NY Nurse: June 2021

nurse New York

New york state edition | june 2021

It’s the law! p. 3

getting into gear, pp. 4-6

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New York Nurse june 2021

THE CATACLYSM In March, 2020, President Judy Sheridan-Gonzalez, RN, wrote the article below.

Her column won the prestigious Metro NYC Labor Communicators Award for first prize as the best op-ed. We decided to reproduce it in this month’s NY Nurse. –Editor

By Judy SheridanGonzalez, RN NYSNA President

UPDATE: As NY declares “normalcy” due to a 70% vaccination rate, we can’t forget what happened in the wake of the pandemic and how the dysfunctionality of our health care system was laid bare as a result. Instead of fixing the flawed system, employers have used the disaster to continue to take advantage of us, cutting staff and attacking our unions. We say, “Never Forget!” We refuse to be victims again and again to an inflationary and corrupt for-profit health care system that fills the pockets of predators as it eviscerates care and exploits caregivers. –JSG

I 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 Second Vice President Karine M. Raymond, RN, MSN karine.raymond@nysna.org Secretary Tracey Kavanagh, RN, BSN tracey.kavanagh@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 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 Vacant 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

write this, wiping away tears, confronting fears, at the nightmare that gets worse every day. One week feels like a year. I cringe every time the phone rings: another nurse sobbing uncontrollably about conditions in the ICUs — so many make-shift ones now — where all bets are off; about a colleague who is positive and sick; about one who is intubated; about another one who’s succumbed to this dreaded plague…

HOW MANY TIMES did we warn our hospitals, government, bosses, the media: “We’re not prepared for a disaster.” We pleaded for staff, supplies, space, beds, training, nursing schools. “Don’t close hospitals. Don’t cut health care. Stop the for-profit frenzy.

Support our public health infrastructure. Provide free nursing education.” We were accused of being alarmists, unrealistic, unreasonable — even greedy.

Nurses were functioning at bare bones before COVID-19 hit, pushing ourselves to the limit. We’ve now learned a new definition for “limit” in COVIDspeak — there is none. The rules for infection control change with the wind — and the whims — of corporate forces and the political “leaders” who depend on their campaign contributions, who value liability concerns and optics over human lives. How dare they!

HOW IS IT POSSIBLE that the wealthiest country in the world is incapable of producing protective gear? Wuhan was a warning: so many lives lost in one province. Did we learn nothing from that? From the measures taken to contain, control and combat the virus? Is our nation so arrogant that it cares little for people in other nations? That we think we can’t learn from their experiences?

Over three months have passed since the virus was named. But over the past 50 years we’ve seen manufacturing relocate into countries with cheap labor, few safety rules and repressive anti-union policies.

This was promoted in spite of the damage it did to the paychecks of US workers and the lives of those in outsourced nations. And so, much of our PPE is produced elsewhere.

While American workers had no say in outsourcing, we and our patients are the victims of the practice. Hospitals refused to listen to us, and so, again, we are the victims. Many of our elected leaders chose to side, not with us, but with the hospital industry and insurance companies, allowing draconian cuts and closings…and so we are the victims. And now, we not only have to fight the virus, we have to fight our employers and our government to safely care for patients…and to survive ourselves.

The CDC, the government, our hospitals, the health care system itself — all have failed us. They missed the boat but left us to drown in the water. So many people are dying that we‘re mastering new techniques in double-shrouding more often than in calculating new drips.

What we thought was unimaginable a week ago, is the new reality: our docs deciding who gets actively coded in an arrest and who doesn’t — based on prognosis — and age — and the need not to “waste” precious PPE. How can we live with ourselves in the aftermath of such things?

We are afraid to go home. We can’t take care of our own parents for fear of infecting them. We don’t see our kids. We tremble at the simplest mistake in removing soiled — but totally insufficient — gowns and masks. We have strategies to strip off our clothes

on porches, stoops and yards. We worry about family, neighbors and friends. We assume we’re COVID-19 positive but testing is backlogged and not always accurate. And we wonder, as we have overlong waits for test results: is a positive result a death sentence or a reprieve, because we are alive.

The president has the power to implement the Defense Production Act (DPA) to mandate industries to retool and manufacture nothing but PPE and hospital supplies like vents. But he says, instead, “the market should rule.” The market has led us down this rabbit hole.

The crazy beauty of this horror is that we have seen coworkers and neighbors, community groups and unions, families and strangers, assemble (virtually) to support us and one another. Our faith in good people is reinforced. Volunteers sew masks, procure N95s and gowns, raise funds to get materials, cook meals, offer their homes. We are blessed in that way. And we have each other, our heroes alongside us, who pronate patients with us, deliver precious oxygen, medication and nourishment, share newly obtained PPE, food, liquids, allow us to cry, even if not on shoulders.

But even as we fear for our lives, our patients’ lives, our family’s lives — we’re angry. We’re disgusted. And we’re fighting back. We invent our own PPE when the hospital can’t — or won’t — provide it. We have the media’s ear…and we’re talking. We’re organizing, to make do, and to make noise.

We’re not only the canaries in the mine of this catastrophe, we’re the witnesses to the neglect, incompetence and criminality of the insufficient, inexcusable response to the greatest challenge facing us in our lifetime.

Silence is not an option.

NEW YORK NURSE june 2021

Victory! It’s the Law!

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n June 18, in a victory for all nurses and healthcare workers in New York, groundbreaking staffing legislation for hospitals and nursing homes became law.

