Issue link: https://nnumagazine.uberflip.com/i/1521816
24 » RNs in Motion Collective Advocacy PATIENT ADVOCACY— OUR GUIDING PRINCIPLE A CASE STUDY RNs Stop Prime Healthcare's "Virtual Dialysis" Scheme at Shasta Regional Medical Center One day, without warning, registered nurses at Shasta Regional Medical Center (SRMC) received an email from management announcing that the hospital was abruptly changing the way hemodialysis patients were to receive care. Patients would no longer receive 1:1 care by a trained dialysis RN working for an outside company. From now on, a new company would bring in hemodialysis equipment accompanied only by a tech. Staff RNs were expected to connect patients to the equipment and administer the medications required throughout the process, while simultaneously caring for their regular patient load, often on a different floor. Only the tech would remain with the patient with back-up from a virtual iPad RN in another state handling remote support for multiple patients. To prepare, RNs were instructed to take a one-hour online module and a one-hour in-person training. At the first training, which was taught just four days before the new program would begin by an educator with no hemodialysis experience, RNs inquired if there were any written policies and procedures on the new set-up. Management admitted that, no, there weren't any. "I thought patients may be harmed by this new practice," said Jon Longo, an RN at SRMC with years of experience as a dialysis nurse. "These patients require constant monitoring. Delays in administering meds or adjusting the equipment can be life-threatening. A trained dialysis RN should be at the bedside throughout the procedure." "We quickly organized to challenge this 'virtual dialysis' scheme," said Michelle Gaffney, RN. "We sent management a cease-and-desist letter, held an emergency meeting on Zoom for all staff RNs, and encouraged nurses to file ADOs documenting any assignment in which the patient requires acute hemodialysis and a trained dialysis RN would not be present at the bedside. We shared a QR code that made it easy for nurses to file complaints with the California Department of Public Health (CDPH)." "We were able to stop this dangerous program in a matter of weeks because, as union RNs, we know our rights," said Heather MacNamara, RN. "When we take collective action, we have the strength to push back on policies that will harm our patients. We are proud that we stopped this pilot program in its tracks." TECHNOLOGY AND PROFESSIONAL RN JUDGMENT Over the past decade, U.S. health care corporations have invested upward of $700 billion on information technology systems. Computer experts, hospital management, and investors cheer the advance of new hospital technologies, which is a multibillion-dollar market. They claim these systems save time and money, improve patient care, and combat the liability of medical errors by keeping more accurate and comprehensive records. RNs who use these systems day in and day out have found that the kind of care they can provide with this new technology is limited. The programs and machines are often counterintuitive, cumbersome to use, and sometimes they simply malfunction, prompting many RNs to worry whether they are also still making errors, just new kinds. Nurses are finding that the machines take time away from patients. Perhaps worst of all, they say that the introduction of these technologies is fundamen- tally changing the nature of nursing: Instead of using our full attention to observe and assess the patient, our eyes are constantly on a monitor and our hands are clicking a computer mouse. NNOC CONTRACTS Patient-Care Technology Review Procedures In anticipation of these kinds of troubles at hospitals across the country, our union has for several years more aggressively pushed for RNs to play a greater role in reviewing and approving new technologies before they are introduced.