NY Nurse June/July 2017

New York

nurse New York City edition | June/july 2017

the official publication of the new york state nurses association

Three unions Two countries One international fight!, p. 11 GERMANY

NEW YORK USA

Fresenius RN and NYSNA member Teresa Schloth in Germany

NYSNA and 1199SEIU on strike at Fresenius

The scourge of gun violence must end, pp. 7-10

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New York Nurse june/july 2017

Independence Day ironies

By Judy SheridanGonzalez, RN NYSNA President

The NYSNA/1199 strike at Fresenius Dialysis Centers illustrates the global nature of what we are coming to know as International Corporate Health Care. The line between corporate healthcare interests (which are about profits, not patients) and healthcare legislation in the United States grows dimmer every day. It only speaks to the power of money and its influence over the laws of the land.

As we celebrate Independence Day — the end of our colonization by England, it’s significant to note that the US is one of the few countries that possesses colonies today, Puerto Rico being the most obvious one.

Simply naming it a “commonwealth” doesn’t change that reality.

The relationship between Big Money’s control over healthcare internationally (and the banks and hedge funds that control so much more, leading to massive debt and forced austerity measures all over the world) and the colonial status of Puerto Rico were factors that generated a request for us to testify at the United Nations Special Committee on Decolonization in June. Excerpts of our testimony follows:

G Advocating for patients. Advancing the profession.SM Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP First Vice President Marva Wade, RN Second Vice President Anthony Ciampa, RN Secretary Anne Bové, RN, MSN, BC, CCRN, ANP Treasurer Patricia Kane, RN Directors at Large Kevin Donovan, RN Jacqueline B. Gilbert, RN Nancy Hagans, RN Tracey Kavanagh, RN, BSN Lilia V. Marquez, RN Sean Petty, RN, CPEN Nella Pineda-Marcon, RN, BC Karine M. Raymond, RN, MSN Verginia Stewart, RN Mary Ellen Warden, RN Regional Directors Southeastern Yasmine Beausejour, RN Southern Seth B. Dressekie, RN, MSN, NP Central Ethel Mathis, RN Lower Hudson/NJ Jayne Cammisa, RN, BSN Western Sarah Annabelle Chmura, RN Eastern Martha Wilcox, RN Executive Editor Jill Furillo, RN, BSN, PHN Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 x 159 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2017, All rights reserved

ood Afternoon, esteemed committee, speakers and guests.

It’s an honor — but a sad one — for us to speak about the drastic impact of colonization on Puerto Rico, particularly regarding its healthcare status.

As nurses, we’re acutely aware of health needs and conditions of patients, causative agents of disease and resources necessary to promote wellness.

Colonizing governments view the lives of the colonized as having lesser value. This facilitates the use of populations and environments as convenient testing grounds for activities and research.

Toxic testing ground

Poor Puerto Rican women served as unsuspecting guinea pigs in the 1950s and 60s as Pharmaceutical Corporations tested oral contraceptives to ensure their safety for US women in a chilling combination of eugenics and population control. In addition, one-third of Puerto Rican women between the ages of 20-49 were surgically sterilized without appropriate informed consent.

Today — no less horrifying — “Medical Tourism” speculators have explored the possibility of creating an organ transplant mecca in Puerto Rico, citing the availability of healthy organs due to high death rates of youths — a direct result of intense poverty and its ensuing violence.

The use of the country as a testing ground for weapons and military training has wreaked havoc on a variety of ecosystems resulting in

disproportionate rates of cancers and other diseases.

Bombing runs and chemical weapons testing in Vieques, Puerto Rico over 60 years resulted in ongoing medical catastrophes.

Viequenses suffer higher rates of cancer: 30%; hypertension: 380%; cirrhosis: 95%; diabetes: 41%; infant mortality: 25% higher than in other regions.

Why? Toxic metals accumulated in the biomass of plants, were eaten by grazing cows and fish, and traveled up the food chain to poison humans. Naval tests in surrounding waters devastated the fishing industry, which was an economic mainstay of locals.

Compromised food resources

Agriculture in Puerto Rico — and access to nutritious food — is seriously compromised. The “one crop economy” perpetrated by US corporations, and the absence of food processing and distribution systems, means that 90% of food — most of which could be grown on the very fertile island — is

imported. The Jones Act — which enriches US companies but starves Puerto Ricans — fosters exorbitant prices for poor quality foodstuffs.

Growing financial concerns

The financial crisis — a direct effect of Congressional and Constitutional provisions — is dire.

The “Promesa” Act negates any pretense of autonomy, increasing unemployment, lowering salaries and abrogating labor rights.