The legislation, a pair of landmark laws—the Hospital Clinical Staffing Committees and Disclosure Act (A108B/S1168A) and the Standard Minimum Nursing Home Staffing Levels Act (A7119/S6346) — is a result of your steadfast advocacy for over a decade which continued, unwavering, as you faced unprecedented crisis conditions, putting yourself at risk on the frontlines while safeguarding the lives of others.

“Safe Staffing Saves Lives” is a part of the vernacular of the troubled state of healthcare in New York today — due largely to the efforts of NYSNA members. From Buffalo to Gloversville, Albany to Valhalla, the Bronx to Syosset, and on Staten Island, these words spoke to patients crammed into ERs with too few RNs, some admitted only to be on stretchers in hallways for hours on end.

Thousands of miles NYSNA members walked thousands of miles on picket lines this past decade, protesting unsafe staffing. You presented petitions to management, lobbied legislators in Albany and testified across the state: Mortality and morbidity go up when staffing is unsafe.

Your Protests of Assignment were a critical component in the fight for safe staffing.

But we need them even more under new law! They will become part of the reporting process to the New York State Department of State (DOH) and Legislature where they will serve to make the case for staffing ratios, evidence recognized by the terms of the law.

That’s a big win.

Over the finish line Worker representatives — from NYSNA and CWA District 1 and 1199SEIU — came together, proposing solutions to state legislators and healthcare industry representatives. In the end, our united effort pushed these laws over the finish line. It’s a win for all of us.

Combined, the two laws bring New York closer than ever before to universal safe staffing standards in every hospital and nursing home throughout the state, regardless of zip code, regardless of whether the facility is public or private, not-for-profit or forprofit, regardless of whether they are union or non-union.

We applaud the State Legislature for prioritizing the safety of patients and nursing home residents, as well as Governor Cuomo for his final imprimatur.

At hospitals, the law empowers all direct care staff in the determination of staffing levels and establishes a statewide, publicly reported enforcement mechanism

when standards are not met. (See “Getting into gear,” pp. 4-6) The second of the laws sets minimum nursing home staffing levels by requiring all nursing homes to meet minimum staffing levels set at 3.5 hours-per-resident day. These include standards for Registered Nurses (RNs), Certified Nursing Assistants (CNAs), Nursing Assistants (NAs) and Licensed Practical Nurses (LPNs) at respective hours of care.

By Pat Kane, RN NYSNA Executive Director

Direct care experience With a statutory mandated seat at the table, nurses and other healthcare workers will draw upon their direct care experience to develop staffing plans and oversee their implementation and enforcement.

Staffing plans must be expressed in guidelines, ratios, grids or matrices that show, in the case of RNs, how many patients are assigned to each nurse. Wherever a NYSNA contract includes a staffing ratio or grid, they must be included in the enforceable staffing plan under the law. Staffing plans must be adopted and submitted to the DOH for posting on its website. This level of transparency is an enormous breakthrough. It gives the public and policy makers details reflecting hospital conditions.

These laws are essential to our duty to advocate for our patients.

We now have in place a process which moves us closer to statewide universal ratios… closer to a more equal healthcare system.

Staffing plans must be expressed in guidelines, ratios, grids or matrices that show how many patients are assigned to each nurse.

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Getting into gear

Coming up this summer In July and August, NYSNA will be offering training on bargaining. A statewide retreat of all bargaining committees (postCOVID) is tentatively on schedule for Winter 2021. Among the issues to be reviewed: What are the employer trends? How to interpret and utilize them.

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he Hospital Clinical Staffing Committees and Disclosure Act (“staffing law”) calls for the formation of a Staffing Committee at every hospital. This body is key to reaching the goals of setting and enforcing safe staffing standards in all facilities throughout the state.

Every hospital must form a Staffing Committee that includes representatives of RNs and other frontline unit staff (LPNs, aides, other direct care and assistive personnel) and management (DON, finance, managers). Half the committee must consist of frontline staff.

An annual Staffing Plan The Staffing Committee’s role is to prepare an annual Staffing Plan. With regard to RNs, the Plan must reflect the number of patients

assigned to a nurse, broken down by unit and shift and cover all units at the hospital. Factors which must be considered and incorporated into the staffing plan include: census, admissions and discharges, acuity, skill mix, professional standards of care, availability of support personnel, physical layout of the unit, and coverage of breaks and benefit time.

Role of the Staffing Committee The role of the Staffing Committee also entails overseeing implementation of and compliance with the Staffing Plan, as well as updating the Plan in the course of the year. Semiannual reviews against patient needs and outcomes keep the Plan current and accurate.

There is more to this essential role: the Staffing Committee resolves complaints over noncompliance and violations of the staffing plan.

As of this writing, over 3,400 members have joined the ranks of NYSNA’s Staffing Captains. The Captains provide staffing data on each unit and each shift — creating frontline nurse driven data critical to enforcing safe staffing. Under the Staffing Law, the Captains take on added importance: they will ensure compliance with the staffing terms set forth and agreed upon in the staffing plan, and will help define the basis for all state complaint filings. Our goal this year is for each facility to generate and use Staffing Captains reports regularly and that any of the reports which reflect unsafe staffing be accompanied by a Protest of Assignment, giving a complete picture of the unit.

NYSNA lobby visits With a body of evidence about staffing, underscored in reports and required to be submitted

Key Dates for Preparation, Implementation, and Enforcement under the law: l January

1, 2022: Staffing Committees to be established.

l January

1, 2022: Staffing Regulations set and promulgated by DOH Commissioner for Critical Care Units.

l July

1, 2022: Hospital Statutory Staffing Plans to be submitted to the DOH, including all areas of agreement and disagreement. This repeats every July every year thereafter for the next year’s plan staffing plans must include provisions of the Collective Bargaining Agreement.

l July

31, 2022: The Hospital Staffing Plans are posted on the DOH website and made available to the public. This repeats every July every year thereafter for the next year’s plan.

