Thursday, June 28, 2007

Nurses, an Oppressed Group?

The Unions’ power structure and their supporters have been hard at lobbying both local and federal legislators -- their latest project convincing our elected officials that it is less intimidating to have union organizers speak to prospective members one on one and convince them to sign a card signifying their desire to unionize rather than holding the secret ballot system that is now most commonly used. I think that for the average American it is a no-brainer, one-on-one lobbying vs. secret ballot -- the secret ballot allows for an individual to freely express their true desires. However, the Unions are quite accomplished at convincing legislators that their members are not adept at representing themselves so Unions are needed to do this. Don't believe me, just read AB 1201, which is now in suspense in the California Legislature. Also below you can read my two cents on the issue.

Nurses, an Oppressed Group? -- NOT!

A couple of weeks ago I was speaking with a nursing colleague from the East Coast. We had connected over a mutual interest in the National Labor Relations Board decision concerning charge nurse and their role in management (or not). During our conversation she shared with me her concerns that she had recently learned that the local nurse’s union was promoting the notion that RNs were an oppressed group and therefore in need of “special protection” that can only be wrought through legislature intervention. The words “oppressed group” rolled around in my head for a few days, and with each passing day I grew concerned at what effect these words might have on our profession. Then several weeks later I received one of the many nursing magazines that I subscribe to and imagine my surprise as I perused the table of contents the phrase “oppressed group” popped up. I read the study with great interest and some concern, puzzled at what the outcomes might be and low and behold the author of the study concluded that nurses met the criteria of an “oppressed group”. So both the conversation and the article gave me great food for thought and it motivated me to speak up (as if this is a problem for me) about what I think on this subject.

My first response to hearing this terminology used to describe us, concerned me and the more I ruminated over it the more concerned I have become. Why, because I see this label, and that is precisely what it is, as a tool to advance some group’s agenda, and that agenda is in all likelihood probably not shared by the majority of Registered Nurses in this country. This doesn’t mean that the profession doesn’t have problems, but nurses “oppressed” – I think not! Our profession shares a lot in common with other first responder professions, I wonder if legislators feel that they are “oppressed” as well, or is it because our profession is still viewed as a predominately a “woman’s” occupation thus requiring the need to be “taken care of”?
Labeling RNs as “oppressed” may seem to be a convenient way for some so-called nursing leaders to get their point across, but I think it sets a very bad precedence. Somehow I don’t think Jane Arminda Delano, Dorothea Dix, Clara Louise Maass, Mary Eliza Mahoney, Florence Nightingale, Mabel Keaton Staupers, Adah Belle Samuel Thoms, Susie Walking Bear Yellowtail, to name a few, would be very happy with being labeled as an “oppressed group”.

So what can possibly be gained by getting legislators, opinion leaders and even the RNs themselves to accept the label of “oppressed” group? Well, for starters there are those that ascribe to the school of thought that by getting people, especially legislators, to accept such a label as fact that this then lays the ground work for the passage a whole host of laws that are “billed” as protection for the “oppressed” group. There are also those who desire to keep the “oppressed” group in a subordinate role, and by getting all parties involved to accept the label it allows for the group to remain in that role, being “looked” out for by their benevolent supporters. This brings me to the topic of AB 1201, a bill pending in the California Legislature that purports to be looking out for the “interest” of the direct care nurse. The language is such that one can almost be lead to believe that without this bill the “evil” hospital and healthcare organizations will run roughshod over the nursing staff thus leaving the patients with out anyone to look out for them; it even goes so far as having language that implies that nurses are in such a weak state that only through unions can they effectively advocate for their patients. Just in case you think I am exaggerating let me share with you some of the testimony provided by the sponsor of AB 1201. The AB 1201 sponsor used the example of the Tenet hospital in Redding, California where numerous cardiac surgeries were performed, later many of these surgeries were found to be unnecessary. The bill sponsor stated emphatically that if only a union had represented these Redding nurses then none of this would have happened, further commenting that it was the lack of “union protection” that kept the nurses silent. As I sat in stunned silence, I wondered, then what was the explanation for the silence of the nurses at both UC Irvine and St. Vincent, both hospitals’ transplant programs racked by recent scandals, since nursing unions (in fact by the bill’s sponsor) represents the nurses at both these hospitals. It is precisely this behavior that allows “nursing” leaders to rationalize distorting facts on the backs of the very nurses they say they are out to protect. However, as my mother was fond of saying when she heard outlandish statements – “better to hear that, then to be deaf”.

