NY Nurse, March 2021

nurse New York

New york state edition | march 2021

Safe staffing speakouts across New York, pp. 4-5, 7 Women’s History Month, p. 12

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New York Nurse march 2021

Women hold up half the sky

By Judy SheridanGonzalez, RN NYSNA President

Advocating for patients. Advancing the profession.SM Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP judy.sheridan-gonzalez@nysna.org First Vice President Anthony Ciampa, RN anthony.ciampa@nysna.org

FACTS: In New York, even with fewer genderrestrictive patterns of employment, 94% of nurses are female. The wage gap between men and women averages 80%. Women overwhelmingly occupy the bulk of no-benefit part time jobs when compared to men. Nationally, 1 in 3 women experienced physical violence by an intimate partner, with 29 million having

suffered severe physical assault by a significant other.

And yet, women continue to carry the bulk of family responsibilities: raising children, cooking, cleaning, arranging for health care and activities for the family. Women dominate, in huge numbers, school, community and other volunteer work in agencies designed to assist others.

In 1911, a tragic fire, due to corporate greed and worker oppression, resulted in 146 deaths—most of them immigrant girls. This led to the affirmation of March 8 as International Working Women’s Day, commemorating these labor struggles around working conditions, health and safety and fairness. Laws were passed, regulations were established and the struggle for workers’ and women’s rights continues to this day.

Three of the 146 workers killed in the Triangle Fire, 1911

Second Vice President Karine M. Raymond, RN, MSN karine.raymond@nysna.org

Why do women give so much, yet remain unprotected?

Why are our struggles so challenging, yet unsupported?

Secretary Tracey Kavanagh, RN, BSN tracey.kavanagh@nysna.org

Why do women work so hard, yet remain unrecognized?

Treasurer Nancy Hagans, RN nancy.hagans@nysna.org Directors at Large Anne Bové, RN, MSN, BC, CCRN, ANP anne.bove@nysna.org Judith Cutchin, RN judith.cutchin@nysna.org Jacqueline Gilbert, RN jackie.gilbert@nysna.org Robin Krinsky, RN robin.krinsky@nysna.org

Dollar Store Strike, Chinese Ladies Garment Workers , 1938

Women have always been the backbone of battles in labor, in health care and for dignity and justice.

The silence about the contributions—and hardships— of women in our society generated the need for a special women’s history month: celebrated in March of each year.

What has substantially changed over the years? Do we still face hazards on the job?

2,900 Health Care Workers Dead from COVID-19 2020

Lilia V. Marquez, RN lilia.marquez@nysna.org Nella Pineda-Marcon, RN, BC nella.pineda-marcon@nysna.org Verginia Stewart, RN verginia.stewart@nysna.org Marva Wade, RN marva.wade@nysna.org Vacant Regional Directors Southeastern Yasmine Beausejour, RN yasmine.beausejour@nysna.org

Bread and Roses march, Lawrence Textile Strike, 1912

The struggle for adequate PPE & ventilation, 2020

Nurses organizing for a union, 1940s

Nurses organizing for a first contract, 2020

Southern Sean Petty, RN sean.petty@nysna.org Central Marion Enright, RN marion.enright@nysna.org Lower Hudson/NJ Jayne Cammisa, RN, BSN jayne.cammisa@nysna.org Western Chiqkena Collins, RN chiqkena.collins@nysna.org Eastern Vacant 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 ©2020, All rights reserved

“We can throw our pebble in the pond and be confident that it’s ever widening circle will reach around the world.”

– Dorothy Day, Influenza Epidemic Nurse,1918, co-founder, Catholic Workers Movement

NEW YORK NURSE march 2021

At the heart of New York

D

uring this month, we look back at a year of grave consequences.

It is the one year anniversary of COVID-19 here in New York City, the epicenter of the epicenter, a designation as somber as any could be.

Our experience was not unique.

Hospitals across the state endured similar fates: very sick patients and overwhelmed nurses, doctors and other caregivers.

To say our members went to work every day knowing the COVID conditions were unchanged, putting yourselves in harm’s deadly way, fearing the consequences of going home after your shift with the dreaded worry of infecting family, and that you continue to work with many of these conditions, just begins to tell your story of fighting one of the worst pandemics in world history.

Holding it together You have been at the heart of holding New York together. We simply would not have survived without your determination to give care at any cost.

Without your commitment to patients, families and community, the toll of death and sickness would be far greater. As it is, these numbers are massive. Still, you helped save more than 150,000 New Yorkers, and that number goes up with every patient on every shift.

Only you understand fully the extraordinary role you have played in treating patients afflicted with the virus, and the daily experience of dealing with death day after day.

Here are stories of NYSNA mem-

Aja Sciortino, RN

By Pat Kane, RN NYSNA Executive Director

Sandra Armstrong, RN

Fred Durocher, RN

bers, like you, thrust into COVID care at the height of the nightmare last year.

Aja Sciortino, RN, works in the Peds ICU at Westchester Medical Center, a public facility that takes patients in large numbers from surrounding counties. Aja has worked at WMC for seven years. When the COVID-19 struck, she was floated to adult units. Understaffing was serious. “It was rough,” she recounts. Nurses “felt very worndown.” The attention each COVID patient required was extensive.

“We spent hours with patients.”

Often she stayed hours past the shift change, working close to midnight.

The “burn out” was very real and some senior nurses left, she recalls, without any animosity. Her commitment to fighting the virus never wavered.

