NY Nurse Winter 2021

nurse New York

New york state edition | winter 2021

2021

Forging ahead!

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New York Nurse winter 2021

Can nurses heal us all?

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

s the nation reels amidst the fallout from the most contentious election in history and the most devastating pandemic in memory, how do we heal as a rational community in the face of the continued threat of COVID, its unknown long-term sequelae, possible future pandemic strains, vaccine distribution, and assorted conspiracy theories, many without an ounce of evidence?

Our kids are disoriented, based on legitimate fears of a medical situation they can’t fully understand, and the absence or severe limitation of social interaction, school normalcy and familial relationships.

Families are torn asunder by the economic crisis, additional fears of contracting the virus and physical separation with older or vulnerable relatives. Hostile political differences among families and friends have driven a wedge that may appear to be unrecoverable.

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

Building a better world

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

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 Seth Dressekie, RN, MSN, NP seth.dressekie@nysna.org Jacqueline Gilbert, RN jackie.gilbert@nysna.org Robin Krinsky, RN robin.krinsky@nysna.org 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 Regional Directors Southeastern Yasmine Beausejour, RN yasmine.beausejour@nysna.org 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

The differences in perception about systemic treatment of people of color in America, the role of the criminal justice system and the need for the “uncomfortable” introspection and discourse that must take place, along with longneeded institutional changes has polarized the country in many areas. A silver lining here is that is has also brought people of various backgrounds together, mostly among our youth.

Youth also leads in the clear determination to demand a better world: a safer community — free from violence, a cleaner and sustainable planet, equity in access to quality education and achievable, meaningful careers that allow them to raise a family in comfort and stability.

Some NYSNA members have questioned the role of unions and our “political involvement.” Given the above scenarios, how can anyone expect to see the changes needed to heal our nation without political involvement? Sitting back and pretending we shouldn’t get involved in players and policies that determine nursing practice and

Comfort zones are like prisons.

We need to break free. health care in general, or those that impact the social determinants of health, or laws that affect workers and unions, or agencies that regulate workplace and community health and safety, directly contradict our obligations as patient advocates and, to be blunt: common sense.

Perception vs. fact As professionals based in the sciences and the principles of humanitarianism, we have an obligation to research issues and deliberate BEFORE we condemn or glorify people or programs. Social and mainstream media have created a culture of “anything goes.” We

can now pick and choose what to believe and run with — with impunity. That is dangerous because it opens us up to be manipulated even as we think we are making our own decisions.

The fact that we have reached a point in which many people say, “I don’t know what to believe” is a sign that such manipulation has become successful. Questioning everything carefully is not a bad thing; believing anything casually is not a good thing. We are supposed to be an educated population.

Critical thinking requires drawing on experience, investigation, healthy

skepticism and objective social interaction. This is the time in our national lives that demands that we “walk in others’ shoes.”

Radical ideas?

Our union, and many organizations declare that every human being has the right to health care, that every patient deserves a nurse who has a manageable load, that no one should go hungry, that families have the right to live in decent affordable housing, that education is a right not a privilege, that we have an obligation to save our planet from destruction, that workers should have a say in workplace policies and that communities should have a say in neighborhood conditions. These are humanitarian and moral considerations, consistent with the Nurses Code of Ethics, not extraterrestrial concepts. These are not radical ideas.

These are the foundations of a civilized society, based on egalitarianism and compassion.

Nurses are healers. We can play a role in our workplaces, families, communities, parishes and unions in promoting healing ideas and practices. Sitting back in the sidelines may be “comfortable” for the moment, but will prove to be ultimately worse than “uncomfortable.”

People trust us for good reason.

Can we translate the way we care for our own patients into the way we care for our society?

Comfort zones are like prisons.

We need to break free.

NEW YORK NURSE winter 2021

2021: FORGING AHEAD

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e are living through unprecedented times, a moment unlike any other most of us have experienced in our lifetimes. Events in our hospitals, our communities and our nation are unfolding fast: an insurrection in our nation’s capital, unemployment the likes of which this country has not seen since the Depression, and a worldwide pandemic that is surging again through the neighborhoods of New York. Taken together, they place before us a set of profound challenges.

ment and government on notice: public health is at risk. OSHA has been formally notified based upon accounts you’ve filed. Strikes were held (on December 1 and December 1-2, respectively, see pp.

6-9) for Unfair Labor Practices and staffing shortages.

A source of great strength We were not alone. Nurses in Connecticut, Pennsylvania and California walked the line over lack of PPE and unsafe staffing.

On December 17, the New York Times reported that in New York

A sense of hope From what you took on in 2020, with remarkable skill, resilience and determination, I know that we can meet these challenges.

2021 — with all its hardships — will be the year in which we overcome obstacles and forge ahead to give the communities we serve confidence in the future and a sense of hope.

Last winterspring, the COVID-19 virus reared its ugly head in New York.

Before long, New York City was the world epicenter of the virus.

You met this extraordinary challenge with extraordinary courage.

You came to work in hospitals in NYC and around the state knowing every day that you faced the very real prospect of infection from the deadly virus.

This remarkable commitment has helped save more than 100,000 New Yorkers to date and curtailed the further spread of the virus. We showed that nursing is not just a profession, it is a calling.

Now we are faced with a second wave of the coronavirus. By identifying shortages of supplies and inadequate equipment in our hospitals, we put manage-

“nurses and other healthcare workers in the state have begun to warn about the conditions in hospitals, as virus patients are checking in at an alarming rate.”

You spoke with clarity and passion. No one knows the innerworkings of the hospitals better than you and your colleagues.

Your professionalism, solidarity and moral courage have proved to be a source of great strength for NYSNA members and beyond.

You led by example on the frontlines at the epicenter of a savage pandemic, the embodiment of commitment — to the health and wellbeing of our patients, our members, the communities we live in, and to our nation at large. You represent what is best in our Democracy.