Do I think that nurses conspired at any of these hospitals to place their patients in harms way, hardly. However, I don’t think that offering the vague promises that only if there had been a union then the nurses would have come forward, just as they failed to come forward at hospitals with union representation. As with almost any similar situations, individuals with mal-intent or with corruption on their minds or just plain weak-willed found a way to use and abuse the system. In turn they recruited like-minded individuals into their scheme and presto a formula where their scheme flourished until it was rooted out. It is easy to lay the blame on the big, “evil” hospital, especially in these times when groups are looking to scapegoat someone and hospitals have a big target painted on them.

However, it concerns me a great deal that those who say they have only the best interest of nurses in mind are using such examples to further an agenda that I believe may have unforeseen consequences for nurses, especially those who remain at the bedside. I encourage everyone reading my column that has access to the Internet to bookmark the following page, http://www.legislature.ca.gov/port-bilinfo.html. Once on the search page you can simply select search by bill number, type in 1201 and it will take you to the page that has all the information on the bill, including the text of the bill, all its revisions, history and status. Read it, formulate your own opinion and then if you are so inclined call the bill author, Assemblyman Mark Leno in Sacramento at (916) 319-2013 and provide his office with feedback. You can also send him an email by directing you browser to the following address http://democrats.assembly.ca.gov/members/a13/capitol.htm and then select “email Assemblyman Leno” or by mailing or faxing him a letter at: State Capitol, P.O. Box 942849, Sacramento, CA 94249-0013 or (916) 319-2113 respectively. If you do send a letter or email, I would encourage you to forward a copy to me as well. While you are at it be sure to send a copy to the Assemblyperson and State Senator that represents you, because it would help if they knew your opinion and feelings about this and other bills that affect nursing. If you don’t know who they are you can access that information on the Internet at http://www.legislature.ca.gov/legislators_and_districts/legislators/your_legislator.html. Select “search by zip code for your legislator” and follow the directions. You can also find the information in the blue pages of your local telephone book.

My opposition to this bill doesn’t mean I think that working in today’s hospital environment is a perfect work environment for nurses; on the contrary anyone who has read any of my columns should be well aware of how I feel that poor nursing and hospital management is a primary reason why so many nurses burnout or leave nursing. I am just unwilling to lay all the blame at the feet of hospitals; some of the blame can and should be laid at the feet of nurses and nursing unions. Before everyone feigns righteous indignation, we all know that sometimes nurses are our own worst enemy. We see it with the cliques that become so tight knit that they are quick to bring attention to non-clique member’s errors or misbehavior all the while protecting their own members from being reported when they commit errors or exhibit unacceptable behavior. Nurses, nursing associations, nursing unions and nursing advocates often bemoan the lack of proactive and responsive nursing leadership in hospitals. However, I have also seen experienced nurses failing to support their nursing administration when that administrator comes under fire for defending nurses and patients by bean counters and poor hospital administration.
It could be said that hospitals and healthcare administration encourages this environment, a form of chaos that keeps the “underlings” undercutting one another for the benefit of the “powers that be”. However this argument is not entirely valid since physicians, for example, have long shown themselves immune to this strategy. It is well known within the healthcare profession that physicians are extraordinarily supportive of the “doctor’s club”, and that they equally defend one another regardless of gender, race and class in most circumstances – so why not nurses?

Call me optimistic but I know that this is not and does not have to be the nursing environment of the future. We, as nursing professionals, can change this milieu. The question is are we willing to put in the effort and emotional investment that it will take to make this change in our own unit, within our own nursing team, hospital, and ultimately within the structure of our nursing schools? This change is not for the faint of heart as it can be and often is painful since the status quo does not exactly respond positively to change. However, if we allow those at the table to succeed in placing the label of “oppressed” on our profession and ultimately on us then our attempts to make change can become encumbered by the very people who profess to support and champion us and our goals. As an individual, who is proud that she chose to become a RN, I am greatly concerned that as our profession struggles to define itself we might fall victim to the whims of some who would have us seen as though we are weak and incapable of advocating for ourselves let alone our patients thus describing us to legislators and those in “power” as somehow oppressed. The question we must all ask ourselves is this, are we willing to accept this label? Because once we accept this label, even in the guise of advancing it for our protection or getting much needed change then changing this perception at a later date could very well be impossible. I for one am not willing to accept the label of “oppressed”. To those who believe that by seeking out these special protections is a kindness or a way to achieve a positive result: I would remind them of the old adage. “The road to Hell is often paved with good intentions.”

