NY Nurse October 2013

New York

nurse october 2013

the official publication of the new york state nurses association

NYSNA

Caring for all New Yorkers SPECIAL Convention issue Looking back at a year of key firsts. Looking forward to our plan to win safe staffing and fair contracts.

RNs at the West Indian Day Parade (above). A first-hand look at our fight to keep hospitals open. Page 4.

Upstate nurses are coming together to join us and build NYSNA power (right). Page 9.

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New York Nurse october 2013

NYSNA’s extraordinary year

Taking stock

By Patricia DiLillo, RN, NYSNA President

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’m writing this shortly before the NYSNA convention, which will conclude with our newly elected board taking office. We’ve had a remarkable year. Literally thousands of NYSNA members stepped up and got involved in the fight for safe staffing and quality healthcare for all New Yorkers.

Nurses are tough. We stare suffering in the face every day, and we don’t flinch. We just keep our professional promise and deliver compassionate, expert care, day in, day out.

We have brought that same toughness to reforming our union.

Together, we have made NYSNA democratic. Every member now has a voice.

Taking new steps

Advocating for patients. Advancing the profession.

SM

Board of Directors President Patricia DiLillo, RN, MEd First Vice President Judy Sheridan-Gonzalez, RN, MSN, FNP Second Vice President Marva Wade, RN Secretary Anne Bové, RN, MSN, BC, CCRN, ANP Treasurer Patricia Kane, RN

We also have made NYSNA sharper. We brought our fight for healthcare to the public, marching in the streets for safe staffing and protesting time and again across New York City and the state to stop service cuts and hospital closings.

For the first time ever, we took a strong stand in the halls of political power. Busloads of nurses traveled to Albany to lobby for a safe staffing law and against allowing

We brought our fight for healthcare to the public this year – and we built a growing movement for healthcare for all. for-profit hospitals into New York.

And, in another first, we made an endorsement for New York City mayor during the primary and helped make healthcare a key issue in the race.

Advocating for healthcare

Nursing isn’t just about bedside care. It’s about advocacy. We can’t give our patients the care they deserve if we’re stretched too thin and our hospitals are cutting services, and even closing. And that means participating as a union in politics. Together, we can descend in numbers on City Hall, Albany and any hospital where elected officials or administrators need reminding how much healthcare matters. Together, we can push for laws and budgets that reflect the needs of our communities.

That’s what we’re doing. And we’re seeing results.

We stopped Long Island College Hospital and Interfaith Medical Center from closing – and, in the

process, won a moratorium on hospital closings statewide. We won a lot of support in Albany for a safe staffing law. We stopped a proposed law that would have let for-profits operate hospitals in New York and another that would have weakened the Certificate of Need process, a tool we count on to speak out when hospital administrators propose service changes that will hurt the communities we serve.

Building a movement

Our fight is far from over.

Hospital closings will be a threat again. Wall Street interests will be back. We must turn support for safe staffing into enough votes to pass a law. But we’ve made a lot of progress – and we’re building a movement that’s tough enough to win.

It has been my great honor to stand with you. This is my last column as president, but I’m most certainly still in the fight with you.

Together, we’ll prevail.

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 Western Gaen Hooley, RN, BS Southern Gwen Lancaster, RN Central Carol Ann Lemon, RN Lower Hudson/NJ Eileen Letzeiser, RN, BSN, MPH 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 ©2013, All rights reserved

NYSNA nurses are taking to the streets and the halls of power to defend public hospitals and to win safe staffing.

CORPORATE ATTACK

NEW YORK NURSE

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october 2013

Hoarders beware

The U.S. can afford healthcare for all

By Jill Furillo, RN, NYSNA Executive Director

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hen you look beyond the homeless, among them 20,000 children in New York City alone, beyond the hardship of elderly women from whom $75 in monthly food stamps – a week’s groceries – was “sequestered” away this year, and look past smoldering forests where firefighters died, their ranks depleted by layoffs from blistering budget cuts, what you see are piles of cash.

U.S. corporations, excluding the banks, have a staggering $2 trillion in cash, according to the Federal Reserve, a historic high. And when you add worldwide holdings, the figure more than doubles, says the IRS. A “$5 Trillion Stash,” headlined The Atlantic magazine. This historic hoarding, the sidelining of capital essential to rebuilding a productive economy, is a national disgrace.