Our allies are a tremendous force unto themselves. We are in regular and engaged dialogue with elected leaders, many of whom we helped, boots on the ground, to win office. The exchange of ideas and coordination of actions are critical to our future. In a new initiative, we are working with other unions and allies to endorse candidates for New York City Council.

We share many of the values of our sisters and brothers in other unions. The solidarity of this bond translates into concrete action: from matters pertaining to safety issues during the pandemic to the general health and welfare of the people of New York.

Our numbers are greatly multiplied when we speak as one with our union allies.

Our allies in organizations that stand for the protection of the public’s health, for racial justice, for the rights of LGBTQIA+ communities, for immigrant rights and others, bring us a more complete perspective on society’s needs.

Healthcare is a human right Together, we form a powerful alliance based upon principles of fairness and justice. We have a strong voice gaining even greater resonance.

Our members — hailing from diverse backgrounds, faiths, creeds, and ethnicities — know that illness does not discriminate, and neither should access to healthcare.

There is opportunity in times of crisis. We stand tall behind our support for our Democratic institutions, for good jobs and a living wage, for decent housing, a clean environment and climate justice and for our unwavering belief that quality healthcare is a human right not a privilege!

By Pat Kane, RN NYSNA Executive Director

You met this extraordinary challenge with extraordinary courage.

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around the union

New York Nurse winter 2021

NYSNA testifies on vaccinations

(l-r) Maddalena Spero, RN, President SIUH-Northwell LBU and Donna Magrone, RN, Membership Chair

SIUH-Northwell nurses in outreach to community Members distributed a COVID safety flyer on Staten Island this December in the lead up to the holidays. The “Stop the Spread” flyer was part of an overall campaign

by RNs to keep the public fully informed about necessary safety measures. “Our responsibilities as RNs are to make the public fully aware of what they need to protect themselves, families and neighbors.

Social distancing and wearing a mask must be a matter of habit until this dangerous virus is tamed,” said Maddalena Spero, RN, President of the SIUH-Northwell LBU. “Patients are the community.”

Upstate nurses ratify contracts During the week of December 21, NYSNA members at Adirondack Medical Center, Alice Hyde Medical Center, Claxton Hepburn Medical Center, Samaritan Hospital, and Massena Memorial Hospital for settling contract extensions that will see us through COVID-19. In addition to wage increases, members at each facility locked in important health benefit and retirement standards.

The number one impediment to vaccination has been the insufficient supply of the vaccine. On January 12, the federal government announced that it was releasing more vaccine to the states . The new release had been earmarked for second injections.

On the same day, NYSNA Executive Director Pat Kane, RN, and NYSNA President Judy SheridanGonzalez, RN, testified before the New York City Council. They pointed to a slew of issues about the vaccines and distribution.

Their remarks include: l vaccines should be universally available, free of charge or out of pocket insurance costs, to all New Yorkers, regardless of socioeconomic status, race or national origin, immigration status or ability to pay; l any vaccination program must be premised on sound science and data; vaccinations, in the context of an insufficient supply of vaccine to immediately inoculate the entire population, must prioritize frontline health workers, older adults, other front line or “essential” workers, people with underlying

Nancy Hagans, RN, NYSNA Treasurer

conditions and people from low income communities and communities of color that have suffered from disproportionate infection, hospitalization and mortality rates; l any vaccination program must include ongoing and intensified efforts to prevent transmission in the community, in workplace settings, and in healthcare institutions. l vaccination cannot be made mandatory, either for the general public or for healthcare providers and

workers. Nurses and other healthcare workers, essential workers and the general public have a right to know about the risks of COVID transmission and infection in their workplaces.

In New York, the state has relied heavily on the private hospital networks in Phase 1 to administer vaccinations to front line employees. The result has been very uneven and lacking transparency.

NYSNA Labor Savings Agreement with the City of New York is a win for our members We are pleased to announce that NYSNA and the City of New York concluded an agreement on January 12 to meet the target for “labor savings” in the current fiscal year. The City was demanding $1 billion in “labor savings” to avoid layoffs of 22,000 or more City workers and to address ongoing City budget gaps.

NYSNA pushed back against the City demands with our ongoing budget campaign, and our efforts helped stop cuts that would affect NYSNA members and our patients. The UFT, DC37 and most other unions reached agreements with the City that included more substantial costs.

Wage increases and retro pay The agreement will not financially affect any members, who will receive all contractual wage increases and the final retro pay

installment that is due in February.

It will not have any practical effect on our Welfare Fund — the Fund has three years of reserves, and the delayed payment of the $461,000 owed represents only 1/3 month of operating expenses.

The agreement allows NYSNA to close the books on our retro pay and allows all members to receive the final installment owed to us on time in February.

NYSNA among honorees at 2020 Heroes of Labor In a virtual celebration, EmblemHealth, one of the nation’s largest non-profit health insurers, and LaborPress, the largest labor news network in New York, honored the extraordinary sacrifices and contributions of the labor community in its 9th Annual Heroes of Labor Awards.

NYSNA President Judy Sheridan-Gonzalez, RN, accepted the award for our union.

public health

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NYSNA Long Term Care Health and Safety Update

New OSHA guidance: LTC workers must have respirators

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SHA has issued new respiratory protection guidance for worker protection in long term care facilities: Respiratory Protection Guidance for the Employers of Those Working in Nursing Homes, Assisted Living, and Other Long-Term Care Facilities During the COVID19 Pandemic. It can be found at https://www.osha.gov/sites/ default/files/respiratory-protectioncovid19-long-term-care.pdf.

The document reviews the appropriate uses of different types of masks and respirators and provides that workers who come in close contact with residents known or suspected to have COVID-19 must wear a respirator. Note that surgical and procedure masks are

not considered to be respirators

by OSHA.

