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Nurses Week

Thank you to members of the PRNC and to all of the Staff Nurses whose time and efforts resulted in enjoyable events for Nurse's week.

Financial Oversight

Comments from a Staff Nurse on the Negotiation Survey reminded us that we haven't reviewed our financial oversight method with you recently.

SNA's quarterly financial statements are available to Staff Nurses. Please call the message line if you would like to make an appointment to review those statements.

The SNA Board submits our finances to a yearly review by the firm Dillwood, Burkel and Sully. At times, this firm makes recommendations to the Board for changes in our accounting or financial practices. Those changes are put into effect. Their recommendations and the Board's response are a matter of record.

A yearly financial report is sent to the Federal Government via the LM-2 process. And, every six months, two Staff Nurses kindly volunteer to review SNA's "books." These Staff Nurses are rotated amongst the membership.

All hours worked and paid to the SNA Board members recorded on monthly time sheets. Excluding the current President, Board Members are paid $48.00/hour. The SNA President, Sue Gadbois, who is no longer a Staff Nurse is paid the wage rate she was paid when she left Hospital employment-SNIII, Step 8 , PM shift. She is currently paid for 24 hours/week.

Vacation, ED time, etc are paid to Sue similarly to Hospital mechanisms. Yearly contributions to her ROTH IRA compensate for retirement contributions she would have received in Hospital employment.

Recall, a vote of the SNA membership was held April 2007 to change the SNA bylaws to permit SNA Board members to be employed by SNA and remain SNA members without being employed by SRMH. This is possible as long as the SNA Board member had been employed as a Staff Nurse by SRMH.

It has become clear over the last few years as the environment at the Hospital becomes increasingly complex and contentious that SNA needs at least one individual to devote their full attention and energy to the problem solving and detail tracking of the multiple campaigns waged by SNA.

Contract Negotiations

Thank you so much for taking the time to respond so thoughtfully to the SNA negotiations survey. The number of returned surveys is especially high this year. We are in the process of collating all of the information you've given us and then identifying the issues most important to you. We'll report those findings in subsequent newsletters.

Market research is currently underway as members of the SNA Board compare SNA's contract to other Hospital union contracts in Sonoma County and The Bay Area.
We've also begun to write proposals for contract changes based on tracking of issues during the current contract.

SNA NEGOTIATION TEAM 2008
Sue Gadbois, President
Stacey Lewis, Vice President
Cathleen Lukrich, Treasurer
Kery Poteracke, Secretary
Michael Broussard, Board Member
Charlotte Schatz, Board Member

NEGOTIATIONS MEETINGS WITH HOSPITAL ADMINISTRATION
1st Meeting July 28, 2008

**Stay tuned for posted notices listing dates, times and location.
**SNA Members are welcome to attend as silent observers.

SNA MEMBERSHIP MEETINGS
Friday August 15th
Friday August 29th (all meetings at 1 pm and 4 pm
Every Friday in September location to be announced.)
PLEASE PLAN TO ATTEND. WE WILL NEED YOUR FEEDBACK AND SUPPORT

Department Staff Meetings

Members of the SNA Board continue to discuss the nature of monthly department Staff meetings with members of Administration. In many departments, the hour long meeting is entirely devoted to an "information download"-without time for discussion, processing of the information or Staff Nurse input. Kathy Hardin, CNO, has stated that managers are encouraged to provide time for discussion but we have yet to see a change in many departments.

ED Ratios

We are asking Staff Nurses to continue to document when the 1:4 Nurse/Patient ratio is not maintained in the Emergency Department. This regulation is most difficult to maintain when the ED is "holding" critical care patients.

CCD patients must have a 1:2 Nurse/Patient ratio regardless of where the patients are located. The ED Nurse(s) caring for the CCD patients being held cannot also be available to other ED patients.

Discussions have been ongoing between the SNA Board and Administration on this issue. Both the Manager and Director of the Emergency Dept. indicate that they have posted positions to hire Nurses and are obtaining travelers to cover leaves of absence. These measures should help to ease some of the short staffing issues
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However, the difficulties associated with holding patients are not resolved so easily. "Patient flow" problems are a daily challenge at SRMH as patients are held in ED and PACU. Administration states that working on timely discharge of patients is key to resolving these problems. However, those efforts do not address the immediate patient safety and patient care issues for Nurses.

GRASP Acuity System

3East has been added to the acuity staffing pilot that already includes 1East and 3West. We understand that at least initially, there have been difficulties with adhering to the pilot's prescriptions for additional staff at particular utilization percentages.

