NY Nurse: Dec 2022/ Jan 2023

nurse New York

New york state edition | december 22/january 23

Nurses’ Unrelenting Fight for Fair Contracts when we fight, we win, p. 2

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New York Nurse december 22/January 23

When We Fight, We Win

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By Nancy Hagans, RN, BSN, CCRN NYSNA President

Advocating for patients. Advancing the profession.SM Board of Directors President Nancy Hagans, RN, BSN, CCRN nancy.hagans@nysna.org First Vice President Judith Cutchin, , DNP, RN, MSN judith.cutchin@nysna.org Second Vice President Marion Enright, RN marion.enright@nysna.org Secretary Nella Pineda-Marcon, RN, BC nella.pineda-marcon@nysna.org Treasurer Jayne L. Cammisa, RN, BSN jayne.cammisa@nysna.org Directors at Large Matt Allen, RN, BSN matt.allen@nysna.org Reginalt Atangan, RN reginalt.atangan@nysna.org Marie Boyle, RN, BSN marie.boyle@nysna.org Seth B. Dressekie, RN, MSN, PMHNP, BC seth.dressekie@nysna.org Flandersia Jones, RN, BSN, MPH flandersia.jones@nysna.org Michelle Jones, RN, MSN, ANP-C michelle.jones@nysna.org Sonia M. Lawrence, RN, BSN sonia.lawrence@nysna.org Benny K. Mathew, RN, MS, CCRN, CEN, SCRN benny.mathew@nysna.org Ari Moma, RN, MSA ari.moma@nysna.org Jean Erica Padgett, RN jean.padgett@nysna.org Regional Directors Southeastern Vacant Southern Aretha Morgan, RN, MSN aretha.morgan@nysna.org Central

Catherine Dawson,RN,CNOR,MSN catherine.dawson@nysna.org

Lower Hudson/NJ Margaret Franks, RN Western

Steven Bailey, RN steven.bailey@nysna.org

Eastern Bill Schneider, RN, CCRN bill.schneider@nysna.org Editor Jennifer R. Farmer Executive Editor Pat Kane, RN, CNOR Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2022, All rights reserved

s president of NYSNA and a long-time nurse at Maimonides Medical Center in Brooklyn, I know intimately the pain of understaffing. I’ve seen the horrible toll of understaffing on patients, nurses, and our communities. Hospitals are not addressing the staffing crisis or the economy. They’re simply not doing enough to address inflation and other economic issues bearing down on workers. These are issues I’ve spoken on for years. While many of us are tired, we cannot get discouraged. We will win if we fight back. As nurses, we must be strong, stand up to management and demand our worth.

My hospital system is one of the 12 private sector New York City hospitals where nurses’ contract expired on Dec. 31. These contract negotiations are one of the few opportunities we have to address persistent understaffing and its deleterious impact on the nursing profession as well as the people who rely on us for care. We stand up not only for our profession, but for the people who rely on us for care.

That’s why I joined over 100 colleagues on the steps of City Hall on Nov. 30 to sound the alarm about the nursing crisis in New York City’s hospitals. Many of our hospitals are more understaffed than they have ever been. We faced understaffing before and during the COVID-19 pandemic, but things have become even worse. Many healthcare employers froze hiring during the pandemic, leaving many vacancies when nurses retired or resigned. They had to have seen that coming, and if they didn’t, that’s an even bigger problem.

Now, we don’t have enough nurses to meet demand. For instance, there are thousands of nurses in New York who have been so traumatized and so poorly treated that they are no longer willing to consider or accept hospital jobs. When there aren’t enough nurses and their patient assignments are too heavy, nurses leave the bedside. Unless these issues are addressed, we’ll be unable to recruit more nurses into the profession or retain the ones we do have. While hospitals could immediately step in and help stabilize the situation, many are unwilling to invest the necessary resources.

They have chosen profits over patients. By ignoring contractual staffing ratios and the requirements to improve staffing under the new state staffing law, hospitals are demonstrating their desire for profits over people.

Failing to Hire and Retain Understaffing did not pop up out of the blue. Hospitals could have monitored trends and made adjustments. Instead, hospitals did not do enough to hire and retain nurses.

Now some facilities have hundreds of nurse vacancies. The severe and chronic understaffing impacts the morale of the nurses who have sacrificed and stayed at the bedside.

They are asked to do the impossible nearly every shift. That creates moral distress when they go home to their families knowing they are unable to provide the safe, quality care to their patients — the way we are trained to do.

The quality of care that patients receive when there is severe understaffing is compromised and can even be unsafe. That is why NYSNA

nurses have demanded better for us and our patients.

They Can Afford Safe Patient Care You cannot tell me that in the richest city in the country, in hospitals where CEOs earn an average of over $1 million a year, where top executives gave themselves $73 million in salary hikes and bonuses during the first and deadliest year of the pandemic, that hospitals cannot afford safe patient care. You cannot tell me that after spending millions in advertising that hailed nurses as essential and as heroes of the COVID-19 pandemic that these hospitals cannot afford to maintain good-quality healthcare for frontline nurses. It is a lie, and it’s one that we do not have to fall for.

They Must Do Better New York City’s hospitals can and must do better. But left to their own devices — without state and city elected officials’ oversight and accountability — healthcare employers will do the bare minimum.

Without our intervention and advocacy, our patients will not get the care they need. It is imperative that hospitals are held accountable for: l Staffing to the bare minimum. l Reducing healthcare to the bare minimum. l Treating nurses as expendable, not essential. l Prioritizing profits over patients.

Further, NYSNA is urging several steps to address the registered nurse shortage in New York City: l New York City-area hospitals must agree to fair contracts with their nurses in the current round of bargaining. l They must increase RN pay rates. l They must improve staffing levels and nurse-to-patient ratios. l Hospitals are nonprofits that don’t pay taxes and are not supposed to hoard money — New York City should look at hospitals’ tax exemptions and use its zoning and regulatory power to make them improve working conditions and patient care.