Schools and hospitals have closed, with massive cuts in health and human services. We see the largest migration in history — with a “deprofessionalization” of inhabitants. Doctors, nurses and other health professionals are leaving in droves — a doctor a day — reducing the already lowest rates of practitioner to patient in the US. While Puerto Ricans pay identical Social Security and Medicare taxes as their US counterparts, reimbursement rates are only half as much!

Thus, per capita health expenditures in Puerto Rico are $3,065 compared to $9,403 spent in the US. This leads to hospital and clinic closures, provider migration, and the dismantling of life-saving programs. The country can’t comply with CDC best practice guidelines for Heart Attack and Stroke — key killers — because it cannot afford the resources. The debt must be repaid first.

Vaccination rates have declined — dramatically among the elderly, a growing population sector. ER waiting times are climbing to hazardous depths. Vector control — as seen with the Dengue, Chickungunya and Zika infections — is totally inadequate.

The crisis exacerbates diabetes, asthma, end-organ failure, chronic pulmonary disease with morbidity/mortality rates higher in nearly every major category than in the Colonizer nation.

As these conditions deteriorate, we ask: who cares about Puerto Rico? Evidence indicates the US government, banks and corporations that dominate don’t have the best interests of the people of Puerto Rico at heart. So: why is this immoral and oppressive situation permitted to continue?

calling on congress

NEW YORK NURSE june/july 2017

Statewide calls for healthcare solutions as house and Senate efforts to repeal the Affordable Care Act have sparked an outcry across the state — and the nation. The U.S. Senate was enable to pass its bill, so far, leading healthcare advocates to see the light. But some in government remain committed to repeal of the ACA, and the fight over laws governing access to healthcare in the U.S. goes on. The Senate reconvenes in July to review its Better Care Reconciliation Act of 2017.

But skepticism abounds regarding a law that gives a tax break of $54,000 to each millionaire while cuts to care are counted in the tens of millions of Americans.

…White Plains in Westchester…

…in Downtown Albany…

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NYSNA members joined in the protest — with religious, labor and consumer advocates, targeting Senators deemed vulnerable to reelection or otherwise considered amendable to stopping efforts to derail the ACA guarantees.

Dire projections

No wonder the objection to the latest House and Senate bills are widespread. The Center for American Progress crunch the numbers and found that between 18,100 and 27,700 Americans would be dead as a result of these bills. More than 20 million Americans would be added to the

rolls of the uninsured — at a minimum — in the next decade if these bills become law.

Here in New York State, our Essential Plan, covering a range of critical healthcare services, would likely disappear, doing harm to 700,000. Medicaid cuts would reach into households across the state, as most families with an elderly relative in a nursing home relies upon Medicaid, as do large numbers of the disabled.

The end of subsidies to working Americans, those earning up to 200% of poverty, would effectively eliminate coverage for this category of our nation’s workforce. At the very time these working Americans had access to an affordable plan, it would be taken away if the legislation becomes law.

The BCRA harms our healthcare AND our jobs. Because New York has a generous Medicaid program this state is one of the hardest hit in terms of job loss. By 2026, the economy of NYS will have lost 132,000 jobs if this bill is passed, according to the highly respected Commonwealth Fund. Of those jobs lost, 81,000 will be in the healthcare sector.

…and Foley Square in Manhattan

July 28 Healthcare Rallies were held (above) in New York City…

Syosset Hospital RNs tabling with Healthcare Information

Long Island RNs and patient advocates rallied in front of Representative Peter King’s office to urge him to save Medicaid, save healthcare and stop the AHCA! King was one of seven New York Congressional members who voted YES on the AHCA, stripping healthcare from 24 million people and destroying healthcare as we know it.

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New York Nurse june/july 2017

Ending gun violence In the aftermath of the shootings at Bronx-Lebanon Hospital Center on June 30, the column of the executive director, “Ending gun violence,” from Dec. 2015/Jan. 2016, is republished here.

By Jill Furillo, RN, NYSNA Executive Director

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s a Registered Nurse in the Emergency Room, I treated hundreds of women, men, and children who fell victim to gun violence. I cared for and comforted people whose bodies were broken by bullets — this wasn’t violence that I just read about in the newspaper, it was something I experienced in vivid crimson every day.

Nurses know that gun violence is more than fodder for partisan debate and political stump speeches; it’s an epidemic that threatens the health and wellbeing of our

or injured by a gun in America every 30 minutes.

These are some of the statistics that have led the Centers for Disease Control to classify gun violence as an epidemic and the American Public Health Association to rightly declare it a public health crisis.

