National Nurses United

Case Studies in Collective Action Our ability to provide safe, therapeutic, and effective patient care depends on reversing the trend of inad- equate hospital staffing driven by corporate health care that is putting patients at risk and is driving nurses out of the profession. CNA/NNU provides nurses with a voice in patient care decisions, which we use to create safer health care facilities to protect our patients and our licenses. Below are a few examples of how RNs in our facili- ties have used the tools in our toolbox to win patient care. These tools include the PPC, Quality Liaisons (Kaiser), the ADO, and the collective action of nurses in your facility. Refusal of Unsafe Assignment, Citing Title 22, Leads to New Training Program "An RN from PACU was told she would have to take care of a pediatric patient [infant] on a ventilator. Since the only requirement at the time was for the PACU RNs to be PALS certified, she was the first to point out that the staff nurses were not competent to care for ventilated pediatric patients. She refused to take the assignment and notified the nurse rep that she faced the potential for disciplinary action. Her knowledge of the law [Title 22] and the unity of the PACU RNs led to an annual skills day with spe- cific patient population competency validation for the unit. As a result, the RN was not disciplined." — Cathy Kennedy, RN, CNA president and NNU vice president, Kaiser Sacramento Medical Center, Sacramento, California ADO Campaign Stops Unsafe Floating and Corrects Short Staffing "Our manager was regularly floating NICU staff RNs out of the department to pediatric and assign- ing travelers to work the NICU. We were also out of compliance for staffing ratios at 1:3. The NICU RNs staged an ADO campaign for one week notifying our manager that we objected to the unsafe floating and consistent short staffing. Management backed down and floating out of order has ceased. Additional staff has been procured and NICU staffing is back in compliance with ratios." — Lois Sanders, RN St. Mary Medical Center, Apple Valley, California Nurses Defend Ratios During Covid-19 Pandemic "Since the start of the Covid-19 pandemic nurses have been struggling to provide quality patient care without enough nurses on the floor to do the work. As soon as we heard that the governor was going to allow hospitals to use the pandemic as an excuse to waive safe staffing requirements, we sprang into action. We quickly found out that UCSF had applied for a waiver, the first UC hospital to do so. The PPC voiced strong opposition to management, then planned a press conference and rally to alert the public to the hospital's dangerous plans. Just three days later, right before the rally date, the hospi- tal rescinded its application for the waivers! This early victory created strong momentum for RNs to beat back waivers throughout the UC system. I'm very proud of the role the PPC played in organizing nurses to defeat this attack on safe staffing. I know we succeeded because we were already very well organized as union members before the pandemic." — Jamille Cabacungan, RN, Nurse Representative, PPC Chair, UCSF, San Francisco, California Nurses Demand Optimal PPE "Shortly after Monterey County nurses organized with CNA in early 2020, the Covid-19 pandemic hit and we found ourselves in an entirely new fight with our employer. Almost immediately, nurses witnessed supervisors locking up N95 masks, ordering us to reuse contaminated respirators, making excuses for why there was no backup sup- ply, and telling us we would have to use untested, and recycled dirty N95 masks. But as county nurses, we realized that now that we were part of a real union, we could stand collectively to demand what we needed to safely care for the growing number of high-acuity patients. We formed a Union RN Covid Committee, demanded weekly meetings with man- agement, reached out to our community and held press conferences, and spoke out before publicly elected officials, and do you know what happened? The nurses won our right to use the highest precau- tionary level of PPE based on our professional discretion. As I look back on this past year of the Covid pandemic, I have no doubt that without a strong union through CNA, we would have lost nurses and more patients." — Jennifer Jean-Pierre, RN, ICU Monterey County public health system, Salinas, California 29

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