Hospitals must stop relying on temporary staffing and use the huge amounts of money they pay for temps to build up their permanent workforce.

Continued on page 11

NEW YORK NURSE december 22/January 23

Hospitals Seek to Shift More Costs onto Nurses

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pproximately 17,000 NYSNA members at twelve hospitals in New York City had contracts expiring on Dec. 31, 2022. Of that number, 15,000 nurses sent 10-day strike notices, with Montifiore and Mount Sinai going on strike before ultimately reaching an agreement with historic gains. There was a NYSNA Executive Director Pat Kane lot of dialogue over the past few speaks with nurses ahead of strike vote. weeks, and I want to ensure that we networks are giving themselves big are all clear about what is happenraises and handing out executive ing and why. bonuses like Halloween candy: First, negotiations occurred in l The CEO of Presbyterian made the context of an intense staffing more than $12 million in 2019. crisis that had nothing to do with l The CEO of Mount Sinai made a lack of nurses. The staffing crisis $5.6 million in 2019. is the result of a mass exodus of l

The CEO of Northwell made nurses from hospitals and nursing almost $4 million in 2019. homes because they are fed up with l In 2020, 364 top executives at understaffing caused by hospital New York hospitals received more management, poor working condithan $73 million in bonuses. tions, inadequate pay, and the stress l Ten executives received more of trying to provide safe care for than $1 million in bonuses, and patients while management ignores another 40 got at least $500,000. nurses’ concerns.

As if this isn’t astounding, these Profits Over Patients hospitals have hundreds of executives who receive $1 million or more Next, hospital systems are comin compensation each year — at mitted to profits over patients.

Presbyterian, for example, at least Their efforts to shift the burden of rising health insurance costs to their 29 executives earned $1 million or more in 2019. By way of comregistered nurse staff was about parison, the CEO of the 11 hospital returning more profits to themHealth + Hospitals public network selves not patient care. In negotiareceived about $700,000 in pay. No tions, employers are claiming to have limited resources amid higher one should be confused. Hospitals are responsible for rising health health insurance costs. No one should believe that hospitals simply insurance costs. And at any point they can make a different decision. cannot do better, because they can absolutely do better.

Healthcare Costs Are Growing Large hospitals are raking in sigUnfortunately, health insurance nificant dollars. Presbyterian made costs have been growing at a rate more than $1 billion in profits in that far outpaces inflation and the 2021 and is sitting on more than pay of nurses and other workers. $19 billion in assets. Mount Sinai In the last 12 months, the inflation made more than $185 million in rate in New York City was about profits and has more than $6 bil6% (lower than national average), lion in assets. Northwell made but healthcare costs rose by 7.9%. more than $177 million in profits Hospital price increases are the (plus $460 million in investment major drivers of increasing health income) and also has a hoard of care costs. Since 2009, hospital pricmore than $19 billion in assets. es have gone up by 80%, compared On a Spending Spree to less than 50% for nonhospital care and 30% for prescriptions.

At the same time hospitals are Much of the increase in hospital seeking to shift the burden of rising health insurance costs onto nurses, costs is the result of price gouging and profit maximizing by these same they are on a spending spree with executive pay packages. The CEOs hospital CEOs that pay themselves so well. These private hospitals charge and executives of the big hospital

exorbitant prices that are on average 316% of the rates paid by Medicare and for some hospital systems reach more than 390% of the Medicare rate, according to an analysis by the SEIU 32BJ member health plan.

As a result, healthcare funds across the country are facing cash flow issues. In 2022, expenses exceeded contributions leading to an average monthly shortfall of $2.6 million.

After nurses put our lives on the line during the worst healthcare crisis of our lifetime, some of our hospital employers had the audacity to consider cutting healthcare for COVID nurse heroes. They proposed 35 different reductions and restrictions to our NYSNA health insurance and were refusing to set their contribution rate to our healthcare fund, which they do every fall. Days before contracts expired, the hospital trustees finally agreed to increase the rate to continue funding nurses’ good health benefits. This is a step in the right direction toward respecting nurses' work and protecting our health.

Price Gouging There are plenty of examples and data showing the degree of price gouging – for example, a normal vaginal birth at NYC Health & Hospitals cost $11,000, while the same procedure costs $41,000 at Montefiore, $33,000 at Presbyterian and $24,000 at Northwell. It is beyond ironic to hear these hospitals say they can’t afford healthcare coverage for nurses and healthcare professionals when they are making huge profits and complaining about the same healthcare costs that they themselves have jacked up.

Again, we shouldn’t be confused.

We also know what needs to happen. Hospitals must keep their hands off nurses’ health coverage — nursing is one of the most dangerous occupations, and nurses need good health coverage if we are going to attract and retain our nurses. But health systems should also fully absorb the cost of health coverage and value their teams the same way they value their executives.

If there is any talk about reducing healthcare coverage, it should be solely to lower the amount that health systems are charging health care professionals and patients.

By Pat Kane, RN NYSNA Executive Director

The staffing crisis is the result of a mass exodus of nurses from hospitals and nursing homes because they are fed up.

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New York Nurse december 22/January 23

NYSNA RNs Hold Press Conference on Steps of City Hall Ahead of Council Hearing on State of Nursing in New York City & Short-Staffing Crisis

M New York City nurses are sounding the alarm on the growing shortstaffing crisis as the “tripledemic” of RSV, flu and COVID-19 threatens to worsen the hospital-created RN shortage.

ore than 100 NYSNA nurses and supporters held a press conference on the steps of City Hall on Nov. 30 ahead of a New York City Council oversight hearing on the state of nursing in New York City and on solutions to the short-staffing crisis. NYSNA nurses and allies say New York City can’t afford to wait another minute to address the hospitalcreated registered nurse (RN) staffing crisis with pediatric units already overflowing with RSV cases and with the threat of a “tripledemic” of COVID-19, RSV and flu as the winter months approach.