Fund mental healthcare

Watching President Obama shed tears as he announced his executive orders aimed to curb this growing crisis, I thought of my former patients, of the six-year-old children massacred at Sandy Hook Elementary School, of the African American churchgoers murdered in Charleston, of the public healthcare workers shot down this December in San Bernardino, and of so many others.

I applaud President Obama for taking these important and necessary steps, but there is so much more to be done.

As healthcare professionals, we know that the most effective treatments are developed through scientific research. Yet our government institutions are blocked from conducting any research that could help us narrow down risk factors for gun violence and determine which evidence-based approaches would work best to stop this epidemic.

Why? Because the National Rifle Association has lobbied and bullied politicians into crushing any research on gun violence as a public health epidemic. Since 1996, the Centers for Disease Control and the National Institutes of Health have been effectively blocked by Congress from conducting gunrelated research.

In the immediate aftermath of the massacre in Charleston, the U.S. House of Representatives Appropriations Committee quietly rejected an amendment that would have allowed the Centers for Disease Control to study the underlying causes of gun violence.

The NRA got its way again, using anti-science political jockeying to put the health of our entire nation at risk.

Protecting our patients

patients and their families.

Every day more than 89 Americans are killed by guns. The latest Centers for Disease Control and Prevention Fatal Injury Reports show that guns were responsible for 164,821 civilian U.S. deaths from 2010 to 2014 — 33,315 of these were under the age of 25.

Women and children are especially vulnerable. Women who are victims of domestic violence are five times more likely to be killed by their abuser if the abuser owns a gun. And, shockingly, according to the most recently available data, one child is killed

President Obama’s orders aim to make it harder for guns to end up in the wrong hands by strengthening background check requirements. And, critically, he also vows to increase funding for mental health services so that those in need receive treatment, preventing acts of lashing out.

As our psychiatric nurse colleagues have witnessed, too many mental health facilities have closed over the past decade, and mental healthcare services rarely receive the funding necessary to ensure that all patients have access to the care they need when they need it.

We need full-scale, funded research to solve the escalating crisis of gun violence. Like other epidemics that we have faced, including polio and auto safety, gun violence is not insurmountable. Imagine how many millions of people around the world would still be impacted by polio if our scientists weren’t allowed to conduct the research necessary to discover a vaccine. Likewise, in just one decade, the U.S. reduced vehicular deaths by 25 percent by applying research that called for increased car safety features and improving our nation’s roads and highways.

NYSNA nurses are united to stop politics from getting in the way of protecting our patients. We will do whatever it takes to end the epidemic of gun violence and keep our patients safe.

NEW YORK NURSE

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june/july 2017

Fresenius RNS get German support

W

ith an estimated 3.8 million kidney dialysis patients receiving care from Fresenius Medical Care worldwide by the year 2020, top management and shareholders at the multinational healthcare company have much to celebrate. Profit estimates are off the charts: the largest chronic dialysis company already pulls down $1 billion a year in profits in the U.S. alone, with $22 billion in assets in this country.

Fresenius is the largest operator of chronic dialysis clinics in the U.S., with 60,000 workers in 2,200 facilities running shifts six days a week.

The vast majority at non-union.

But here in the New York metro area six clinics are staffed by a union workforce: our NYSNA registered nurses alongside caregivers from 1199SEIU. Experienced nephrology staff makes the difference in chronic dialysis, both in terms of assessment of care for patients in the course of each dialysis treatment and as a matter of continuity of care. Over and over again, patients express a strong desire to maintain nurses and caregivers whose familiarity with their condition helps ease the burden of treatment for End Stage Renal Disease. “We see them three times a week, for years at a time,” said Fresenius RN Gloria O’Neill.

“There is a very close bond with them. We are there to advocate for our patients. That’s why this is so important.”

Several significant issues

This year, negotiations were stuck on several important points: wages have not been increased for many years; for 1199SEIU both wages and benefits remain an issue; and a new facility, Degraw, opened with a non-union workforce, despite promises by Fresenius that union staff would be offered employment. Also of much significance, NYSNA members have asked that a Professional Practice Committee be formed, allowing Continued on page 6

Fresenius RN and NYSNA member Teresa Schloth with German colleague

“The 150 members of the Fresenius Helios group works council representing 111 hospitals all over Germany send their solidarity to the NYSNA and 1199-SEIU workers.

They wish them success and want to make clear that they stand with the NYSNA and 1199SEIU workers!”

“Stop Union Busting!”

Fresenius strikers in NYC

German workers in support of U.S.Fresenius strikers

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New York Nurse june/july 2017

German support Continued from page 5

South Side Fresenius strikers

nurses to offer their comments and suggestions about patient care. But Fresenius has steadfastly refused in its negotiations to allow nurse involvement in this way.

