National Nurses United

J U LY | A U G U S T | S E P T E M B E R 2 0 2 4 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 N A T I O N A L N U R S E 13 W hen the "triple- demic" of Covid, influenza, and respiratory syncytial virus (RSV) hit in the winter of 2022, the pediatric unit at Ronald Reagan UCLA Medical Center in Los Ange- les was at maximum capacity. Management's solution was to get a waiver to add "shadow beds," their term for the placing of an additional unlicensed bed in a single-occupancy room. "It was a nightmare from day one," recalled Nikki Cuadra, RN in UCLA's pediatric unit. "We found out about it during a huddle but there was no plan or system in place for shadow beds." "There wasn't enough space in the room for the extra IV cords, drips, and extension cords," said Cuadra, who is also a member of UCLA's Professional Practice Committee (PPC). "It was unsafe to walk through to get to each patient." Even worse, if you needed emergency oxygen or suction for the patient in the shadow bed, it did not always work. "Primary oxygen was set up for one bed," noted Cuadra. "The other side had a splitter device installed. It wasn't something we could count on working when we needed it." UCLA's use of shadow beds began in March 2020 after California Gov. Gavin Newsom declared a state of emergency due to the Covid-19 pandemic, which allowed hospitals to request waivers from the Califor- nia Department of Public Health (CDPH) to add unlicensed beds. UCLA nurses waged a three-year campaign to stop management's use of space waivers that let them place two patients in single-occupancy rooms and in hallway beds in the emergency department. Squeezing in a shadow bed, plus all the associated equipment and extra wiring as well as makeshift dividers, was not safe for patients or nurses. Not only was the room filled with potential trip hazards, but there was also little to no space for a crash cart if a patient needed emergency intervention, not to mention the lack of privacy or dignity for patients. Hallway beds in the emergency department were arguably worse, with no privacy, no call lights, no infection control, and a dearth of proper equipment. The PPC has the authority to document unsafe practices and the power to make real changes because it is part of collective bargaining agreements negotiated by Cali- fornia Nurses Association/National Nurses Organizing Committee (CNA/NNOC). The PPC, composed of elected staff RNs who represent every major nursing unit, meets with hospital administration about working conditions and any changes that affect patient care, nursing practice, and work- place safety. CNA represents nearly 22,000 nurses across the University of California (UC) system, including nearly 5,400 RNs at UCLA. Campaigns to change the situation— whether it's improving patient care or enforcing certain contract terms—typically start with the PPC and can last anywhere from a few months to a few years. Sometimes the bigger the fight, the bigger the win. Nurses on the PPC know that speaking up and holding manage- ment accountable is what makes change possible. "The PPC makes sure manage- ment in the hospital is following policies and practices promised to us," said Cuadra. "We also help and support nurses if they face any injustices when they stand up for patients." When Covid numbers were down in 2021 and there was no clear need to continue the shadow beds or hallway beds, nurses began filing assignments despite objection forms (ADOs) documenting their concerns. UCLA had acquired Olympic Medical Center in January 2021 and closed it, which infuriated nurses because UCLA patients were being doubled up in single rooms and spending days in the hallway. PPC members and RN leaders began handing out flyers to patients, urging them to call UCLA Health's Office of the Patient Experience about the shadow beds and hallway beds. Meanwhile, CDPH extended the expiration date of space waivers to the end of 2021. The RNs' fight continued in 2022 when CDPH extended space waivers through June and UCLA did not stop using shadow beds or hallway beds. Kathrin Muellerchen, RN at UCLA and chair of the PPC, says that at every PPC meeting with management, nurses demanded that UCLA stop the use of shadow beds and hallway beds because it Third in a series Winning Big How UCLA's PPC stopped the practice of doubling patients in single-occupancy rooms. By Chuleenan Svetvilas Nikki Cuadra, RN Kathrin Muellerchen, RN

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