In addition to NYSNA nurses, New York City Council Hospitals Chair Mercedes Narcisse, Council Speaker Adrienne Adams, NYC Central Labor Council, AFL-CIO and other allies attended as well.

“Our patients are suffering because of short staffing too,” said Craig Berke, RN, of Flushing Hospital. “In the emergency department, each nurse should be assigned six patients. There are times when nurses are charged with caring for more than 15. This is unacceptable.

As a result of deficits in staffing, nurses do not call out and work overtime. Nurses end up working a 16-hour shift, which can become exhausting for nurses and unsafe for patients.”

NYSNA nurses from the largest academic medical centers to the smallest safety-net hospitals shared details on terrible working conditions in the city’s hospitals, including the safe staffing and healthcare

NYSNA nurses attend NYC Council Oversight Hearing, discuss state of nursing.

crisis that is putting patients at risk and driving nurses away from the bedside.

Expiring Contracts Approximately 17,000 NYSNA members at 12 hospitals in New York City, including private hospitals such as Montefiore, Mt. Sinai and NewYork-Presbyterian, have contracts that expired on Dec. 31.

Hospital executives paid themselves millions in sky-high salaries and bonuses during the pandemic at the same time they hiked hospital prices. Nurses are calling for their bosses to invest in hiring and retaining enough nurses to keep their patients safe.

“In our last union contract, the hospital management and NYSNA agreed to a staffing grid that would maintain 17 nurses on shift day and night,” said Kiera Downes-Vogel, RN, of Mount Sinai West. “But our staffing almost never meets the number 17; patients are lucky if we are scheduled for 15. Research has

shown that appropriate staffing improves patient health, prevents death and reduces nurse turnover.

Our current staffing has only exacerbated nurses leaving because they are frustrated and exhausted.”

Fighting for Our Future “When I started out as a young nurse, I was given ample time to train,” said Lorena Vivas, RN. “We had safe patient ratios. Today they understaff the hospital to maximize profits. Mount Sinai Hospital has over 500 vacancies for nursing positions.”

With two-thirds of RNs across the country saying they are planning to leave the profession in the next two years, NYSNA nurses are sounding the alarm on the staffing crisis that has left caregivers burnt out and at their breaking point.

Nurses say that hospitals are not doing enough to keep them at the bedside — from safe staffing ratios to good healthcare benefits to competitive pay.

NYSNA and Coalition for Affordable Hospitals Demand Hospitals Pay Their Fair Share

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n Dec. 7, NYSNA joined fellow union members and members of the New York City Council in expressing support for the Healthcare Accountability and Consumer Protection Act. We are clear that in one of the richest nations in the world, no one should forgo care because they’re unable to afford it. Yet, healthcare prices continue to skyrocket with disas-

trous impact on community members, including healthcare workers.

Today, medical debt is the leading cause of bankruptcy.

As healthcare professionals and concerned community members, we’ve seen how profit-driven hospitals line their pockets with tax breaks while failing to invest in the community or in quality patient care. New York City’s

private hospital received $700 million more in tax breaks than what it spent on community benefits.

That was revealed via research from The Lown Institute, which developed its Fair Share Spending Index to evaluate the extent to which hospitals provide financial assistance and community investment in excess of their tax Continued on page 7

Patient Care Alert

NEW YORK NURSE

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december 22/January 23

The National Hospital Industry Is Peddling Programs to Treat Acute-Care Patients in Their Residences, Instead of in The Hospital Where They Belong

By Rachel Berger and Lucia Hwang

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atmeh Kalaveras has spent almost 30 years as a bedside registered nurse and thought nothing could surprise her, but her hospital last year rolled out what until then was unimaginable to her: a nightmarish scheme to care for patients needing acute hospital care in their own houses.

“It is an insult to nurses, to the nursing and all medical professions, and even more worrisome, it is straight up dangerous for our patients,” said Kalaveras, who saw the program first hand when she worked as an emergency department nurse at Kaiser Permanente Medical Center in Vallejo, Calif.

These remote programs, what nurses are calling “Home All Alone” schemes, are aimed at keeping patients needing acute care out of the hospital. Instead of admitting these patients, who would otherwise be traditionally hospitalized, they are sent home with an iPad and a smartwatch to be “admitted” for “hospital care” at their home. The patient is told a team of medical professionals will monitor them remotely from a medical hub.

These hubs could be many miles away, or even in a different state, from the patient. From the hub, “care teams” are sent out to check on the patient as the need arises.

In cases where a provider needs to physically be with the patient, the remote team will then send out a nurse or what they are calling an “upskilled paramedic.”

Unholy Alliance These Home All Alone schemes were born of an unholy alliance between a profit-driven hospital industry, technology giants, and venture capitalists seeking to reap profits by replacing hands-on skilled hospital care with robots, gadgets, and less-skilled contract workers.

“Labor is expensive and nurses have historically and continue to be undervalued for their professional expertise,” said Michelle Mahon,

RN and assistant director of nursing practice for National Nurses United. “Hospital and health care executives have long pushed an agenda to cut labor costs by slashing nursing budgets. And now they are taking it a step further, by putting patients in a situation where they effectively have to care for themselves.”

While the hospital industry has for many years pushed to decentralize care away from the hospital and towards outpatient and telehealth programs, the pandemic provided an opening to promote, establish, and normalize these schemes on a much larger scale. In November 2020, as hospitals were overrun with Covid patients, the U.S. Centers for Medicare and Medicaid Services (CMS) waived significant regulations governing the provision of hospital care, making it feasible for hospitals to send acute-care patients to their own homes but still collect as much in CMS reimbursements as if they were housed at the hospital.

The List Grows by the Week Today, some 206 hospitals run by 92 systems in 34 states currently have temporary CMS waivers to run these Home All Alone programs. The list grows by the week.

“Nurses know that patients need us with them. Health care executives are trying to move us closer and closer to the day that medical professionals will no longer work in hospitals,” said Mahon.