With a one-day strike noticed for June 12 here in New York , NYSNA decided to reach out to Fresenius workers in Germany, where the company is headquartered. The healthcare union to which Fresenius workers belong – although, like here, many Fresenius workers are not in unions – is ver. di, and workers and their union were eager to meet with us.

A delegation set out from here comprised of Fresenius RN Teresa Schloth and NYSNA lead representative Marsha Niemeijer. Schloth is on the NYSNA Bargaining Committee for the Fresenius contract. She and Niemeijer were met with much support and solidarity from Germany’s labor movement, including ver. di, LabourCampaigns and the European Works Council.

Schloth and Niemeijer met with Fresenius workers and other healthcare union representatives on many occasions, as their delegation was able to share infor-

German workers support U.S. Fresenius strike

Standing in support in Germany

Support meeting in Germany

mation about shop conditions as well as the role of unions in both countries. It was a very successful bridge building trip and one that will serve as a model in our dealings with multinational healthcare corporations and in building international solidarity on economic and social issues.

Statement issued

In Germany, the Workers Council has a direct role with corporations in a formal way and our delegation sought through this mechanism to object to the anti-union posture of the North American operations of Fresenius.

The Workers Council group within Fresenius issued this statement at the time of our strike here in NYC:

“The 150 members of the Fresenius Helios group works council representing 111 hospitals all over Germany send their solidarity to the NYSNA and 1199SEIU workers. They wish them success and want to make clear that they stand with the NYSNA and 1199-SEIU workers!”

This substance of this message was delivered by the Workers Council to select members of the Fresenius Board of Directors. It is meant to be brought before them with the details of the positions of NYSNA and 1199SEIU regarding the negotiations and more broadly our contentions that the company has an unfair perspective about the role of unions in chronic dialysis care in the U.S.

New York

nurse special edition | june/july 2017

the official publication of the new york state nurses association

Dr. Tracy Sin-Yee Tam

The scourge of gun violence must end

Officer Miosotis Familia

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New York Nurse

gun violence

june/july 2017

Surge of gun violence must end

W “It was really disturbing. We waited and stood quiet.

Everyone was texting their loved ones. We put our phones on vibrate so they wouldn’t make noise. Our main mission was to save our patients. There was a woman with an infant, and I knew no matter what—that baby had to live. That was my mission.”

ithin the span of 6 days, June 30 to July 5, two exceptional women — one a medical doctor, the other a New York Police Department officer — were gunned down while working in the South Bronx. The loss of Dr. Tracy Sin-Yee Tam, 27, of Bronx-Lebanon Hospital Center and Officer Miosotis Familia, 48, from NYPD 46th Precinct, shocked the communities of the South Bronx where these professionals dedicated themselves.

Officer Familia was, in fact, a responder to the Bronx-Lebanon shooting just days before her death.

Their names are now added to the roll of victims of senseless gun violence, acts of killing that have come to define daily life in this nation. Gun violence took the lives of 13,286 individuals in 2015. Of these, 372 were mass shootings, with a death toll of 475. Sixty-four gun incidents were at schools.

America is immersed in gun violence, a public health threat that

Ruth Velazquez HIV Counselor, Bronx-Lebanon

“I think our government has to do more to prevent gun violence. This was a terrible tragedy.”

Natalie Cruz, RN Bronx-Lebanon

reaches into virtually every community in the nation.

Shootings at BronxLebanon For Bronx-Lebanon Hospital Center the shootings of June 30 were not the first in recent memory.

In November, 2011, a Bronx man entered the Emergency Room, discharging his gun in what reports described as a “wild shooting”.

A nurse and security guard were wounded.

One killed, six wounded

But the shootings of June 30 were on a different scale, as young doctor Tam was killed and six wounded, one seriously. The mayhem that followed sent shudders through the hospital, as police scrambled to search throughout the facility, uncertain as to whether other armed killers were inside.

Officer Familia was shot to death in her vehicle by a man with a recent history of mental illness. Dr. Henry Bello, the shooter at Bronx-Lebanon, also suffered from mental illness.

“How could somebody like this get a gun?” asked Dr. Ahmed Baiomi, doctor at Bronx-Lebanon.

“Everything was so strange. I’ve been here 34 years, and it’s a family. We’re trying to console each other. The counseling has been very helpful. Each time I see the staff on those floors I give them a hug.

I thought gun violence was just an issue out there, but now…. This is horrendous.”

“I came back in to work, and everyone was just numb. It was like a ghost town. Yesterday, I handed out water to the 46th precinct and gave my condolences.

There are too many guns around.”

