NY Nurse July/August 2014

New York

nurse July/august 2014

the official publication of the new york state nurses association

Contract victory for HHC/Mayorals!

See pages 6-7

A huge step forward See page 7.

Anne Bové, RN, Bellevue Hospital Center and president, NYSNA‘s HHC/Mayorals Executive Council

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New York Nurse july/august 2014

The best defense… powerful force for change in health care delivery for our patients and in demanding justice on We are a

O

By Judy SheridanGonzalez, RN, NYSNA President

ne of the most famous quotes in US history is John F. Kennedy’s appeal to the American people when he said: “Ask not what your country can do for you, but what you can do for your country.”

Sounds corny?

The ’60s ushered in an age of idealism. Many people saw JFK as an icon of hope, right or wrong.

More importantly, people all over the world were in motion: fighting injustice, promoting free thinking, working together to make a better world.

Advocating for patients. Advancing the profession.

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Collective action 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 Western Kris Powell, RN Eastern Martha Wilcox, 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 ©2014, All rights reserved

Times are different now. Many young people don’t envision a wonderful future. Older Americans fear for their jobs and worry about surviving as they age. We can and we must recover that sense of collectivity and unity that permeated our culture and inspired us 50 years ago.

When our nurses join NYSNA it is more than a pre-requisite to working in our hospitals. We see our role in creating something more than a vehicle for salary increases or a new pair of eyeglasses. In this age of austerity, with bosses demanding givebacks and pleading poverty, we can choose to take the offensive.

“Union” means we’re together, we build community, we create a culture of strength and camaraderie. That doesn’t happen without recognizing the importance of collective action and participation.

Just ask a nurse who worked in a non-union hospital. There is no job security, no contract, no obligation on the Employer’s part to treat you fairly.

the job and in our contracts.

The union is the tool to address our issues; the vehicle that we, the members, drive to the destination of our choice. It is not a “thing” separate from us. It is what we make it.

A powerful force

Our Employers would like for us to believe that we are helpless, bound by limits and definitions that they set for us. They want us to be on the defensive, to thank them for employing us. They say they’re losing money while paying their CEOs millions; that we must tighten our belts while they waste money on expensive consultants and unproven technologies; that we’re greedy as they merge and acquire facilities, expand and monopolize the health care market.

We cannot let them get away with this farce. Recent contract

settlements, while not perfect, have demanded and won salary increases without givebacks, among other improvements. Approximately 15,000 NY nurses are entering or engaged in negotiations right now.

Every nurse should be a member or supporter of facility Contract Action Teams, a key tool to winning decent contracts. We are a powerful force for change in health care delivery for our patients and in demanding justice on the job and in our contracts.

We just have to believe it.

Attend the Biennial

For these reasons it’s critical that you sign up for the NYSNA Biennial Meeting at Javits Center in NYC September 16 & 17. We have a big surprise planned for our Employers on that Wednesday – you won’t want to miss it.

New NYSNA members at Mt. Sinai! Certified RN Anesthetists won a vote to join the union and the NLRB made it official on July 25.

NEW YORK NURSE

bargaining

july/august 2014

Focus on private sector bargaining

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ur focus on private bargaining got more intense on June 18 when members gathered in midtown Manhattan to meet and review priorities, approaches and schedules at 17 private hospitals. NYSNA’s Bargaining Platform was shared and discussed.

This important, concise document sets forth five key goals that serve as a framework for all our negotiations: First, we call upon employers to recognize that our union is a fundamental voice for nurses, patients and the community. Nurses need to work together unimpeded by management in caring for patients and meeting responsibilities. We are professionals and demand a professional workplace. Our contracts need to guarantee, and improve upon, our ability to act as a union – with access by staff to members and leave for members to carry out union business. Regarding technology, we are for it, but not as a substitute for our professional judgment. Human interaction is essential to nursing.

Safe staffing and more

A second goal is safe staffing.

No one is without a story about staffing shortfalls and their links to quality patient care and protecting nurses from injury and assault. Safe

patients and communities should share a role in assessing needs and developing access plans for all.

“NYSNA is a democratic organization,” reads our fourth platform position. “We believe in open and transparent negotiations – open to our members, the community, and to all New Yorkers.”

Security at the bedside

Rehana Lowtan, RN, Brooklyn Hospital Center This is a way for us to come together and make our contract better. Our staffing is horrible.