“Patients will only have gadgets, unlicensed personnel, and even lay people with minimal training providing their ‘care’ in outpatient settings. These Home All Alone schemes set us on the path to this dystopian and dangerous future.”

Opening the Floodgates The concept of treating acutecare patients in their homes is not new and some large hospital systems such as Mount Sinai Medical Center in New York and Johns Hopkins Medical Center in Maryland have been running a version of these programs for decades.

But the federal government’s willingness during the Covid-19 pandemic to offer flexibility to hospitals to accommodate patient surges opened the floodgates to industry efforts to dramatically expand these programs and make such crisis standards permanent in pursuit of profit.

When the federal government declared a public health emergency (PHE) in March 2020, the Centers for Medicare and Medicaid Services (CMS) granted hospitals blanket waivers to treat patients through temporary expansion sites. But in November 2020, CMS expanded that waiver to allow hospitals to treat acute-care patients at home.

Most importantly, it suspended the normal requirements under its conditions of participation to receive Medicare and Medicaid reimbursements for round-the-clock nursing care to be provided on site to patients, and for the immediate availability of a registered nurse.

Industry Players Heavily Involved According to a Dec. 7, 2021 New England Journal of Medicine Catalyst article, the “Acute Hospital Care at Home” program was developed with heavy input from industry players in just eight days. The waiver application form for “experienced” hospitals that have already treated 25 or more patients under such programs is literally two pages long. The waiver form for “inexperienced” hospitals is five pages long.

The program requirements shockingly lack in-person assessments of patients. After an initial in-person history and physical is taken of the patient by a doctor or advanced practice provider, there’s actually no requirement for any more in-person visits by a doctor or registered nurse. The program only requires two in-person visits per day, which can be fulfilled by an “MIH/CP,” which basically stands for a paramedic. Everything else is allowed to be done remotely, through telehealth visits and monitoring through technology and video. Only two vital sign readings need to be taken per day.

FOR THE COMPLETE STORY View National Nurse Magazine – January | February | March 2022 Issue

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New York Nurse december 22/January 23

Agency Fee Objection Policy

N Beck Notification

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f you are represented for collective bargaining by NYSNA, you have the right to be or stay a nonmember and pay an agency fee equivalent to dues. If you choose to be a nonmember, you are entitled to object to paying for activities unrelated to the association’s duties as a bargaining agent and to obtain a reduction in fees for such activities. If you submit a timely objection, the agency fee that you will be required to pay will include costs incurred by the union for expenditures related to collective bargaining, contract administration, grievances and arbitration, and other matters affecting wages, hours, and other conditions of employment. In 2022, the most recent calendar year for which a calculation was done, the agency fee charged to timely nonmember objectors represented 84.08% of the dues amount for that year.

If you choose to be a nonmember, please be aware that you will deny yourself the opportunity to exercise the full rights and benefits of union membership. Full membership rights include, among other things, the rights to: (1) vote on acceptance or rejection of proposed contracts covering your wages and working conditions, thereby ensuring your input on issues central to your working life; (2) participate in development of contract proposals; and (3) vote for your union officers.

A copy of NYSNA’s agency fee objection policy is published annually in the January edition of the New York Nurse. You can also request a copy from NYSNA’s Membership Department.

YSNA’s agency fee objection policy, which will be published annually in the January edition of New York Nurse, works as follows: To become an objector, a non-member who is represented by NYSNA shall notify NYSNA. Such objection must be in writing, signed by the non-member and mailed to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001. The objection must be postmarked within 30 days of resignation of membership, or, if the non-member did not resign within the prior twelve months, in the month of February. A non- member employee who initially becomes a bargaining unit member after February in a particular year and who desires to be an objector must submit written signed notification to the NYSNA Membership Department within thirty (30) days after the employee has become subject to union security obligations and been provided with notice of these procedures. Public sector employees may revoke their dues deduction authorization and resign member- ship in accordance with applicable law and the terms of any signed dues deduction authorization card.

Agency fees payable by non-member objectors will be based on NYSNA’s expenditures for those activities undertaken by NYSNA to advance the employment-related interests of the employees the Union represents.

These “chargeable” expenditures include: preparation for and negotiation of collective bargaining agreements; contract administration including investigating and processing grievances; organizing within the same competitive market as bargaining unit members; meetings, including meetings of governing bodies, conferences, administrative, arbitral and court proceedings, and pertinent investigation and research in connection with work-related subjects and issues; handling work-related problems of employees; communications with community organizations, civic groups, government agencies, and the media regarding NYSNA’s position on work-related matters; maintaining membership; employee group programs; providing legal, economic, and technical expertise on behalf of employees in all work-related matters; education and training of members, officers, and staff to better perform chargeable activities or otherwise related to chargeable activities; and overhead and administration related to or reflective of chargeable activities.

Non-chargeable expenses are those of a political nature. The term “political” is defined as support for or against

a candidate for political office of any level of government as well as support for or against certain positions that NYSNA may take, which are not work-related. The following are examples of expenditures classified as arguably non-chargeable: lobbying, electoral or political activities outside of areas related to collective bargaining; litigation expenses to the extent related to non-chargeable activities; and member-only activities.

NYSNA shall retain an independent auditor who shall submit an annual report verifying the breakdown of chargeable and arguably non-chargeable expenditures and calculating the percentage of arguably non-chargeable to chargeable expenditures (the “fair share percentage”). The auditor’s report shall be completed promptly after the conclusion of the fiscal year. The report shall be provided to any non-member who submits an objection.

Non-members and new employees will be given the foregoing explanation of the basis of the reduced agency fees charged to them. That explanation will include a list of the major categories of expenditures deemed to be “chargeable” and those deemed to be arguably “non-chargeable.”

The fees paid by non-member objectors shall be handled as follows.