Agnes Deyro, RN

Sidney Flores

Bronx-Lebanon

Housekeeper, Bronx-Lebanon

NEW YORK NURSE

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Still, the men who killed Dr. Tam and Officer Familia were able to acquire guns, an indication of the ease with which firearms can be purchased — legally and illicitly — in the U.S. Huge demand for guns

More guns were sold in 2016 than in any year in the history of the U.S. The FBI carried out an astonishing 24,767,514 background checks last year, 160,000 more than in 2015. But the market for guns in the U.S. is notoriously porous, as comprehensive checks in the face of massive demand difficult to carry out, not to mention black market sales. That leaves the population vulnerable and

task of stopping gun violence formidable.

“It’s surreal. You have to take it day by day. We need stronger regulations for guns,” said Francys Simons, RN, who works on the 15th Floor at Bronx-Lebanon, just two floors below where the gunman carried out his carnage.

“They give you training, but in the moment, you’re scared,” said Elida Ramirez, a Certified Nursing Assistant at Bronx-Lebanon and member, 1199SEIU Healthcare Workers East. “Every day there is gun violence in this country. They’re not doing enough.

Sometimes something bad has to happen to make people care.”

Continued on page 10

President SheridanGonzalez, RN, on gun violence Every day, nurses and other caregivers in our facilities are cursed at, threatened, spit upon, slapped, punched, kicked, pinched and, as we have seen, stabbed and shot. Violence is endemic in our society and if we don’t tackle the root causes, these incidents will only increase. While management are in their offices, it’s we who are on the frontlines that face the brunt of patient frustration that sometimes ends in violence.

Workers must be respected, supported and recognized for what we do; yet we are understaffed, lack necessary equipment and resources to do our jobs. Our patients—many of whom are poor, are people of color, lack social capital, are immigrants who speak different languages, who do not receive adequate care to begin with—are subjected to interminable waits, overcrowding, the impact of understaffing and a system that is anything but seamless.

Many of us are victimized by the impossible-to-navigate bureaucracy that is healthcare today—and could actually become much worse if federal proposals are implemented—and its thrust to dehumanize caregiver and patient alike.

On stage at the June 30 Vigil

The frustrations that these obstacles to healthcare promulgate serve to aggravate any situation. And then someone loses it. And there we are.

“What happened was tragic. The only way to cope is if we all come together. The nurses and doctors are coming together and helping each other cope. I’m completely against the culture of having arms.”

“It’s overwhelming. It’s just a lot to deal with. It’s very, very sad. There’s a lot to be done about gun violence, especially with this being so close.

This is like, right in your backyard.”

Danial Shaikh, MD

Cheryl McLune, RN

Resident, Bronx-Lebanon

Bronx-Lebanon

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New York Nurse june/july 2017

Ending gun violence Continued from page 9

Vigil attended by thousands

“It was horrifying. It’s just hitting me now.

We come here to feel safe, and now there is none here. Now, every time an alarm goes off or there’s an announcement, my heart jumps out of my chest. The access people with mental health issues have to guns is a real problem.”

Three unions with members at Bronx-Lebanon came together to help members in the immediate aftermath of the shootings. NYSNA worked with the Committee of Interns and Residents/SEIU and with 1199SEIU Healthcare Workers East, arriving within hours of the shootings to listen to members and express profound concern, coordinating counseling for respective members and, the following day, giving out lunch to all hospital staff.

The unity of the unions was very significant in these days of healing.

A Vigil for Peace & Reconciliation and against Gun Violence was conceived by and organized by the three unions, including NYSNA, and held outside Bronx-Lebanon on July 6, drawing in total thousands during five hours of prayer, comment, sharing and support.

Doctors, nurses and caregivers were able to attend at shift changes.

Their emotions are still raw, but the words of religious leaders, fellow union members and leaders, city and state politicians, and Congressman Jose Serrano helped to start the healing. “There is too much violence and hatred in our country,” said Rep. Serrano. “I will do whatever I can to keep guns out of

the hands of people who should not have them.”

New York State has taken significant steps to control access to weapons and our state laws are considered among the toughest control measures in the nation. In the aftermath of the Sandy Hook Elementary School shooting in Connecticut, Governor Cuomo signed the New York Secure Ammunition and Firearms Enforcement Act (referred to as “NY SAFE Act”). It limits the sale of high volume ammunition magazines, for instance. It calls for background checks for purchases and bans on direct sales of ammunition via the Internet. The Act amended the state Mental Hygiene Law to mandate reporting of individuals likely to “engage in conduct that would result in serious harm to self or others. Sentencing was made harsher for gun-related murders.

Some protection

We must make certain that our hospitals are secure, that security is professional and our working conditions protected from all forms of abuse and violence, the worst being what occurred at Bronx-Lebanon.