OSHA recommendation A respirator is an N95-level filtering device (or a device that provides a higher level of protection such as a P100).

Whenever respirators are required, employers must first issue a written, worksite respiratory protection program that includes medical evaluation, fit testing, training and other elements as specified in the OSHA Respiratory Protection Standard 29 CFR 1910.134 (https://www.osha. gov/laws-regs/regulations/ standardnumber/1910/1910.134).

OSHA also recommends that employers look into expanding their supply of elastomeric and PAPR reusable respirators as an

Current testing rules for long term care facilities: twice a week if the nursing home is in a red, orange or yellow zone and once a week if it’s not in a red, orange or yellow zone. https://coronavirus.health.ny.gov/system/files/documents/2020/11/ dal_nh_20-16_testingandvisitationrequirementsinredorangeandyellow zones004.pdf

An elastromeric respirator

alternative to disposable N95s.

Reusable respirators make the facility less dependent on the highdemand N95 supply chain and save money in the long run.

Engineering controls While acknowledging the importance of respiratory protection for healthcare workers, the OSHA document underscores that exposure to virus should be managed by engineering controls (such as ventilation) and administrative controls (such as physical distancing, work protocols, etc.). PPE alone is never the appropriate response to a workplace hazard.

For more information on health and safety protections in long term care facilities, contact the NYSNA Health & Safety Representatives at healthandsafety@nysna.org.

Rollback of New Rule Prevented

Facilities must have infection preventionist in place

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uring the Obama Administration, a rule was enacted mandating long term care facilities have a dedicated infection control specialist on at least a part-time basis. The subsequent administration attempted to remove the rule before its November 2019 date of implementation. These efforts failed, however, and all long term facilities had one-year to be in compliance.

Has your facility met this goal?

If not, this should be a topic for a labor-management meeting.

Short staffing is linked to infection control shortcomings in long term care.

That’s why under the rule, §483.80(b, employers must have/

assign: “one or more individual(s) as the infection preventionist(s) (IP)(s) who are responsible for the facility’s IPCP” and the person must “have completed specialized training in infection prevention and control.”

Union action a difference Of course this still allows for potential leeway and loopholes.

What does part time mean? Will the person assigned be provided

with the resources needed to address problems? Will the duties just be dumped on someone who is already overwhelmed? But this is where union action can make a difference — challenging and pressuring for full compliance.

For more information on health and safety protections in long-term care facilities, contact the NYSNA Health & Safety Representatives at healthandsafety@nysna.org.

NYS facilities cited over violations OSHA and PESH recently cited sixteen long term care facilities in New York State. Most of the violations were over failure to provide proper respiratory protection or failure to fit test workers for their respirators.

Some of the citations included fines of $12,000 or more.

Judy Johnson, RN, at Rutland Nursing Home, is fitted for an elastomeric respirator. The Brooklyn Hospital Center, Interfaith Medical Center and Kingsbrook Jewish Medical Center are among several hospitals in Metro NYC that have acquired elastomeric masks.

Implementation planning is still underway.

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albany medical center

New York Nurse winter 2021

RNs will not be silenced

A “...Covid revealed years and years of a chronic condition— understaffing of RNs and other healthcare workers...”

lbany Med nurses have shown their grit over and over again.

After months of health and safety organizing, documenting unsafe practices, and exposing AMC’s dangerous COVID practices,f the hospital is finally dropping the mandate to reuse N95s up to 20 times.

Now nurses receive an N95 after donning and doffing 5 times, or if their respirator is soiled — a critical win on their way to a first contract.

Another significant change in hospital conditions is testing for virus for all patients.

Unfair Labor Practices and unsafe conditions NYSNA members will continue to organize to press AMC to follow best practices for respiratory protection and to meet other safety standards, such as co-horting COVID-positive patients.

“This acute condition, called COVID, obviously required our full attention. But it revealed years and years of a chronic condition — understaffing of RNs and other healthcare workers to such an extent of being unsafe,” said Patricia Pinho, RN. “Patients are our number one priority. But AMC impedes our ability to provide the necessary care safely.”

“RN’s are assigned 5-6 patients every shift and have 1-2 nursing assistants per 26 patients. We see our patient care and satisfaction declining before our eyes,” said Kele Vanlare, RN. The latest battle took place on December 1 in a one-day nurses’ strike, a walk out over Unfair

Labor Practices and unsafe conditions. A two-day lock out of striking nurses ensued, with more ULPs filed against the hospital. The charges addressed hospital threats directed at RNs including loss of health benefit coverage, interrogating nurses who planned to strike, locking out RNs for striking and

NEW YORK NURSE winter 2021

union activity, and threatening RNs with discipline who attempted to return to work.

“Albany Medical Center’s administration does absolutely nothing to train their management to treat nurses like the critical assets they are and this obviously leads to turnover,” said Liz Egan, RN. “It frightens me that an organization that employs individuals that care for and save lives everyday does nothing to try to retain nurses. Nothing.”

Ineffective infection control system Nurses point at conditions that require serious and immediate attention to an ineffective infection control system. The administration has failed to put in place key COVID-19 protections for staff and patients. If the hospital had used methods and protocols wellknown in the industry from the first pandemic wave and from prior emergencies, like Ebola, SARS and MERS, the conditions leading to recent exposure incidents would have been preventable.

It is imperative that AMC takes steps immediately to address the following: a universal policy is needed to test all patients for COVID-19, using the most accurate means and protocols; separa-

(Excerpted) 2. Reuse of N95 Filtering Facepiece Masks – The program at AMC involves reuse of N-95 filtering facepiece masks after sterilization up to 5 times. ... Problems with this program are as follows: a. If employees inspecting masks develop pre-symptomatic SARs-C0V-2 infection there is a potential for contaminating all of the masks they inspect. b. N95 respirators are not designed or intended for reuse.