Wednesday, June 20, 2007

AB 1201 remains in "suspense" -- and this is a good thing!

Question: What can one person or a small group accomplish? Answer: A lot, if they are committed, determined and perseverant.

Defeat of AB 1201 - Related to Collective Bargaining, is or should I say was a bill in the California Legislature (you can find text of the amended bill here:
http://www.nrnpa.org/legislation). Today, May 31, 2007 at 16:26, I learned that AB 1201 was left held in the Suspense File, which means that it is for all intents and purposes inactive for the remainder of this legislative session. This is welcomed news since the bill, in my opinion, characterized nurses as so weak as to require legislative intervention in order to perform their responsibilities. I know several nurses that shared my concerns and that I encouraged them to contact AB 1201's author (Assemblyman Leno) and their Assemblyperson. I know that Suzanne Geimer, RN, not only wrote to Assemblyman Leno but that she also took the time to contact her elected Assemblyman and meet with one of his field representatives to share with him her opinion and experiences (I joined her in this meeting as per her invitation). To all those who took the time to contact their elected representatives I want to say THANK YOU. The NRNPA is all about getting information both professional and legislative that affects and effects our chosen profession and then encouraging them to inform and educate their elected officials about how they feel this will impact them.

You can read a copy of my letter of opposition that I emailed to Assemblyman Leno, and my elected representatives at the end of this post. The attachment that is referred to in the letter can be emailed upon request (it is in PDF and easily attached to this blog entry). In the meantime, until AB 1201 is withdrawn, not passed or vetoed it can be resurrected in the next or future legislative session so it will be important to be vigilant.

May 29, 2007

The Honorable Mark Leno
13th Assembly District
State of California
P.O. Box 942849
Sacramento, CA 94249-0013

Re: Opposition to AB 1201

Dear Assemblyman Leno:

I have long been an outspoken advocate on issues that affect and effect nursing and a nurse's ability to deliver quality of care. It is this concern that has spurred me to make my opposition to AB 1201 clear. AB 1201 is not a bill that enhances a nurse's ability to deliver quality of care to their patients, contrary to the statements of its sponsor even though I believe they think it does. The language used in AB 1201 denigrates nurses and our profession; its chauvinistic language makes nurses out to be so weak as to be unable to stand up for their rights let alone the rights of their patients. In truth if a nurse is this weak I would not want this person caring for me or a loved one.

Below are some of the key points made in AB 1201 that I believe are erroneous and incorrect assumptions made by the bill's sponsor:

1) Only nurses in unions can effectively advocate for safe patient care -- NOT:

a) In your testimony before the Assembly Labor and Employment committee you testified that California is facing a critical nursing shortage. However you must ask AB 1201's sponsor why then did their representatives when interviewed by the Pasadena Star News editorial board on April 5, 2004 say that there is not a shortage? They asserted that the nursing shortage was manufactured and was now no longer a major issue. (See attached). Also, the bill's sponsor testified at this same committee meeting that if the nurses' at the Tenet run hospital in Redding had only been unionized that somehow the scandal involving unnecessary cardiac surgery would not have occurred. However more recently at two Southland hospitals there have been transplant scandals where no nurse came forward to blow the whistle, and yet the sponsors of AB 1201 represent both of these hospital's nurses.

2) The card check protects the nurse -- NOT:

a) AB 1201 also attempts to establish a card-check or petition system over the secret balloting system now in place. I find this very concerning since during unionization or decertification attempts "feelings" from both sides can be very volatile and a secret balloting system permits the individual at least the security of being the only one who knows how they chose to vote. I would like to share with you several examples of what can only be described as efforts to intimidate that I personally know of having occurred.

i) After a failed attempt by the C.N.A. to organize at a local southland hospital, a particularly outspoken anti-union nurse had all their employment records, including time cards, as well as all the patients' records (of patients that the nurse had cared for) subpoenaed. The C.N.A. only relented after that nurse engaged a private attorney to fight the release of the records.