The Acuity Committee is also focusing on the remaining Med-Surg departments-Palliative Care, 2East, 2CE, and 4West and Critical Care. We want to be certain that these departments have the manager and staff support to meet the criteria to join the Pilot.
The goal, of course, is to have acuity influence staffing. This is both a contractual and Title 22 regulation requirement.

The SNA Board is aware that there are shifts (frequently, at times) when the Hospital states that they cannot provide the additional staff that are required to meet the specifications for staffing associated with the utilization %. This is not acceptable and we will be addressing this issue.

Recall Process

Staff Nurses who were laid off when the SOU and Acute Psych departments closed have had access to the contractual recall process since early May. Positions are subject to the recall process before being posted. Several Staff Nurses have been recalled to positions already.

Barbara Darling, Hospital Recruiter, has been coordinating the recall process with collaboration and oversight by the SNA Board.

OVERTIME

The SNA Board continues to be deeply concerned about the Hospital's practices concerning Nurse's use of overtime.
We have recently become aware of two tactics used by managers against Nurses who work overtime and record it on their timecards.

1) 3West-a list of Staff Nurses who had recorded overtime on their timecards during a particular pay period was posted by a 3West manager.
We feel that this constitutes intimidation regarding overtime and is therefore a violation of the law.

2) CCD-Memo posted by CCD Managers on 4/23 amongst other things, the memo indicated that Staff Nurses would be disciplined if their timecards showed overtime on 50% or more of the shifts they worked. The memo was revised 4/28 to indicated that Nurses would be disciplined for time management issues if they had overtime on their timecards 50% or more of the shifts they worked.

Both of these circumstances were reported to Debra Miller, Vice President of Human Resources and Kathy Hardin, CNO, by the SNA Board.

Discussion with both Debra and Kathy revealed that the managers had been instructed, in both cases, to take the actions they took by the "budget watch team."
Apparently, the "budget watch" team was unaware of overtime laws.

We remain very concerned because the revised CCD memo posted on 4/28 stating that Nurses will be disciplined for time management issues if they have overtime 50% or more of the shifts they work may be unlawful.

In fact, the discipline process was initiated for a number of CCD nurses in the form of "verbal" warnings from CCD managers.
We do not believe that 15 minutes of overtime constitutes a time management problem . It may will reflect the lack of sufficient secretarial help, extended report time for complex patients complicated and non-user friendly computer charting systems and patient acuity.

The Hospital is required to be consistent with discipline actions across the Hospital. To our knowledge, Nurses who have been disciplined for time management issues have had 30 minutes to 2 hours of overtime, consistently, each shift they worked.

The SNA Board has referred this issue to our attorney for investigation and follow up. We have many concerns related to the Hospital's tactics.

Intimidations of Nurses to under report their actual hours of work is a significant concern and seems to be a natural outcome of the Hospital's tactics. The erosion of Nursing Practice at SRMH is another, more longterm consequence and concern.

Meanwhile:
Individual Nurses must continue to report:

1) Change in timecard without your knowledge/permission

2) Intimidation tactics by Management

To: Labor Standards Enforcement 576-2362

Remember, SNA cannot file complaints on your behalf-YOU MUST CALL.

CES Compensationfor Extra Shifts Benefit Accrual

Eight hour shift Nurses who work extra 8 hour shifts that result in them working over 80 hours/pay period are paid overtime rate (per state law) and and additional halftime (per contract) for a total of double time for the extra shifts.

12 hour shift Nurses who work extra 12 hour shifts that result in them working over 40 hours/week earn overtime rate (per state law) and an additional half time pay (per contract) for those extra shifts worked over 40 hours/week.

CES contract language states that benefits shall accrue for all CES hours worked. The contract language does not distinguish between CES hours that are also overtime in regard to benefit accrual.

Article IX of the contract states that ETO/sick leave only accrues for straight time hours worked. These two contractual provisions seem to be in conflict.

After consultation with our attorney, SNA's position is that the CES benefit accrual language is specific and was negotiated at the same time as the language recognizing CES shifts for overtime shifts. Therefore, despite the generic language of Article IX, benefits should accrue for CES shifts that are also overtime.

The SNA Board began discussions with Administration in January 2008 regarding this issue. Despite their promises to "get back" to us in the intervening months, they finally responded on May 20th that they don't wish to pursue the issue further and want to leave the language unchanged.
We are in the process of formulating our response.

Please call the SNA Message Line if you have recently been denied benefit accrual for CES shifts (full 8 hour or 12 hour) that were over 40 hours/week or 80 hours/ pay period.

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STAFF NURSES' ASSOCIATION
Message Line: 575-8853
Fax: 575-8138

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© Staff Nurse's Association 2008