CDC NIOSH has recommended that a nurse can reuse a mask up to 5 times through the course of entering and exiting an infectious patient room. The major manufacturer of N95 respirators in the United States, 3M, does not recommend reuse or cleaning of disposable N95 respirators. 3M warns that filtering facepiece N95 respirators are not intended to be decontaminated.1 Edward Olmsted, CIH, CSP

tion and cohorting measures need strict adherence; building ventilation overall needs to be enhanced to reduce risks, without delay.

“Very hopeful” Nurses are coming forward in increasing numbers to state their demands. They are saying loud

and clear: the Albany community deserves better hospital care and nurses have an essential role to play in the city’s public health system. A win on masks will lead to a win on other safety measures, from greater improvements in respiratory masks to ventilation and policies that help retain nurses.

“We are very hopeful,” said Patricia Pinho, RN. “This year we are going to get and ratify a contract that will lead to the establishment of strategic committees in which we will have an active role.

We have been missing from healthcare planning. That’s got to change and it will.”

NYSNA commissioned a study from a former OSHA official on safety conditions at Albany Medical Center. At left is an excerpt. To view the report in its entirety go to: http://bit.ly/ olmsteadRpt

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New York Nurse winter 2021

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MNR nurses go the distance w n December 1 and 2, close to 200 nurses at Montefiore New Rochelle hospital joined together and went on strike. They were determined to make their voices heard on the critical issue of safe staffing. For two years of contract negotiations, including this year when the pandemic and its latest resurgence reappeared in force, the hospital ignored NYSNA nurses and the alarm they sounded about serious understaffing at the hospital.

Virtually the entire RN workforce voted to strike.

“It’s clear that Montefiore does not want us to have a voice in patient safety,” said Kathy Santoiemma, an RN at New Rochelle. “After so many bargaining sessions, their position on safe staffing still has not changed — they’re not willing to spend a dime to ensure we have enough nurses to safely care for our community.”

Nurses were pushed to the brink.

The hospital attempted to keep RNs from communicating with fellow RNs and to restrict their use of social media — both formed the basis of Unfair Labor Practice charges filed with the National

Nurses and our labor, community, and elected official allies braved the cold for two days on the picket line.

Labor Relations Board. These federal charges are under investigation.

MNR unprepared for another surge Understaffing came to the fore again with news of a rapid uptick in COVID-19 cases. New Rochelle was the New York community first hit — and hit hard — by the COVID pandemic in the spring.

With several red clusters emerging in Westchester County, it became clear to nurses that the hospital was

not prepared for another surge of COVID. “In the emergency department where I work, we are not fit-tested for our N95s and the straps are constantly breaking,” explained Peggy Sinkkonen, RN. “Frontline workers and the community are also risking greater exposure because we don’t have the space or staff to move patients efficiently out of the ED and into isolation rooms, where someone with an airborne virus should be.”

On October 6, Montefiore New Rochelle nurses hosted a speak out to demand that Montefiore reopen the Maternal Child Health unit and settle a fair contract.

New Rochelle

NEW YORK NURSE winter 2021

with unity and solidarity

OSHA Complaint November 28, 2020 [excerpted] Nurses picket Montefiore’s billboard bus, demanding resources go to patient care, not advertising!

In late November, NYSNA filed two Occupational Health and Safety Administration (OSHA) complaints against Montefiore New Rochelle. The complaints detail reporting failures by the hospital as well as lack of fit testing for respirators and insufficient numbers of face protection for staff assigned COVID patients. Another serious charge against the hospital: it failed to follow global standards of infection control by mixing COVID patients with the general population and exposing nurses and patients to unnecessary risk of virus transmission.

“What has Montefiore done since June? They put a bunch of billboards up on the highway and bought TV commercials calling us ‘heroes,’” said Maria Castillo, an RN in the hospital’s Emergency Room. “They want the community to think they appreciate us. The reality is that they would rather spend millions of dollars on their public image, instead of making sure we have enough nurses to care for everyone who is sick!”

Montefiore notified nurses by email and phone of changes to their schedules — effectively leaving them locked out. There were reports of severe understaffing and two units, the dedicated COVID unit and a post-surgical unit, where approximately 35 nurses work, remained closed.

Montefiore stands down On December 8, nurses held a press conference to underscore the loss of services to the community, demanding Montefiore bring back the striking nurses. “Montefiore may be trying to punish nurses who went on strike, but it’s the patients who suffer when there are not enough nurses, and when the services at their community hospital are shut down,” said Shalon Mathews, an RN who worked the ER.

The next day Montefiore reopened its COVID unit. The postsurgical unit was reopened two days later. All 35 nurses were back at work.

The nurses’ unity, clarity of messaging and community outreach had prevailed. They returned to bargaining with a renewed sense of empowerment.

“Our community deserves a fully functional hospital,” said Lisa Gehrung, RN. “We know that when we are united, we can get the job done!”

Since returning to work, New Rochelle nurses have filed dozens of POAs documenting unsafe staffing and floating outside their competencies. New Rochelle nurses are getting ready for the next phase of the fight for a fair contract!

Outpouring of community support Elected officials, union leaders and community members rallied to live music and chanting. The strike — and safe staffing crisis — got extensive local, national and even international news coverage.

The strike ended at 7 a.m. on December 3. But it wasn’t over.

Nurses won’t stop until they win a fair contract that improves staffing

The employer is failing to apply and enforce basic, globally accepted and CDC proposed, measures to keep patients, staff and visitors safe that can reduce the risk of virus transmission.

This is particularly the case in the emergency department, where patients are crowded on top of each other in the waiting areas and in the hallways, with complete failures to apply social distancing standards or to properly separate COVID positive and COVID PUI cases from each other and from other patients, staff and visitors...

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public hospitals

New York Nurse winter 2021

Buffalo RNs

Where’s the stockpile?