ii) A nurse had her picture prominently displayed on a flyer, along with a picture of her husband who was running for elective office. The flyer tried to characterize her husband as being less than honest. One wonders what his campaign had to do with the union's attempt to unionize a hospital, especially since the candidate was not at all involved in healthcare except for being married to a nurse.

iii) Two other nurses received numerous telephone calls that threatened the two dogs that the one owned and the daughters of the other. The threats though vague (we know where you and your daughters live) were worded in such a way that a reasonable person could interpret them as being of a threatening nature.

b) All the examples provided above can be found in the public records. These are clear examples that unions can at times be found to play fast and loose with the rules. I think you must ask yourself this, if hospitals were the ones pushing for the legislation of a card check/petition system rather than the secret balloting system would you be as quick to support them in this legislative endeavor.

3) The NLRB was wrong -- NOT:

a) Lastly, the sponsor of AB 1201 argues that the recent NLRB decision somehow diminishes the charge nurses ability to effectively advocate for nurses and patients. Personally, as an RN with over thirty years at both the bedside and in nursing management I believe that the NLRB decision was a sound decision based on good management principles. One of the main complaint nurses cite for their dissatisfaction and for leaving the profession is often poor nursing management. If we are ever going to address this issue our profession must develop strong and competent pathways into nursing management and the charge nurse is the entry level into this pathway. The NLRB decision made it clear that its ruling applied only to the full time charge nurse and not the rotating charge nurse position, and thus making it clear that the rotating charge nurse is not in a position of management. It is important to remember that in California the highest nursing position in a hospital, often referred to as the Chief Nursing Officer, is required by law to hold an active California RN license. The reason for this is to make it clear that even at the highest level of nursing management the individual is still a nurse first and therefore bound by our nursing rules, regulations and oath and remains first and foremost a patient advocate. It is my personal and professional belief that AB 1201 undermines this since its language clearly defines the nurse as being incapable of fulfilling this requirement without legislative intervention. In my 30 years I have never felt that my ability to properly advocate for my patients has ever been prevented by "administration".

I hold licenses in three states and the District of Columbia and I have practiced as a nurse (either as a LVN or RN) in Kansas, Texas, Georgia, South Dakota and of course California - so you can see my experience is vast. Perhaps my success is in knowing and understanding the nursing regulations as well as I do, which is one of the reasons that I share my skills and talents with the almost 200,000 RNs in Southern California and Arizona who read my monthly column, "From the Floor".

In closing I ask that you place my letter and name in firm opposition to AB 1201 in the official record.

Respectfully submitted,
Geneviève M. Clavreul, RN, Ph.D.

Cc: State Senator J. Scott
Assemblyman A. Portantino

For a copy of the attachment referenced in the letter email me at clavreul@nrnpa.org

Question: When is a news story not a news story? Answer: When it's a planted story.

Well here we go again, many readers in Texas were subjected to a lengthy, though already rather worn, tale of the triumph of the C.N.A over to evil hospital corporations/ However for those of us, many who are RNs, this story was yet another pubic relations tall tale about the C.N.A. and its non-nurse executive director DeMoro. Early this month the San Francisco Chronicle tried to portray DeMoro as some kind of modern day Florence Nightingale and now the Texas Observer would want us to believe that she is a modern day Wonder Woman. The problem with both analogies is that they are incorrect. First, as so many of us know DeMoro is not nor has she ever been a licensed RN and her actions and behavior would shame the woman credited with founding modern nursing. As for being a Wonder Woman, those of us who grew up with Wonder Woman recognize that the reference to the nurse members of the C.N.A. as her (DeMoro's) nurses is an insult to the Wonder Woman myth. Wonder Woman would have never tolerate anyone referring to people as "hers" as if they are owned by DeMoro.

So when I read this what I can only characterize as a publicity stunt I responded with a letter to the Texas Observer, and a follow up phone call. Again no response except the request to resend the email to another individual at the Texas Observer, which I did. Still no response so up on the "Nurse Unchained" it goes. Below you will find my letter and the link to the article it is in response.

Enjoy.