But, as we know, nurses are assaulted or under threat of assault on a regular basis.

In 2010 the NYS Penal Code Section 120.05 was amended by

Beatriz Torres, RN Bronx-Lebanon

Vigil Memorial carried to within Bronx-Lebanon Hospital

adding RNs and LPNs to the occupational protected under the law. It allows certain assaults, previously classified as misdemeanors, to now carry a felony charge. This law, in effect, “lowers the bar” on the degree of injury that must be suffered in order for an assailant to be charged with a felony. However, even under the amended law, not all assaults will result in felony charges and we must continue to call for strict enforcement of this law.

Firearm-related deaths

Nurse, doctors and caregivers are on the frontlines in caring for the victims of gun violence, and that is no small task. Between 2000 and 2014, the Centers for Disease Control and Prevention recorded 468,758 firearm-related deaths.

Casualties from gun violence are in greater numbers. Our emergency rooms, operating rooms and medsurg floors are taxed beyond limit in many places, including hospitals in NYS where NYSNA members work.

This fundamental condition makes gun violence central to our profession and ability to care for patients and communities. We support all efforts – as well as new, stepped up enforcement – to end the scourge of gun violence. This violence is senseless and overwhelming.

Trust in our profession is the greatest in the nation and we must use that heralded voice to denounce gun violence in all its forms.

NEW YORK NURSE/NYC

unity

june/july 2017

International solidarity against Fresenius!

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nternational solidarity is on the lips — and in the shouts — of NYSNA members battling with healthcare mega-corp Fresenius Medical Care. Linked together here in New York are NYSNA members with the caregivers, members of 1199SEIU Healthcare Workers East at six metro NYC area Fresenius chronic dialysis clinics. The other dimension to this unprecedented cross-Atlantic solidarity is the support our union and 1199SEIU is receiving from — and giving in return to — the Fresenius dialysis workers in Germany. (See pp. 5-6 for more detail on the international dimension of this important labor struggle.)

We are one in our struggle against Fresenius!

The German-based healthcare corporation is among the biggest in the world, running dialysis clinic systems and manufacturing dialysis and other healthcare supplies for international distribution. It is the largest operator of chronic dialysis clinics in the United States, with 2,200 U.S. dialysis centers caring for a substantial percentage of this nation’s 400,000 patients with End Stage Renal Disease. The U.S. division of Fresenius is among the most profitable of all, raking in more than one billion dollars in annual profits.

One unifying factor in the Fresenius modus operandi is its

staunch anti-union management position. Both here and in Germany, the dialysis colossus does not show interest in union-staffed clinics.

That is a mistake because dialysis patients are much better served by a well-trained workforce comprised of union nurses and other caregivers. The superior education and long-term commitment to work in the field of nephrology pays off in patient care and satisfaction.

Patient care concerns

Despite these factors, Fresenius negotiators have to date failed to negotiate an acceptable contracts with both NYSNA and 1199SEIU. Wages and benefits are factors, but a key element in the NYSNA contract demand is a refusal by

the company to allow nurse input.

The vast majority of NYSNA contracts across the state allow for Professional Practice Committees.

Within these committees, nurses join in discussion with management about patient care concerns.

It is both a practical matter and one of respect for nephrology nurse expertise that our negotiators have pursued the establishment of PPCs at Fresenius.

Against this backdrop, on June 12 NYSNA nurses and 1199SEIU caregivers at six Fresenius union clinics went on strike. The one-day strike was a success, drawing support from patients and their families and media attention.

“Everything we do is for our patients, [but] this company doesn’t even want to hear our feedback on patient care,” Fresenius RN Gloria O’Neill told the New York Daily News in a three-page story evaluating the company and worker demands.

Fresenius strike facilities Altantic PD NephroCare Inc. NephroCare West Soundshore Montefiore Dialysis Center III Montefiore Dialysis Center IV

Fresenius RN and NYSNA member Teresa Schloth in Germany Fresenius nurses and caregivers on strike

Gloria O'Neill, RN, Fresenius

Public Advocate Letitia James addresses Fresenius strikers.

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New York Nurse

safe staffing

june/july 2017

Safe Staffing Mini Lobby Days held in Albany

A NYSNA Advocate Award Nominations

lthough the 2017 Legislative Session concluded, the future of New York healthcare remains at stake. From June 5-8, members of the NYSNA Board of Directors joined members and patient advocates to directly lobby Albany lawmakers for the passage of the Safe Staffing for Quality Care Act (A01532/

S03330). They met with state legislators (including State Senate Democratic Conference Leader Andrea Stewart-Cousins), who stated their commitments to Safe Staffing for New York’s nurses and their patients.

of patients that a nurse can care for at any one time. Studies have shown that creating proper nurse to patient ratios saves lives — plain and simple.

