National Nurses United

NewsBriefs:JanFeb 3 2/28/09 12:55 AM Page 4 NewsBriefs With New Contract, UC RNs Make Progress in Fixing Staffing Problems NATIONAL niversity of california RNs in late January reached a contract where UC for the first time acknowledged its responsibility to provide relief staffing during nurses' meal and rest breaks. RNs also successfully maintained their pension and retiree health benefits, and won 4 to 7 percent across-the-board salary improvements for some 10,000 UC RNs. Bargaining had been tough during this time of state budget crisis and general economic crisis; in December UC RNs voted to authorize the RN negotiating team to call a strike if talks did not progress. The biggest issue on the table during this round of talks was inadequate staffing. Most UC medical centers fail to meet minimum RN-to-patient ratios when nurses need to go on breaks, if nurses are able to take their breaks at all. UC's practice is to have charge nurses provide break relief for RNs, a problematic situation since the charge nurses are busy overseeing the unit, or to have nurses double up during breaks and violate the ratios. Instead of endangering their patients, many nurses eat on the run or skip their breaks entirely, causing them to risk becoming run down and less mentally sharp. Unlike private-sector hospitals, UC RNs are not eligible for California Industrial Welfare Commission-ordered penalty pay for missed meals and breaks. UC nurses in 2007 won missed break pay in the UC contract. "People are not going on breaks, or end up working during breaks," said Janice Webb, a step-down unit RN at UC San Diego Medical Center and a CNA/NNOC board member. "Nurses take their phones to the lounge and the doctors come and get us if they have any questions. Sometimes people haven't gone to lunch and it's four in the afternoon! It's really not fair." The University of California does not want to spend the money to hire dedicated break relief RNs, even though the UC medical centers as a whole netted a whopping $228 million in 2008. "It's not an issue of money, it's an issue of how they choose to U 4 REGISTERED NURSE University of California RN bargaining team spend the money," said Geri Jenkins, a surgical ICU RN also at UCSD and a member of the CNA/NNOC Council of Presidents. The only UC hospital with dedicated break relief staffing is UCLA-Westwood Medical Center. According to Manny Punzalan, an oncology RN, chief nurse representative there, and a bargaining team member, the professional practice committee at UCLA-Westwood recruited RNs from each unit to educate and conduct walk-throughs of the hospital, gathering data about staffing matrices and patient populations. The PPC worked out a proposal with UCLA's chief nursing officer about how to stick to the ratios even during breaks, and the plan was implemented on July 7, 2007. Punzalan said that adhering to the plan has taken a lot of creative education (the PPC once passed out brown paper lunch bags containing energy bars and flyers about staffing rules) and mass assignment despite objection (ADO) campaigns, but that it is now working fairly smoothly for both day and night shifts. "The culture has changed tremendously," said Punzalan. "Although it's not perfect, it has improved the nurses' morale. We're like cell phones, being used constantly. Your batteries get low and you have to recharge and W W W. C A L N U R S E S . O R G step away from patients care to take care of yourself." The estimated cost of UCLA's dedicated break relief program was $1.8 million last year, but it appears the medical center believes it's a smart investment. RNs certainly do. In addition to not staffing properly during breaks, nurses charge that UC medical centers are at other times are not staffing to the acuity levels of patients as California's ratio law actually mandates. Because the UC medical centers are tertiary care centers, patients are more acute than at many hospitals – requiring even better RN-to-patient staffing ratios that the numerical ratios dictate. "They went back to just the bare minimum," said James Darby, a neurological ICU RN at UC San Francisco Medical Center and a bargaining team member. "Nurses who are already feeling like they weren't able to give the care they wanted to give are feeling pushed even further." Last December, RNs filed a formal complaint with the California Public Employment Relations Board over lack of staffing, and the charge is ongoing. Nurses plan to test out the new break relief language for the next six months and return to the table in August 2009 to fight for any needed improvements. —staff report JANUARY | FEBRUARY 2009

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