May 18, 2007

Letters to the Editor
The Texas Observer
Austin, TX 78701

Re: An Ounce of Dissension

Dear Editor:

When I read the above article I was struck with a strong sense of déjà vu? Why, because I had read a strikingly similar article a week earlier in a local California newspaper. There is a term in journalism for this kind of reporting and its called planting a story. I wasn't surprised to discover the California newspaper had engaged in such a practice - it's common in a state that makes its business in the marketing of illusions - but to see it being excepted in the Texas press is very saddening.

As for the Texas nurses taking a stand for nurses and patients rights I say kudos, though I'm not sure the NNOC is the way to go. I find Sharp's reference to nurses as "her (DeMoro's) nurses" tacky - since they are not her nurses! As a nurse who has worked at the bedside in many states, including Texas (Bexar County Hospital) and now lives in California I can proudly state that I am no nurse of DeMoro; and I am one of the more than 250,000 active California RNs that have said no to the antics of the C.N.A. and DeMoro. I also find it intriguing that no mention was made of Deborah Burger, who is a RN, and the president of the organization. But what should I expect of an organization that pays its executive director (who is not a RN) almost three times what they pay their president (who is a RN). Sounds to me like DeMoro has more in common with the hospital/healthcare corporations she so adamantly denounces than she knows.

Sincerely,
Geneviève M. Clavreul, RN, Ph.D.

The link to the article is here: http://www.texasobserver.org/article.php?aid=2495

Is the San Francisco Chronicle providing free PR for the C.N.A.?

Freedom of the press is critical to the foundations of our democracy, however accuracy of the press is also equally important! For when the press reports erroneous information or moves from reporting the news to acting as a "public relations" agent for a person, group, organization, etc then the press fails to keep its promise to the people it purports to serve.

Recently the California Nurses Association (a nursing union) has garnered some press for their antics and outspoken "activism". This is all well and good since we do live in a free society, however it is imperative that when the press covers actions of the C.N.A. that they do so with accuracy. It is my opinion that this was not the case in a recent San Francisco Chronicle article, "The Rabble-Rouser" published on May 6, 2007 and written by Kathleen Sharp. After reading the article, I felt compelled to respond, since I felt it was more a free public relations article then news article; and that there were numerous inaccuracies and mischaracterizations that needed to be addressed. You will find my response to the article as well as the article archived here.

Why, you may ask, have I posted this letter as well as copies of the letter and article to the NRNPA website? Since it would seem that the San Francisco Chronicle editorial staff has chosen not to run my letter nor answer three separate phone calls, I persevered and tried a fourth time and on May 7th I spoke with Ms. Greene. At her request I e-mailed a copy of my letter directly to her, she was kind enough to acknowledge the receipt of my email and informed me to whom she had forwarded copies of my email. Meanwhile I waited and surmised the SF Chronicle would not print my letter since I strongly believe that they had an unadvertised "support" for unions and the C.N.A., in particular. So I am not completely surprised that they have yet to run my response, though I had hoped they would have presented another viewpoint.

And this is why I have decided to run it. I encourage you to read both my letter and the article to which it is in response to and to formulate your own opinion and if you feel so incline share it with me at clavreul@nrnpa.org.


May 10, 2007

Letters to the Editor
San Francisco Chronicle
901 Mission Street
San Francisco, CA 94103

Re: The Rabble-rouser

Dear Editor:

I read the above article, or should I say PR piece, with interest and concern. Your reporter made several errors in the article; according to the C.N.A.'s own website they have approx. 75,000 members not the 80,000 your reporter cited and Ms. DeMoro is no modern day Florence Nightingale - in fact she is no RN and her actions are an insult to the memory of Florence Nightingale!
Finally, RNs across this country (both in unions and not) have not exactly jumped on the C.N.A.'s bandwagon. Nurses represented by other nursing unions have decried DeMoro and the C.N.A.'s tactics since they often play fast and loose with the facts in order to push their agenda; they have received at least one written warning from the Calif. Board of Registered Nursing for violating the Continuing Education program - all which often runs counter to the oaths we as nurses take when we become licensed. And finally before you paint them as though they represent a large portion of RNs in this country please remember that we are almost 3 million RNs compared to 75,000 RNs in the C.N.A.
For the record I am one of the 290,000 California RNs that has chosen not to let the C.N.A represent nor speak for me and who despises the deceptive tactics that their organization employs.

Sincerely,
Geneviève M. Clavreul, RN, Ph.D.

The link to the article is here: http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/05/06/CMGJIP6QD41.DTL