T New York State Council of Churches honors NYSNA NYSNA nurses from Ellis Medicine, Bellevue Woman’s Center and Albany Medical Center were honored with the Social Justice Award at the New York State Council of Churches’ 5th Annual Awards and Fundraising Gala on December 2.

here has been a significant jump in COVID hospitalizations in Western New York.

Nurses at Erie County Medical Center are seeing the next COVID surge and urging the hospital to take further action to prevent what nurses, patients and their families underwent last spring.

Not enough RNs NYSNA Western Regional Director Kena Collins, RN, ECMC, said, “I feel like we’re just getting over the ramifications of that and some of us are still struggling psychologically and now we’re basically throwing ourselves back into the fire again.” The entire 12th floor of ECMC was turned into a COVID unit, as Erie County reported 436 cases of COVID-19 on a single date, December 8.

“What this virus did not expect was the resilience of nurses, the endurance to battle and the courage to fight for what was needed to do our job safely, to continue fighting for each other and our communities until we prevail.

“We are demanding that administrators, management and governing bodies be held accountable, pushing legislation toward the Defense Production Act, safe staffing and appropriate PPE. These things didn’t just occur. It was the strength of nurses who made these things possible, the nurses that refused to be hushed, that would not stand down, that demanded action, this created change.”

Lona Denisco, RN, ECMC

Nurses are very concerned that their numbers are not enough to adequately staff the hospital. They are also concerned that the N95 supply falls far short of the needed amount for proper protection.

ECMC is one on a list of hospitals that has failed to report details of their N95 supply.

“We want to protect our people, but we want to protect ourselves, too,” said ECMC nurse Lona DeNisco, RN. “How do we take care of our communities if all our nurses get sick? And you have seen how many nurses have lost their lives to this? We still go to work.

We still carry that burden.”

Questions and answers/Judith Cutchin, RN December 30, 2020 With The Chief Leader Q: Can you share what are your greatest concerns?

JC: We are particularly concerned about the racial disparities that resulted from insufficient resources distributed to communities of color in NYC. The stark differences between death rates among African American and Latinx call out for greater and more equitable resource allocation. CARES Act funding failed to address disparities, adding fuel to the fire.

NYSNA Board Member Judith Cutchin, RN, President, NYSNA’s NYC H+H/ Mayorals Executive Council

Q: Do you feel confident and better prepared to handle a surge of COVID patients now compared to the spring?

JC: Yes. This may involve “load balancing” — opening more space for acute care in any given NYC H+H hospital or the transfer of patients within the NYC H+H system. The system is paying attention to load balancing, has committed to that and to building capacity.

At the City Council hearing on hospitals, Dr. Katz made the point that during the height of the pan-

demic, the factor that limited their ability to transfer patients — to balance the load — was not having enough doctors and nurses to prepare and execute transfers. Staffing was the limiting factor and critical to be able to load balance.

Q: Are nurse staffing levels sufficient to deal with an increase in patients?

If not, how many more nurses do you think are needed across Woodhull and/or in your unit?

JC: Understaffing is a persistent problem in all NYC H+H hospitals and one that predates the COVID19 crisis We are implementing our contract to assess where the greatest staffing needs are and working with NYC H+H management on local and system-wide nursing practice committees to address these needs.

Implementing safe standards is a quality of care issue and also an equality of care issue.

Q: Are there enough N95 masks, medical gowns and other PPE at Woodhull? JC: Are nurses still being told to reuse N95 respirators for five days? Nurses, doctors and

other healthcare workers in the COVID units are given priority access to protective equipment.

The system changed their policy to no more than “5 uses” as opposed to days, which conforms with CDC recommendations of no more than 5 “donnings” per N95.

We have advocated for the city to procure and stockpile more reusable respirators, like elastomerics, to avoid dealing with supply chain issues of disposables, which are also more cost effective in the long term.

Q: How did you and your colleagues mentally/emotionally deal with the first wave of COVID and where do you think staff morale stands now?

JC: Conditions in our public hospitals in the spring did exact a serious toll on direct caregivers. But we are professionals, trained to provide care under the most severe circumstances.

I am incredibly proud to be a part of the city’s public hospital system, where all patients are welcome, without regard to ability to pay or immigration status. NYSNA nurses of NYC H+H are here for you.

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winter 2021

Sheila Conley, RN, with NYSNA nurses and local allies urging St. Elizabeth to put patient safety first.

Nurses speak out at St. Elizabeth’s

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n December 10, nurses in Utica sounded the alarm and urged St. Elizabeth Medical Center along with parent Mohawk Valley Health System (MVHS), to hire more nurses to address critical staffing shortages.

With COVID-19 cases climbing in Utica and Oneida counties, the number of COVID hospitalizations is more than twice what it was at the peak in the spring surge. As of January 10, there were 169 hospitalizations in the county.

NYSNA nurses spoke out: RNs in the Medical/Surgical units are each caring for nine or more patients, when industry guidelines call for five or six patients at the very most.

“Never seen things so terrible”

recruiting traveling nurses. Their outreach to former employees to boost staff triggers memories of staffing struggles with management prior to the pandemic.

“A year ago, we talked about the shortage. We need more nurses.

They need to be competitive in the workforce. And they need to think out of the box and we’ve got to do it now. We can’t wait. It’s has to get done,” said St. Elizabeth LBU President Sheila Conley, RN.

Nurses continue to advocate Since speaking out, conditions at the hospital have grown worse, as the COVID case load has climbed.

The ICU is full, and there are nurse-to-patient ratios of 1:12 on the COVID unit. The hospital is running out of ventilators and basic equipment to take people’s vitals, blood pressure, and check oxygen.

The administration has come out publicly minimizing the issues.

