to send colleagues overseas and supplies to the victims.

Even absent major disasters, NYSNA nurses often spend a portion of their free time to deliver care or engage in humanitarian work among underserved populations throughout the country and the world – and in our own communities.

Some RN contracts have negotiated language that provides for employer support for relief missions, an indication of how widespread the practice is. The role of the union goes far beyond simple “bread and butter” issues. But there are still many nurses who have not yet won the right for union representation in New York.

Bravery yields results

Fears of retaliation contribute to the absence of a union presence in many hospitals in our state. The

rallying cry for the protection that only a union can offer. The next hurdle will be negotiating a just contract, a first-time experience for these courageous nurses who have served to inspire us all.

Imagine the influence nurses will have if we build on this win and organize others throughout the state. If organized nurses like us have to fight constantly to defend our rights, think of how hard it must be for the unorganized, forced to deal with unbridled repression on the job every day, lacking the necessary structure and avenues to fight back.

Every grievance won, every bullying manager neutralized, every rally attended, every unit that fights for safe staffing, even every POA filed builds upon our collective strength. Everything that we do makes a difference. We need to celebrate this important truth.

DISASTER RESPONSE

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dec 2013 / Jan 2014

Caring knows no bounds Typhoon Haiyan, called Yolanda in the Philippines, tore through the country on November 8, leaving a swath of destruction. As we go to press, the death toll stands at more than 5,700, with about 1,800 people still missing. The typhoon displaced more than four million people and destroyed more than one million houses. The massive agricultural and infrastructure damage is still being tallied.

Close to 3,000 RNs – including more than 250 NYSNA nurses – have volunteered through RNRN, a project of National Nurses United that coordinates sending volunteer nurses to disaster-stricken areas, to go to the Philippines and help in this time of extraordinary need. In November, NYSNA’s Board of Directors approved a $20,000 donation to RNRN to support the Philippine relief effort.

Our own Nella Pineda-Marcon and Linda Benoit, both RNs at Mt. Sinai, and Mireille Leroy, RN at Lincoln Hospital, have returned recently from volunteering in the Philippines.

Linda Benoit, RN at Mt. Sinai and president of the Haitian American Nurses Association (HANA) I go on global nursing missions at least twice a year, but still I was shocked and overwhelmed by what I found in the Philippines.

We set up a medical station.

Mostly I was doing triage. We saw a lot of wounds, many foot injuries.

A young man came with his foot half split and we treated it, without anesthesia.

There was a constant stream of patients. The stress on people, even children, was very, very serious.

Very high blood pressure was common, from anxiety and extreme fatigue. Lots of people complained of palpitations. When no place is dry, you cannot sleep for very long.

People never dry off.

People were dazed and confused.

Without rest they become disoriented, they cannot function. You do not even want to eat. But, they were so grateful we arrived to give them help.

MIREILLE LEROY, RN, Lincoln Hospital Many people just vanished because of the water. For days we were finding people. There was so much loss and devastation.

The most affected are the elderly and the youngest. Children don’t know where to go. And the elderly don’t want to leave the only community they’ve ever known, even when it’s entirely gone.

People were still in shock. Some will never recover mentally. There’s nothing to rebuild and many are suddenly completely on their own.

We converted a school to a medical center and worked long days.

Made one classroom an OR and set up a big tent with different stations, an area for triage, a pediatrician, an ob/gyn, internists, a surgeon.

I did a lot of teaching about water and infection. There’s a lot of debris and people are barefoot.

Chronic wounds are a problem.

And I’m afraid there’ll be cholera in the coming months.

I was a first responder in Haiti after the earthquake in 2010. The people are similar: resilient. They will help each other.

Nella Pineda-Marcon, RN, Mt. Sinai Hospital It was tough. I’ve been on missions to the Philippines before, but on planned missions to give free medical services, never in a disaster situation.

I ended up with a group with others there to help with reconstruction and mental health services.

I was the only one with medical expertise.

We went from makeshift house to makeshift house. I did a lot of health teaching around water and saw a lot of kids with diarrhea and taught parents how to prevent electrolyte imbalance. I sutured a gaping wound, without anesthesia.

And I helped the volunteers who were getting sick.

It humbled me to see so much suffering. I think the experience will help me be more patient. I would go on a relief mission again.

I received thank you letters that made me cry.

From top: Mireille Leroy, RN, Linda Benoit, RN, and Nella Pineda-Marcon, RN, providing medical help in the Philippines.