Sandra. “The patients had no one to console them. It’s so sad that they died alone.”

The understaffing was unrelenting, adding to the frenzy many of you faced every day.

Staffing the ER when COVID hit, ER nurse Kelley Cabrera of Jacobi Medical Center in the Bronx knew that frenzy well “When I reflect on the last year, I feel tremendous pride for all the work we did at Jacobi,” she recalls. “Despite all the loss, the grief, and the frustration, we continued to fight for improved working conditions. Nothing got in the way of us coming to work and caring for our patients. And at the end of the day, that’s what it’s all about. I am proud to be a Jacobi nurse and work alongside such brave and incredible nurses who will always fight for a just and equitable system for all,” says Kelley.

For Fred Durocher, a nurse for 25 years at Ellis Hospital in Schenectady, he still remembers arriving for his ER shift in midMarch, one year ago. “We didn’t know what to expect, this COVID pandemic was turning everything upside down. I was amazed to see experienced ER nurses ‘shaken’ after a particularly critical patient.

“To see these ER nurses in that condition, with every day bringing something new, and practices we had for years, all changing daily—I never experienced anything like it.”

Like all nurses, Fred wore a mask meant to be disposed of, only to be told that the N-95s were then sent in paper bags to be ‘cleansed.’ “This year was something I will never forget and will always be proud for all my fellow nurses being on the frontline.”

Conquering fear Sandra Armstrong, RN, has given 32 years to patient care, 27 of those at Long Island Jewish Valley Stream / Northwell. An orthopedic/general surgery OR nurse, Sandra was floated to a MedSurg floor when the virus swept into the hospital.

She recalls a “fear of the unknown,” in and of itself a source of terrible stress. Understaffing was very bad. She was feeding and bathing patients.

This was the very stark reality for patients: “some did not make it.”

The patient death toll was high.

There was a common refrain from nurses and healthcare workers present during the worst of the pandemic, never having before experienced patient deaths mounting so fast in such large numbers.

“I cried when I got home,” says

Kelley Cabrera, RN

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Nurses speak out for safe

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he call for safe staffing is gaining volume as the COVID-19 pandemic underscores the essential role nurses play in fighting this deadly disease.

On March 16, NYSNA members rallied for a Day of Action to commemorate the one year anniversary of New York City’s lockdown during COVID-19, adding to the momentum. Speak-outs were held at New York-Presbyterian and Mount Sinai hospitals.

“When COVID hit, nurses were overwhelmed. Some got sick, some quit and some retired,” said Melissa Balogh, RN, NYPresbyterian, Infectious Disease MedSurg Unit. “We continue to serve a high number of COVID patients and in the midst of all this hospital administrators instituted a hiring freeze, causing us to work with even less staff, ultimately reducing the quality of care our patients deserve.”

Understaffing is a crisis Christina Hilo, RN of NYP-Brooklyn Methodist

The understaffing crisis is not new, and could have been prevented.

Nurses have warned for years that safe staffing standards are necessary to protect patients and nurses.

A report by Attorney General Letitia James on New York’s nursing homes, along with a safe staffing study about New York co-authored by Linda Aiken, RN, PhD [see pp 10-11], are the latest evidence that connects safe staffing to positive patient outcomes. The central finding and core recommendation in the AG’s report: poor

NYP-Columbia nurses

NYC Councilwoman Carlina Rivera, chair of the NYC Council’s Hospitals Committee, speaking at Mount Sinai in support of safe staffing.

staffing was a major factor in the high death toll in nursing homes; New York must enact enforceable, minimum staffing standards, or hours of care per resident.

Safe staffing momentum Since the report’s release, safe staffing legislation has gained even more attention and public support.

NYSNA nurses and supporters are calling on New York state lawmakers to pass the Safe Staffing for Quality Care Act. NYSNA now counts 1,600 staffing captains who are tracking understaffing at their respective facilities. In addition, NYSNA nurses are speaking out publicly across the state in growing numbers, urging lawmakers to take action.

On February 17, nurses kicked off demonstrations at Montefiore New Rochelle. They were joined by dozens of nurses and health-

care workers from hospitals in the region and by community and elected leaders, who rallied to raise awareness of the effects understaffing has had on patient safety during the COVID-19 pandemic.

“I am exhausted, but I keep on fighting because I want to make sure the next generation of nurses is better off. I look for creative solutions when we’re understaffed, so that one person doesn’t get overwhelmed and burned out,” said Marcia Hayles, RN, a veteran nurse at Montefiore New Rochelle Schaeffer Long-Term Care facility. “And I keep demanding that Montefiore deliver the resources and safe staffing to make sure every patient receives high quality care.”

Shortage continues In long-term care units, the number of patients has decreased since the height of the second COVID surge, but some units continue to be short-staffed, especially when nurses become sick. Ignoring warnings, Montefiore continues to put profits before patients, investing $292 million in the wealthier and whiter Montefiore White Plains facility.

On February 23, NYSNA members took their campaign to Brooklyn and Long Island, rallying in front of NewYork-Presbyterian Brooklyn Methodist Hospital and St. Charles Hospital, where staffing shortages have reached near-crisis levels. For the past year, NYPBrooklyn has failed to properly staff units and has shuttered less

NEW YORK NURSE march 2021

staffing across New York profitable units, such as pediatric and psychiatry, closed early in the pandemic. From August 2020 to January 2021, 100 nurses left the hospital and only 14 new nurses were hired to replace them.