“We do everything we can as caregivers to make sure our patients are safe, but unfortunately, with understaffing like this it’s impossible to ensure quality care,” explained ICU nurse Alyssa Thompson, RN. “It’s so hard to see patients die alone and know I can’t be there becau se I’m spread so thin. The administration doesn’t come to the floors to see what’s happening. They seem more focused on their new hospital, instead of listening to their frontline nurses and providing the care our community deserves.”

St. Elizabeth nurses are continuing to raise their voices — calling on the MVHS administration to be real public health leaders in this crisis by educating the community about how to stop the spread of COVID, getting needed supplies to the frontlines, and hiring enough nurses to save lives!

This isn’t the first time MVHS has jeopardized patient safety.

At the height of the spring surge, dozens of nurses were laid off and many more ancillary staff were furloughed. The nurses have since returned, but the hospital is still chronically understaffed as the county faces a greater virus wave.

“In 12 years of being an RN here, I’ve never seen things so terrible,” said Kathleen Moccaldi, RN. “We need more techs and nurses, and I couldn’t be prouder to be a caregiver in our community working with folks that are giving of themselves 150% every single shift.”

Short-staffing is not new at the Mohawk Valley Health System.

Management says that they are Community and labor allies in solidarity with Utica nurses

“... I couldn't be prouder to be a caregiver in our community, working with folks that are giving of themselves 150% every single shift.”

Kathleen Moccaldi, RN

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New York Nurse winter 2021

Notice of Nominations for 2021 NYSNA Election Nominations are being accepted for the following NYSNA offices and positions: l President l First Vice President l Second Vice President l Secretary l Treasurer

listed above will commence at the conclusion of the ballot count.

Ten (10) Directors at large Eastern Regional Director l Central Regional Director l Western Regional Director l Southern Regional Director l Southeastern Regional Director l Lower Hudson and New Jersey Regional Director l Six (6) members of the Nominating Committee (one for each region) l Three (3) members of the Election Committee

Nominating Committee New York State Nurses Association c/o Marisa Jimenez 155 Washington Ave, 4th Fl. Albany, NY 12210 nominations@nysna.org Fax: (888) 395-7259

l l

Nomination forms, Consent to Serve forms, and Candidate Statement forms must be submitted no later than April 1, 2021.

Terms of Office All elected officers and directors will serve three-year terms. The terms of office for the positions

Nominations Nominations may be submitted in writing by mail, email, or fax to the Nominating Committee at the following address:

Nominations, Consent to Serve, and Candidate Statement forms will be available on the NYSNA website at www.nysna.org/election, and from the Nominating Committee at the above address.

No member may accept nomination for or serve in more than one office or position.

Eligibility to Nominate A member may self-nominate or nominate a candidate for office

only if he or she is not: (1) in arrears in the payment of dues, fees, or financial obligations to NYSNA; (2) a supervisor or manager within the meaning of the National Labor Relations Act; (3) a member of the NYSNA staff; or (4) serving on the Nominating or Election Committee.

Eligibility to Run for Office A member is eligible to run for office only if he or she is not: (1) in arrears in the payment of dues, fees, or financial obligations to NYSNA; (2) a supervisor or manager within the meaning of the National Labor Relations Act, within the twenty-four (24) months preceding the nomination; (3) a member of the NYSNA staff; or (4) serving on the Nominating or Election Committee.

While all members meeting these criteria may run for Associationwide office, only members assigned to a designated Region (available at www.nysna.org/election) may run for that Regional Director position.

NYSNA 2021 Board of Directors Election – Key Dates Nominations notice mailed

Before Monday, February 1

Nominations and candidate statements due

Thursday, April 1 by 11:59 pm

Slate Declaration Forms due

Friday, April 30 by 11:59 pm

Candidates Meeting with Global Election Services

Tuesday, May 4 at 5:00 pm

Candidate statements in NY Nurse

May issue

Ballots mailed

Tuesday, June 1

First date to request replacement ballot

Monday, June 7 starting at 9:00 am

Last date to request replacement ballot

Tuesday, June 22 by 5:00 pm

Ballots counted

Tuesday, June 29

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Agency Fee Objection Policy NYSNA’s agency fee objection policy, which will be published annually in the January edition of New York Nurse, works as follows: 1. To become an objector, a nonmember who is represented by NYSNA shall notify NYSNA. Such objection must be in writing, signed by the non-member and mailed to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001. The objection must be postmarked within 30 days of resignation of membership, or, if the nonmember did not resign within the prior twelve months, in the month of February. A non-member employee who initially becomes a bargaining unit member after February in a particular year and who desires to be an objector must submit written signed notification to the NYSNA Membership Department within thirty (30) days after the employee has become subject to union security obligations and been provided with notice of these procedures. Public sector employees may revoke their dues deduction authorization and resign membership in accordance with applicable law and the terms of any signed dues deduction authorization card.

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

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

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

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

5. The fees paid by non-member objectors shall be handled as follows. (a) Newly-Hired Non-Members.

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

newly-hired non-member timely objects, an amount at least equal to the fair share percentage shall continue to be escrowed pending resolution of a challenge (if any) by the objector. Once the challenge is resolved, the amount of the nonchargeable balance plus interest will be returned to the non-member from the escrow. (b) Resignation. In the case of an employee who resigns NYSNA membership (or who continues in non-member status) and who timely objects, NYSNA will place or maintain in an interest-bearing escrow account an amount at least equal to the fair share percentage of the agency fees received from the nonmember or employer on behalf of the non-member and the non-member is permitted to challenge the fair share fee percentage during the thirty (30) day period noted in the annual publication of the Association’s objection procedure. If the non-member files a timely challenge, amounts at least equal to agency fees collected from the non-member employee or employer will continue to be placed or maintained in the escrow account pending resolution of any challenge.

If the non-member does not file a challenge within the challenge period, then the fair share fee amount will be credited to NYSNA’s general treasury and the balance (if any) paid to the non-member from the escrow plus interest.