To put it in perspective, our total annual national healthcare expenditure is $2.7 trillion. Do the math. America’s richest shareholders – the 1 percent – have set aside a sum equal to almost two years of healthcare. In just one year, 2012, 80 million Americans did not make a recommended doctor visit or fill a prescription because they could not afford it, a Commonwealth Fund survey found. This economy, a juggernaut of inequality, is doing us in.

Census Bureau. New York City is now dubbed the “Inequality Capital of America,” says Huffington Post.

Mayor Bloomberg leaves office with personal wealth of $27 billion, New Yorker magazine reported, much of it derived from providing financial information services to Wall Street.

Those are the “financial engineers” we bailed out with tax dollars five years ago, but from whom a promised recovery in the vast majority of our communities has yet to materialize.

Corporate aid

The lowest corporate taxes in two generations plays an important part in corporate cash hoarding. The average effective tax rate for U.S. corporations was 12.1 percent in 2011 (the latest available figure), bringing the rate to a 40-year low. Since 2009, when Wall Street paid itself $140 billion in bonuses with our tax dollars, 10,000 public employees have been laid off each month, mass public layoffs that continue today.

Hospitals have a role in this historic cash hoarding, with hospital corporations and nonprofits alike operating as profit centers.

Time magazine reported that hospital equipment manufacturers, suppliers, and drug makers routinely gouge the healthcare system, with charges in many multiples of those in other industrial countries.

“If we paid what other countries did for the same prescription drugs, we would save about $94 billion a year,” said Time. No wonder healthcare companies are ablaze on Wall Street, where their mergers and acquisitions mount. For the hoarders, healthcare is just another source of cash.

As we know, hospital CEOs get their share. At Montefiore and Presbyterian, CEOs pocket more than $4 million a year each, with other executives in our hospitals taking home more than $1 million a year.

Pressures continue to mount to raise revenue at our hospitals, to do our share for corporate hoarding.

For patients, the price is quality of care. That’s not a price we can pay.

We held the line in Brooklyn and we will continue to hold the line wherever we are unified and ready to act. Let the hoarders beware.

Greed run amok

The hoarders are insatiable.

Income of the 1 percent rose 31 percent between 2009 and 2012, while the income of the bottom 40 percent fell 6 percent.

New York stands out in this diabolical undoing. Income inequality is greater in New York State and in the New York City region than in any other state or metropolitan area in the country, according to the

NYSNA President-elect Judy Sheridan-Gonzalez, RN (third from right), Treasurer Pat Kane, RN (second from right), and fellow members rallied before the U.N. in September, calling for a small tax on Wall Street transactions, called the Robin Hood Tax, to fund social needs like healthcare and public education.

“

The preamble of the U.S. Constitution talks about promoting the general welfare of the people. It’s time “We the People” started enforcing our constitutional rights.

There is plenty of money to meet the human right to quality healthcare.”

– NYSNA President-elect Judy Sheridan-Gonzalez, RN

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our fightback

New York Nurse october 2013

How we saved our hospital

By Julie Semente, RN, Secretary, LICH Executive Committee

NYSNA’s fight to save LICH led to a statewide moratorium on all hospital closings!

See www.nysna.org/LICHLessons for a longer version of this article.

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ast January, I opened the morning newspaper and found out that SUNY planned to close LICH, the hospital where I’ve helped save lives for 30 years. I knew what the fight to save LICH’s life would take and thought, “I can’t do this again.”

But LICH nurses never walk away from a fight.

A week later we gathered on a corner for a speak-out in below zero weather. NYSNA board member Gwen Lancaster, RN, came from Manhattan. For the first time, we felt that our leadership was paying attention to our struggles in Brooklyn.

We formed a coalition with the doctors and service union and invited community leaders and officials to our meetings to bring them on board. And we worked with community organizations to build support.

For SUNY’s first unlawful vote to close LICH in early February, we requested a NYSNA bus and opened it to everyone in the hospital and community.

Julie Semente, RN (left), with fellow lead ers in the fight to save Long Island College Hospital: Loreto Gasmen, RN, Joan Rowley, RN, and Herdley Hill, RN.