1, 2023: The Hospital must implement the July 1st Staffing Plan and that Staffing Plan becomes enforceable under the law. This repeats every January every year thereafter for the next year’s plan.

l January

l July

1, 2023: Numbers of complaints and data on unresolved complaints must be included with the Staffing Plan submitted to the DOH. Reports required by the Nurse Staffing Disclosure law and the actual staffing at the Hospital will be made publicly available on the DOH website.

l October

21, 2024: The Hospital Staffing Advisory Commission submits their report and recommendations to the Legislature*

*The Commission will have 3 union members, 3 hospital members and 3 academics/experts.

NEW YORK NURSE june 2021

to and posted by the NYS Department of Health, the stakes are raised during lobby visits.

Is the legislator aware of legal violations in their district that they are obligated to enforce? All NYSNA lobby visits will now have source documents — state documents — that back up nurses’ claims.

Every staffing plan must be expressed in guidelines, ratios, grids or matrices that show specifically “how many patients are assigned to each registered nurse.” They must incorporate and include all staffing ratios, grids or other provisions of the collective bargaining agreement.

A numerical representation of a nurse-to-patient number is the gold standard for all CBAs today, and now there is state law backing it.

This is the key win of the law.

Failure to include a contractual staffing grid or ratio in the staffing plan violates state law. Staffing plans must comply with staffing laws or regulations, including the law prohibiting mandatory overtime.

The staffing law calls for NYS Department of Health to issue regulations for minimum ratios in ICUs by January 1, 2022. This regulation, like any new staffing law or regulation, must be referenced in a staffing plan and subject to compliance by management.

resolve or dismiss a complaint.

Because the decision must be by consensus, the labor side can veto any bad employer decision. l If a complaint is not resolved it can be appealed to the New York State Department of Health (“DOH”) for investigation. l DOH will investigate unresolved complaints that involve failure to: Follow the procedures of the law (forming committees, adopting plans, filing plans, etc.)

Non-compliance with staffing plans Patterns of failing to reach consensus on plans or on compliance (this is targeted to dysfunctional or rogue employers who show a pattern of refusing to work for consensus) l If DOH finds a violation after investigation, it will issue an order to correct the violation within 45 days l The DOH can fine a hospital for failure to comply with an order to comply with a corrective plan l Under current law the fines can range from $2000 to $5000 per violation. Additional sanctions can be imposed under public health law. l The DOH complaint process is separate from and in addition to the existing rights to enforce our

contractual staffing under the CBA l NYSNA and unions now have two enforcement mechanisms — full rights to enforce through contracts (grievance, arbitration, etc.) AND DOH complaints/fines l This new enforcement structure is particularly important for our public sector contracts and private sector contracts with little to no enforcement rights. l All of the reports generated through this process will ultimately be reviewed by the Hospital Staffing Advisory Commission, which will include union representation and will make recommendations to the Legislature on hospital staffing.

Each facility and region already have access to Captains dashboard reports (see sidebar). These are perfect tools to measure compliance with the law from the RN perspective. The Captain system gives a snapshot of what’s going on in your unit. Protests of Assignment give a fuller snapshot of what’s transpired.

Hospitals will have to report their actual staffing of RNs, LPNs and assistive personnel (expressed in hours of staff time per shift, and in ratios for RNs).

Continued on page 6

Enforcements under the staffing law Here is a list of key enforcement mechanisms codified in the Staffing Law: l If consensus cannot be reached on any part of the plan, an explanation of the position taken by each side must accompany the staffing plan. l Once a staffing plan is adopted it essentially becomes state law and hospitals must comply with the staffing plan under the law l If NYSNA has ratios or grids in contracts, those staffing ratios also become state law — they must be included in the plans and the hospitals must comply with such ratios under the law l If there are violations or variances from the adopted plan, Unions and allies can file a complaint to the committee l The committee must review and

The dashboard aggregates and charts reports submitted by NYSNA staffing captains. Users can filter by facility and unit to view Captain data, and average reported staffing levels.

If an existing contract has a ratio or grid, it must be included in the plan.

Failure to include a contractual staffing grid or ratio in the staffing plan violates state law.

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Getting into gear

Continued from page 5

JOIN the Statewide Staffing Committee Sign up: http://bit.ly/sscsign The Statewide Staffing Committee will coordinate the union-wide implementation of the statewide staffing laws. The committee will: Develop statewide and regional standards to be incorporated into facility staffing proposals.

Develop and share internal and external organizing strategies for optimizing implementation of the law and advancing our ultimate goal of establishing statewide staffing ratios.

Share best practices for relating to and building consensus with representatives of other frontline unit staff, and training resources.

Gay Pride 2021

Offering hands-on support for local all-staff committees.

Reach out to and educate non-union nurses with staffing ratios template proposals and organizing campaign tools.

Share information on employer compliance with Transparency and Reporting requirements of the law.

Monitor overall progress of implementation.

Issue reports on the progress of implementation.

A Proclamation on Lesbian, Gay, Bisexual, Transgender, and Queer Pride Month, 2021 The uprising at the Stonewall Inn in June, 1969, sparked a liberation movement — a call to action that continues to inspire us to live up to our Nation’s promise of equality, liberty, and justice for all. Pride is a time to recall the trials the Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) community has endured and to rejoice in the triumphs of trailblazing individuals who have bravely fought — and continue to fight — for full equality. Pride is both a jubilant communal celebration of visibility and a personal celebration of self-worth and dignity. This Pride Month, we recognize the valuable contributions of LGBTQ+ individuals across America, and we reaffirm our commitment to standing in solidarity with LGBTQ+ Americans in their ongoing struggle against discrimination and injustice.