6. A non-member objector may file a written challenge to the calculation of the fair share fee and percentage, challenging any of the items of the expenditures as chargeable.

Such a challenge must be submitted within thirty (30) days of the date the non-member objector is provided an explanation of the basis of the reduced agency fees and initiation fees charge to them. Such a challenge must be in writing, signed by the non-member and sent to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001.

If NYSNA does not agree with the challenge either as to the expenditures or as to the percentage of amount of dues to be paid, it will notify the timely objecting non-member in writing that he/she has thirty (30) days thereafter to request arbitration; and if he/she fails to do so within that time, then such non-member waives the right to arbitration. A request for arbitration must be in writing, signed by the person filing the request, and sent to the NYSNA Executive

Director, 131 West 33rd Street, New York, NY 10001.

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

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

Beck Notification If you are represented for collective bargaining by NYSNA, you have the right to be or stay a nonmember and pay an agency fee equivalent to dues. If you choose to be a nonmember, you are entitled to object to paying for activities unrelated to the association’s duties as a bargaining agent and to obtain a reduction in fees for such activities. If you submit a timely objection, the agency fee that you will be required to pay will include costs incurred by the union for expenditures related to collective bargaining, contract administration, grievances and arbitration, and other matters affecting wages, hours, and other conditions of employment. In 2020, the most recent calendar year for which a calculation was done, the agency fee charged to timely non-member objectors represented 83.61% of the dues amount for that year.

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

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

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in the news

New York Nurse winter 2021

Hospital CEOs have gotten rich cutting staff and supplies. Now they’re not ready for the next wave.

Years of understaffing nurses and health care workers have consequences, experts say.

Matthew Cunningham-Cook

By Matthew CunninghamCook. Originally published on December 20, 2020.

Republished with permission from The Intercept, an award-winning nonprofit news organization dedicated to holding the powerful accountable through fearless, adversarial journalism. Sign up for The Intercept’s Newsletter .

Sheeja Kurian, RN, Montefiore

December 20 2020, 6:00 a.m.

I

n 2006, Montefiore Medical Center in the Bronx had healthier patients, just enough nursing staff to take care of them, and a CEO who was earning $2 million a year, a senior nurse and union leader told The Intercept. Fifteen years later, its patients are sicker than ever before, its staffing levels are inadequate, and, as of 2018, its new CEO is earning $13 million per year.

The nonprofit hospital, like hundreds of others across the nation, has been cutting costs, progressively going leaner on staffing and supplies over the years. This accelerated approach has meant that the pandemic has hit the hospital, especially health care workers, doubly hard.

The nurse, Karine Raymond, has provided care at the facility for 27 years. In the second wave of Covid19, as in the first, she and her colleagues are taking care of double the patients that they typically do.

“It’s untenable and unmanageable and left us feeling very concerned that perhaps we might have done better if circumstances were different,” said Raymond. “[Our CEO] makes $13 million. How many nurses would his salary pay for? I do have a problem with seeing the suffering of the community I’m supposed to serve while others are collecting funds that have been provided by state and federal governments just because they can.”

Nurses were overworked before, but since March, many nurses have left the industry entirely, retiring early or seeking other work. While personal protective equipment supplies are more abundant now than in the spring, nurses are more burnt out than ever — just as hospitals are getting ready for another wave of Covid-19 patients.

The executives who typically make the decisions at the United

States’s hospitals, whether forprofit or ostensibly nonprofit, are uniquely unprepared for the coming deluge, experts say. A decadeslong failure to recruit and retain health care workers like nurses, technicians, and nurse’s aides has made U.S. hospitals less able to manage the scope of a pandemic, and makes it much more likely that hospitals will break down, as they did in the spring in Wuhan, Italy, and New York City.

“Even before the pandemic hit us so hard hospitals were using a policy called ‘Lean,’ which is justin-time staffing and supplies,” said Linda Aiken, a professor of nursing at the University of Pennsylvania who has long studied the relationship between nurse staffing and patient care. The concept of lean hospitals was developed by management consultant Mark Graban in 2009, but business practices imported from manufacturing based on lean staffing began to be introduced in health care starting in the early ’90s. “All of our research shows those policies were a failure well before Covid and now they are a disaster during this national emergency,” said Aiken.

Graban said that some executives have drawn the wrong lessons from the management practice. “It’s unfortunate, if not harmful, when hospital executives misunderstand Lean to mean cost cutting, working harder, or not having enough supplies,” he said. “Lean, with its origins at Toyota, provides a management system and improvement method that focuses on first improving safety, quality, and access to care — and there are many published journal articles that document this. Lean aims to reduce the overburden on workers by improving the way work is done. A true ‘just in time’ system is designed to have the right number of people and supplies and medications.

Lean organizations don’t boost

the bottom line at the expense of employees, with UMass Memorial Health as a noteworthy example of a system that had a ‘no furloughs, no layoffs’ commitment even during this pandemic.”

Bonnie Castillo, executive director of National Nurses United, the largest union of registered nurses in the U.S., lambasted “Lean” in a statement at the beginning of December, saying, “Lean industry practices slashed preparedness.

They treat safe staffing and needed supplies as a drag on budget goals and profit margins, rather than the prerequisite for a humane, fully prepared patient-oriented health care system.”

Lean policy has had concrete results on the ground. “During the current surge, nurses are seeing patients die who could have been saved, if they had the proper staffing and supplies,” National Nurses United said in a recent statement.

Staffing shortages at hospitals have been reported in California, New York, Pennsylvania, Kansas, Maryland, Texas, Alabama, Idaho, Massachusetts, Arizona, Louisiana, Oregon, and Nevada in just the past two weeks. While the staffing crisis at this point is similar to the spring, it was supposed to be a once-in-alifetime event, and now it’s happening again. The result, Raymond says, is that “the older nurses are retiring out and the younger nurses aren’t staying” at a pace more rapid than pre-pandemic.