You can help Recovery will take a very long time. It’s not too late to volunteer or donate. Sign up at bitly.com/NYSNAhaiyanrelief

ON THE COVER (from left): NYSNA RNs Linda Benoit, Mireille Leroy, and Nella Pineda-Marcon back in New York after volunteering in the Philippines.

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COMMON CONCERN

New York Nurse dec 2013 / Jan 2014

Inspired to keep up the fight We honor Mandela best by carrying his

By Jill vision forward in our fight for quality Furillo, RN, NYSNA healthcare for all and in all we do to make Executive the world a better place.

Director

Meet Kris Powell Western Regional Director The NYSNA Board of Directors has selected Kris Powell to fill the vacancy for Western Regional Director. Kris is an RN in the emergency department at Olean General Hospital, where she has been active in NYSNA since helping to lead the organizing campaign there in 1997. Currently, she is the chair of the local bargaining unit. In October, Kris won NYSNA’s “Tough as Nails” award for her fearless, outspoken advocacy for quality patient care, safe staffing, and respect for nurses – work that she'll continue to help build RN strength statewide. Welcome Kris!

Power in numbers

Mandela knew that power comes from unity and collective action.

The national stay-at-home strike that he helped lead in May 1961, like all strikes in South Africa then, was illegal and helped lead to his life sentence and 27 years in prison. But it was a demonstration of two things: collective power and the inextricable link between freedom and workers’ rights.

“We are the people of this country. We produce the wealth of the gold mines, of the farms, and of industry,” wrote Mandela in June 1961 about the strike.

“Non-collaboration is the weapon

offered conditional release from prison several times. And each time, he refused: There can be no conditions on freedom.

But he was also a very real person. “I am not a saint,” he’d

we must use to bring down the government.” As the Congress of South African Trade Unions put it, Mandela stood against “the exploitation of workers and the poor,” just as he did against racist dictatorship and brutality.

say when given too much praise, “unless you think of a saint as a sinner who keeps on trying.”

The world very much still needs the example, direction, and grace that Mandela gave us. We honor him best by keeping on trying, by carrying his vision forward in the care we give our patients every day, in our organizing efforts, in our fight for quality healthcare for all, and in all our work to make the world a better place.

lasanta.com.ec

T

he world lost one of its great leaders with Nelson Mandela’s death. Around the globe, people have mourned the loss and celebrated the inspiration that, as President Obama put it, “one of the most influential, courageous, and profoundly good human beings that any of us will share time with on this earth” gave to all of humanity.

Mandela’s vision, ideals, and principled life have inspired countless struggles for freedom and equality worldwide.

His unbending resolve and unmatched political and organizing skill have taught many how to turn dreams into reality.

“It always seems impossible,” he said, “until it’s done.”

Our challenge

Mandela is revered for his unyielding commitment to freedom and justice, for his fearlessness, and his brilliant leadership. He was

New York State Nurses Association financial position The Board of Directors of the New York State Nurses Association met on November 19, 2013 and included on the agenda was a regular review of all matters pertaining to our financial condition. We are pleased to report that the Association’s financial status remains extremely sound. NYSNA is continuing to perform in a strong fashion, with considerable assets and planning and oversight measures firmly in place.

Here are some pertinent details: Assets have increased to $55 million as a result of the recent purchase of combined office and meeting space in New York City. Investments and reserves continue to increase as well. The Protected Action Fund doubled in size during this fiscal year. Revenue is reported at $40 million annually, a reflection of expanding membership. As of October 2013,

NYSNA‘s budget performance is $575,000 below projections.

Under the authority and with the vision of the Board of Directors, the Association continues to invest in our strategic campaigns related to safe staffing, member mobilization, countering corporate healthcare, and fighting privatization.

NEW YORK NURSE

UNION YES

dec 2013 / Jan 2014

Speaking with one voice for patient care

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ometimes 25 babies can be assigned to just three nurses in the nursery where Jennifer Gunderman works. Often many of them are NICU babies requiring two-on-one attention.

Jennifer is a NICU nurse at Bellevue Woman’s Center near Schenectady. “That’s not the kind of care we’re used to giving,” she says.

“Some nurses used to shrug their shoulders and say ‘What can we do about it?’” recalls Jennifer. “We realized we if we were going to be heard, we needed to join NYSNA. We needed to speak with one voice.”

And so they did in their 92-18 vote on Dec. 3 to join our union.