Excerpt from the White House statement on June 1, 2021

Reflections: George Floyd one year later

By Judy Sheridan-Gonzalez, RN NYSNA President

M

ay 25th will be marked in history as a day many “lost their innocence.”

No one could deny a brutal murder took place, by the hands of law enforcement, against a human being who was no threat to anyone when this occurred.

What came to light for others is what people of color, especially Black people, have known for centuries.

Blessy vs. Ferguson — separate but equal — and the Brown vs. Board of Education overturning Blessy decisions, didn’t tell the true story of the viciousness and prevalence of institutionalized racism in our nation.

Pandemic reveals racial inequalities Conditions in the United States are separate and UNEQUAL. In terms of education, housing, health care, employment, wealth, and, as illustrated time and again, in the criminal justice system.

The pandemic has illustrated the savage inequalities in health care along racial lines for those who may have been unaware, as nurses know only too well.

We mourn the loss of loved ones, no matter how they are taken from

us. We offer our heartfelt condolences to the family of George Floyd, whose death opened up a searing wound not only for the grieving family, but for a nation and a world.

Hearts and minds The nearly unprecedented guilty verdict visited upon the murderer may give us cause to wonder if things are really changing, if there is hope for a country so long divided, with a history and reality that is viewed through many different lenses, that is experienced in dramatically different ways, depending upon what you look like, where you come from, where you live and work, and what you think.

Laws are needed, for sure; judgments are critical, no doubt — but entire systems must be examined and assessed for fairness, equity and humanitarianism in a country that has the resources and capability to do so much more for the vast majority of its inhabitants.

And, whatever you think about the demonstrations and protests that have marked the national landscape over the past year, they have provoked a response. They have brought people together…and they have pulled people apart. They

have epitomized what a people in pain looks like.

Ultimately, we have to come together as a nation to change our hearts and minds to the extent that we can empathize with those whose experiences and social realities are different, to be open to taking a new look at what we’ve been told is our history, to fully understand our relationship to power in our country, to embrace our differences with the overwhelming majority of our people with love, understanding and respect, so that true dialogue and interchange can take place, so that we can all live with dignity.

The 99% There are a scant number of people who wield extraordinary economic, political and social power over the so-called “99%,” the rest of us, who have so much more in common with one another than with those who lord over us.

Unity and solidarity are words.

Our actions give these concepts true meaning.

Do we have the courage to step out of our comfort zones to take action around what we say we believe? That all of us have the right to Life, Liberty and the Pursuit of Happiness? Time will tell.

health & safety

NEW YORK NURSE june 2021

CDC’s latest guidance

Pulling back an important protection

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he CDC has historically worked with healthcare professionals to implement policies that protect both the public and, therefore, healthcare and other essential workers. Yet, in the case of the COVID-19 pandemic, the CDC has consistently made decisions that are neither backed up by science nor adequately protective of workers and public health. The most egregious example of this has been the CDC’s refusal to accept, and act upon, airborne transmission of the SARS-CoV-2 virus.

For nurses, who have experienced the devastating effects of COVID-19 firsthand, lifting indoor mask mandates too soon puts lives at risk, especially those most vulnerable to COVID infection.

Indoor mask rollback In May, the U.S. Centers for Disease Control and Prevention (CDC) updated its guidance to allow fully vaccinated persons to “resume activities without wearing a mask or physically distancing….”

This new guidance, quickly adopted by NYS, includes all indoor spaces except those in healthcare, public transportation and schools.

While everyone is eager to resume pre-COVID lives, NYSNA has serious concerns about the health ramification of this change for both the public and workers.

For nurses, who have experienced the devastating effects of COVID19 first hand, lifting indoor mask mandates too soon puts lives at risk, especially those most vulnerable to COVID infection. Most store owners, managers of large venues, and other indoor sites will be hesitant to demand proof of vaccination, and it is likely that many people who

have not been vaccinated, or are not yet fully vaccinated, will remove their masks. The CDC has provided no guidance for enforcing the new mask recommendation.

NYSNA takes a stand Many people have not yet been vaccinated, cannot yet be vaccinated because of age, or are unable to generate a strong immune response to the vaccine. And, although the

COVID vaccines are highly effective, there will always be a small percentage of vaccinated people who still become ill since no vaccine is 100% effective. In addition new, more infectious variants continue to spread throughout the US and other parts of the world.

In response to this premature action by the CDC, the NYSNA Board of Directors has issued the following position statement:

It is the position of the New York State Nurses Association that: lT he federal, state, local, and tribal governments must

uphold a key principle of medical practice to ‘do no harm’ and use the best available science to guide infection control in public places; lT he federal, state, local, and tribal governments must

uphold the key principles of justice and beneficence regarding mandatory vs voluntary mask-wearing decisions to protect those who experience greater rates of disease and worse outcomes (socially vulnerable groups): older adults, people with underlying medical conditions, and people from disadvantaged racial and ethnic groups; lM andatory mask wearing in public places appears to

be an effective, fair, and socially responsible solution

to curb transmissions of airborne viruses. Voluntary mask policies may have yet unknown social and behavioral consequences related to the effectiveness of the measure; lV oluntary mask wearing would likely lead to insuf-

ficient compliance and would potentially intensify stigmatization; lU nder a voluntary policy, those wearing a mask are

likely to be judged as belonging to the risk group; lA s high compliance is needed for infection control ef-

fectiveness, public policies that encourage or enforce mask wearing need to be in place.

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OSHA issues emergency standard Is it enough to keep healthcare workers safe?