They’re compromising patient care. With better staffing ratios, we would get to spend less time in front of a computer and more time with our patients.

staffing needs to spelled out in our contracts.

Equal access to quality care for all New Yorkers is a third priority we share. Every neighborhood should have quality healthcare resources for all. It is our belief that

Our fifth, and final, goal supports an experienced and stable RN workforce. Quality patient care comes with a contract that secures our place at the bedside. To keep experienced RNs there, employers need to raise our wages beyond the rate of inflation, guarantee the NYSNA pension plan, and provide NYSNA health insurance, or a better plan is offered by the employer, and restores healthcare concessions if made. We deserve a “follow the work” rule, giving us work opportunity in various healthcare settings. To recruit and retain RNs, we are seeking new, unionwide funds, paid by employers, with key supports and services, such as in training and education, child care and enhanced job security.

These are the terms that spell respect – for us, our families, our patients and communities.

Annella Lumsden, RN, Mt. Sinai Hospital We’ve had a big problem with staff. We protested. We had change – more staff being hired.

I think we can win anything as long as we stick together.

Theresa McGorty, RN, Flushing Hospital Medical Center Kimberly Callender, RN, New York Presbyterian Hospital We’re constantly working short of staff, which exacerbates patient issues. Even as we get new nurses, some leave. These are issues that go across the city. As nurses, we need to be together as one united front.

Orlando Rosario, RN, Maimonides Medical Center The main issue is the overcrowding of patients and never having enough nurses to take care of them. I’m hearing nurses across the city bring up the same exact issues, and we have a much clearer picture of where we need to go.

We are here for the Queens community. In contract negotiations, we need our members involved.

Participation is essential – if you want your ideas reflected in bargaining, you need to speak up. I think having training and brainstorming with leaders from different hospitals is crucial.

ON THE COVER Bellevue RNs come together after the vote.

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healthcare delayed

New York Nurse july/august 2014

Hospital care is needed more than ever

By Jill Furillo, RN, NYSNA Executive Director

W

e see it every day, in most units, on virtually every floor: patients arriving at the hospital with greater acuities and in need of comprehensive care.

We have been saying for the last several years that healthcare delayed would have dire results. Well, that’s exactly what’s happening.

According to studies published in the Wall Street Journal this summer, 27% of those new to the healthcare system, having recently enrolled with insurance companies under the Affordable Care Act (ACA), exhibit “significant health issues such as diabetes, psychiatric conditions, asthma, heart problems or cancer.”

In comparison, people who had coverage and kept it had these same significant health issues at the much lower rate of 12%. That translates into more than one million Americans with serious health conditions that went untreated.

It is also compelling evidence of the greater need for hospital care as

We have been saying for the last several years that healthcare delayed would have dire results. the serious consequences of delayed and denied care are more apparent.

These data, drawing on studies of Inovalon Inc., a health-technology firm that crunches figures from 200 insurance companies, “provides the clearest picture so far,” according to WSJ, of the health status of patients newly arrived in the healthcare system.

Playing catch up

Another 2014 study, by The Commonwealth Fund, merits a serious look. Comparing the U.S. healthcare system with that of 10 other industrialized countries, the U.S. rated poorly, on the bottom in terms of outcomes and last or near last on measures of access, efficiency and equity. Other countries compared were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.

The study, which pre-dates the implementation of the ACA, is most pointed on access. “Not surprisingly,” the study relates, “given the absence of universal cover-

All out to stop climate change!

Labor, students, religious groups and environmental activists – anyone and everyone concerned about the fate of the Earth in the face of an historic climate crisis – will come together by the tens of thousands in New York City on Sunday, September 21.

NYSNA will be there!

age, people in the U.S. go without needed healthcare because of cost more often than people do in the other countries….Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick, not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs.”

More than one-third (37%) of U.S. adults reported forgoing a recommended test, treatment, or followup care because of cost.

We have seen this sobering data before on the large percentage of people who have foregone care due to cost. What we are seeing now is the compelling connection between missing care and serious illness.

Playing catch up on healthcare

The costs of exclusion from care are very high, especially when gauged in acuities. The cancer that went untreated, the heart condition unattended, the diabetes uncontained, the asthma unaddressed, the depression unrevealed… these are the real human costs to a system that puts profits before patients.