Not out of the woods Nurses know they’re not out of the woods yet. COVID variants are emerging and new COVID cases have not declined in NYC as quickly as in other regions in the state.

Speaking before nurses and other supporters, Diane Bonet, pediatric RN, NYP Brooklyn Methodist, said, “They use COVID as an excuse to under-staff throughout the whole hospital. They use the pandemic as an excuse to throw nurses into new specialties without the necessary training.”

Tracy Kosciuk, RN, St. Charles, spoke to the moral necessity of safe staffing: “Our healthcare system has lost sight of the individual person, and the only way we can get that back is for New York State to pass legislation for safe staffing.

We want to give our patients the quantity of time and the quality of time. Anything less is unacceptable. We see our own mortality.

We want to do everything we can to bring our patients back home to their families.”

Tammy Miller, RN, of St. Catherine of Siena Medical Center spoke out with St. Charles nurses.

staffing is now our daily staffing and in the meantime we have everincreasing responsibilities.”

Since these actions, more evidence of safe staffing practices connected to positive patient outcomes has emerged. NYSNA members from Olean General Hospital reported that 753 POAs signed by 2,820 nurses have been filed in the past two years.

ECMC for safe staffing Erie County Medical Center NYSNA members came out strong to show administrators, lawmakers, and Western NY that healthcare workers need safe staffing to ensure safe working conditions and patient safety. “We have put these people in positions of power to help us, not to get into power to forget about us. We feel like we have been forgotten. We feel like our patients have been forgotten,” said NYSNA Board member and ECMC nurse Kena Collins, reflecting on the role of elected officials.

Steve Bailey, RN, Terrace View Long Term Care, pointed to the critically dangerous shift in ECMC’s staffing. “What used to be minimum staffing is now our ideal staffing,” he said. “What used to be minimum staffing is now our daily staffing. What used to be panic

Erie County Medical Center nurses

In addition, lawmakers have voiced support for safe staffing legislation.

Over 100 elected officials and community allies have joined the fight.

There’s never been a more pressing time to pass safe staffing legislation in New York. And NYSNA nurses will continue to make their voices heard, urging lawmakers to take action and staff hospitals to provide the highest quality patient care.

Over 100 elected officials and community allies have joined the fight.

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In the words of Judith Cutchin, RN NYSNA Board Member Judith Cutchin, RN, President of NYSNA’s NYCH+H/Mayoral Executive Council, testified before the Joint Assembly and Senate Hearing on the Fiscal Year 2022 Executive Budget: Health, on February 25. Below are excerpts of that testimony.

“We need bold action to increase spending, mandate minimum staffing standards, and target extra funding to the safety net.”

I

want to focus on three critical issues in my testimony today.

First, we think it is outrageous that the budget is considering hundreds of millions in cuts to hospitals and other health services in the middle of an ongoing pandemic.

We should not be cutting—we should be increasing funding to build up our public health infrastructure to deal with COVID and future health emergencies.

In addition, we should be expanding funding for hospitals and other providers in the front line fight against the pandemic.

We should also be providing more funding for Medicaid and to cover uninsured people, including undocumented workers.

Second, we should be implementing minimum staffing standards to all hospitals and nursing homes.

In my hospital [Woodhull Hospital] we saw firsthand that

Judith Cutchin, RN

Judith Cutchin, RN, speaking at an H+H annual meeting on June 7, 2017.

Austerity: Race, Class, Public Health & Policy On February 24, NYSNA hosted a panel discussion of the deadly roots and cost of austerity. Panelist were asked, what must be done to create a more just and equal society?

(L-R) Panelists were Professor Gloria J. BrowneMarshal, Constitutional scholar at CUNY John Jay College; Dr. Michael C. Dawson, University of Chicago political scientist; and Professor Steven Pitts, economist, UC Berkeley.

Author and scholar Bill Fletcher, Jr., (at right) moderated the discussion.

Judith Cutchin, RN, giving virtual testimony

we did not have enough staff to provide the care that patients needed and this contributed to higher death tolls in all of our hospitals and, as noted by the Attorney General in our nursing homes.

Establishing minimum staffing standards is also vital to addressing racial and economic disparities in care. Richly funded private hospitals had more staffing (and PPE and other equipment) than our public and private safety net hospitals.

These disparities had a devastating impact on the communities of color and low income patients that safety net hospitals serve.

Minimum staffing standards are a first step toward addressing inequities in health care.

Finally, we have to provide increased funding for Enhanced Safety Net hospitals and other safety net hospitals. We should be increasing ICP/DSH funding for these hospitals and increasing their Medicaid reimbursement rate to reflect their disproportionate share of these patients.

Now is not the time for business as usual in addressing our health care budget gaps.

We need bold action to increase spending, mandate minimum staffing standards, and target extra funding to the safety net. Instead of cutting costs, the budget must be balanced and vital social service spending must be increased by raising taxes on the wealthiest New Yorkers, Wall Street interests, and the corporations that have gotten richer during the crisis.

The legislature needs to rise to the occasion—we are in a serious crisis and we need act like it.

Thank you.

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Nurses and community unite for equitable healthcare in Westchester

T

he fight to Save and Transform Mount Vernon Hospital is alive and well.

And so is the fight to make sure all communities, particularly low-income communities and communities of color, have access to the quality healthcare they deserve.