Newly-Hired Non-Members. NYSNA will place or maintain in an interestbearing escrow an amount at least equal to the agency shop fees remitted by newly-hired non-member(s) (or by an employer on behalf of newly-hired non-member employee(s)). A newly hired non- member employee will be mailed a copy of this Policy. The non-member will have the later of the date he/she is subject to the obligations of the union security clause or thirty (30) days from the date of mailing to remain a non-member, object or to join NYSNA. If the non-member employee joins NYSNA, then the full agency shop fee remitted on his/her behalf is credited from the escrow account to the Association’s general treasury. If the newly-hired employee does not join NYSNA and does not file an objection within the thirty-day objection period, then the escrowed amount will be credited to NYSNA’s general treasury.

If the newly-hired non-member timely objects, an amount at least equal to the fair share percentage shall continue to be escrowed pending resolution of a challenge (if any) by the objector. Once the challenge is resolved, the amount of the non-chargeable balance plus interest will be returned to the non-member from the escrow.

Resignation. In the case of an employee who resigns NYSNA

membership (or who continues in non-member status) and who timely objects, NYSNA will place or maintain in an interest-bearing escrow account an amount at least equal to the fair share percentage of the agency fees received from the non- member or employer on behalf of the non-member and the non-member is permitted to challenge the fair share fee percentage during the thirty (30) day period noted in the annual publication of the Association’s objection procedure. If the non-member files a timely challenge, amounts at least equal to agency fees collected from the non-member employee or employer will continue to be placed or maintained in the escrow account pending resolution of any challenge. If the non-member does not file a challenge within the challenge period, then the fair share fee amount will be credited to NYSNA’s general treasury and the balance (if any) paid to the non-member from the escrow plus interest A non-member objector may file a written challenge to the calculation of the fair share fee and percentage, challenging any of the items of the expenditures as chargeable. Such a challenge must be submitted within thirty (30) days of the date the non-member objector is provided an explanation of the basis of the reduced agency fees and initiation fees charge to them. Such a challenge must be in writing, signed by the non-member and sent to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001. If NYSNA does not agree with the challenge either as to the expenditures or as to the percentage of amount of dues to be paid, it will notify the timely objecting non-member in writing that he/ she has thirty (30) days thereafter to request arbitration; and if he/she fails to do so within that time, then such non-member waives the right to arbitration. A request for arbitration must be in writing, signed by the person filing the request, and sent to the NYSNA Executive Director, 131 West 33rd Street, New York, NY 10001.

If more than one challenging non-member objector timely requests arbitration, NYSNA will consolidate all such challenges into one annual arbitration proceeding. NYSNA will provide an impartial arbitration proceeding through the American Arbitration Association and will pay the administrative costs and the arbitrator’s fees. The challenger will be responsible for any fees associated with his or her representation at the hearing.

NYSNA will administer this policy in a manner that is consistent with the objectives of the policy and the applicable federal and state law to provide a fair and equitable procedure regarding nonmember employees. NYSNA reserves the right to change the policy set forth above.

Health Equity Forum

NEW YORK NURSE december 22/January 23

NYSNA RNs, CIR/SEIU and The Northwest Bronx Community and Clergy Coalition Host Bronx Community Health Forum

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n Dec. 19, NYSNA nurses, Committee of Interns and Residents and Northwest Bronx Community & Clergy Coalition hosted a community health forum to confront Montefiore over unfair practices and health inequities.

As the Bronx’s largest employer, Montefiore has a responsibility to meet the healthcare needs of the local community.

Health outcomes in the Bronx are the worst in New York state and among the worst in the country. The Bronx ranks dead last in health among New York’s 62 counties. This contributes to long-

standing inequities and poor health outcomes for vulnerable communities. For instance, across the nation, women of color are 3 times more likely to die than white women due to maternal complications.

Poorer Health Outcomes The Bronx has the highest infant mortality rate in New York City.

At the same time, Montefiore, the largest healthcare provider in the borough, has cut services, including by reducing staffing at the Home Health Agency from 100 nurses to 50, and is planning to shut down the Family Health Partnership program that cares for the most high-risk mothers and

babies in the Bronx and Yonkers.

Montefiore also recently closed the Grand Concourse clinic, displacing patients, and reducing primary care access in the Bronx.

“Our community deserves quality care,” said NYSNA Director at Large Benny K. Mathew, RN, and member at Montefiore. “Nurses want to improve conditions in the Emergency Department and the hospital. In the ED where I work, I sometime care for 20 patients at a time, instead of a safe standard of 3 to 6 patients. In the critical care part of our ED, instead of one nurse caring for 2 patients, they are sometimes caring for 6 or 9. This is not safe or fair for nurses or patients.”

Coalition for affordable hospitals Continued from page 4

breaks. According to the report, “NYC hospitals received about $1.5 billion in tax breaks in 2019, but spent only $1.1 billion on meaningful community benefits, resulting in a $435 million gap in Fair Share spending. However, Fair Share was markedly uneven, ranging from a $76 million surplus to a $359 million deficit.” The Lown Institute also found that “Many of the city’s largest and most prestigious hospitals had the greatest Fair Share deficits. New York-Presbyterian hospital had the largest Fair Share deficit; at -$359 million, this amounted to about half of the city’s entire deficit.”

That is unjust and unacceptable.

Shining a Light This must end. New York’s wealthiest hospitals are charging working people three to four times what the hospitals need to cover the cost of services. The Lown report found that New York City hospitals are taking in $400 million more in tax breaks than they are giving back in community benefits.

And to be clear, that money isn’t going to patient care. It isn’t going to lowering the cost of care, hiring more nurses or offering competitive wages and benefits to healthcare workers.

Throughout the pandemic, our members have shown up and risked their lives to ensure that New Yorkers get the healthcare they need. Some nurses even lost their lives, leaving their families forever altered. But while nurses have taken on this heroic fight, hospital executives have focused on maximizing revenue rather than doing what’s right for patients.

They’re not only overcharging for care, but they’re refusing to pay healthcare workers a wage that is just and fair.