Promises broken

When Bellevue merged with Ellis Hospital in 2008, nurses thought about joining NYSNA. Nurses at the main Ellis campus have been NYSNA members since the 1960s. But Ellis management promised Bellevue nurses they would always get the same pay and benefits as Ellis nurses – if they did not join NYSNA. This year, management broke that promise. They cut paid time off for Bellevue RNs. They delayed a pay raise. And when they decided to restructure units and the hospital’s care delivery model, they refused to listen to nurses’ experience and concerns.

“We’re on the front lines. We’re important,” said Paula Platt, an RN at Bellevue. “But management saw us as expendable.”

Nurses at Bellevue could not stand by quietly: They started

Chris McCann, RN at Bellevue Woman’s Center near Schenectady, N.Y., announcing the 92 to 18 vote for NYSNA.

talking about joining the union.

Carol Ann Lemon, central regional director on NYSNA’s board and an RN at Ellis, began meeting with Bellevue nurses to help plan their organizing campaign.

A majority of nurses signed a petition calling on management to recognize the union. A speak out in October got significant attention in the local news. Local elected officials called on Ellis management to sit down with nurses.

Management finally agreed to respect the results of a vote, although it actively encouraged nurses to vote no.

Nurses stayed focused on the issues. On election day, nearly 90 percent turned out to vote: The vast majority chose NYSNA. NYSNA’s mission

have a union. This hurts every nurse, making it harder to win strong contracts and to pass a safe staffing law.

NYSNA’s board recently created the New Organizing Department to help build our union and improve conditions for all nurses statewide by bringing nonunion nurses into NYSNA. The win at Bellevue Woman’s Center is the first fruit of this labor.

As Carol Ann Lemon put it when the results were announced: “NYSNA is on a mission to change healthcare for the better, to put patients before profits, to stop those who’d cut patient care to pad the bottom line, and to ensure every New Yorker has access to quality care.

“Our voice is stronger because of today’s vote.”

Nurses at more than half of hospitals in upstate New York don’t

New York State Senator Cecilia Tkaczyk (left) congratulating Bellevue nurses (right) on their vote for NYSNA at the celebration of the vote count.

“Nurses and our patients need a voice in healthcare.

NYSNA is that voice.”

– Christine Walthers, RN, Bellevue Woman's Center

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New York Nurse

PUBLIC SECTOR

dec 2013 / Jan 2014

On the move with our message

RNs demand that NYSNA nurses start from a simple premise: Healthcare is a human right. We strive to make this ideal real every day in our work as front-line caregivers and patient advocates. It’s an ideal that grounds the public healthcare system.

And it’s under siege.

Public hospitals are being squeezed from all sides. Acuity is rising among patients.

Reimbursement rates are falling.

Private hospitals are closing or cutting services, and cherry picking patients with the best insurance.

This leaves safety net hospitals to meet greater needs with fewer resources. Management’s solution: greater “efficiency” – doing more with less. But that’s dangerous business when lives are at stake.

Fewer nurses cannot care for more patients. Assembly lines are meant for factory production, not caring for the sick. Patients need time and attention to be put back together, as it were, in a way that goods

NYSNA RNs presented our petition against privatizing services directly to HHC CEO Alan Aviles.

HHC provides

45%

UPDATE

33%

of all uninsured patient ER visits in NYC

36%

of NYC’s acute psychiatric admissions

of all uninsured admissions

f trauma 24% oadmissions

Westchester RNs fight on Nurses at Westchester Medical Center are standing strong in the struggle to win safe staffing. In 2012, they filed more than 3,600 Protests of Assignment (POAs) because layoffs left them without enough qualified staff to meet patients’ needs safely. In 2013, they did the same.

“Due to outsourcing of our valuable resources, our nursing assistants and hospital clerks, our jobs caring for patients have become more difficult,” notes Jules Hatzel, RN (right). “We continue to impress upon management the need for increased RN positions and educational retraining for our outsourced personnel.”

simply don’t. This is what our campaign for safe staffing is about.

Speaking out at HHC

The New York City Health and Hospitals Corporation (HHC) is required to hold just one public meeting in each borough every year. This year, NYSNA members gave these meetings some teeth.

Instead of the usual pro forma, dull sessions, we were out in numbers, making our case.

We highlighted key concerns: cutting services, the effects of short staffing, threats to inpatient behavioral healthcare, and the dangers of privatization.