On Valentine’s Day we held a community informational night and 300 people attended. By mid-April, 500 marched across southwest Brooklyn for LICH. This time was different

We’ve long voiced dissatisfaction that Brooklyn wasn’t getting the attention we needed from the association. But this time was different.

Our executive director was with us fighting day and night, as were our reps and numerous NYSNA staff.

Together, we built a movement.

By June, when SUNY started unlawfully moving patients out of LICH, we had built such an effective rapid response team that we were able to mobilize a rally with 200 people, elected officials, and tons of

press within one hour. I had texted a “call to arms” and by the time I got downstairs, the TV news was filming, and there was a full-blown demonstration commencing. Incredible.

Our efforts resulted in two Supreme Court judges ruling that LICH cannot be closed. Today, the ambulances are gradually coming back, patients are being admitted, and there’s hope for LICH. Even more, our legal victory led to a statewide moratorium on all hospital closings! This fight is so much bigger than us now – it’s for patients everywhere.

With NYSNA, we have won every battle so far, and together we will win the war for our patients, from Brooklyn to the Bronx and beyond.

Our vow: No more closings The story of how we kept LICH and Interfaith open is a story of dedication, commitment – and how changing our union has given us the power to stop hospital closures.

Since 2000, 28 hospitals have closed across our state. As the new NYSNA, we’ve vowed to stop this.

Until now, NYSNA was not up to the challenge. When a hospital closing was announced, NYSNA’s old orientation was

OPE N FOR CARE Rini Templeton

to hold resumé writing workshops – rather than to organize a comprehensive and strategic campaign to fight the closing.

What a difference a year makes. The new NYSNA brought together all of the resources of our organization, members, and allies to the fight – and we won a moratorium on all hospital closures. The moratorium may not last. We have many tough fights ahead. But our union is readier than ever before.

Hospital closings since 2000 Massapequa General Hospital Genesee Hospital Interfaith Medical Center/ Jewish Hospital Medical Center* Mary McClellan Hospital St. Agnes Hospital Staten Island University Hospital/ Concord Site Island Medical Center The Caledonian Hospital ViaHealth of Wayne/Myers Campus

Closed 2000 2001 2003 2003 2003 2003 2003 2003 2003

*Relocated & consolidated to Interfaith Medical Center

Beth Israel Medical Center/ Herbert and Nell Singer Our Lady of Mercy Medical Center/ Florence Durso Pavilion Our Lady of Victory Hospital St. Joseph’s Hospital of Flushing New York United Hospital Medical Center St. Mary’s Hospital of Brooklyn United Memorial Medical Center/Bank Street Division St. Vincent’s Midtown Hospital

2004 2004 2004 2004 2005 2005 2005 2007

Cabrini Medical Center The New Parkway Hospital Victory Memorial Hospital Albert Lindley Lee Memorial Hospital Mary Immaculate Hospital St. John’s Queens Hospital North General Hospital St. Vincent’s Hospita/Manhattan Millard Fillmore Gates Circle Hospital Peninsula Hospital Center Sheehan Memorial Hospital

2008 2008 2008 2009 2009 2009 2010 2010 2012 2012 2012

NEW YORK NURSE

NEXT STEPS

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october 2013

The 2014 challenge

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here’s no time to hang back and rest on our recent progress. We stopped the fullon assault on healthcare in 2013. But we have not won – yet. This year we’re upping our ante in every fight and pushing even harder to

bring home a safe staffing law and strong contracts, and to keep Wall Street out of healthcare in New York for good. Here, NYSNA board members share their thoughts on what success will take.

Beating back Wall Street

Carol Ann Lemon, RN, (second from left) marches with NYSNA members to the Department of Health office to keep hospitals open for care.

Pat Kane, RN, speaking on the steps of City Hall.

Winning safe staffing “We won support for the safe staffing bill during the last legislative session in Albany (86 Assembly members and 23 Senators) but we didn’t have enough momentum to stop hospital opposition and get out of committee.

“We’re not giving up; we’re just getting stronger.

We’ll be out in bigger force than the hospitals this year, uniting with community groups and pressing politicians to do the right thing.