No Real Commitment We know that healthcare outcomes are better when there are more nurses and healthcare workers present. The same hospitals that are raking in tax breaks are refusing to hire enough nurses to provide safe staffing levels.

They have yet to make a real commitment to community programs to create a strong hiring pipeline for good union jobs. To add insult to injury, these hospital systems are looking to pass their outrageous healthcare costs onto nurses. That shouldn’t be acceptable to anyone who values healthcare, and it’s certainly not acceptable to the hard-working nurses and healthcare professionals who provide it.

Hospitals cannot beg for tax breaks and then turn their back on the people who subsidize those tax breaks. Enough is enough.

People should always be prioritized over profits. As a member of the Coalition for Affordable Hospitals and as believers in a healthcare system that works for all, NYSNA and other members of the Coalition for Affordable Hospitals are demanding that the New York City Council pass the Healthcare Accountability and Consumer Protection Act and do what is right for the community as well as nurses.

“I want the public to know that nurses are fighting for quality care for the community.”

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members speak

New York Nurse december 22/January 23

Why Would Nurses Go On Strike?

By Judy Sheridan-González, RN; Emergency Room nurse, Montefiore Hospital, Bronx, NY; Immediate past president, NYSNA

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he thought of 17,000 nurses from NYSNA, New York City’s largest nurses’ union, striking in January 2023 is frightening. For nurses, who personally and professionally make the commitment to caring for our patients and communities, it is a decision we don’t take lightly. It is a last resort, after having exhausted all other strategies to raise the alarm that patients are in danger.

Unfortunately, given current conditions, those of us who care for them cannot adequately protect them.

We, Like Doctors, Take an Oath to “Do No Harm.”

17,000 Nurses from NYSNA Prepare to Strike

Nurses take an oath to do no harm. What is harmful is the way in which our patients and communities—and those of us who care for them—are treated by our employers on a daily basis. Here are some examples of the harm being done: 1. Our emergency rooms are overcrowded while overflow facilities are being closed.

2. Emergency Room patients are being housed in hallways with little or no privacy and conditions that cannot be handled in that setting while VIP patients are given private rooms and etc.

3. Overcrowding creates conditions for the spread of disease (such as COVID-19 and the flu).

4. Forcing pregnant women to endure long waiting times for appointments, which could create a situation where dangerous conditions are missed and maternal and infant health endangered.

5. Shutting down clinics in communities where working and poor people live are served while new facilities in wealthy areas are opening.

Clearly, communities with the greatest need suffer the greatest from a lack of easy access to care and sub-standard treatment. We as caregivers make no distinction between people with inferior or no insurance, communities of color, those struggling to survive at subsistence wages or who are precariously employed, people who suffer with disabilities or mental illness, immi-

grants, the elderly, women, children with few resources, and, ironically, many people with chronic illnesses.

But we are seeing that the hospitals that employ us make a distinction and are not providing equal access and treatment for healthcare.

How is it that a humanitarian system, in an industry theoretically built on a non-profit model (no for-profit hospitals are permitted in New York State)? Instead, we as nurses, see a system driven by an insatiable drive to make money, not to serve the community.

What Happened to that Social Contract?

Although taxpayers foot much of the bill for health care, in addition to premiums, co-pays, co-insurance, and assorted “out of pocket” costs, they get little bang for their buck.

Our health care system is hopelessly entangled in a morass of red tape, with funds diverted to the pockets of insurance stockholders, CEOs, topheavy hospital administration, consultants, high priced lawyers, public relations & advertising, and donations to electoral campaigns and Big Pharma, all dedicated to squeezing the system to make money.

So instead of hospitals joining the movement to build a stronger, patient-centered healthcare system, much of which is codified in the bill known as the NY Health Act, they play this quasi “Hunger Game.” It is a game where the big hospitals compete against each other to buy up smaller systems. These Mega Hospital Systems consume community hospitals and clinics, transforming them or, often, shuttering them completely, using public funds to do so while expanding in affluent communities where a greater profit can be made.

Nurses have served on the front lines of this deterioration of care for so long. We were seriously exploited during the height of the pandemic, while the already existing shortage of nurses has continued unabated. We can no longer hold up the fort. The current situation is untenable.

The Cure: More Than Band-Aids Our demands would push our hospitals in the direction of shifting their budgets from a profit-focused model to one that prioritizes direct care. We

support and are fighting for a system that improves access to primary and specialty care, one that addresses the social determinants of health and the brutal inequities in the system.

Without dramatic changes that will recruit and retain nurses, the current trend will only worsen.

It is projected that by the year 2030 there will be an international shortage of 13 million nurses. While hospital CEOs claim there’s nothing they can do about this, they themselves have created this so-called “shortage.”

There are thousands of nurses in NY alone who would return to the bedside if conditions changed.

A Nurses’ Strike Is Like a Smoke Alarm Something is burning and you need to move quickly to put out the flames.

Our health system is on fire and we need to do something about it. That is what our strike is about. But we are not simply “walking out.” We provided hospitals a “10 day notice” to cancel procedures, transfer patients and make needed arrangements for emergencies. We shared information for patients who need services to go to alternate facilities and receive assistance in a variety of ways.

We want nurses to remain on the job. We want others, who have left in frustration and/or despair, to return. We want new nurses to experience the joys of our honorable profession. We want our hospitals to be welcoming homes of healing. We want to care for our patients with all of the compassion and resources they deserve.

Many of us gave our health and our lives during the height of the pandemic. We continue to suffer from understaffing and from not being able to provide the care our patients deserve. Nurses know what is needed to make the necessary changes, not those who sit in remote offices who operate like puppet masters and trade lives and health for money.

We, the front-line caregivers, the nurses once venerated as heroes, are willing to make a sacrifice: to go out on strike, to ensure that the unspeakable tragedies that occurred in March and April of 2020 never, ever happen again and that the people of New York City will have a healthcare system to serve them and their families now and in the future.