T In all of U.S. history no other occupational exposure (i.e.

COVID-19) has caused more illness and death in a single industry in such a limited time.

he U.S. Occupational Safety and Health Administration (OSHA) issued an emergency temporary standard (ETS) on COVID safety in healthcare on in early June and, while OSHA should be commended for taking this step, a number of serious shortcomings in the standard, as written, will limit the ability of the regulation to keep frontline healthcare workers safe from the recognized hazard of airborne SARS-CoV-2.

OSHA can only issue an ETS where “grave danger” exists. By issuing this standard OSHA is affirming what we have known since early 2020: that healthcare workers have been in grave danger since the COVID pandemic hit the U.S. It is estimated that approximately half a million healthcare workers in the U.S. have been infected with COVID and thousands have died. In all of U.S. history no other occupational exposure has caused more illness and death in a single industry in such a limited time.

Foundation flawed OSHA regulations specifically covering healthcare workers are few and far between. In the 1980s and 90s healthcare workers had to fight for protection from Hepatitis B and HIV exposure. Despite forceful and sustained opposition from healthcare employers, we won the Bloodborne Pathogens Standard in December, 1991.

While not perfect, that regulation “got it right” on key issues and has saved untold numbers of lives.

Unfortunately, the COVID-19 ETS mirrors flawed guidance from the CDC which, in turn, has rolled back and watered down protections as a result of healthcare employer pressure and federal support. For this, and other reasons, the ETS falls short of the protection needed to keep healthcare workers safe.

Out of the gate the ETS has a very serious omission: it fails to fully recognize the airborne nature of COVID and ignores current

science on the airborne dispersal of viral pathogens. Without this foundation the resulting regulation is destined to be a mix of measures, some welcome and helpful, others frail and compromised.

Helpful provisions of the ETS include: l That healthcare employers are

required to conduct a workplace COVID hazard assessment, address the hazards identified in the assessment, and develop and implement a written COVID-19 plan. All of this must be conducted with the input and involvement of non-managerial employees and their representatives. l That the employer must implement a patient and visitor screening and management system to limit the risk of exposure. l That respirators (N95s, elastomerics, PAPRs, etc.) must be provided when a worker comes in close contact with a COVIDpositive patient or a PUI. l That employers create a log of all employees who have contracted COVID-19, whether it was due to workplace exposure or not. l That employers provide notification of exposure to employees within 24 hours.

Areas where the ETS falls short include: l Does not adequately recognize

airborne and asymptomatic transmission. l Assumes there is absolutely no risk for vaccinated persons. l Continues to allow the unhygienic and dangerous practice of N95 reuse. l Skirts the issue of airborne transmission by failing to mandate clear and effective ventilation measures to reduce exposures.

l In part bases PPE on length of

exposure (the discredited “15 minute rule”), creating an opening for employers to refuse PPE to workers who are still at great risk of exposure. l The standard does not clearly define a number of issues; for example, using terms such as “appropriate” for the level of outdoor air required for ventilation. All told, these shortcomings will lead to harm for workers. l Input from the American Hospital Association and other employer organizations is plain to see in the ETS. From the outset they opposed any ETS whatsoever. Then, when it became clear one would be issued, mobilized to lessen its effectiveness.

NYSNA working with other unions NYSNA, along with other healthcare unions, stands ready to work with OSHA to ensure that the science of COVID-19 transmission and methods to control the spread of COVID-19, based on science, are followed in every workplace where workers are at risk of COVID infection.

To that end, NYSNA calls for a permanent OSHA standard on airborne transmission of infectious agents — one that recognizes current science and puts worker safety ahead of employer pushback. In addition, NYSNA calls for an effective ETS and permanent infectious disease standard that protects ALL workers, including the hundreds of thousands of essential workers who have kept our country running at great risk to their own health. If we are to honor and protect the true heroes of this pandemic, we must protect them now and in the future.

around our union

NEW YORK NURSE june 2021

CVPH members speak out for safe staffing, healthcare services in their community

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ealthcare workers at CVPH are speaking out about the damaging restructuring happening at their community hospital. The administration at UVM-CVPH has used COVID-19 as an excuse for financial restructuring that helps the bottom line at corporate headquarters in Burlington, VT, but harms frontline staff, essential healthcare services, and quality care in Plattsburgh, NY and the surrounding communities the hospital serves.

From the emergency room, to critical care, to medical surgical areas of the hospital, frontline staff is stretched to the breaking point.

In 2019 and 2020, more than 1,500 nurses at CVPH signed onto 410 Protest of Assignment (POA) forms.

On the medical-surgical oncology floor, nurses and clinical assistants are often staffed to the absolute minimum. Two years ago, the unit had six clinical assistants — now after the restructure, it has two.

Charge nurses are always trying to recruit nurses to extend their shift, just to have minimally acceptable staffing. The result is that nurses are regularly pressed to work 16 hours straight.

Stretched to the breaking point “We may be healthcare heroes, but we’re not superhuman,” said Zach Witkop, RN. “When we clock out, we feel physically and emotionally exhausted because we know our patients haven’t received the care they deserve, because we were understaffed.”

Linda Fisher, RN, said, “Sometimes I’m in the ER working triage and I’m there by myself with 25 people waiting. Sometimes patients wait for days to be seen.

They could be holding for days on a hospital stretcher, instead of a bed, in an appropriate room, with the appropriate level of staff to care for them.”