Playing catch up in healthcare is our nation’s great challenge, now that more people are covered by health insurance and with an expanded system of Medicaid in many states that gives care to more families. If we are ever to build a comprehensive quality primary care system for everyone in this country we have some very serious catching up to do.

Healthcare is a matter of catch up in the U.S. We can do it with a strong national commitment. It cannot be done without keeping our hospitals open and thriving, and by a determined effort to make quality patient care the number one priority.

around the union

NEW YORK NURSE july/august 2014

Nurse unity NYSNA continues to pick up steam around the state, pulling together large numbers of members and supporters. “Firsts” were

seen in the Capital Region, where a first bargaining conference was convened; and a first interregional was carried out in Olean. Contract

votes and filings to join the union filled out a summer season of union strength and solidarity.

Upcoming Interregional Meetings INTERREGIONAL MEETING: OLEAN

A unanimous vote ratified a It was a first! The first bargaining conference of nurses in the Capital

new three-year contract for members at A.O. Fox Memorial Hospital in Oneonta.

Region. One hundred NYSNA members were joined by other area RNs on July 10. They voted yes to develop a bargaining platform to build nurse unity for quality patient care. Capital Region nurses are some of the lowest paid in the state. Calls for fair wages, affordable healthcare and retirement with dignity resonated at the conference, as did demands for safe staffing ratios. Union protections for patient advocacy were also given a high priority. Designated the highest priority: quality patient care at all facilities, for all patients, in all communities.

INTERREGIONAL MEETING: WESTCHESTER September 2, 2014 at 6:00 pm DoubleTree by Hilton 455 South Broadway Tarrytown, NY 10591

In another first, RNs met in Olean at the first Interregional meeting of members in Western New York State.

Thirty members reviewed a presentation on pension protection, building unity at Olean Hospital and strengthening ties with members throughout the state.

In the Bronx, yet another group of 100 RNs gathered at an interregional meeting to plan a winning future and protect patient care.

INTERREGIONAL MEETING: Western New York August 26, 2014 at 6:00 pm Salvatore’s Italian Gardens, 6461 Transit Rd, Depew, NY 14043

In Amsterdam, NY, RNs at St. Mary‘s Hospital filed to form a union and join NYSNA. The July 16 action underscored the RNs‘ desire for staffing improvements and for protections when nurses invoke a collective voice and advocate for patients. There is an outpouring of support in the community for the nurses. A delegation of community leaders delivered petitions signed by more than 200 residents of Montgomery County calling for hospital management to respect the RNs and recognize the union.

August 25, 2014 at 6:00 pm The Old Library Restaurant 116 South Union Street, Olean, NY 14760

INTERREGIONAL MEETING: LONG ISLAND September 10, 2014 at 6:00 pm NYSNA Long Island Office 900 Walt Whitman Rd. Melville, NY 11747

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HHC/ Mayorals

New York Nurse july/august 2014

NYC public hospital RNs get the c

T

here is much to celebrate in the new contract won by HHC/ Mayorals in New York City.

The terms are exceptionally good; two new funds – for education and training and for child and elder care – are very meaningful additions. The contract lays a “foundation for a strong future,” said Anne Bové, RN, Bellevue Hospital Center and president of NYSNA’s HHC/Mayorals Executive Council. But this deal also signals a new era in city government, a spirit of cooperation and commitment to bringing an end to healthcare disparities, and a tangible step towards countering the array of inequality that has defined New York City in recent years.

This important contract victory is the result of many forces coming together, a coordinated effort of members and leadership over many months to position the union in negotiations and for support.

First, members provided input and direction, as attendance at the monthly Executive Council meetings was consistently high and engagement at meetings very pronounced.

Both public hospital RNs and Mayoral nurses posed questions, sought information and helped shape the negotiations early on.

What permeated these meetings, facility gatherings, community outreach and city-wide messaging

was the paramount commitment on the part of public hospital nurses to access to care for all New Yorkers.

RNs at the public hospitals provide quality care to all who seek it, no matter their condition, immigration status or ability to pay. This extraordinary ethic binds the nurses to one another; more, it serves as a reminder of New York’s great-

ness – a welcome to an exceptionally diverse population with a promise of healthcare when needed.

