National Nurses United

RoseAnn DeMoro Executive Director, National Nurses United 101 Reasons For RN Unity Why it���s a critical time to take our RN movement to the next level I f there was ever a critical moment for building a powerful, effective movement of all registered nurses to protect the interests of patients and nurses, that time has surely come. Here are 101 reasons for RN unity. All re���ect the way in which nurses, their patients, practice, families, and communities are under attack. Let���s call this a partial list. Add your own reasons. I welcome your thoughts. 1. Budget-driven short staf���ng, regardless of patient need 2. Erosion of RNs��� ability to practice in the exclusive interest of patients rather than maximizing pro���ts 3. Misleading ���patient satisfaction��� goals that substitute budget-driven scripting and rounding for actual care 4. Time spent on the caring process considered ���non-productive��� time 5. Needed patient services cut based on corporate business models to increase pro���t margins 6. ���Evidence-based��� medicine eroding care based on individual patients��� needs 7. Hospitals cutting back on basic equipment and supplies needed to provide good care 8. RNs being required to ���oat to specialty units without proper clinical expertise or orientation 9. Replacement of specialist RN care with generalist RN care 10. Efforts to roll back California���s nurseto-patient ratio law 11. Hospital industry���s nationwide campaign against nurse-to-patient ratios 12. Medical redlining, i.e. hospitals cutting services for lower-income patients and communities 13. Long waits for emergency care 14. Patients being shifted from hospitals to outpatient and home settings where care is provided by non-RNs or family members 15. Laws and regulations that sacri���ce patient safety to the bottom line and erode RN practice 8 N AT I O N A L N U R S E 16. Lack of protection for non-union RNs who advocate for better patient care 17. Deskilling of the nursing process by routinizing it, i.e. by fragmenting and standardizing it 18. Standardized clinical protocols that limit RN judgment 19. Manipulation of hospital census numbers to short staff and reduce RN hours 20. Speed-up through understaf���ng 21. RNs being denied meal and rest breaks via short staf���ng and manager coercion 22. Support staff cuts 23. Mandatory overtime 24. Attacks on RNs��� hard-won scheduling options 25. Increased employer discipline of nurses on pretexts 26. Exposure to antibiotic-resistant and other hospital-acquired infections 27. Hospitals failing to provide protective equipment or inform nurses of exposure to infected patients 28. Unsafe lift policies and other hazardous working conditions that increase injuries 29. Employers��� failure to enact measures to protect staff and patients from workplace violence 30. Lack of mentorship for new RNs 31. Lack of protection for non-union RNs who blow the whistle on unsafe hospital conditions or billing fraud 32. Crises of conscience for nurses unwilling to work in unsafe settings 33. Nurses leaving the profession due to stress, burnout, or employer-created hostile environment 34. Increased management control through workplace surveillance technologies 35. Surveillance of nurses��� use of social media, such as Facebook and YouTube 36. Use of information technology to displace RNs and override RN professional judgment 37. Technology-driven speed-up 38. Use of information technology to downgrade patient acuity to justify short staf���ng W W W. N A T I O N A L N U R S E S U N I T E D . O R G 39. Electronic charting that forces the RN to focus on a computer rather than on the patient 40. Telemedicine displacing hands-on patient care 41. Medical errors caused by electronic medical record systems and other health information technologies 42. RNs being scapegoated for medical errors actually caused by technology 43. Employers��� isolation of individual RNs through technology adoption and other tactics, undermining senses of unity and community 44. Loss of institutional memory of what nursing was prior to the advent of health IT and other management innovations 45. Federal government tying reimbursement to adoption of health information technology 46. Cuts in or elimination of employerpaid pensions (de���ned-bene���t plans) 47. Employers eliminating health bene���ts or reducing them by increasing outof-pocket costs, among other changes 48. Reduction of sick leave so nurses are forced to work when sick, a risk to themselves and patients 49. Employers not paying overtime 50. Two-tier wage and bene���t structures that pit new RNs against more experienced RNs 51. Reductions in paid continuing education leave for RNs 52. Unpaid hospital internships and preceptorships 53. Attacks on RNs��� hard-won seniority rights 54. Loss of contract-based due process and freedom of speech rights in the workplace 55. Lack of protection against unjust ���ring or other discipline for non-union RNs 56. Multi-tier healthcare system based on ability to pay 57. Skyrocketing insurance premiums, co-insurance, co-pays, and deductibles 58. Hospitals and physicians making medical decisions based upon insurance coverage NOVEMBER 2012

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