“Hospital executives made a mighty effort to stop us. Wall Street has money, but we have our hearts and nurse power and community support on our side.

We can’t afford as a society to have anything but safe staffing. Patients are people who deserve care. They’re not dollar signs.”

– Carol Ann Lemon, RN, Ellis Hospital, NYSNA Central Regional Director

Building a movement for strong contracts Verginia Stewart, RN, endorsing Scott Stringer for NYC comptroller because of his stand for quality healthcare in all communities.

“Winning the contracts nurses deserve depends on our actions.

“In politics, we need to elect our candidates in November. But Election Day is just a start. We have to hold politicians accountable and make sure they defend healthcare and negotiate with us.

“We need to keep building a coalition of patient groups and community groups. We need to keep raising awareness about the threats to quality healthcare and showing that our efforts together make a difference.

“And we need to empower NYSNA members. Everyone needs to be involved in moving our cause forward.

Demonstrate. Lobby. Talk to neighbors and your congregation. New Yorkers need to hear from us. And we need to send a message: we’re unified in large numbers.

“I’m definitely expecting a new day in New York.

Something great is happening, and we are helping to make it happen.”

– Verginia Stewart, RN, Metropolitan Hospital, NYSNA Director at Large

“The idea that profit would be more important than care is innately abhorrent to nurses.

So when it came out that Wall Street was trying to weaken the Certificate of Need process as prep for bringing for-profits into healthcare in New York, we mobilized.

“We surprised people in Albany. We were fired up, chanting in the hallways, practically having a rally. But it was important to make a public issue out of this. We’re not playing nice anymore. And it worked. We beat three tries to let Wall Street take over our hospitals.

“Wall Street will be back.

And we’ll need all hands on deck: building our base, working closely with community groups. People need to know that another way is possible. We don’t have to accept big business in healthcare – and we won’t.

“At first, keeping LICH open seemed like a noble fight, but impossible to win. It’s incredible what we accomplished. We can do that with Wall Street too.”

– Patricia Kane, RN, Staten Island University Hospital, NYSNA Treasurer

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New York Nurse october 2013

Public sector nurses unite statewide

Defending quality care for all New Yorkers

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n September, 200 of NYSNA’s public sector nurses from every part of the state came together for our first-ever conference dedicated specifically to sharing our experiences and strategizing our next steps in fighting the attack on public hospitals.

New York-Presbyterian Hospital RN Anthony Ciampa expresses the support of private sector RNs for public sector nurses and our mission.

“There’s unconscionable inequality in healthcare. As public sector nurses, we share a core principle: a non-negotiable commitment to standards of care, respect for nurses, and advocacy for enduring access to quality care in our neighborhoods.”

– Anne Bové, RN, President of the NYSNA HHC Executive Council

“I have witnessed the ravages of HIV and the efforts to stop its transfer from mothers to children.

I have seen kids come through, persevere, and make it. Do the titans of Wall Street see this history? Profit motives have no place in public hospitals.”

– Jackie Gilbert, RN, President of the NYSNA Congress of Local Bargaining Units

“I want to have a voice at work.

We’re seeing more people, and sicker people, without a change in the staff ratios. We can stand together and fight at the state level for changes to protect patients and nurses.”

– Cathy Bystrak, RN, Terrace View Long-Term Care, Erie County Medical Center

“I’m most concerned about privatization in public hospitals.

I’ve seen quality declining drastically because of it, and we’re being required to do more outside the scope of nursing. This takes us away from the bedside and undermines patient care.”

– Sonia Lawrence, RN, Lincoln Hospital

“Budgetary hardship in New York State makes no sense. Think of all that has been privatized; hospitals make money, and we go home more tired. We must use our voices, together, and have a common strategy to take care of our patients and ourselves. We have the power if we come together.”

– Eileen Letzeiser, RN, NYSNA Lower Hudson/NJ Regional Director

“Many working class people desperately need public healthcare.

Nurses are rallying, speaking out at City Hall and Albany, for safe staffing and improved funding, and against the travesty of privatization. As one of the most trusted professions, our voice makes a difference.”