A city government that respects nurses

Politics also played an important role in this win. For the first time in NYSNA history, the union endorsed city candidates. Bill de

More than 97% of members ratified the contract with HHC/Mayorals. Here are some of its highlights: l1 9.41% increases over the life of the contract. lR etro Pay. We’ll be getting retro payments owed to our city nurses

back to our previous contract. lN ew employer-paid child and elder care funds. This is a

groundbreaking fund that will make a difference in the lives of nurses caring for children or elder relatives. lN ew employer-paid training and education fund. This fund will help

ensure that HHC RNs have more opportunities to advance our skills. lN o givebacks.

Betty Alcindor, RN, Elmhurst Hospital Center. “I’m excited about the child care services. I work one job but my husband also works. This would provide time, not having to worry. My son gets a new experience.”

Christopher Dubissette, RN, Kings County Hospital Center. "Any benefits that you gain without giving back is impressive."

Pictured above KCHC, from left – Christopher Dubisette, Junietha Goodwin, Marlena Brown, Leunz Cadely, and Dallas Gordon-Grant

NEW YORK NURSE

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july/august 2014

contract they deserve Blasio stood with nurses at protests to stop hospital closings, called for an end to healthcare disparities, even engaged in civil disobedience during his campaign, landing in jail to further these causes. For these actions, for telling the “Tale of Two Cities” – a time of gross inequality under the leadership of his predecessor, Michael Bloomberg – we got behind de Blasio.

During the contract negotiations, Mayor Bill de Blasio and his

team showed respect for nurses and made a fair deal. Others in city government, many who we supported during the election season, echoed that respect.

Like the contract, this new era in progressive politics in the city calls for celebration. These are a politics that embrace union workers and their contributions to the city and re-elevate labor to a place of respect. That’s a win-win.

We did it. We outlasted Mayor Bloomberg and his appalling intransigence with regard to our contract. We staffed the units and provided quality to care – to everyone.

We survived a super storm; some of us helped evacuate patients amidst that historic deluge. Some of us went home to damaged residences of our own.

But we kept our hospitals open and never budged from our total commitment to patients.

Susan Flanagan, RN, Bellevue Hospital Center (center). “I just buried my father and now I have my mom at home. It’s not just kids that need us. With support, it enables me to come to work with peace of mind and not have constant worry.”

Arlyn Vasquez, RN, Bellevue Hospital Center (voting). “With child care, I have this sense of security. It allows you to focus, body and mind.”

Mayor de Blasio was fair with us.

He has shown a degree of integrity absent from City Hall for many years.

With his continued leadership we can work to address healthcare disparities and close that ugly chapter in the Tale of Two Cities. It will take a considerable amount of work and commitment. What better goal to seek?

Our contract is good and helps build a foundation for a strong future. No givebacks. Retro pay, raises are solid, lump sum payments included, benefits protected. We have an exciting opportunity in the form of two new funds: one for union training and upgrading, the other for child and elder care. These are our funds to develop and manage in the interests of ourselves and our families! And they are funded by HHC! In coming weeks you will learn more about these funds, what benefits you are provided, and how you can be involved.

Nursing Practice Councils expand our role in the hospitals, providing us with research and data-based analysis. The Councils will enhance our place in the hospitals, providing further protection for quality patient care and nursing practices and policies.

Leatrice Durant, RN, Jacobi Medical Center. “I‘m happy that we‘re getting increases and there‘s some lump payment. I‘m happy that we don‘t have to give back. I feel more confident about my paycheck as a homeowner.”

Barbara Ann Turner, RN, Harlem Hospital Center. “I‘ve been a nurse for 38 years. We have such a volume of very sick patients. I think the nurses work hard, and we deserve what we‘re entitled to. It‘s a new beginning.”

I want to express a personal thank you to all fellow members in the HHC/Mayorals system. You make me very proud.

–Anne Bové, RN and president, NYSNA HHC/Mayorals Executive Council

“

Our contract is good and helps build a foundation for a strong future.

No givebacks.

Retro pay, raises are solid, lump sum payments included, benefits protected...[and] two new funds.”

Anne Bové, RN

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New York Nurse

rn memoir

july/august 2014

Double challenges and rewards Esther Uy, RN

I

Esther Uy, RN Montefiore Medical Cemter

have been a neurosurgical operating room nurse at Montefiore Medical Center in the Bronx for 32 years. The work is not easy; it can be stressful, exhausting, but definitely is challenging and rewarding, as well. After many years, I thought I had seen it all, until the separation of the Aquirre craniopagus conjoined twins 10 years ago.