New York City has the best public hospital system in the country.

We intend to keep it that way by making sure that HHC lives up to its mission.

That’s why we’re standing strong for safe staffing and respect for our nursing practice. It's also part of the reason that a new contract is so important. A contract defends standards, which helps retain experienced nurses and attract new ones.

It can be tough going, but our actions get results: HHC is reopening Labor and Delivery at North Central Bronx Hospital. Now we’re pressing for HHC to deliver early on its commitment.

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dec 2013 / Jan 2014

HHC meet its mission

“

We won’t allow patient care to be compromised.

Privatization and outsourcing threaten HHC’s mission to deliver quality care to every patient in need.”

– Anne Bové, RN, Bellevue Hospital and president of the NYSNA HHC Executive Council

DRAMATIC EFFECTS The well-being of New York City’s public healthcare system is a matter of life and death to the people of our city. NYSNA nurses brought the issues that threaten quality care to light with a little street theater before HHC’s public meetings. The challenges New Yorkers and front-

line caregivers face are no laughing matter, but sometimes humor makes the point that much more pointed.

Our actions included: an expectant mom worrying about where she’ll deliver in the face of Labor and Delivery’s closing at North Central Bronx Hospital; the time burglar stealing vacation and sick

time from nurses at Elmhurst Hospital because of short staffing; patients playing musical beds because of the pressure on psych beds in Brooklyn. And of course we chanted, sang, signed petitions, and generally made it known: Nurses will not sit quietly and let public healthcare be starved.

Brooklyn in need HHC has 50 percent of Brooklyn’s psych capacity, but its beds are almost always full. Where will people in need go if Interfaith and LICH, which together provide 18 percent of the borough’s psychiatric beds, and the only ones in the central-south part, close?

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PRIVATE SECTOR

New York Nurse dec 2013 / Jan 2014

Private sector nurses join forces Patients before profits

The A, B, C’s of a comprehensive contract campaign Activate members because there’s nothing like sending a strong, united message – in the streets, through petitions, in meetings, and at every bargaining table – to get management’s ear.

Private sector nurses from more than a dozen hospitals across New York City held their first-ever bargaining conference on Dec. 5.

The purpose: to prepare for the tough contract fights ahead, to discuss the issues that concern us, and to plan our strategy to win in 2014.

Nurses agree: Our central concerns – safe staffing and maintaining the integrity of our nursing practice and our role as patient advocates – cross hospital boundaries. We’re developing a comprehensive contract campaign (see box) to forge a new approach to negotiations that draws on our collective strength. And we’re already out front, raising our voice and demanding that patients come before profits, always.

Build strong alliances with other healthcare unions (like 1199), patients, clergy, community groups, and elected officials to present a united front for quality patient care.

Coordinate bargaining across all voluntary hospitals.

Confronting hospitals together, united around safe staffing and speaking with one voice, gives us the strength to win strong contracts everywhere.

UNITY IN ACTION UPDATE

LICH & Interfaith The situation in Brooklyn is changing by the day as the fight to keep LICH and Interfaith open continues. For updates, go to /Open4Care

NYSNA and 1199 have launched the Campaign for Quality Care at New York-Presbyterian to protect our patients and fight corporate greed. Our first campaign rally on Dec. 5 brought together 500 RNs and caregivers, and a surprise visit from Danny Glover (right), to celebrate our historic alliance. “We are the patients’ advocates. And we will not stand divided any more: not from our patients, not from members of other unions, not from the broader community,” NYSNA President Judy Sheridan-Gonzalez, RN, told the cheering crowd of red and purple.

NEW YORK NURSE dec 2013 / Jan 2014

for safe staffing & respect

WE ARE NYSNA “We’re tired of being bullied by management, of having our practice diminished, and of our patients being shortchanged,” said Karine Raymond, RN, NYSNA board member and president of the local

bargaining unit at Montefiore’s Einstein Division. Nurses at the Moses (pictured here) and Einstein Divisions held simultaneous actions, dramatizing the issues that incense them most: short staffing and

patients relegated to the hallways for care. “More and more nurses are becoming active,” says Karine, “and understanding that collectively we are NYSNA and by acting together we can solve problems.”