– Doreen Gatanas, RN, Elmhurst Hospital

NEW YORK NURSE

PUBLIC SECTOR

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october 2013

5 attacks on our public hospitals A nti-union politicians and business interests are out to destroy our public hospitals. And they’ve got a strategy:

1. PRIVATIZE. Hospital executives in Massena, near the Canadian border, are trying to fully privatize the town hospital. In the 1990s, Rudy Giuliani tried the same with HHC hospitals. He failed, but Mayor Bloomberg and HHC executives have been privatizing in bits and pieces – from services like dietary, laundry, and housekeeping to key treatments like dialysis.

Privatizing is supposed to save money. But the real cost is to quality care. For-profit companies make dialysis treatments faster and patients get less attention. And nurses end up filling service gaps – picking up linens, getting food, and cleaning – taking time from patients and bedside care.

2. Subcontract. Executives at Westchester Medical Center laid off 140 RNs at the end of 2011. The next summer, they axed hundreds of aides, too, replacing them with workers from private, for-profit staffing agencies. Management even sunk so low as to advertise for RNs on Craigslist.

Subcontracting also is supposed to be about savings, but it’s been a disaster. On Westchester Medical’s burn unit, skilled aides have been ditched for aides with no experience replacing a burn dressing. Patients deserve better.

3. Cut services & close units. NYC officials shut down Labor and Delivery at HHC’s North Central Bronx Hospital in August, cutting 10 percent of the Bronx’s L&D capacity. Moms in labor now have to travel much further to give birth.

Public hospitals bear the brunt even when private hospitals eliminate services. When they shut “unprofitable” units, the extra patients come to us – but we don’t get additional resources. That’s what happened in Harlem when Continuum closed pediatrics and the detox unit at St. Luke’s.

4. Destroy standards. A strong contract with good pay and benefits protects nurses and patients alike. It helps recruit and retain new, talented nurses and protects us from being worked to the bone.

HHC nurses have gone five years without a raise. Last year, Albany passed the Tier 6 pension cut for new nurses. That’s bad news for the long-term health of our public hospitals.

5. Wall Street. We beat three attempts to let Wall Street take over New York hospitals last year.

But Stephen Berger, an investment banker who has already made his mark closing hospitals, warned that they would be back again.

Wall Street and private equity firms have taken over hospitals in other states. The results are disastrous. They cut RN staffing. They eliminate “unprofitable” services.

Wait times skyrocket. Community hospitals close. People suffer.

Our public hospitals care for all New Yorkers. That’s a mission millions of people agree with. We can save our public hospitals by bringing together the communities and patients who rely on us. We will not see our mission destroyed.

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Our story. Our voices. Nurses have a long, proud history in New York’s public hospital system. We share it at www.nysna.org/HHCdocumentary

Our fight back Nurses have a strategy too. In September, 200 of us gathered to begin preparing our next steps at NYSNA’s first-ever public sector conference.

1. Using our votes.

NYSNA had never made an endorsement in a New York City mayoral election, until now. We sat out every election Bloomberg faced – even the last one, which he almost lost. This year, we endorsed candidates for mayor, comptroller, public advocate, and city council who support nurses and patients.

2. Documenting unsafe staffing. At Westchester Medical Center, we documented over 3,000 separate Protests of Assignment in 2012. We used that documentation to win back 50 of the positions that executives had subcontracted out.

3. Building alliances, and a movement. In Massena, we’re working with other unions and community groups to keep our community hospital public. In the Bronx, new moms, community leaders, and City Council members are coming together with NYSNA to continue challenging service cuts.

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healthcare policy

New York Nurse october 2013

Which way to healthcare for all?

“We need publicly accountable, publicly funded universal coverage that cares as much about the poorest New Yorkers as the wealthiest because we would all be in the same boat.”

–Dick Gottfried, Chair, New York State Assembly Health Committee

Whether or not history one day considers the Affordable Care Act (ACA) a victory for patients or insurance companies depends, in part, on what we do next.

The Affordable Care Act’s healthcare exchanges began selling insurance plans on October 1 – and already big insurance companies are twisting the law to make a buck.

The New York Times found that companies like Cigna are offering ACA plans with small networks of doctors and hospitals in order to make a profit.

That’s just one of the contradictory effects of the new health law.

A look at the Affordable Care Act

Millions get covered The ACA has already improved insurance coverage for millions of Americans. It’s now illegal for insurance companies to deny coverage based on pre-existing conditions.