On March 12, dozens of NYSNA members, labor, community and elected officials gathered on the steps of Mount Vernon City Hall to release a new report about healthcare inequality and to demand greater transparency and accountability.

A new look at racism as a public health crisis Patient advocates from Mount Vernon and New Rochelle spoke out about how Montefiore Health System’s expansion into Westchester County and its disparate investment in communities has had a negative impact on healthcare access and community health in the region.

The report, Unequal Empire: How Montefiore’s Expansion Reinforces Racial Disparities in Healthcare, finds that Montefiore is not adequately serving the healthcare needs of all the communities it is supposed to serve in Westchester County. It examines data, including demographics, health outcomes, preventable hospitalizations, premature deaths, and emergency department wait times for three

communities where Montefiore has recently acquired hospitals: Mount Vernon, New Rochelle, and White Plains — and finds wide disparities.

Speaking out for healthcare justice NYSNA President Judy SheridanGonzalez, RN, said: “Both hospital systems and policymakers must do more to end racial disparities in healthcare. Allowing hospitals to prioritize profits over patient care has dire impacts on the health of our communities, particularly low-income communities and communities of color. We need greater oversight to ensure equitable, quality healthcare for all.”

Nurses were joined by members of the Save and Transform Mount Vernon Coalition, Reverend Dr. Stephen W. Pogue of Greater Centennial A.M.E. Zion Church, Mayor Shawyn Patterson-Howard, Mount Vernon Council Member Delia Farquharson, Westchester County Legislator David Tubiolo, Westchester County Legislator Tyrae Woodson-Samuels, Office of Congress Member Jamaal Bowman, New Rochelle Alliance for Justice (NRAJ), Commission on the Public’s Health System (CPHS), New York State Alliance for Retired Americans, Doctors Council SEIU, CIR SEIU, CSEA, Teamsters Local 456, and Firefighters Local 628.

Many speakers echoed Mount Vernon nurse RN Bernetta Urquhart’s assessment of Montefiore’s lack of investment in quality healthcare in Mount Vernon and New Rochelle: “NONSENSE!” Urquhart said, “We know that Montefiore’s plan to close this hospital will harm this community.

Mount Vernon is a majority Black city. The closure of our ICU and our hospital is dangerous, and it is racist. Every patient deserves quality care — regardless of their zip code!”

Solutions and next steps The report includes several recommendations to increase equity and promote healthcare justice.

Solutions include: increased investment from Montefiore; a moratorium on hospital cuts, closures and expansions; transparency and accountability when public subsidies are given to private corporations; the release of COVID data critical to understanding hospitals’ response; legislation to establish statewide safe staffing standards; and an investigation into how Montefiore has allotted resources to the communities it serves.

Advocates pledged to continue fighting for more information, more healthcare access, and more quality care for all communities for as long as it takes.

Bernetta Urquhart, RN, speaks out demanding racial justice and for Montefiore to DO MORE!

Read the report The report is available online at www.SaveMVH.org and the report launch event was livestreamed on www.facebook.com/nynurses.

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Evidence mounts for safe staffing or several decades, one nurse has distinguished herself in the discipline of safe staffing for hospital nurses. Since the 1990s, Linda Aiken, PhD, RN, and colleagues have produced numerous studies on RN staffing. These studies are considered the gold standard for the nursing profession.

Aiken is the founding director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing. The Center has received the top research awards from the National Academy of Medicine and the Joint Commission that accredits hospitals, among others.

Since the early 1990s, RNs reported that there were not enough nurses in hospitals to provide high-quality, safe care to patients. These studies, discussed below, validate the hospital RN experience, including Aikens’ most recent findings in New York.

This past year Linda Aiken and her team released two “peer reviewed” studies. Both drew upon survey data. The first surveyed nurses and patients in New York and Illinois from December 2019 to February 2020 and was published

in Open Access under the title, “Chronic hospital nurse understaffing: an observational study” (August 8, 2020). The second survey results ran in the American Journal of Infection Control, titled “Evaluation of hospital nurse-to-patient staffing ratios and sepsis bundles on patient outcomes.” (December 9, 2020) The latter contained this result: “Each additional patient per nurse is associated with 12% higher odds of in-hospital mortality, 7% higher odds of 60-day mortality [and] 7% higher odds of 60-day readmission….” (p.1) NYSNA, like other unions, associations and organizations whose members’ work is in a scientific field, often refers to “peerreviewed” studies in the process of upholding the legitimacy and accuracy of data and conclusions in a study. Peer reviewed has the force of law and may be introduced in a court as irrefutable evidence.

Before New York: Aiken’s peer reviewed studies Previous Aiken research demonstrated the validity of nurse reports,including hospital mor-

Linda Aiken, PhD, RN

Members and supporters at Montefiore New Rochelle Hospital

tality outcomes. In California in 2010, looking back at nurse-topatient ratios six years after the implementation of its ratio law, the conclusion was that hospital nurse staffing ratios led to lower patient mortality and better nurse retention.

Reflecting on the California law, Aiken said, “One of the best natural experiments occurred when California enacted mandated nurse-to-patient ratios. When implemented on January 1, 2004, the hospitals that were not in compliance with the staffing ratios had to change on that day and they did it. Our research has shown that staffing did change — even in safety net hospitals, which have been very difficult to get to change on hospital nurse staffing…. Almost 15 years later, California still has the best nursing-staffed hospitals in the country. The state has seen steeper declines in mortality and improvements in other indicators than other states.” (National Nurses United, “Learning from the California Experience,” 2018) Aiken’s study of California RN ratios found that when the ratios were applied to other states results were dramatic. New Jersey hospitals, for example, would have 14% fewer deaths and Pennsylvania 11% fewer if they matched California 1:5 ratios in surgical units.