Critical care nurse Travis Larche, RN-BC, PCCN, LEAD II RN, said, “Many days we have less than the required clinical assistants, less than enough nurses, no charge nurses,

and reduced ancillary department staff to care for our patients. As a nurse I not only care for the critically ill and those inflicted with the virus, but have the added challenges of answering phones, doing clerical work, fixing and searching for needed equipment and supplies, bathing and feeding patients, and trying to keep our patients safe from falls and other injuries. These challenges combined are too much for anyone to handle including myself, an experienced, efficient, and dedicated nurse.”

Fighting for our community hospital “We were short-staffed before the failed corporate restructure of our hospital began, and now we are even more short-staffed,” said Dea Lacey, RN. “Our administration spends money on expensive traveler nurses but can’t create a schedule that’s not shot full of holes before the shift even begins.

Nurses are leaving, and I wonder if my job will even be here in five years. CVPH used to be our community hospital — now we’re just a hospital in your community.”

More and more of the services close to home at CVPH are being shipped off across the lake to Burlington. On May 20, CVPH healthcare workers held a speak out outside the hospital to address

the understaffing and the slow elimination of services.

ICU nurse Tracey Garvey, RN, said, “Since the pandemic hit, the UVM-CVPH Administration has been using COVID as an excuse for why we can’t give patients the care they deserve. People are waiting too long for care. They’re being transferred to UVM in Burlington to get care that we should be providing right here in Plattsburgh.

Our specialty services are so limited that our patients need to take extra time and money to get their care elsewhere. I want to serve this community and my patients. I don’t want to blink an eye and see more of our healthcare services or staff disappear.”

CVPH nurses and healthcare workers urged the hospital to staff safely, and spoke out for the new staffing bill, which will make the safe staffing ratios at CVPH enforceable by New York State law.

Witkop concluded: “I’m excited that a new staffing law could incentive hospitals — through fines and reports to the community — to provide better staffing and to reduce the times we’re short staffed.

Understaffing in any part of the care team impacts the whole care team, so I’m pleased that we’ll have enforceable staffing standards in all direct care areas.”

(Above and below) Nurses gather and speak out in front of CVPH.

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New York Nurse june 2021

Hudson Valley nurses demand safe staffing

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urses in the Hudson Valley are speaking out about safe staffing.

Several nurses at Vassar Brothers Medical Center and Westchester Medical Center have been connecting with the media to let the public know about the need for the region’s hospitals to be safely staffed and how the new staffing law will positively impact patient care.

“

Mary-Lynn Boyts, RN

Nurses at Vassar are still in crisis mode, but the Administration acts like it’s business as usual,” said Chelsea Patton, RN. “They invested in a new building that looks like a hotel and has made patient care more difficult, instead of hiring and staffing enough nurses to provide quality care to our community.

Unfortunately, it’s our patients who suffer, and we see that reflected in our recent scores.”

“

Over one-third of our nurses on the Covid Med Surg unit have left since January and as of yet they have not been replaced,” said Margaret Franks, RN, of Vassar.

“We just want to be able to deliver safe timely care but feel that when we speak up to advocate for our patients, it falls on deaf ears.”

Margaret Franks, RN

huge impact on patient care,” said Vassar Emergency Room nurse Stephanie Bayer, RN. “There are too many sad stories and near misses. It’s very stressful to think

you could have done more or prevented a bad outcome, if only the administration had staffed safely.

Nurses just want the hospital to put patients first.”

Chelsea Patton, RN

Stephanie Bayer, RN

“

I work in an acute rehab, so I see firsthand how much better patients do when nurses have more time to care for, support, and educated them. They’re able to leave the facility sooner, and less likely to return to us with problems. We need a safe staffing law. It will help ensure that hospitals look out for the best interest of patients, not just the bottom line. All patients need to be treated with respect, and safe staffing will help us make sure our patients are heard, valued and truly cared for,” said Westchester Med nurse Mary-Lynn Boyts, RN.

“

Since patient numbers went down at beginning of COVID, the administration decided to keep us low-staffed. Understaffing has a

NEW YORK NURSE june 2021

Olean nurses speak out for safe staffing

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n June 8, Olean nurses spoke out to save quality care at their small community hospital. The shortage of nurses has come to a head, as more patients are seeking care after delaying care for more than a year, and because nearby Bradford Regional Medical Center has reduced services.

The nurse staffing shortage is hitting the emergency room, ICU, and medical-surgical floors especially hard. In the ICU, nurses are sometimes caring for 3 or even 5 patients, when the safe standard is 1 or 2. On a recent night shift, an ICU nurse was training and orienting a new nurse at a time when there were 8 critically ill patients to care for — a recipe for disaster.

ICU Nurse Tricia Sebastian, RN, said: “We have had to decide

which patients are ‘more sick’ or who can use the equipment more.

Triaging patient care is unacceptable and makes the nurses job even more difficult. Running around the hospital searching for equipment takes away from already critically low patient care time. We have been warning Olean administration for years about safe staffing.”

Rally for respect At the speakout, LBU President Kris Powell, RN, said: “We are here for our patients — that is our concern. We need staff and we need equipment in order to provide safe, quality care…How can you give quality care when you’re caring for 17 patients? We worry about our license but more importantly, the well-being of those entrusted to our care.”

The speak out was featured widely in local media — in the Olean Times Herald, ABC 7, and NBC 2.

Progress and the work ahead Nurses at Olean General Hospital are demanding the hospital hire more nurses and develop robust plans to retain nurses in order to provide safe, quality care.

They’ve already made some headway with the Administration, who have doubled sign-on and referral bonuses for RNs, increased “block time” pay for overtime in the most understaffed areas of the hospital, hired more travel nurses to support in the short-term, and hired 22 recent grads.

Olean nurses are continuing to push for more nurses and a solid retention plan to address the staffing crisis now and into the future.