NEW YORK NURSE

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december 22/January 23

Nurses, Faith and Community Leaders Hold Vigil to Honors Colleagues and Patients Who Lost Their Lives to COVID-19

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n Dec. 13, nurses, faith, and community leaders held a vigil outside NewYorkPresbyterian to honor colleagues and patients lost to the COVID-19 pandemic. Nurses shared stories to commemorate their colleagues who died on the frontlines. These nurses and healthcare professionals died even as they worked to save lives during the pandemic. The vigil was designed to draw attention to the continued and urgent need to protect the health and safety of caregivers and community members.

“My friend and coworker Peter Chin died of COVID after getting sick at work. I will never forget Peter,” said NY Presbyterian nurse Anna Czarny, RN. “Before the pandemic, he and I were the early birds of the unit, coming into work early to sip our coffee, debrief on how our backs still hurt and our body ached from yesterday, listening to classic rock jams. Peter was right there with us all the time. He could sense when my workload was overwhelming and would swoop in to help me clean patients, never saying no, rather ‘who’s next.’ Then the pandemic hit, and it was a scary and traumatic time for all of us. Having a team of nurses that we could depend on is the only way we survived the worst of the pandemic — for those of us who did survive. And Peter was essential to that team.”

NY-Presbyterian Pediatric ER nurse Deidrea Bryan, RN. “I am not the same. I don’t breathe the same. I don’t have the same exercise tolerance and I experience brain fog.

Since the pandemic began, I have been in the ICU twice because of COVID-19. My most severe experience was last year when I had severe COVID pneumonia that required BiPap to help me breathe. I’ve experienced trauma and so have my loved ones. If I’m asleep, they check if I’m breathing. If I catch a cold, they’re scared that I’ll end up in the ICU again. It has been a trying experience. I am speaking out at our vigil because the trauma is still with me and with all the healthcare workers who had severe COVID.”

100 Million Confirmed Cases

‘My Son Asks If I’ll Come Home’

Weeks after the event, health officials reported that there have been more than 100 million confirmed and formally diagnosed cases of COVID-19 by the last week in Dec. Officials warned that the number of Americans who actually had the virus since the beginning of the pandemic is likely twice as high.

CNBC reported that “Covid-19 has easily infected more than 200 million in the U.S. alone since the beginning of the pandemic — some people more than once.”

“I have long COVID now and my life will never be the same,” said

“We lost patients, we lost loved ones, we lost colleagues,” said NY-Presbyterian ICU nurse Lori Wagner, RN. “We also lost time that we’ll never get back again. I have a child who is immuno-compromised and has asthma. I couldn’t go home for two months because I couldn’t risk bringing COVID home to my child. I was sleeping in a dorm room alone every night during that time, working 16-hour shifts, 7 days a week, knowing no matter how much we did, it would never be enough and patients would still die. To this day, my son will ask me

NYSNA Nurses at NewYork-Presby remember their fallen colleagues and friends.

when I leave for work if I’m going to come back home.”

Worst Public Health Crisis of Our Lifetime “We are experiencing the worst public health crisis of our lifetime, and with that comes selfless sacrifices from our City’s frontline workers, especially our nurses,” said New York City Council Member and Health Chair Lynn Schulman (29th Council District, Queens). “As we commemorate those we lost and honor their memory, we need to do everything possible to support and protect our current frontline workers and make sure they have the resources needed to work in a safe and healthy environment.”

“After almost three years of Covid, we are facing a hospital staffing crisis that if left unresolved will lead to worse care and patient outcomes, especially for the most vulnerable New Yorkers,” said Manhattan Borough President Mark Levine.

“It is imperative that NewYorkPresbyterian come to the bargaining table with an offer for nurses that honors their worth and keeps them safe. The only way to survive this pandemic and prepare for the next one is by fully staffing our hospitals — that means NYP must provide wages and conditions that make nursing positions sustainable for the heroes who accept them.”

“The only way to survive this pandemic and prepare for the next one is by fully staffing our hospitals.”

SOURCES https://www.cnbc.com/2022/12/28/ us-records-100-million-covid-casesbut-more-than-200-million-americanshave-probably-had-it.html

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Around our union

New York Nurse december 22/January 23

NYSNA Nurses at Northwell Health Win Contract Victories

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YSNA nurses at two Northwell Health’s Long Island hospitals have been fighting for a fair contract for over a year. They recently won a tentative agreement that will help recruit and retain the nurses needed

for safer patient care. Nurses at Plainview Hospital ratified their contract in mid-December. Nurses at Syosset Hospital ratified their contract on Dec. 23.

Power concedes nothing without a demand and these nurses know

this well. The breakthrough came after a year of negotiations and actions, including informational pickets and a march on the boss at Northwell Health’s corporate office. Congratulations Plainview and Syosset nurses.

Erie County Medical Center Nurses March on the Boss

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rie County Medical Center (ECMC) nurses went on a march on the boss tour to speak to management about a staffing plan in the comprehensive psychiatric emergency program units. They spoke to the behavioral vice president, human resources, director of nursing and the CEO, who all gave no answer and no plan on how to support nurses. The CEO directed hospital police to remove nurses from his office on the third floor.

NYSNA nurses captured the conversations with management on video and shared it on TikTok, where it has amassed widespread solidarity online and featured in ABC Buffalo. Now the state health department will investigate staffing concerns at the ECMC psychiatric emergency units.

The march was part of a series of actions as nurses bargain with management. Nurses are emboldened by the support and are ready to do whatever it takes to demand safe staffing in their units.

NYSNA nurses at Plainview (left) and Syosset (right) hospitals urge better healthcare and benefits.

