National Nurses United

20 J U L Y / A U G U S T 2 0 0 5 C A L I F O R N I A N U R S E ID #1 Patient Advocacy Changes: Article II, Sections 2(K)(6) & (7) are amended to include the professional RN responsibility of patient advocacy and the CNA core value of collective patient advocacy as ele- ments of the CNA Code for Registered Nurses. Article II, Section 2(K)(8) is amended to expressly state that clinical competence is an essential element of professional responsi- bility under the CNA Code. Rationale: Patient advocacy is a bright line of demarcation for the activist staff nurse movement built by CNA—it has and continues to define the essential contradictions between the corporate healthcare agenda and the "single payer" agenda. As the fee-for-service regulatory scheme and specialized RN classification continues to erode, the regulatory agencies turn even more, and "institutional licensure" approaches, the "patient advocacy" brand will become more important than ever in organizing and defending organized units, negotiating and enforcing safe staffing practices, and addressing the pub- lic health crisis. As a core principal and condition of "affilia- tion" it provides a measure of organizational integrity for would-be affiliates of CNA. Translated into collective advoca- cy, it has and will continue to be a proven vehicle for political education and action. ID #2 Affiliations Changes: Article II, Section 3 is added to the Bylaws to estab- lish and define the scope of authority of the Board of Directors to enter into affiliation arrangements and relation- ships with other organizations. The proposed changes author- ize Board action and agreement on an affiliation providing certain expressly enumerate conditions are satisfied concern- ing organizational compatibility and conditions of agreement for affiliation. Rationale: CNA affiliations and alliances with organizations that have a mission and purpose consistent with the mission of CNA are absolutely necessary to confront the significant attack on RN professional practice standards, patient advoca- cy responsibilities, and delivery of safe, available, and accessi- ble healthcare we face today by the large healthcare corpora- tions, hospital chains, HMOs, insurance companies and phar- maceutical corporations, and other powerful economic insti- tutions and interests which seek profit at the expense of ade- quate healthcare delivery and the health and lives of patients. This amendment is necessary to conform the Bylaws to the reality of CNA organizational practices and needs in con- fronting corporate healthcare's profit agenda, clarify the pur- pose and conditions of affiliation arrangements to ensure alle- giance to CNA mission, and provide expressly defined authori- ty to the Board of Directors in order to ensure the feasibility and integrity of affiliation arrangements. ID #3 Council of Presidents Changes: Article IV is substantially amended to create a Council of Presidents, consisting of four members, which will perform all the functions and discharge all of the duties previ- ously assigned to and undertaken by the offices of CNA President and Vice President. The four members of the Council of Presidents are collectively responsible for perform- ing these responsibilities and for allocating among themselves specific responsibility for performance. Each member of the Council has the authority, right, and responsibility to perform the duties defined in these bylaws or otherwise assigned by the Board. The allocation of specific duties and assignments made by and among members of the Council is subject to the advice, guidance, and ultimate authority of the Board. The proposed amendments provide for designation of a single "president" or agent where necessary to comply with legal obligations. Election of the Council is conducted by slate, a collective group of four individuals constituting the "candi- date" for election. Individual CNA member eligibility for nom- ination and election as a Council Member is limited to a sin- gle slate. Conforming technical amendments occur in other articles. Rationale: The creation of a Council of Presidents is neces- sary to meet the demands on elected staff nurse leadership resulting from the significant growth in membership due to an incredibly successful organizing program, the expanded scope and complexity of CNA operations required to fulfill represen- tational responsibilities, and the high public profile CNA now commands as a result of its leadership, commitment, and direct actions in support of an activist patient and healthcare consumer protection agenda. This is an important change in leadership structure and cultural orientation, affirming CNA's model of collective leadership that will increase the organiza- tion's capability for rapid response and accountable decision- making across the national scope of current CNA operations and obtaining the efficiencies and quality of critical analysis offered by disciplined group decision-making based on compe- tent investigation, meaningful assessment of available options, and timely execution of plans for action. Collective attention and determination of difficult policy and operational issues confronting CNA will greatly improve accountability to mem- bers and perceived integrity of CNA decision-making process- es. If successful as anticipated, this new model of collective leadership is expected to attract significant interest through- out the organization, enhancing collective decision-making. ID #4 Regional Functions Changes: Article IX is amended to expressly define the princi- pal purpose of a Region as establishing and maintaining an effective means of member communications and accountabili- ty by and between members and elected CNA leadership and administration in order to support the essential CNA repre- sentational function of member mobilization. Article X is SUMMARY OF BYLAWS AMENDMENTS PROPOSED BY THE CNA BOARD OF DIRECTORS

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