Craniopagus twins are the rarest of conjoined twins. Connected on their heads, this condition occurs in only one of approximately 2.5 million births. Only a handful survive and attempts to separate them often result in death or permanent handicaps for one or both.

Clarence and Carl

On September 10, 2003, Clarence and Carl Aguirre, a set of 16-month old craniopagus twins from the Philippines, came to New York with their mother for separation surgery at the Children’s Hospital at Montefiore. All services were provided free by Montefiore and other support facilities.

On the 10th anniversary (August 4, 2014 ) of the successful separation of the two boys, I recall with

Clarence and Carl Aguirre prior to their historic surgery.

great honor and pride my participation in such a historic humanitarian and scientific endeavor. The stage separation, four operations over a 10- month period, was the first ever done in this state. It has also become an international model for craniopagus separations.

I looked back in awe at what we accomplished as a team, for only a dedicated team of nurses, doctors, nutritionists, physical therapists, speech therapists, social workers and chaplain could have made it possible. Not to be forgotten was the mother, an important member of this team. Montefiore and the Filipino communities, especially in NY, rallied around her.

NYSNA float at July 4th Parade

The OR team had the daunting task of planning for nurse staffing needs, educating nurses about separating craniophagus twins, including the special pieces of equipment and products needed, preparing the surgical suites, surgical sites, positioning for surgery, draping of the surgical sites, traffic control in the OR, and public relations. Along the way, we had to harness our creativity in draping and positioning and in anticipating emergencies.

I have the pleasure of seeing the twins now twice a year, on their birthday on April 21 and on the August 4 anniversary , which their mother refers to as their “second birthday”. Carl and Clarence are now 12 years old. Clarence has become a very active boy. He speaks well and loves to sing. Carl has had a tougher time. He developed a seizure disorder and his ability to learn has been hampered by the seizure-control medications.

A humbling roll

Scores of NYSNA RNs road the float at the Staten Island 4th of July Parade this year. “Caring for Staten Island, USA” was the float theme, as nurses and their families stood proud on the nation‘s Independence Day.

I have shared my experience of this extraordinary medical undertaking with colleagues in nursing grand rounds, at open house for the hospital and as a keynote speaker for the International Society of Pediatric Neurosurgeons in Liverpool, UK. I co-authored an article, “Staged Separation of Craniopagus Conjoined Twins: A Multidisciplinary Approach,” published in the AORN Journal (Association of periOperative Registered Nurses).

Very few nurses have the opportunity to separate craniopagus twins. I am very fortunate to be one of them and am humbled by the role I played.

NEW YORK NURSE

in solidarity

july/august 2014

Water is a human right On block after block, businesses are shuttered, homes fore-

closed by the thousands. Detroit is a city in bankruptcy, a city on the auction block, its population fighting demise at every turn. So bad are conditions that 17,000 households and small businesses were without water in July, a shutoff caused by profound poverty in the form of inability to pay the water bill. That leaves some children with no water with which to brush their teeth.

NYSNA nurses joined thousands of protesters, including nurses in the Michigan Nurses Association and other RNs of National Nurses United, in strong protest onJuly 18, demanding the water be turned on, and left on.

“We cannot afford to have sick people or have the healthcare system comprised if there’s not clean water,” said Patricia James, RN, who came in from Brooklyn’s Kings County Hospital Center.

“This is a great health issue.”

Detroit’s water shutoff stands in contravention of the laws and principles of the United Nations, which formally recognize “the right to safe and clean drinking water and sanitation” as “a human right that is essential for the full enjoyment of life and all human rights.”

Once a metropolis

Once a thriving metropolis and backbone of blue-collar black America, when Chrysler alone represented 1% of the payroll of the entire U.S. black population, Detroit is unraveling fast. For the Michigan’s largest city, industrial displacement became the model, as factories moved to non-union settings here, Mexico and overseas, abandoning the workforce that built the brand and enriched the shareholders Detroit may be an extreme example of de-industrialization, but it is not alone. NYSNA members see the effects of enduring economic hardship and inequality on the healthcare of communities around New York State, as patients in need of essential healthcare forewent that care for years because they simply could not afford it. They arrive now in hospitals with illnesses made worse by the delays incurred by empty wallets, with the greater acuities that comes with care delayed.