SAFE STAFFING ACTIONS IN ALBANY SAT, FEB 15 Black, Latino, and Asian Caucus: State budget under debate TUES, APRIL 15 NYSNA Safe Staffing Lobby Day and Rally THURS, JUNE 26 End of legislative session when key laws pass or die

THE SAFE STAFFING CRISIS

looms across the state. In recent weeks, RNs at Nyack Hospital (above) and St. Joseph’s Medical Center in Yonkers (right) picketed in from of their hospitals, calling for guaranteed minimum staffing levels to protect quality care for their patients.

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HEALTHCARE POLICY

New York Nurse dec 2013 / Jan 2014

Proposed regulations threaten to put profit before quality

The big business of ambulatory care

A Ambulatory care is a big and growing business. In 2012, private equity firms invested nearly $4 billion in health and medical services, much of it in retail clinics and urgent care centers.

ambulatory care can seem like a practical way to deliver healthcare, but the rapid expanse of for-profit ambulatory care may well undermine primary care networks and the financial viability of safety-net hospitals and systems.

The state’s regulatory planning body, the Public Health and Health Planning Council (PHHPC), is considering new regulations for the establishment and oversight of ambulatory care services, including physician-based mega-practices and non-hospital surgery, retail

with clinics and urgent care centers accounting for much of that growth.

Minimal regulatory hurdles help make these attractive investments.

Profits from privately owned retail clinics – such as CVS’s MinuteClinic and The Clinic at Walmart – stem from revenues from new customers and greater sales of prescriptions and health-related products. Most often, these clinics serve low-income people who have delayed getting care and don’t have a doctor or usual source for getting care.

Like retail clinics, the convenience of urgent care practices draws

clinics, urgent care centers, freestanding emergency departments, advanced diagnostic imaging, and radiation therapy.

patients, though typically those with more serious medical needs.

Research has shown that urgent care also attracts patients without a regular source of primary care.

Health insurers looking to increase profits may promote using retail clinics and urgent care centers because they save the insurers money. But this is likely to leave physicians and community health centers to care for the chronically ill while clinics skim off high-value patients. The insurers’ push to avoid emergency departments, an essential part of the admissions process, will further squeeze hospital finances.

Beyond the financial strain that this model creates for safety-net hospitals and established primary care networks, an approach to healthcare that relies heavily on episodic treatment may significantly increase

The big squeeze

Proposed recommendations overwhelmingly favor market-driven controls, outsource oversight to third party accreditation organizations, and eliminate or limit Certificate of Need (CON) review for most providers. The results will be the unrestrained proliferation of ambulatory care services, resources diverted out of the system, and substandard care as the norm for the least advantaged.

Ambulatory care is a big and growing business. In 2012, private equity firms invested nearly $4 billion in health and medical services, a four-fold increase since 2009,

the risk of missing underlying health problems and it threatens the very goal of improving health through coordinated care.

Risky business

The draft recommendations would allow the corporate practice of medicine, an exemption currently limited to dialysis providers where the disastrous effects of mixing the profit motive and healthcare are already well documented.

For-profit healthcare is a failed model paid for not just in dollars but in life itself. NYSNA research expects outsourced dialysis services at HHC to result in significant cuts in patient care, doubled, and even tripled, nurse-to-patient ratios, and cuts in nurse hours per patient of up to 60 percent.

The recommendations on ambulatory care services also continue a disparate system of oversight, holding some providers to a more rigorous standard than others and allowing unfair competitive advantages to providers outside the hospital system. The CON process for Article 28 hospitals and hospitaloperated services requires a needs analysis, an assessment of financial feasibility, and a review of operator character and competence. It establishes standards for staffing and facility structural requirements.

Less oversight, greater profit

Under the proposed recommendations that same logic and oversight would not apply to physician-owned, office-based surgery facilities, despite mixed research on the quality of care of these providers. This will allow such facilities to expand rampantly, further undermining the stability of community health networks and hospitals.

The insidious influence of profitdriven corporate medicine underlies all of these recommendations for relaxed regulatory oversight. But without strict controls, the incursion of ambulatory care threatens the healthcare of those most vulnerable and the very viability of safety-net hospitals.

nursing practice

NEW YORK NURSE dec 2013 / Jan 2014

Seminar at sea

New resource guide to help RNs avoid injury

NYSNA nurses are heading out to sea – Feb. 1-8, 2014 – for eight days of learning, union building, and fun! We will cruise to Haiti, Jamaica, and Cozumel, with education along the way.

Go to www.nysna.org/HealthHazards.pdf to download your free copy of “Controlling Health Hazards to Hospital Workers: A Reference Guide,” which describes more than 150 proven and practical ways to avoid dozens of the risks hospital workers face. The injury you spare could well be your own.