NEW YORK NURSE march 2021

This lead to some revisions in New Jersey’s staffing laws.

In August 2020, a paper coauthored by Aiken was the basis of a report in the American Journal of Infection Control. It looked at staffing ratios and incidence of sepsis between December 2019 and February 2020 in 116 hospitals (including in New York). The data show an average MedSurg patient-to-nurse ratio to be 6.3:1.

The study found: “[T]he average hospital provides appropriate sepsis care only to a little more than half of patients. … In this study, we find that every additional patient in a nurses’ workload is associated with higher odds of death, as well as higher odds of readmission and longer lengths of stay….” (AJIC, August 2020, p. 5)

Staffing in the time of COVID At the onset of the pandemic, Aiken and her colleagues proved prescient about hospital conditions in Illinois and New York. They began gathering data on staffing in January and February 2020, surveying all registered nurses licensed in the two states. In New York, the result was an aggregation of average staffing in 116 hospitals across the state, where Aiken linked nurse reports to outcome records of 418,000 Medicare patients treated in these same hospitals.

The conclusions appeared in a published paper, “Chronic hospital nurse understaffing meets COVID-19: an observational study.” (August, 2020) The main purpose of the study, the authors state, was “to provide relevant evidence to inform hospital nurse staffing legislation… in the two states.”

(Open Access, p. 1; also reported in LDI Research, August, 2020) The paper’s discussion of New York conforms to experiences NYSNA nurses have had and shared at meetings. “In the weeks before the surge, … hospital nurses in NY and IL were already struggling with high patient workloads and frequent operational failures including missing supplies and missing or broken equipment,” the study found. “Patient-to-nurse ratios ranged considerably across hospitals in both states from means of 3.3 to 9.7 in adult medicalsurgical units. Half of nurses were experiencing high burnout, and one

Members speak out at Mount Vernon Montefiore Hospital

in four planned to leave their job within a year.” (Open Access, p. 5) Aiken and her co-authors concluded: “Hospital nurses were burned out and working in understaffed conditions in the weeks prior to the first wave of COVID-19, posing risks to the public’s health.” They added, “[C]hronic nurse understaffing has persisted in a significant share of US hospitals for decades, and poses significant risk to patients even without the presence of a pandemic.” (Open Access, pp. 1, 7)

The New York Study In her most recent publication, Aiken looks squarely at New York and nursing practices in the state.

The article in the journal, Medical Care, is entitled, “Is Hospital Nurse Staffing Legislation in the Public’s Interest?” and was released in February, 2021. In it, Aiken utilizes hospital Medicare data gathered from the years 2017-2018.

The article lays out a history of New York’s Safe Staffing for Quality Care Act and explains the sources of her data, from a total of 417,861 MedSurg patient claims from all parts of the state submitted to Medicare. (“It is likely,” she notes, “that the staffing data collected in 2019-2020 closely resembles staffing in 2017-2018.”)

Aiken’s testimony at the New York Joint Legislative Budget Hearing on February 25 included these remarks: “We found that each patient reduction in nurses’

workloads was associated with a 13% decrease in patient deaths for elderly patients hospitalized with common surgical and medical conditions.” (p. 2, emphasis in original) Aiken findings showed that, on average, hospital nurse staffing ratios in hospitals across NY state were 6.3:1 patients per nurse. In NYC, that average was 6.9:1 patients per nurse. These ratios were brought out in previous studies in other states where poor patient care and high mortality were observed.

Saving lives and costs Among the most significant conclusion in Aikens’ recent paper is this startling fact: If NY hospitals had staffed medical-surgical nurses at the 1:4 ratio as proposed in the current legislation, “We project there would have been 4,370 fewer in-hospital deaths in the 2-year period among Medicare patients,” writes Aiken. With regard to costs, Aiken provides, “With roughly 388,160 fewer hospital days annually, we project $658 million in cost savings to hospitals annually from shortened lengths of stay.”

She concludes: “These estimates are produced by only about 25% of the Medicare hospitalizations in NY, so the actual savings when applied to all inpatients — both Medicare and non-Medicare — would likely be many-fold higher.” (p. 5) Safe Staffing Saves Lives!

“We project there would have been 4,370 fewer inhospital deaths in the 2-year period among Medicare patients.”

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A Celebration of Women’s History Month On March 7, NYSNA Treasurer Nancy Hagans, RN, spoke at the site of the Triangle Shirtwaist Factory in NYC to commemorate International Women’s Day. It was 110 years this month when, on March 25, 1911, 146 people died in the Factory fire, including 123 women and girls. Below are excerpts of her speech.

Happy International Women’s Day!

“Women, in particular Black women, should not have to live with the reality, that in the United States, they are more likely to die giving birth than in any other developed country.”

–Nancy Hagans, RN

I

have worked on the frontlines at Maimonides Medical Center in Brooklyn for the past 23 years. I am Treasurer of the New York State Nurses Association, the largest nurses union in NY State.

Let’s hear it for all the women frontline workers! Let’s hear it for all the immigrant women!