[See Furillo column, p. 4] Still, the very profound impoverishment of living without water

stands out, casting a pall on the Detroit protests. How could it be that in the richest country in the world – by far – thousands of Detroit families could be without water?

Emotions were running high the afternoon of protests. And representatives of labor, NYSNA included, spoke out loud and clear.

“This is what our union does: not only speak on behalf of wages and work, but on behalf of humans,” said Patricia Morris, RN, of Dr. Susan Smith McKinney Nursing & Rehabilitation Center in Brooklyn.

“Let’s transform this crisis of shutting off the water into a golden opportunity to meet the needs of the people,” said John Armelagos, RN and president, Michigan Nurses Association.

As protesters looked around at a city where more than the half the street lights do not work, where 20,000 properties a year – 5% of Detroit’s housing stock – are forced into foreclosure, and where more than 100,000 properties have been razed, erased altogether from once-thriving neighborhoods, the magnitude of catastrophe sent a shudder. “What I see is that we all need each other,” said NYSNA’s Lesline Brownn-Hazel, RN, of East New York Diagnostic & Treatment Center. “We have to unite.”

As of July 1, more than $89 million was owed on nearly 92,000 past-due residential and commercial accounts.

A temporary reprieve won

The march helped invoke a temporary reprieve, when Detroit’s shutoff was suspended for 15 days.

The city’s Water and Sewerage Department was transferred out of the hands of State-appointed emergency manager Kevyn Orr to Detroit Mayor Mike Duggan. That reprieve appears to be temporary, as authorities sort out the process of informing residents about delinquent bills.

The underlying issue, of rebuilding the economies of communities

left out of a promised national recovery, remain elusive, at best.

While American profits are soaring today, many communities are not, as the hard-nosed priorities of an economy tied to finance and geared to austerity – cutting back on essential government support – continue to dominate.

But the cries of protest of July 18, “Water is a Human Right: Fight, fight, fight!” are resonating.

Some members of Congress are now asking the Obama administration and the Department of Health and Human Services to intervene in Detroit, in what they contend is a humanitarian crisis. It’s “a little bit inhumane to put it kindly,” said Rep. John Conyers (D-MI) of the water crisis. “Water is a lifeline,” said Rep. Sheila Jackson Lee (D-TX) in late July, “it is a human rights issue and if necessary there should be federal intervention.”

NYSNA members join the protest of Detroit's water shutoff, July 18. (l-r) Lesline Hazel-Brown, RN, Patricia Morris, RN, and Patricia James, RN, all traveled from Brooklyn for the day.

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nursing practice

New York Nurse july/august 2014

Computers are not a substitute for care We know that there are no substitutes for direct patient contact – the human connection – that characterizes our professional work. Touch, observation and treatment are central to nursing.

Electronic Medical Records, like all other forms of technology and artificial intelligence, has the potential for flaw, error and abuse. We need to maintain a critical perspective as computer and EMR systems do, in fact, interfere with the nursing process and practice.

Computers cannot replace good nurses

At a recent workshop held by NYSNA for the nurses at Shore Medical Center, there was much criticism of computer systems.

One pediatric nurse commented, “We spend too much time dealing with the various computer systems in order to thoroughly document on our patient.” Another said, “It is frustrating and can potentially interfere with effective communication with others on the healthcare

team because there is more than one computer system we have to document in.”

These comments led to a lengthy discussion on strategies to diminish the barriers that computers and EMR systems place on the relationship between the nurse and the patient. “Interaction, trust and connection are the foundation for the relationship between the nurse and patient, which are key to fulfilling the nursing process and facilitating our practice, ” said Sheila Jargowski, RN, of Shore Medical Center. “We cannot let computers get in the way of that.”

At Maimonides Medical Center in Brooklyn, doctors in the ER frequently rush to discharge patients in order to handle the high volume of patients in the ER. The EMR system facilitates these actions.

And if a nurse subsequently enters a note in the EMR after the actual noted time of discharge, malpractice and other liability issues may arise and may jeopardize the nurse’s license.

Workshop NYSNA can help you safely and proficiently navigate the world of recording everything you see, discover, think, evaluate, and do: we have a Documentation in the Electronic Age workshop that goes over all of the topics you need to meet industry standards in documentation.