Continued support needed

We continue to ask you to urge you to support the Safe Staffing for Quality Care Act. The legislation will set a maximum number

Do you know an outstanding advocate? Here’s your chance to help them get the recognition they deserve.

The 2017 NYSNA Convention will honor outstanding contributions to our practice and patient care. Award categories include practice, collective bargaining, organizing, legislative advocacy, culture and arts, and peer assistance. Plus there’s a special award for student nurse leadership.

You can use this link to nominate an outstanding advocate today: www.surveymonkey.com/r/ nysna-advocate

NYSNA members and leaders lobbied legislators in the waning days of the 2017 Session for safe staffing support.

August 23 – September 4 NYSNA returns to exhibiting at The Great New York State Fair and is seeking member volunteers to share our message of quality patient care for ALL New Yorkers!

Sign up for a shift or two, and enjoy complimentary admission! Contact Rehanna Singh-Mohan at rehanna.singh-mohan@nysna.org, or call 212-785-0157, ext. 110.

NEW YORK NURSE

PUBLIC HEALTH

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Candida auris

The New Kid on the Block

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pportunistic HAIs (healthcare associated infections) such as C. diff, MRSA, CRE and VRE are a constant concern in healthcare settings, especially among patients who are weakened by chronic disease and compromised immune systems.

The NYS Department of Health (NYSDOH) has raised a warning flag regarding a new HAI, Candida auris. NYSDOH is reaching out to healthcare facilities throughout the state to provide education and guidance in an effort to stem the spread of this serious, and potentially deadly, pathogen.

Candida auris, also known as C. auris, is a form of yeast that can cause bloodstream, wound and ear infections. Patients clinically diagnosed with C. auris have a high mortality rate. However, because these patients are typically already extremely ill, it is unknown whether C. auris is the cause of death.

Background

C. auris infection was first identified in Japan in 2009. It has since been identified in many countries throughout the world. The first U.S. case, found retrospectively in 2016, occurred in 2013. Most cases of C. auris identified in the U.S. have occurred in New York.

C. auris infection can be difficult to identify because tests for other types of yeast infection can cause false positive results. In NYS C. auris suspect specimens can only be tested at the NYSDOH Wadsworth Laboratory located in Albany.

Since most strains of C. auris are resistant to some or all classes of antifungal medications, a false positive can delay effective treatment.

In addition to C. auris being hard to diagnose and treat, it is extremely hardy and, therefore, survives for long periods in the hospital environment. It can take months for a patient to clear a C. auris infection.

Patients most at risk for C. auris infection include: l those who have been in the ICU for a long time and/or l have had recent surgery and/or

In addition to C. auris being hard to diagnose and treat, it is extremely hardy and, therefore, survives for long periods in the hospital environment. have a central venous catheter placed in a large vein, and l have previously received antibiotics or antifungal medications Symptoms of C. Auris include: l fever and chills while on antimicrobial medication l sepsis l isolation of Candida-like yeast from patient’s blood l little or no patient response or improvement with conventional antifungal therapy

Infection control protocols for hospitals and nursing homes include: l standard and contact precautions l diligent hand hygiene l single room (or cohorting with other C. auris-infected patients in nursing homes if single rooms not available) l all potentially infectious surfaces and equipment must be thoroughly disinfected with an EPA-registered hospital grade disinfectant effective against C. diff spores l both daily and terminal cleaning (NYSDOH recommends environmental cleaning monitoring include fluorescent markers and ATP bioluminescence)

l personal protective equipment including gowns and gloves So far healthcare workers treating patients with C. auris do not appear to be at risk for infection.

The NYS DOH is taking the following steps to contain the disease’s spread: l developing infection control selfassessment tools for healthcare facilities l conducting on-site surveys of hospitals and nursing homes l developing guidance for hospitals, long-term care facilities and homecare l developing educational materials for healthcare facility employees l developing a new rapid test for faster C. auris identification l meeting with stakeholders to provide information and solicit feedback More information on C auris can be found at www.cdc.gov and www.health.ny.gov.

If you would like to discuss this issue or any other health and safety issue with NYSNA’s occupational health and safety representatives, please send an email to healthandsafety@nysna.org.

Mission to Guatemala NYSNA Board Director at Large Nella Pineda-Marcon, RN at Mount Siani Hospital, recently accompanied a group of healthcare professionals on a medical mission to Guatemala. “I am very honored to have represented NYSNA on this medical mission to Guatemala.

Nurses from all over the country were quite impressed of the many works that we do as an organization, when I spoke during a press conference that was held there.”