Young adults can stay on their parents’ insurance until they turn 26. And the law extends Medicaid coverage to 16 million people.

These changes are a victory for patients, and they deserve our full support. Hospitals will start getting reimbursed for many patients who were uninsured until now, which is particularly important for safetynet hospitals. And yet, as we go to press, the federal government remains largely shut down because Republicans in Congress refuse to fund the law.

The profit takers The ACA is not a panacea: it leaves for-profit corporations in charge of healthcare. And the big insurance companies are shifting many costs onto patients. The least expensive, or Bronze, plans available on the ACA exchanges require patients to pay 40 percent of their healthcare costs. And the law expects low-income families to pay 9.5 percent of their total income on premiums, not counting deductibles and other out-of-pocket healthcare expenses.

The law does nothing to stop insurance companies from denying medical procedures to those they cover. For-profit insurers will still be calling the shots on patient care decisions.

Access to care Having insurance may not always translate into having access to care.

The ACA emphasizes primary care, but many communities in our state don’t have a primary care network.

“Elite” hospitals will have every incentive to poach patients with better insurance who need expensive procedures, at the same time that the law ends the Disproportionate Share Hospital funding that many of our safety-net hospitals have relied on to help pay for uninsured patients. Safety-net hospitals are likely to struggle mightily, and more may well be in danger of closing or cutting services.

Healthcare for all It’s simple, really. Healthcare and profit making don’t mix. And neither do healthcare and politicking. Just look at what the Republicans in Congress are doing.

We need a healthcare system that cares for everyone. Vermont has started to build a not-for-profit single-payer insurance system in which everyone gets the same level of insurance coverage and care.

Dick Gottfried, chair of the New York Assembly Health Committee, is proposing similar legislation in New York. “We need publicly accountable, publicly funded universal coverage that cares as much about the poorest New Yorkers as the wealthiest because,” Gottfried said in a recent interview with NYSNA, “we would all be in the same boat.”

NYSNA has made winning this law a top priority for our legislative work. Success depends on our building a powerful coalition of patients, community leaders, and caregivers. With universal healthcare, history won’t have to debate who won. It’ll be clear: patients.

NEW YORK NURSE

the reality

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october 2013

A growing emergency

Upstate New York’s healthcare crisis

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he nationwide trend of hospital consolidation has sparked controversy about the potential long-term effect on healthcare costs. Hospital consolidations are already having unexpected consequences in upstate New York, where 68 percent of all hospitals (outside of the New York City metropolitan area) are affiliated with at least one other hospital.

The fallout of system savings through greater economies of scale must be measured, though, not just in dollars but also in patient care.

Cuts in services – and proposals for further cuts – are increasingly par for the course in upstate hospital systems, putting more and more New Yorkers at risk.

Service cuts St. Joseph’s Hospital in Elmira, for instance, became part of Arnot Health in 2011, a system with three hospitals in New York’s Southern Tier. In August, plans became public that the hospital would shift acute and intensive care services to Arnot Ogden, another system hospital; 54 nurses lost their jobs as part of this transition.

In New York’s North Country, Adirondack Health has plans to replace the 24/7 Emergency Department (ED) at Adirondack

Medical Center in Lake Placid with a part-time ED. Local residents and visitors (over 1 million each year) will be forced to go to another Adirondack Health hospital in Saranac Lake (17 miles away) for emergency service between 11 p.m. and 11 a.m.

Merger madness New York is not alone in coping with the aftermath of consolidations. There have been more than 1,000 hospital mergers and acquisitions in the U.S. since 1994. The rate of consolidation deals is accelerating, with 50 in 2006 and 105 in 2012. There were 46 merger deals in the first seven months of this year, and the pace may well increase with the Affordable Care Act (ACA).

The ACA encourages consolidations of hospitals and physician practices under the premise that this will reduce healthcare costs. Savings will result, says the theory, from creating accountable care organizations and by shifting Medicare and Medicaid reimbursements from volume to value.

Hospitals also are facing financial pressure from reductions in federal reimbursements. Hospitals in our state will face sequestration-related Medicare cuts of more than $2 billion between 2013 and 2021, on top

of more than $20 billion in other federal cuts over the next 10 years.