Documentation in the Electronic Age: The Impact on Nursing Practice and Judgment.

Program purpose statement: Are you unaware of your professional rights and responsibilities with regard to medical record documentation? Have you felt unsure about how to record your clinical and professional observations? Have you contemplated that your nursing judgment is being overridden by Electronic Medical Record technology? Have you wondered whether your charting practices could result in disciplinary action or the filing of a lawsuit against you? If you answered yes to any of these questions, then this workshop is for you.

If you would like more information on this or other NYSNA nursing education program, contact education @nysna.org.

Documentation is never factored into the workload

“Real time charting” poses another problem for nurses.

Experts in nursing documentation have always recommended that charting take place as near in time to the actual event or episode of care as practical. Nevertheless, workload issues, such as insufficient staffing, excessive patient loads, and unpredictable and rapidly changing clinical situations continue to be barriers to accomplishing real-time charting. How can you chart in the moment when you are changing a sterile dressing and then have to move quickly to give medications?

Nurses take notice

There are some things that your employer is responsible for and that nurses should demand, such as promulgating policies that thoroughly reflect the particular computer system that the nurse must chart in and the data that should be charted. Nurses should also demand that their employer provide them with education on the computer system being used as well as routine updates.

If your employer is instituting a new computer system at your facility, it is imperative that bedside nurses, who will be using the system, be involved in making sure that the system is built as a useful tool for the nurses, not a hindrance to the nursing process.

Clicking and checking off boxes in the electronic medical record may be intended to help decrease the time that it takes to chart, but nurses must be vigilant in maintaining and exercising their critical thinking skills throughout the stages of the nursing process.

Official Call to Meeting 2014 Business Meeting of the New York State Nurses Association New York City Tuesday, Sept. 16 – Wednesday, Sept. 17, 2014 Anne Bové, RN, Secretary, New York State Nurses Association Register for the meeting using the insert or at www.nysna.org.

NEW YORK NURSE

NEWS IN BRIEF

july/august 2014

1199 contract win​ With our many congratulations, 1199SEIU reached agreement with the League of Voluntary Hospitals and Homes in July. 1199’s contract campaign included walks-in-on-theboss, pickets and rallies. No benefit takeaways, a significant wage increase and a more fair process for nonunion workers to organize in outpatient clinics were agreed upon.

Presby RNs win Safe Staffing victory​ Overcrowding at Presbyterian’s Children’s Hospital ED, documented by 170 POAs, led to a big staffing win for RNs. A total of nine new positions were added.

Midwives ratification​ Bronx Midwives ratified their first contract on July 29 in a big win for the nurses, mothers and babies of the Bronx. Midwives from Jacobi Medical Center and North Central Bronx Hospital voted unanimously for the contract with PAGNY, the Physician Affiliate Group of New York.

15 on fast track​ Reinstatement for Monte RN​ Geetha Uppin, RN, an OR nurse at Montefiore’s Moses Campus, was reinstated on July 7 after the employer failed to prove just cause for discharge. Scores of fellow RNs had protested and petitioned to fight for her reinstatement.

At Montefiore’s Weiler ED in the Bronx, after a POA campaign, outreach to press and electeds, 15 RNs positions were designated for addition on a fast track. A big victory for safe staffing, as overcrowding and inadequate staffing will be addressed with additional positions.

A terrible loss

Last year’s parade was the best! Please join NYSNA members and families at this year’s West Indian Day Parade in Brooklyn on September 1. For more information contact your rep or go to www.nysna.org.

NYSNA continues to mourn the loss of Katy Peterson, RN, who died tragically in an automobile accident on June 27. Katy was a devoted and talented Med/Surg nurse at Nathan Littauer Hospital and an inspiring union leader. She will be deeply missed by her fellow nurses and by her patients.

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NEW YORK NURSE

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

july/august 2014

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

INSIDE NYSNA continues the tradition of exhibiting at The Great New York State Fair this year, from August 21 through September 1. Please join our corps of volunteers to staff our exhibit and share our message of quality patient for ALL New Yorkers.

RNs protest Detroit water shutoff, p. 9

Craniopagus conjoined twins, p. 8

Contact Rehanna Singh-Mohan at rehanna.sign-mohan@nysna.org or call 212-785-0157, ext. 110.

HHC/Mayorals win major contract, pp. 6-7