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Happy Holidays

The SNA Board extends our best wishes to you and your family for a safe and happy holiday season.

Election of SNA Officers 2009

You'll find the ballot to elect SNA officers for 2009 Enclosed in this newsletter.
Please vote and return the ballot to SNA by Monday Dec. 22, 2008.
You may either:

" Mail the ballot to the SNA office at: 401A College Ave. Santa Rosa, CA 95401

" Return the ballot in person to a current SNA Board member.

Thank You Liz Snyder

Liz has decided not to return to the SNA Board for 2009. We appreciate Liz's contributions to the SNA Board and her dedication to representing Staff Nurses.
Thank You, Liz. We will miss you!

Float Nurse Update

As this newsletter is written, 3 positions have been posted for Float Nurses. Hospital representatives indicate that those positions, once filled, will allow sufficient float nurses to be scheduled to meet contractual requirements.

Acuity/GRASP

4W tele and 2C Ortho are the remaining Med-Surg depts. that have not completed the necessary steps to use GRASP to influence staffing.

Depts must:

• Score patient acuity every shift, every patient, consistently over a period of time (at least 1 month).
• Interrater reliability monitor scores must be 90% or greater,
• Lead Nurses must complete the staffing questionnaire every shift, consistently over that same month.
  
  These steps , establish that the patient scoring tool is reliable and valid. Unless the tool is proven to be reliable and valid, the utilization % that GRASP calculates, that is used to determine the effect on staffing is not credible!

The Acuity Committee is focusing their efforts on helping 4W and 2C to complete these steps.

The Critical Care Dept is in the process of refining their patient scoring tool and getting back on track toward accomplishing the same steps. Now that GRASP is available on all computers and E-ICU implementation is accomplished, it will be easier to focus on GRASP implementation.

The Acute Rehab Dept (ARU) is completing their testing process and on their way to staffing with the influence of patient acuity.

Pediatrics has renewed their efforts to score patients accurately, complete the questionnaire and IRM's.

Staffing by Acuity

Staff Nurses in departments that are using GRASP to influence staffing- Palliative Care, 2E Neuro, 3E Surgery, 4N Tele and 1C Oncology have noted a number of shifts when the Hospital is unable to staff according to GRASP requirements.

Both the SNA contract and Title 22 law require that staffing be influenced by Acuity. The Acuity Committee and members of Hospital Administration have agreed upon the formula for additional staff (Lead Nurses have input as well) based on the GRASP utilization % generated by the GRASP program.

The SNA Board requests that Nurses document the date & shift when the Hospital fails to provide the additional staff proscribed by the formula & confirmed by Lead Nurse assessment of staffing needs.

OR Call Requirements

The number of Call hours assigned to OR Nurses has increased dramatically over the last few months. In particular, on-call hours at the end of the day shift have increased first from 2 to 3hrs. Then, recently additional call hours have been assigned from 6:30p-9:30p.
These additional hours have placed an increased burden on the day shift Nurses who may then be on call for the night shift and be scheduled to return to work the next day.

OR Nurses were not given notice of the increased call requirements, nor did OR Managers discuss the reasons for the increase in call hours with Staff Nurses.

The SNA Board will be discussing with members of Hospital Administration the impact of these increased call requirements, the Hospital's rationale for assigning more call and the unreasonable expectations that the Hospital creates with these additional requirements.

Call Back—3 hr Minimum Pay

The new contract changes the minimum call back guarantee pay from 2 to 3hrs. This change has had some unintended consequences.

Staff Nurses in some Depts where call is a requirement are now being required to stay at the Hospital for the full 3hrs, if called in, regardless if there is work for the Staff Nurses to do.

This represents a change in practice as Nurses were not previously required to stay at the Hospital for the entire 2 hour minimum when called in.

Interestingly, Kathy Hardin, CNO has indicated her belief that Staff Nurses did remain at the Hospital for the entire 2 hours if called in.

The SNA Board had been aware for many years that Staff Nurses completed their work and made sure that any needed work was completed when called in. But, if there was no further work to do, they left work prior to 2 hours.

Again, requiring Staff Nurses to remain at the Hospital for the entire 3hr minimum time has increased the burden on the remaining Staff Nurses in OR- especially in view of the increased call requirements.

Discussions continue on this issue between the SNA Board and member of Hospital Administration

Letter re: Changes in Call & Call Back Policy

Nurses who have a call requirement recently received a letter from Jessica Jauregui, HR with a copy of the new Call/ Call Back Hospital Policy that reflects changes made as a result of contract negotiations.

Note: The Hospital Policy is incorrect in that it states there is a 2 hour minimum Call Back pay guarantee rather tan the 3 hour minimum just negotiated.

Also, the policy states that Nurses on Call must respond within 30 minutes. OR Nurses must respond in 20 minutes.

BALLOT FOR SNA OFFICERS 2009

President (2009-2010, 2yr. Term): Sue Gadbois

Vice President: Stacy Lewis

Treasurers (vote for 2): Cathleen Lukrich
Florie Tiscornia

Secretary: Kery Poteracke

Appointed Board Members:
Charlotte Schatz
Michael Broussard

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