National Nurses United

NewsBriefs.3:March alt 2 3/16/09 9:20 PM Page 5 Arizona RNs Count Off Their Reasons For Ratios Arizona RNs demonstrate at state Capitol for safe staffing ratios ARIZONA R egistered nurses Marlene Bullock and Deborah Rice can think of many reasons why their state of Arizona should adopt mandatory RN-to-patient ratios and strong whistle-blower protections for RNs. They can easily count off 24 of them, in fact. That's the number of charges they won against their former employer, Vanguard Health Systems, in a National Labor Relations Board case they filed last year when the hospital retaliated against them for challenging unsafe staffing conditions in their unit. Both RNs' experience with management's refusals to fix poor staffing conditions pushed them to rally Jan. 13 in Phoenix in support of the Arizona Hospital Patient Protection Act of 2009, a state bill CNA/NNOC is sponsoring to set safe staffing ratios, defend RNs who speak out, and assure RNs have the right to act as patient advocates. The bill is titled HB 2186 and is sponsored by Rep. Phil Lopes. "Arizona needs the patient protection act to allow us to take care of our patients how they really should be taken care of," said Bullock, who now works in neonatal intensive care at a Scottsdale hospital. Bullock and Rice both worked in the newborn nursery at Arrowhead Hospital, a facility near Phoenix which is part of Abrazo MARCH 2009 Health Care, which in turn is owned by Vanguard Health Systems. Both say staffing is abysmal, with nursery RNs often assigned six babies or more while simultaneously expected to help with deliveries, do discharge teaching, and instruct on breastfeeding. "It was extremely stressful more often than not," said Bullock. "With a large number of babies, you'd be lucky if you could check on them even once." She believed the situation dangerous; once she happened to be in the room with a mother whose baby was having major trouble breathing. Bullock immediately took the infant back to the nursery, where they learned the baby had a serious infection. She cringes to think what would have happened if she had not been in the room. "Those kinds of things easily get missed," Bullock said. In June 2008, Arrowhead tried to fire Bullock for, she believes, being too outspoken about patient safety. She resigned first. The tipping point for Rice came during the 2008 Fourth of July weekend. Rice reported for work the morning of July 5 to discover that only six RNs were on shift when they needed "at least two more" to ensure the babies' safety. They asked the charge nurse to increase staffing, but her response was "deal with it," said Rice. All six RNs then wrote and signed a note reading "Staffing in the nursery today is unsafe" and sent it to the house supervisor, who forwardW W W. C A L N U R S E S . O R G ed it to the director of nursing. By midmorning the hospital added one additional RN for the well-baby side of the nursery, and the unit managed somehow to finish the shift without letting any patients get hurt. "We felt very much on our own and out on a limb that day," said Rice, who described the incident as the final straw for her unit. "We felt like we were putting patient safety in jeopardy." Rice was even more shocked when, a few days later, the director of nursing and chief nursing officer called the six nurses into a meeting for "the chewing out of our lives." The administrators reprimanded and demoted a number of them, including Rice, so that they could not work in the level 2 nursery, where more complicated cases were handled. "We were absolutely floored," remembered Rice, who ended up transferring later to a different hospital within the Abrazo system because she could no longer tolerate the workplace. Luckily, Rice and Bullock had both been in contact with CNA/NNOC and labor attorneys, so knew their rights as employees. In July, both filed charges against their employer with the National Labor Relations Board for retaliating against them and creating a hostile work environment. The other five RNs involved in the incident also either filed similar charges, or served as strong witnesses for the others. In early January, the hospital agreed to a settlement with the nurses that included admission of guilt, reinstatement of the RNs to their positions, back wages, and promises to stop future retaliation. Rice and Bullock relish in particular the notice the hospital must publicly post that states how it violated their rights. For Rice and Bullock, their victory is just a first step in reforming nursing in Arizona. Both want to see Arizona ratio legislation passed and signed, like California enjoys. "If we'd had a ratio law, we would have had more nurses on that day," said Rice. "None of that stuff would have happened." Bullock points out that they have a duty, and even self interest, in improving nursing standards. "What kind of legacy do we want to leave to other nurses?" said Bullock. "And we're not going to live forever. Someday, we're going to be that patient." —lucia hwang REGISTERED NURSE 5

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