Nurses and Labor Allies Applaud Bill for Legislation to Hospital Price Transparency Prevent Medical Debt Garnishment ew York City Councilmem- Presbyterian tops the list for havber Julie Menin, NYSNA ing the biggest difference between Signed into Law and our allies in the Coalitax dollars taken and money spent

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tion for Affordable Hospitals recently announced the introduction of the Healthcare Accountability and Consumer Protection Act. If passed, this bill will create a firstin-the-nation Office of Healthcare Accountability to protect patients from unfair hospital pricing. The bill comes after the Lown Institute released a report showing that nine New York City hospitals took more than $727 million more in tax breaks than they spent on our members’ communities. NewYork-

on community benefits. NYSNA Executive Director Pat Kane, RN (below, center), spoke out at the press conference on the steps of City Hall announcing the legislation. She said, “Some hospital executives have been more focused on maximizing their profits, while our members experienced sickness and trauma. We won’t let these profit-driven hospitals win. We will win for nurses and working people across NYC.”

NYSNA nurses, led by Executive Director Pat Kane, RN, (at mic) urge hospital accountability to protect paients.

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t some point or another, we will all need medical attention. Needing medical assistance should not increase the likelihood of financial ruin. But for too many people, medical debt, and aggressive debt collection practices, has ruined their financial health, stolen their peace, and decreased their quality of life.

That’s why NYSNA was elated when Gov. Kathy Hochul signed legislation to prevent hospitals from garnishing patients’ wages and placing liens on homes because of medical debt. This victory came shortly after patients, advocates and local leaders in Brooklyn testified on their own experiences at a forum hosted by our friends at Citizen Action.

This victory is a huge step for healthcare justice in New York, and NYSNA is proud to work in coalition with community groups including Community Service Society of New York and Citizen Action. To learn more about the statewide campaign to end medical debt, reach out to NYSNA’s Political and Community Organizing team.

NEW YORK NURSE

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december 22/January 23

Nurses Fight Back Against Cuts to Healthcare and Sick Leave, Speak Out for Safe Staffing & Its Impact on Vulnerable Seniors

When We Fight, We Win Continued from page 2

ew York City should push hosN pitals to increase tuition support, mentorships, apprenticeships and other programs to address racial and social inequities and recruit local youths to work in its hospitals. l Most importantly, hospitals need to listen to and respect their nurses.

History has taught us that many hospital systems won’t automatically do what is right. They need oversight. They need accountability.

And they need to be mandated to do what is right for nurses, patients and the broader community. l

Ozanam nurses participate in informational picket

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embers of the New York State Nurses Association at Ozanam Hall of Queens Nursing Home held an informational picket outside the nursing home on Dec. 13. The picket comes after nearly eight months of contract negotiations and calls for a fair contract that includes safe staffing ratios, strong retention policies, and good healthcare benefits.

Nurses called attention to the dangers of mandated overtime at their facility and the harm mandated overtime has on residents.

Nurses highlighted how they are

pushed to work for 16 hours straight on a regular basis.

In the wake of many Ozanam nurses falling ill during the COVID-19 pandemic, management proposed reductions and restrictions in nurses’ sick leave. Ozanam administration also proposed reductions in nurses’ health benefits and increased costs to nurses.

NYSNA members spoke out about why good benefits are essential to them as well as residents.

“Nurses faced severe staffing and PPE shortages through the COVID-19 pandemic,” said local

NYSNA president at Ozanam Hall of Queens Nursing Home Sabrina Adonus, RN. “Many of us fell ill and lost loved ones. Today we still have too few nurses pushed to work too many hours to provide care for our residents. Ozanam management refuses to listen to the nurses about safe staffing, and they want to limit our sick time and healthcare benefits and increase our costs. We need Ozanam Health to negotiate a fair contract that includes the safe staffing and healthcare benefits we need to provide quality care.”

NYSNA Honored at Labor Press Awards Dinner

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YSNA nurses attended Labor Press’ annual Labor Leaders Award Reception on Dec. 2. The labor publication honored those who have fought tirelessly for their members, including NYSNA Director at Large Michelle Jones, RN, MSN, ANPC, of Flushing Hospital Medical Center. Aretha Morgan, RN, MSN, a NYSNA Southern Regional Director, presented the award to Jones, stating that, “Ms. Jones has been a fierce advocate for safe working conditions and an active community member.”

Jones was the only woman to receive an award at the reception.

“NYSNA members are patient advocates,” said Jones. “We work at hospitals, clinics, long-term facilities, schools, homes, and even jails.

NYSNA nurses recognized during Labor Notes awards ceremony.

We are nurses, advanced practice nurses, respiratory therapists, pharmacists, and more.” Ensuring quality care for patient care is of the utmost importance, Jones added as she

asked union members from other unions to support her union’s efforts to improve the healthcare system throughout New York and support nurses in their fight for fair contracts.

Choose Something Different At the New York City Council oversight hearing, more than a dozen New York City nurses from throughout the five boroughs spoke about the working conditions, understaffing and potential healthcare cuts that could further cripple the public health system. This is not a function of chance; it is a matter of choice. And healthcare employers have the potential to choose something different.

And if they continue down the current path, 17,000 nurses at 12 New York City hospitals will continue to rise up and demand change. They have contracts that expired on Dec. 31 and will do whatever it takes to improve the lives of their colleagues, families, patients and communities.

NEW YORK NURSE

Non-Profit US Postage Paid NYSNA

december 2022 / January 2023

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

INSIDE

WE ARE NURSES

& We Demand Health Equity Patient Care Alert, p. 5

In honor of Dr. Martin Luther King, Jr. and the ongoing struggle for civil rights and healthcare justice, NYSNA NYC H+H/Mayorals nurses are marching on H+H headquarters to demand that nurses, our patients, and our communities are treated like we matter. We are essential, yet we are understaffed, under resourced, and underpaid. We are rising up to demand a fair contract with pay equity for nurses and health equity for our patients and communities.

Speak-out & March on the Boss WHEN: January 18 at 11:30 AM WHERE: 55 Water St., Manhattan WHAT:

I AM A NURSE

RSVP

bit.ly/iAmANurse

For more information, contact your Rep or Henry.rose@nysna.org or 917-843-8022

COVID-19 Vigil, p. 9