I emigrated from Haiti to Brooklyn when I was 10. I was the third of 10 children and was always taking care of my younger siblings.

I’ve always wanted to take care of people. One of the strengths of being a woman is that we know how to care for others, but not only that, we know how to care about others. And we raise and mentor young women to become strong leaders, leaders that care and know their value in this world. I cannot be prouder of my two teen daughters and the strong women they are becoming.

The constant attacks on women’s health issues have got to stop!

Reproductive freedom should never be up for debate. Our bodies, our choice! Women, in particular Black women, should not have to live with the reality, that in the United States, they are more likely to die giving birth than in any other developed country. Black women are tired of not being listened to when they say they are sick and in pain. All too often we are not listened to and shooed off as being hysterical or exaggerating. This has led to senseless deaths and health outcomes. Women are fed up with being taxed just because of our gender. The predatory Pink Tax which taxes female hygiene products has got to go. Enough is enough!

Women workers are critical to making the world function and we must support women workers.

Women consistently earn less than men for equal work, 81 cents to every dollar, and this gap widens when you are a woman of color.

The more we can organize, the

Nancy Hagans, RN, NYSNA Treasurer

better off women will be. Unions can help to narrow the wage gap, but this is not enough, we must demand that the Equal Rights Amendment be finally ratified.

Additionally, Congress should not delay passage of the Paycheck Fairness Act. This has been a really difficult year. We’ve lost over 2.5 million people worldwide to COVID-19.

Many of these people were our mothers, sisters, daughters, mentors, colleagues and friends: so many amazing women lost in the blink of an eye. Such a loss of knowledge, wisdom and strength.

We know that we will never forget these beautiful souls. Instead we will incorporate their legacies into our own and fight that much harder for true equality for all women.

We need to be supported. We need to be heard. We won’t stop at anything less!

Woman in history

hood, old age or other lack of livelihood in circumstances beyond his control,” Article 25 states.

Eleanor Roosevelt — Standard bearer for Universal Health Care

Shaped by international influences, Article 25 has uniquely American roots as well, in the call by the Progressive Party Platform of 1912 for a social insurance system, in FDR’s proposed Second Bill of Rights, including “The right to adequate medical care and the opportunity to achieve and enjoy good health …”

On December 10, 1948, Eleanor Roosevelt gave the world a great and enduring gift — the Universal Declaration of Human Rights (UDHR). Made up of thirty short articles, the longest of which is five sentences, the Declaration is eloquent in its brevity, listing simply and clearly the rights to which we are all entitled as human beings, including the right to healthcare.

During Women’s History Month, we honor Eleanor Roosevelt and her enduring legacy immortalized in Article 25 in the UDHR in our fight for universal healthcare.

“Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widow-

But until the UDHR was drafted, the world had not come together to agree, in writing on a framework for the responsibilities to their citizens that all governments share.

Inspired by these rights, every major industrialized country in the world but one — the United States — has implemented some form of universal health care system.

We salute Eleanor Roosevelt and we stand in her shadow with Rep. Pramila Jayapal (D-WA), who this month introduced the Medicare for All Act of 2021, tweeting, “I reintroduced #MedicareForAll today because healthcare is a human right …”

PUBLIC HEALTH

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Albany NYSNA members win OSHA citations

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n a step to recognize the risk of occupational exposure to COVID-19 in the workplace, OSHA has begun a National Emphasis Program (NEP) focusing on enforcement effort to limit COVID exposure in high-hazard industries including, but not limited to, healthcare, communal living, meat processing, grocery stores, restaurants and correctional institutions.

Jim Frederick, the Principal Deputy Assistant Secretary of Labor for OSHA has stated that, “This deadly pandemic has taken a staggering toll on U.S. workers and their families. We have a moral obligation to do what we can to protect workers, especially for the many who have no other protection.”

The NEP prioritizes investigations into COVID risk in highhazard industries and employers that engage in retaliation against employees who complain about unsafe or unhealthy conditions.

As a result of the COVID-19 NEP, there will likely be more written guidance materials, more on-site inspections, additional employer citations and better follow-up on correction of hazardous conditions that employers received citations for.

The full OSHA COVID-19 National Emphasis Program can be found at https://www.osha.gov/sites/ default/files/enforcement/directives/ DIR_2021-01_CPL-03.pdf

OSHA cites Albany Medical Center Over 70,000 complaints have been filed with OSHA related to COVID-19 exposure in the workplace. Yet few on-site inspections and citations have been issued.

NYSNA has filed a number of complaints about unsafe working conditions for its members with minimal action from OSHA. However, after very aggressive follow up by union members and staff, OSHA has issued citations and fines against Albany Medical Center. According to AMC ED nurse Michele Hanna, “AMC has refused to listen to us or take proper measures to protect us during this pandemic. They do not support nurses but, even in the face of this, we have continued fighting to provide quality care.”

The OSHA citations include: l Not providing a respirator to each employee when such equipment was necessary to protect the health of the employee l Employees did not perform a

NY COVID vaccine delays

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istribution of the COVID-19 vaccine remains gridlocked in New York, impacting many communities that have suffered most from the virus. The standstill has provoked fear and frustration among medical professionals, who say it could have been avoided, and leaves already devastated neighborhoods wide open to further infection.

