National Nurses United

Profile:FINAL 11/20/08 11:07 PM Page 15 in the end to pay for school by cobbling together loans and scholarships, her problems with health insurance after the birth of her third child andreceivedsupport inotherways through family, friends,andclassmates. some 15 months ago just reinforced her position. As a unionized RN with one of the best contracts in the nation, GutierGutierrez-Vo graduated in 1998, becoming the first person in her family to receive a college education in the United States, and soon rez-Vo never dreamed she'd run into insurance benefit problems. But found a job at Kaiser Permanente Oakland in the telemetry depart- that's exactly what happened. Her third pregnancy turned out to be a comment. As a rookie nurse, she said she soon got into trouble with man- plicated Caesarean section, and she had to take more time off than expectagement for speaking up about substandard patient care, heavy ed. Her period away from work triggered a gap in healthcare coverage for herself, her three children, and her husband, who all rely on her for insurpatient loads, and problems with the acuity system. ance. If she didn't return to work immediately, CNA/NNOC labor reps and nurse leaders they would have to start paying hundreds of dolrecognized that Gutierrez-Vo was a firebrand not afraid to speak out, and quickly recruited "It has been my struggle in the lars each month for healthcare. Though she wasn't ready to go back and would have liked her onto the professional practice committee. eight to nine years I've been more time to bond with her newborn, she felt With children at home, Gutierrez-Vo here to draw the lines for like she had no other choice. "People who have jumped at the opportunity in 2000 to transfer to patients. These patients are a day shift position with one of Kaiser Frepaying a lot of money and not employer-covered benefits think they're mont's outpatient departments. She soon getting the care they should." untouched by the crisis," said Gutierrez-Vo. "Well, I'm here to say that they're not immune." learned that outpatient nursing was like the She says that her story should be a wake-up "Wild West" of medicine, with, as she describes it, "no regulations. It's a free for all." She explains that encroachment is call to all RNs, especially younger ones who say they don't like to get rampant across all scopes of practice. Gutierrez-Vo is constantly printing involved in politics. Her eldest son is now studying to become an RN, out and reading statutes, California Board of Registered Nursing guide- and she's so proud. "When you took your oath to be a nurse, to preserve life at its fullest, lines, recommendations, rules on competency, you name it. She says her mission at work now is to reform and raise nursing prac- it's not just about patients at the bedside," she said. "You're a nurse inside tice standards in the outpatient setting. With more and more treatments and outside of the hospital. Your patients don't stop being patients when and procedures now being done on an outpatient basis, and with hospi- they leave the hospital, and you don't stop being a nurse." I tals prematurely discharging very sick patients who wind up seeking help from outpatient clinics, Gutierrez-Vo sees structural reform as one of the Lucia Hwang is editor of Registered Nurse. best ways she can be a forceful advocate for the safety and health of her patients. "It has been my struggle in the eight to nine years I've been here to draw the lines for patients," she said. "These patients are paying a lot of money and not getting the care they should. I'm working so that patients get the appropriate care from the appropriate skill level [of staff ]." As one example, Gutierrez-Vo said that Kaiser's electronic health record system, HealthConnect, allows RNs to "initiate" procedures like ear washes for patients, even though they are supposed to get orders from Name: Michelle Gutierrez-Vo, RN physicians first. "I have to say, 'No, just because that button's there doesn't Facility: Kaiser Permanente, mean you should click it,'" said Gutierrez-Vo. Standardized procedures, Fremont protocols, training, and proof of competency are lacking, spotty from Unit: Outpatient medicine, facility to facility, not updated, or just used inappropriately, she added. urgent care One of her first challenges was to connect the RNs and NPs since the Nursing for: 10 years outpatient departments tend to be spread out. As PPC outpatient chair, she On CNA/NNOC board since: 2006 has worked to recruit a representative from each department, and recently Sign: Scorpio compiled a master contact list for all outpatient PPCs. In October, she Nursing pet peeve: Nurses who helped plan a PPC fair, where outpatient RNs convened to discuss more become managers and have selective amnesia than a dozen significant topics affecting their practice and how to best Favorite work snack: "Cheese. How bad, huh? Maybe advocate for patients. And recently, she fought against Kaiser Fremont for I should've said broccoli." wanting to close the outpatient screening window where patients could Latest work accomplishment: Being able to open walk in and get triaged by an RN. If the window closed, patients would get communications between all outpatient PPCs shunted to the advice call center, where they might not get to speak to a Color of favorite scrubs: Red registered nurse. The screening window remains open, for now. Hobbies: Reading, troublemaking Beyond her workplace, Gutierrez-Vo is emphatic about the counFavorite musician: Luther Vandross try's need for a single-payer healthcare system that guarantees care Last book read: Sesame Street Elmo's First ABCs to anyone, regardless of their income, employment status, or preex(to her toddler) isting conditions. Her stints as an uninsured single mom and college Secret talent unrelated to nursing: Practicing feng shui student were already enough to convince her that single-payer, universal healthcare is the fundamental change the country needs, but Profile NOVEMBER 2008 W W W. C A L N U R S E S . O R G REGISTERED NURSE 15

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