Meanwhile, many analysts fear that the end result of consolidations will likely be higher, rather than lower, healthcare costs. Increased consolidation will lead to less competition, which will grant healthcare systems greater leverage in negotiating rates with insurance companies. The combination of higher hospital charges and high deductible health insurance plans may well make it hard for even the insured to pay their medical bills, much less the uninsured.

Unsure future The full effect on patients and hospitals is yet to be seen. As David Aker, CEO of Canton-Potsdam Hospital, which is acquiring E.J. Noble Hospital in Gouverneur, recently observed, “New York is 49th in the nation in terms of acute care hospital profitability, so we will not defy gravity forever.”

Not surprisingly, Canton-Potsdam won’t commit to keeping all services open in Gouverneur. Nurses are not waiting for bad news: We’re actively standing up with the community to make sure that the people of Gouverneur and the surrounding area have access to the care they need, when and where they need it.

On guard for care upstate From the North Country to the Southern Tier, we are uniting to protect care in our communities:  In Plattsburgh, we’re fighting for

a contract that guarantees safe RN and caregiver staffing levels.  In Gouverneur, we’ve joined

with 1199SEIU to demand that all services stay open at E.J. Noble Hospital.  In Elmira, we’ve built a powerful

coalition of neighbors and patients to speak out against the downgrading of services at St. Joseph’s Hospital.

Uniting for patient care Almost every single RN at the Bellevue Woman’s Center in Niskayuna has signed a petition to management to recognize our new union – NYSNA. Many Bellevue nurses are especially trained to care for newborns or mothers who have delivered by C-section. Management is re-assigning these skilled nurses to care for other kinds of patients – without the appropriate level of training or orientation, say nurses.

“We are very concerned that the changes management has made could compromise care for our patients – new mothers, women, and babies,” said Christine Walthers, registered nurse in the post-partum unit at Bellevue. “We need a say in patient care decisions in our hospital. That’s why we are joining the New York State Nurses Association.”

“I see nurses being forced to take on 10 patients at once. That is too many,” said Vickie Decker (left), a registered nurse for 24 years at Bellevue. “We’re on the front lines of the changes in healthcare. We’re looking forward to sitting down with Ellis Hospital management to discuss how we can work together to improve care for our patients.”

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environment & health

New York Nurse october 2013

Fighting climate change is our imperative

P

“

Any nurse who went through Hurricane Sandy should take an immediate interest in climate change. The nurses who cared for patients during and after the storm, those who went up and down the stairs in apartment buildings in the Rockaways and Red Hook helping stranded New Yorkers get care, who went home to devastation in Staten Island, saw all too closely the effects of climate change.

We are in a unique position to speak out against it.

We can’t ignore this danger to our world.”

rofessor Wade Hill is an RN with a Ph.D. in Public Health.

He teaches and researches at the College of Nursing at Montana State University. His specialties include the health effects of climate change and the leading role nurses should play in addressing the climate crisis. He and May Boeve, executive director and co-founder of 350.org, a global organization fighting climate change, will be leading a workshop on climate change, health, and nursing at the NYSNA convention. We spoke recently.

Professor Hill says he first understood the connection between nursing and the environment as a nursing student. As he puts it, “Florence Nightingale was the first environmental nurse.”

The connection between nursing and the environment has largely been lost, contends Hill. He’s on a mission to change that: “We need to re-attach ourselves as nurses to the environment.” To that end, along with about 20 other nurses, he co-founded a national organization, the Alliance of Nurses for

The facts about climate change The Intergovernmental Panel on Climate Change (IPCC), a worldwide committee of hundreds of scientists, issued a major report in September on the physical science of climate change. Its conclusion: “Warming of the climate

system is unequivocal, and since the 1950s, many of the observed changes are unprecedented over decades to millennia. The atmosphere and ocean have warmed, the amounts of snow and ice have diminished, sea level has risen, and the concentrations of greenhouse gases have increased.” The reason for these changes?

“Human influence.”

–Sean Petty, RN, Jacobi Hospital, NYSNA Director at Large

Healthy Environments, which is bringing environmental concerns into nursing.