According to a former senior city health official, Dr. Denis Nash, the government handed over the lion’s share of vaccines to hospitals and lost control of the vaccination at the outset. “That was the bottleneck,” Dr. Nash, a CUNY epidemiology professor, said. “To

put hospitals in charge of a public health initiative — for which they have no public health mandate, or the skills, experience or perspective to manage one — was a huge mistake, and I have no doubt that’s what introduced the delays.”

By the numbers Adding to concerns about the rollout, a new CDC report found: “During the first 2.5 months of coronavirus vaccine distribution within the U.S., counties with higher levels of poverty and other indicators of socioeconomic vulnerability were inoculated at lower rates.”

As of March 21, demographic data from the New York State website showed 77.5 percent of

user seal check each time they put on a tight-fitting respirator as required under the respiratory protection standard l The employer did not ensure that employees knew how to inspect, put on, remove, use and check the seals of the respirator Fines for these citations come to over $40,000.

In response to the citations, AMC MedSurg nurse Tonia Bazel, stated, “AMC management has never taken COVID protocols seriously. OSHA has confirmed what we have been saying for months. We as nurses are doing everything we can to keep people safe and healthy without the help of our management.”

NYSNA members continue to provide information to OSHA in an effort to gain citations on other COVID-related hazards at AMC as well.

Emergency Temporary Standard At this time the only OSHA standard that directly addresses infectious disease in the workplace is the Bloodborne Pathogens Standard.

However, within the next few days or weeks, it is expected that OSHA will also be issuing an emergency temporary standard (ETS) for COVID-19. The ETS requirements will be enforceable and result in monetary penalties to employers who do not follow them. NYSNA will keep members updated on any new developments related to workplace safety as soon as possible.

white New Yorkers had received their first vaccine but only 11.9 percent of Hispanic/ Latino New Yorkers had received their first shot, 11.2 percent of Asian New Yorkers and 9.9 percent of African-American New Yorkers.

As of March 7, 2021, the last day The COVID Tracking Project at The Atlantic reported information, 352 per 100,000 Black/ African-American New Yorkers had died from COVID; 268 per 100,000 Hispanic/ Latino New Yorkers had died; 184 Asian/ Pacific Island New Yorkers; and 156 per 100,000 White New Yorkers. The Atlantic noted as well that as of the above date “New York has reported race and ethnicity data for 0 percent of cases and 88 percent of deaths.”

“OSHA has confirmed what we have been saying for months. We as nurses are doing everything we can to keep people safe and healthy without the help of our management.”

–Tonia Bazel, RN

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New York Nurse march 2021

Racist attacks on AsianAmericans and Pacific Islanders

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he killings of six Asian women in the Atlanta area this month added to the grief — and terror — Asian-Americans and Pacific Islanders are suffering nationwide, reminding us all: racism is a public health crisis.

Nurses are acutely aware of this crisis. It is visible each day across the country in Emergency Rooms and on Psych units, and in the emotional trauma of patients who have experienced this brand of verbal and/ or physical violence.

Our patients are not the only targets. As the Washington Post reported, “Some COVID-19 patients refuse to be treated by them [AsianAmerican healthcare workers]. And when doctors and nurses leave the hospital, they face increasing harassment in their daily lives, too.”

Racism has health consequences According to healthaffairs. org, “The negative health consequences for victims are numerous …

Experiences of hate are associated with poor emotional well-being such as feelings of anger, shame, and fear. Moreover, victims tend to experience poor mental health, including depression, anxiety, posttraumatic stress, and suicidal behavior. Medically, impacts include poor overall physical health, physical injury, stress, and difficulty accessing medical care.”

In the last year, in the wake of COVID-19, nearly 3,800 hate

On March 20, people gathered at Foley Square in New York City to protest the rising wave of anti-Asian violence. It was one of many rallies in the city, state and country.

incidents have been reported to “Stop AAPI Hate.” The organization counts verbal harassment and name calling, shunning or deliberate avoidance of Asian-Americans, and physical assaults as acts of bigotry and racial hatred. In New York City alone, acts of Anti-Asian violence are up 900 percent. Among the worst of these nationwide: l a woman putting the trash out in front of her Brooklyn home last April was doused with a caustic chemical; l i n July, two men in Brooklyn lit an 89-year-old woman on fire; l i n January, in San Francisco, an 84-year-old Thai man died after being assaulted; l i n Oakland’s Chinatown, a 75-year-old Asian man died after being robbed; l i n February, on a crowded street in Flushing, an elderly woman was shoved to the ground; l a nd a man of Asian descent was stabbed in Manhattan’s Chinatown.

Not all were classified officially as hate crimes. In addition, groups like AAPI believe hate crimes against Asians are chronically under-reported, especially psychological violence, like racial stereotyping and hate speech.

According to the journalist Jiayang Fan, the racially charged language surrounding COVID-19, such as “Wuhan Flu” and “Kung Flu,” have left many reeling. “To live through this period as an

Asian-American is to feel defenseless against a virus as well as a virulent strain of scapegoating. It is to be trapped in an American tragedy while being denied the legitimacy of being an American,” Fan wrote in the New Yorker.

Racism and public health As nurses, we recognize that random acts of racist violence constitute a public health crisis. We also know that structural racism is a key determinant of population health. As Nancy Krieger, Professor of Social Epidemiology and American Cancer Society Clinical Research Professor, Harvard T.H. Chan School of Public Health, has written: “Making sense of the causes of health inequities and developing meaningful steps to rectify them, however, requires addressing ‘interconnected institutions, whose linkages are historically rooted and culturally reinforced’ and ‘the totality of ways in which societies foster racial discrimination, through mutually reinforcing inequitable systems (in housing, education, employment, earnings, benefits, credit media, health care, criminal justice, and so on) that in turn reinforce discriminatory beliefs, values, and distribution of resources, which together affect the risk of adverse health outcomes.’”