Nella served as a first responder in The Philippines following the devastation of Super Typhoon Haiyan in November, 2013, and plans to return there this fall. We very proud of Nella’s commitment to her profession and her patients around the world, and couldn’t have a better representative! Read more about her work on the NYSNA Blog: www.nysna. org/blog/2017/02/24/medicaland-solidarity-mission-philippinessept-3-13-2017

14

New York Nurse/NYC

NYC H+H

june/july 2017

Keeping the Public sector strong!

W

These remarks are excerpted from a presentation of Judith Cutchin, RN, NYSNA’s H+H Executive Council President, before the NYC H+H Board of Directors, at Harlem Hospital.

e, in the public system, have accomplished a great deal for our patients and our profession. Contracts at NYC H+H, ECMC and Westchester Medical Center were won. These are very good contracts. Solidarity, persistence and commitment to patient care were present in every campaign and these wins were tremendous.

Here in New York City, we added Child and Eldercare Funds, where we are now extending these benefits. Tuition and continuing education are also available to members.

We do recognize the challenges of funding our systems, of contract campaigns to come, of a union-wide safe staffing campaign, of work towards Medicare for all. The New York Health Act just passed in the New York Assembly, again. We are proud to be part of a union so committed to social and economic equality.

That equality must reach into our safety net hospitals. We demand full and fair funding.

We demand that Medicaid dollars follow Medicaid patients. And that resources also be provided for those hospitals that care for the uninsured. That is what the Enhanced Safety Net Hospital legislation entailed.

Last year with fought alongside a broad coalition of unions, public health experts, immigrant rights and other organizations to make this law.

While that bill was not signed last year, it IS in this year’s state budget, adopting the same terminology and language from last year. That is very significant. And $40 million is allocated in the 2017 budget for these safety nets, with a possibility of matching federal funds.

Fighting for strength and power

We want this made into law this year and added permanently into the state’s health laws… and we have many allies in Albany and in our communities. Once in our health laws, it is there to stay. That is worth fighting for.

I have such great confidence in our public sector nurses — in all our NYSNA nurses — that the power we have gained from our commitment as patient advocates will carry us through.

Let me pause. I must raise the specter of Right to Work laws that threaten us here in our public hospitals.

That threaten to divide us. And we cannot and will not let this happen.

For 40 years the Supreme Court

held... and it was unanimous at the time… that agency fee laws — basic dues that fund our unions — were legal. Where everyone contributes to our union and this is the source of our strength. That is how we win and keep winning. Pay your share of dues that help us prepare for and carry out collective bargaining. Pays for enforcement of our contracts and for actions we take to further social and economic equality in our society.

In 2014, the Supreme Court in an Illinois case struck down agency fees for new home health workers. Another case, Friedrichs, was brought by some California teachers who objected to paying dues.

The decision in that case was effectively stopped when Justice Scalia unexpectedly died.

But another, similar case, the Janus case, also involving public sector workers, is making its way to the Supreme Court and its outcome will be announced in the first half of 2018. Scalia’s replacement is said to be to the right of Scalia. What does this mean? It means that Right to Work laws in the public sector, that could eliminate dues payments and effectively destroy unions … including our public hospitals… will be the law of the land.

Stand with all our members

NYSNA once again joined the LGBT Community in the 2017 Pride March, June 25.

As long as unions remain viable, non-dues paying members will get the fruits of our collective bargaining and enforcement. It’s called a free ride. But it is a free ride to a dead end. Not just the public sector workers here in New York and around the country. But it starts to destroy unions altogether and the level playing field our union rights help maintain are scorched. If that day comes, when Right to Work becomes the law in our public sector and you can cease paying dues, you must say NO! We must stand with all our members in solidarity.

Stay committed to funding collective bargaining.

Stay committed to the unions to protect our patient advocacy.

Stay committed to the communities we serve.

The union keeps us strong.

United we stand!

NEW YORK NURSE/NYC june/July 2017

long island – Peconic Bay: New

westchester /hudson valley –

growth, new staff

NYSNA’s newest

capital /north country – CVPH

central region – Disastrous health

ratifies new contract

care proposals

western region – NYSNA joins the

staten island – SI NYSNA RN joins

2017 Juneteenth Parade

the Fresenius fight

Around the state

15

NEW YORK NURSE

Non-Profit US Postage Paid NYSNA

june/july 2017

131 West 33rd Street, 4th Floor New York, NY 10001 6 NYC

INSIDE

NYSNA 2017 Convention Rallying to save healthcare, p. 3

October 11-12 Javits Center, NYC SEE YOU AT THE CONVENTION! Look for a registration form in the mail or go to www.nysna.org/convention

Confronting C. auris, p. 13