Find out more and register at www. nysna.org/news/online/080313.htm

NYSNA Leadership Academy Leadership is about providing inspiration and direction. If you’re interested in developing your leadership skills – to help you on the job and in our shared effort to build a stronger union – apply for the 2014-1015 NYSNA Leadership Academy.

Go to www.nysna.org/ce/academy.html to apply. Application deadline: April 30, 2014. For more information about the program, call the Nursing Education and Practice Department at 518-782-9400, ext. 282.

Specialists in occupational medicine from the U.S. and India describe ways to control hazards ranging from anesthetic gases to X-rays. Each section discusses the literature on controls (including engineering means like ventilation and administrative changes in procedures) of a specific hazard and includes a list of Internet resources for more information. There are also general tips about identifying hazards and setting priorities.

Call for articles NYSNA’s peer-reviewed periodical, The Journal, explores the multiple dynamics of nursing, clinical practice, and the socio-political economics of healthcare.

We welcome articles that reflect a variety of research methods, provide commentary, or offer personal accounts of nursing. Journal articles cover all manner of issues relevant to nursing today: legislation and regulation; advocacy; solutions to healthcare disparities; nursing’s role in advancing healthcare quality and patient safety; healthcare financing; and more.

All submissions – up to 20 pages including tables and references, plus a 100-150 word abstract – must be original, unpublished, and not under review elsewhere. For more information or to submit a manuscript for review, contact NYSNA’s Education, Practice, and Research Program at journal@nysna.org or 518-782-9532

HEALTHCARE POLICY

Our stand New York State’s “Triple Aim” on healthcare actually has four goals: improving the quality of care, improving health outcomes for the people of New York, providing equal access to care, and containing the costs of healthcare.

NYSNA’s guiding principles We applaud these goals, and share them. But goals are not enough. We measure proposed healthcare reforms – including regulations regarding ambulatory care services and free-standing emergency departments – on the following principles: 1. A comprehensive assessment of local needs must drive healthcare distribution and resource allocation.

2. T he state, local governments, and the community must make healthcare distribution and resource allocation decisions.

3. Corporate interests cannot dictate the operation of healthcare delivery services.

4. F or-profits in healthcare are the primary force behind today’s healthcare crisis, pushing up costs and distorting the way healthcare resources are allocated.

5. The major goal of healthcare restructuring must be to move away from, and limit the prevalence of, market-based, competitive, for-profit models of healthcare delivery.

Ambulatory care NYSNA continues to speak out against the influence of corporate healthcare and for a healthcare system that’s responsive to local needs and strengthened by community participation in the planning process.

We strongly support rigorous state oversight by the Dept. of Health (DOH) and through the CON process of any expansion of ambulatory care services.

And we call for regulations on such services that establish: l Clearly defined and enforceable

standards on quality, practice, minimum staffing, and the scope of services. l Preference for nonprofit and

existing Article 28 providers. l DOH as solely responsible for

oversight (we oppose the state delegating accreditation to any outside organization). l Guaranteed access to care regardless

of a patient’s insurance or ability to cover out-of-pocket expenses.

Free-standing emergency departments So far, the community and NYSNA have been able to keep the emergency room in Plattsburgh open 24/7. But the Hospital Association of New York will probably try again to close it. And up to 12 other emergency departments in New York may be submitting plans to the Dept. of Health for similar downgrades or to become free-standing facilities.

NYSNA supports a full CON review of applications for free-standing emergency departments, but we believe that communities know what they need and must have a real say in such decision-making.

NYSNA opposes regulatory revisions that would allow off-campus EDs to operate part-time. This model threatens public health by limiting access to lifesaving, time-sensitive medical care in cases of strokes, cardiac arrest, and serious injury. And it creates a dangerous precedent for cutting services more broadly.

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NEW YORK NURSE

Non Profit Org. U.S. Postage PAID L.I.C., NY 11101 Permit No. 1104

Dec 2013 / Jan 2014

131 West 33rd Street, 4th Floor New York, NY 10001

INSIDE

Best wishes for 2014 NYSNA nurses help in the Philippines, p 3

Victory at Bellevue Woman’s Center, p 5

Private sector RNs unite for strength, p 8

Public sector fight backs in NYC & Westchester, p 6

The year of building our movement for safe staffing, strong contracts, and respect for patients and nurses.