“How can you give quality care when you’re caring for 17 patients? We worry about our license but more importantly, the well-being of those entrusted to our care.”

Kris Powell, RN

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New York Nurse june 2021

Albany Med Nurses keep the pressure on! Nurses hold solidarity pickets to demand a fair contract

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n their first picket since the December strike, Albany Med nurses, community allies, and labor friends rallied at picket lines outside several Albany Medical Center facilities to demand leadership settle a fair contract now.

Albany Med nurses have said that negotiations with leadership are heading in the right direction. Over 130 nurses attended the latest negotiations and offered solutions to the staffing crisis and retention prob-

lems that compromise patient care here at Albany Medical Center.

NYSNA nurses have moved leadership to propose a raise to full-time and part-time nurses, an increase for Per Diems, increase for weekend and night differentials, and more! But nurses know the fight doesn’t end here until we win a fair contract. Albany Med has remained unwilling to recognize defects in its expensive and incomprehensive family health insurance

coverage. That’s why nurses and community members mobilized to keep the pressure on Albany Med and held solidarity pickets across Albany Med facilities.

Over 50 nurses and community members rallied to keep the pressure on Albany Med to settle a fair contract. Next negotiations are coming up in the next few weeks, and NYSNA nurses are energized and emboldened to cross the finish line and win!

ECMC RNs see big win

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rie County Medical Center and Terrace View Long Term Care nurses were speaking out about what the new law will mean for patients in Buffalo and Western New York.

On May 4, nurses and other caregivers receive the news. Two bills that would establish mandatory staffing levels for all nursing homes and hospitals across the state. They understood all too well that pre-existing staffing shortages exacerbated the problems faced by caregivers during the COVID-19 pandemic.

Now, with Governor Cuomo’s action, for the first time in New York State there a clear process for setting and enforcing staffing standards at every hospital and nursing home.

ECMC nurses have recently spoken out about how chronic understaffing in the hospital puts patients at risk. With new state staffing committees to set and enforce staffing standards, and with annual reports to be made publicly available, they are celebrating the legislation as a win for nurses, frontline caregivers and patients.

LICH RNs to receive pension monies

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settlement in the LICH Pension dispute was released as part of an overall agreement of unresolved issues. NYSNA settled pension litigation, dating to 2014. Over 60 nurses will

receive payouts of over $400,000 for missed pension contributions during the final months of LICH service. (See p. 15 on the death of NYSNA RN Joan Rowley​. She was a stalwart in the battle to keep LICH open.)

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OSHA cites Montefiore New Rochelle

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s nurses and other frontline caregivers battled COVID-19, NYSNA filed an OSHA complaint on behalf of members at Montefiore New Rochelle Hospital. Unsafe working conditions had escalated and many NYSNA members at the hospital spoke with the OSHA inspector assigned to the case, outlining in detail their workplace exposure to COVID-19 and the ongoing unsafe conditions at the hospital. NYSNA was notified

by OSHA that Montefiore New Rochelle was cited for: l lack of adequate fit testing l nurses having to wear respirators that failed a fit test l not conducting medical evalu-

ations for all staff who had to wear respirators l lack of information on the chemical products used for qualitative fit tests Citations for COVID-related hazards has not been easy. Nurses spoke up not just for themselves, but also for their co-workers.

OSHA issued these citations against Montefiore New Rochelle based on a complaint filed by NYSNA: l Lack of fit testing l Continued use of N95s after failing fit test l Recordkeeping l Lack of medical evaluations (needed for respirator use) l Lack of adequate documentation of chemical products used for qualitative fit testing

OSHA did not cite the hospital practice of moving nurses from a COVID to a non-COVID unit wearing the same respirator.

SIUH nurses say: fill vacancies (Left to right) Nurses Kate Caneco, Anne Marie Cori, Burcin Uzun, Maddalena Spero, Dawn Cardello, Jessica Ardi, Donna Magrone, and Jenifre Ritchie, May 27. The delivery of the petition to hospital management to honor the union contract specifically on provisions on staffing by posting numerous vacancies throughout the hospital. The hospital has been delaying on posting vacancies.

Congratulations to NYSNA President Judy Sheridan-Gonzalez, RN, and Executive Director Pat Kane, RN, for placing 49th in City and State NY's 2021 Albany Power List! Under their leadership NYSNA fights for the rights of nurses, patients, workers, and families across the state.

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solidarity

New York Nurse june 2021

NYSNA in solidarity with striking nurses in Massachusetts

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une 12 marked the 97th day of a strike by more than 700 members of the Massachusetts Nurses Association against Dallas-based Tenet Healthcare, a for-profit healthcare company. NYSNA leaders and staff traveled to the Worcester, Massachusetts hospital to support the striking MNA nurses. U.S. Senator Elizabeth Warren, Congressman James McGovern and Sara Nelson, international president, Association of Flight Attendants-CWA joined the large crowd of community, labor, nursing, and politicians for a solidarity rally in support of the St. Vincent nurses. The strike is now the longest nurses strike in the nation in more than a decade.

“Nurses work hard to take care of us when it matters most and I stand with them in this fight. It is time for Tenet to return to the bargaining table and conclude negotiations so St. Vincent nurses can go back to doing what they do best — caring for our community,” said Senator Warren.

Threat of replacement “Tenet already made an unbelievable $97 million in profit this year. They have plenty of money to address the concerns of St. Vincent nurses, but they won’t. It’s just plain wrong,” said Congressman McGovern. “I know firsthand how amazing the nurses at St. Vincent are — they’ve cared for members

(Left to right) Pat Kane, RN, NYSNA Executive Director, Julie Pinkham, RN, MNA Executive Director, Judy Sheridan-Gonzalez, RN, NYSNA President, Tracey Kavanagh, RN, NYSNA Secretary and Eileen Norton, RN, MNA Director of Organizing (retired)

of my own family with incredible skill, commitment, and love.