A majority of U.S. health care goes through hospitals that have been set up as nonprofit, which means that they are exempted from federal, state, and nearly always local taxes, and are obligated by their charter to operate in the public interest. (Those charters, however, don’t get in the way of handsome executive compensation packages.) Fifty-eight percent of hospitals are nonprofit, 20 percent are public, and 21 percent are for-profit, dominated by big

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chains like HCA Healthcare, Tenet Healthcare, and LifePoint Health.

“Nominally nonprofit community-spirited institutions have actually come to operate as profitmaximizing monopolies,” with the excess going to executive compensation instead of dividends, said Phil Longman, the policy director at the Open Markets Institute. “That has consequences here because a huge part of what happens with consolidation is a lot of hospitals are closed, so we don’t have the surge capacity that we need for this pandemic.”

Longman has highlighted in particular the role of the University of Pittsburgh Medical Center, or UPMC, the dominant hospital monopoly in western Pennsylvania. When crafting the organization’s future in 1995, its president, Jeffrey Romoff, said, “At the heart of the matter is the conversion of health care from social good to a commodity.”

Suzanne Gordon, an independent health care scholar, said that type of thinking has affected hospitals’ ability to manage the pandemic.

“If you have an economic view of health care as opposed to a patient care view of health care you’re going to define effectiveness and efficiency not as patient outcomes, but as how few staff can you have to produce this widget which is some version of patient care,” said Gordon. “If you have a workforce that is overloaded before a pandemic and demoralized and too old, you’re going to have problems with staffing.”

Montefiore is not the only hospital that has seen significant escalations in executive compensation.

The CEO of Banner Health in Phoenix, which has 28 hospitals in six states, made $21 million in 2018, while the CEO of Ascension Health, a Catholic health system with 145 hospitals in 19 states and Washington, D.C., also made $13 million. The rising executive compensation is a reflection of the financialization of health care, by which hospitals, regardless of their tax status, become not communityfocused institutions but entities whose raison d’être seems to be to enrich their executives. A 2018 study from Clinical Orthopaedics and Related Research found that hospital executive salaries increased by 9.3 percent annually from 2005 to 2015.

An August study from the BMJ Quality & Safety Journal confirmed Gordon’s thesis. It found that, in Chicago and New York City, “Hospital nurses were burned out and working in understaffed conditions in the weeks prior to the first wave of COVID-19 cases, posing risks to the public’s health. Such risks could be addressed by safe nurse staffing policies currently under consideration,” referring to legislation that would mandate nurse-to-patient ratios. Only California has limits on how many patients can be assigned a nurse. “Over half the nurses in both states experienced high burnout,” the study additionally reported.

“Half gave their hospitals unfavourable safety grades and two-thirds would not definitely recommend their hospitals.”

“What the research shows is that professional nursing care is the primary service provided by hospitals, but there are many decision makers who are not clinicians. And so they don’t naturally gravitate to science,” said Aiken, the study’s co-author. “They think it is technology, or the quality of the food, or having more marble in the lobby. But there’s so much research that shows that’s absolutely not the case. The primary service on the inpatient side is nursing.”

“So many hospital decision makers don’t read the scientific literature because many of them come out of manufacturing and other business sectors. Nurses are the alarm bells, and we have never figured out anything that replaces the handson, eyes-on-the-patient professional assessment that nurses do that allows everybody else to intervene in a timely way,” said Aiken.

Nurse short-staffing has been found to lead to higher levels of patient infections and mortality overall. Nursing turnover in 2018 was 17 percent, which nursing unions and numerous studies have attributed to chronic short-staffing and poor working conditions.

“Hospitals are being operated for the purposes of maximizing not literally profit, as they’re technically nonprofits, but you can see the luxury cars in the parking lot and deduce what’s going on,” said Longman.

Hospitals have consistently opposed efforts to expand the California model to other states. In 2018, the Massachusetts Hospital

Association spent $25 million campaigning against a ballot initiative that would have guaranteed nurseto-patient ratios. Other state-based hospital associations around the country have consistently lobbied against ratio laws as well.

“Taxpayers pay around 70 percent of the cost of hospitals [through Medicaid and Medicare], so we’re paying for people to act against us as patients,” said Gordon.

“These hospital executives think there’s a faucet of nurses that you can turn on and off and nurses will come out. It doesn’t work that way; it takes two, four, six, eight years to produce nurses. You don’t just want bodies, you want experienced bodies. You want the appropriate skill mix so you have to have enough nurses there to be able to fill the pipeline of retirement,” Gordon concluded. “I just think this is a completely predictable and avoidable crisis. Do we learn from this or do we go back to the same old, same old?”

While safe staffing legislation faces an uphill battle in the Senate no matter the outcome of the Georgia runoffs in January, Democrats in the states could take action, following California’s lead.

Besides California, there are 14 states where Democrats have control of both houses of the legislature and the governorship, including New York, Illinois, Virginia, New Jersey, and Colorado.

“If we’re going to provide the level of care that we need to keep our patients healthy and safe and out of the hospitals or home quicker, we have to have safe staffing,” said Raymond, the nurse.

By Matthew Cunningham-Cook.

Originally published on December 20, 2020. Republished with permission from The Intercept, an award-winning nonprofit news organization dedicated to holding the powerful accountable through fearless, adversarial journalism.

Sign up for The Intercept’s Newsletter.

Xenia Greene, RN, Children’s Hospital at Montefiore

NEW YORK NURSE

Non-Profit US Postage Paid NYSNA

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

INSIDE

around the union,

Albany Medical Center, pp. 6-7

Montefiore New Rochelle, pp. 8-9

Nancy Hagans, RN, NYSNA Treasurer

p. 4