This escalating national trend in racially motivated violence must be addressed with the utmost urgency.

NEW YORK NURSE

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march 2021

Celebrating Certified Nurses

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arch 19 is designated Certified Nurses Day worldwide in celebration of our colleagues with specialty, subspecialty and advanced practice certifications.

Certified nurses hold the highest credentials in their area of specialization and bring to their practice the latest advances in medicine.

NYSNA nurses staff the most prestigious medical institutions in the nation and the world. They are counted among the world’s most skilled, trusted and gifted healthcare workforces. They contribute stateof-the-art expertise to patient care and medical facilities. They hold their colleagues and healthcare insti-

tutions accountable to the highest standards of medical proficiency.

And NYSNA nurses keep their institutions abreast of the latest advances in medical technology and care.

At NYSNA, we acknowledge and honor the value of specialty, subspecialty and advanced practice certifications.

NYSNA offers free certification review to members Among the benefits for NYSNA members are dozens of free certification review courses provided

by NYSNA throughout the year.

These courses help nurses with the required years of experience to prepare for a certification exam by

identifying a study plan of action and timeline to review for the test.

NYSNA has bargained in many of our contracts for financial recognition for a certification differential and in some cases advancements on the clinical ladder. NYSNA also supports Advanced Practice Nurses through this nursing professional development program — NYS Nurse Practitioners and Midwives: Prescribing Information.

At NYSNA, we recognize March 19 as a day to celebrate the ongoing achievements of our colleagues in their areas of specialization and salute them for keeping our medical facilities up-to-date on the latest advances in healthcare.

Congrats, Michelle! Welcome Fareed!

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ongratulations to NYSNA Political Director Michelle Crentsil! The CUNY School of Labor and Urban Studies has given Michelle one of its 2021 Rising Leaders awards. “Rising Leaders — those who have demonstrated exemplary commitment to the rights of workers and working-class communities — are announced every year since 2013 as part of the School’s Joseph S. Murphy Scholarship for Diversity in Labor awards ceremony,” provides CUNY. The award is intended for women and students of color who “aspire to leadership in labor, community, and social justice organizations.”

The “2021 Diversity in Labor Scholarship Awards Ceremony” will be held on April 22 via Zoom.

Further details to come.

NYSNA Political Director Michelle Crentsil named to City & State Labor 40 under 40 City & State’s Labor 40 Under 40 highlights an impressive array of rising stars in labor — all under the age of 40 — who you might not know, but should. This list features individuals who have been on the front lines of the battle against COVID-19, who are training New Yorkers to adapt to an evolving economy, who are advocating for women and people of color.

These young leaders are taking on

Political Director Michelle Crenstil

Organizing Director Fareed Michelen

such timely causes as immigrant rights, diversity in workplace and criminal justice reform. And a number of them are running for elected office, as a way to have an even greater impact on the lives of working New Yorkers.

Worker Advisory Council. He has worked for the NYS AFL-CIO for the past 13 years building and maintaining relationships between Labor unions, allied groups, constituency groups, and community organizations. Before joining the AFL Fareed was an organizer with 1199SEIU. “During a global pandemic and economic collapse we are watching the gap between the haves and have nots widen,” Fareed explains. “The wealthiest few have the money and healthcare is denied to average working people. There is no time like now for nurses to take control of their own agency and lead the fight for equity and care at the bedside and in the community.”

NYSNA Organizing Director Fareed Michelen NYSNA welcomes Fareed Michelen as Director of Organizing. Fareed served as the Special Assistant to the SecretaryTreasurer of NYS AFL-CIO. He also served as the Assistant to the President of the International Coalition of Black Trade Unionists and was one of two Co-Chairs for the National AFL-CIO Young

FREE COURSE OFFERINGS! Nurses should go to www.nysna.org Click on Nursing Practice Click on Continuing Education Click on the "here" button under Certification Review Courses to register for scheduled programs online

NEW YORK NURSE march 2021

Non-Profit US Postage Paid NYSNA

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

INSIDE STATEMENT OF NEW YORK STATE NURSES ASSOCIATION IN SUPPORT OF ASIANAMERICANS AND PACIFIC ISLANDERS AND AGAINST THE RACIST TERROR AIMED AT THEM Holding New York together, p. 3

NEW YORK—The killings of six Asian women on Tuesday in the Atlanta area added to the grief—and terror—Asian-Americans and Pacific Islanders are suffering nationwide. In the last year, since the coronavirus appeared, nearly 3,800 hate incidents have been reported to “Stop AAPI Hate.”

The organization counts verbal harassment and name calling, shunning or deliberate avoidance of Asian-Americans, and physical assaults as acts of bigotry and racial hatred. As nurses, we recognize that random acts of racist violence constitute a public health crisis. This escalating national trend must be addressed with the utmost urgency.

Our hearts and prayers go out to the families of those killed in Atlanta. We call upon all Americans to work together to address the terrible fear and pain that such acts impose upon Asian-Americans and Pacific Islanders.

Experts on safe staffing, pp. 10-11