They deserve to be respected, not replaced.”

The rally follows Tenet’s decision in early May to cease negotiations with the nurses and issue a threat to permanently replace them. That threat has been met with outrage by the nation’s labor and community groups.

Big profits for Tenet The strike began on March 8, triggered by Tenet’s refusal to bargain over improvements in what nurses deem unsafe patient care conditions. The decision to strike was taken after two years of bargaining over poor work conditions — made worse as a result of the pandemic.

For Tenet, the pandemic has offered a tremendous profit opportunity. The company’s CEO was quoted about plans to use staffing furloughs and funding from the CARES Act stimulus package to improve Tenet’s “cash position.” Tenet did exactly that, raking in more than $2.8 billion in taxpayer funding while laying off staff. Profits of $414 million were reported last year, $97 million in the first quarter of 2021.

Tenet’s stock value has nearly tripled, from a low of $21 per share at the beginning of the pandemic to a high of $64 a share as of May 25.

St. Vincent nurses are continuing efforts to reach an agreement to end a strike, improve staffing levels and working conditions that brought nurses and supporters out on the streets. Striking nurses have been held up as being heroes for the courageous stand they took in the face of the COVID pandemic.

The nurses’ strike has galvanized support from a range of public officials, labor, faith-based organizations, community advocates and the entire Worcester City Council and the Worcester state legislative delegation.

Honoring the picket line On April 28, the Massachusetts Building Trades Council delivered a letter to Tenet CEO Carolyn Jackson informing her that the Council will not be sending its 75,000 members to the hospital for care until the strike is resolved.

In the year leading up to the strike, nurses filed more than 600 official “unsafe staffing” reports (including the more than 110 reports filed so far this year). These reports are similar to NYSNA POAs in that nurses informed management in real time about patient care conditions jeopardizing the safety of their patients.

Stay tuned: if the strike continues we’ll be organizing buses. In the meantime join the fight and support the strike: www.massnurses.org/ StVincentNurses.

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Remembering Joan Rowley, RN

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ongtime NYSNA colleague, activist, and nurse Joan Rowley, RN, passed on May 28 due to COVID19. She had been battling COVID-19 in the hospital for many weeks.

Known to her friends as “Joanie,” this dedicated nurse began her long career in the Kings County Diploma Nursing Program.

Upon completion, she joined the staff at her beloved neighborhood hospital: Long Island College Hospital (LICH).

As an ICU nurse, Joanie led that unit for years, while becoming a mother and gaining a Master’s Degree. She joined NYSNA on February 2, 1976, remaining active in the union for 45 years.

Open for care After decades of LBU leadership at the LICH Executive Committee, Joanie was a founding member of the SaveLICH Coalition. Launched in 2012, Joanie and her colleagues fought a multi-year battle against the state to keep LICH open for care. The campaign, along with a parallel effort to keep open Interfaith Medical Center, became

a hallmark of the new NYSNA as a fighting Union.

Joanie and her colleagues kept the doors open for two and a half years, occupying their hospital and forging deep alliances between the Union and community. Joanie and her colleagues sued the State of New York and SUNY, packed courtrooms, held daily press conferences with dozens of media outlets, helped elect Mayor Bill de Blasio, and led a landmark mobilization of thousands of

workers and allies in support of nurses and other healthcare workers at Interfaith.

Joanie was at LICH the final day, as the last shift of nurses departed the hospital. She was willing to sustain the fight for what was right and would see that fight through to the end. For those of you who knew Joanie, she put her soul into that campaign and lived at that hospital those final days.

Sadly, LICH is today a slew of condos. But the legacy of LICH is that closures provoke a battle cry in NYC. Joanie and her union sisters and brothers planted their flag and said ENOUGH.

An inspiring presence After Joanie retired as a nurse, NYSNA convinced her to join staff as a Per Diem Nurse Organizer and help with the RUMC contract campaign. That was two cycles ago in 2015, and she remained on staff ever since. She will also be remembered as a steady, knowledgeable, and inspiring presence to the RUMC members.

Another significant part of Joanie’s life was her activism in the National Alliance on Mental Illness (NAMI). She was an active organizer and advocate in the Staten Island Chapter, and spent most of her postICU nursing career focusing on mental health issues in New York. Her leadership will be sorely missed.

“The higher powers packed a lot of punch into her 5-foot frame,” said her friend, NYSNA Executive (Left to right) Julie Semente, RN, Joan Rowley, RN, and Deborah O’Hara, RN, March 2012 Director Pat Kane, RN.

Joan Rowley, RN, dedicated nurse and advocate, read her obituary in the Staten Island Advance here.

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june 2021

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INSIDE

NYSNA

convention save the date

Wednesday, October 27 Victory! It's the law!, p. 3

NYSNA’s Convention plans for this year are underway. Unfortunately, we are faced with many of the same challenges as last year due to COVID-19 restrictions and enhanced safety guidelines for in person events. The final decision on how to present this year’s Convention will ultimately be based on safety and the guidelines in place at that time.

We would like your feedback on what you would like this year’s convention to look like. Please e-mail MCP@NYSNA.org and let us know: 1. If you plan on participating in this year‘s convention 2. If yes, do you prefer to attend in person or virtually.

We appreciate your feedback and will have a final decision in the coming weeks.

NYSNA President Judy Sheridan-Gonzalez, RN, on the pandemic, p. 2 and George Floyd, p. 6