What we must know

Professor Hill says every nurse should know this about climate change: 1. Climate change is real. Its consequences are serious. Human activity is the cause.

2. Its health effects are important, and happening now.

3. Taking action is our imperative as nurses. It’s a necessary part of our mission to promote health.

What we can do

1. S upport adaptive measures that help our communities respond when environmental disaster strikes.

2. Fight for policies on clean air and clean energy to slow, stop, and reverse climate change.

3. Spread the word. People trust us. This gives us a unique ability to educate the public and advocate for change.

Health effects limate change kills. The World √ CHealth Organization estimated that in the year 2000 there were 160,000 excess deaths globally due to climate change alone. weather and storm surges √ Enotxtreme only cause drowning and injuries; displaced populations create catastrophic public health threats. arming temperatures negatively √ Waffect air quality, exacerbating respiratory problems.

“We need to re-attach ourselves as nurses to the environment.”

–Prof. Wade Hill, RN, PhD

pring pollen season is already √ Sstarting earlier in the U.S. and may be lasting longer, making allergies worse. eat waves put people in danger. √ HAnnual heat-related deaths in Los Angeles are projected to increase up to 7 fold by the end of the 21st century.

election action

By Marva Wade, RN, NYSNA Second Vice President

NEW YORK NURSE october 2013

Your vote is your voice

NYSNA endorsed candidates NEW YORK CITY Mayor

Bill de Blasio

Comptroller

Scott Stringer

Public Advocate

Letitia James

Manhattan Borough President Gale Brewer

L

New City Council Districts

ike it or not, politics matters – a lot. Elected officials at every level of government pass budgets and laws that profoundly affect our lives. Healthcare is far from immune. Just think about our efforts to win a statewide safe staffing law, funding for public hospitals, and the fact that thousands of NYSNA members working in those hospitals need to win strong, new contracts.

We cannot let others shape healthcare in America without hearing loudly – and clearly – from us, the people at the bedside delivering care and putting our professional oath into practice.

Manhattan 1

Margaret Chin

2

Rosie Mendez

3

Corey Johnson

4

Daniel Garodnick

8

Melissa Mark-Viverito

10 Ydanis Rodriguez Bronx 16 Vanessa Gibson Queens 20 Peter Koo 21 Julissa Ferreras 24 Rory Lancman 25 Daniel Dromm 26 Jimmy Van Bramer 27 Daneek Miller

The power of the ballot

They say that power is the ability to get things done. Well, we’re showing our power this election season.

We made endorsements around the state for candidates who’ve taken a stand for quality, affordable healthcare. In New York City, we helped Bill de Blasio win the primary in September without a runoff – and we’ll help elect him mayor in November. Last year, NYSNA’s work for CeCe Tkaczyk put her over the top in the closest race for State Senate – and she signed on to support our safe staffing bill.

Our right to vote is under attack.

That is one reason why it is so important to exercise our right and vote.

As I see it, helping to elect officials who will put healthcare for New Yorkers before profiting from the healthcare industry for Wall Street investors is part of our responsibility as nurses. That’s why I urge each and every one of my fellow NYSNA members to use our power at the polls and vote on November 5.

11

30 Elizabeth Crawley 31 Donovan Richards Brooklyn 33 Stephen Levin 34 Antonio Reynoso 38 Carlos Menchaca 39 Brad Lander 40 Mathieu Eugene 42 Inez Barron 45 Jumaane Williams Staten Island 49 Deborah Rose

ERIE COUNTY See www.nysna.org/elections

NASSAU COUNTY Executive

Tom Suozzi

Legislature District 2

Robert Troiano

District 5

Laura Curran

District 11

Delia DeRiggi-Whitton

SUFFOLK COUNTY District 3

The candidates in New York City who will stand up for patients when they’re in office: Bill de Blasio for Mayor, Letitia “Tish” James for Public Advocate, Scott Stringer for Comptroller.

For a complete list of NYSNA’s endorsements statewide, go to www.nysna.org/elections

Kate Browning

WESTCHESTER COUNTY Executive

Noam Bramson

VOTE NOV 5

for the people who help decide the future of hospitals and healthcare.

NEW YORK NURSE october 2013

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

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

Vote November 5 Inside: NYSNA SPECIAL CONVENTION ISSUE