nurses united In 2010, our lives are busier, our days are shorter, and our time

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1 nurses united newsof the 2010 Negotiation Edition Official Newsletter of Nurses United Being Prepared: We Prepare Because We Care Nurses United President Dottie Hararas, RN This special edition of NU News is timed to go to print and get to our members so all of us can be informed and well prepared for upcoming formal negotiations with our employer. This negotiation cycle we have tried to be better prepared than ever before. We have an outreach program in place where each of our members can be contacted by one of our Union nurse leaders, either by cell, text, , or traditional phone call. If you have not sent in your best contact information, please do so. You can send it to We conducted rolling membership meetings, with more planned, in addition to our regular general membership meeting, which will be held the first Wednesday of March. Go to our Web page and check out the Meetings link for time, date, and room. We have in place Union negotiation facilitators who coordinate the flyers, meetings, and messages that are going out to membership. They are staff nurses at Washington Hospital Center just like we are and understand the issues. Your Union s board of directors has approved our participation on Facebook in an effort to keep our membership as up-todate as possible. If you are on Facebook and are a member of Nurses United, you can ask to be included. We believe our strength is in our membership, so it is imperative for each of us to stay informed. Seek information from Nurses United. Attend our meetings. Carefully read the articles in this issue, especially the article entitled Be Prepared for What Exactly? And above all, stay focused and united. Dottie Hararas, RN, President of Nurses United Together we can move mountains. Alone, we can t move at all. n Be Prepared for What Exactly? Strategies for the Proactive Registered Nurse Beth Landry, RN, 2010 Negotiation Facilitator In 2010, our lives are busier, our days are shorter, and our time is valuable. Nurses United believes that being prepared now is of the utmost importance. But being prepared for what, exactly? Without a mutual contract between the employer and a union, it is left up to the individual to navigate through the legal and managerial jargon. Nurses United works for you and advocates for our members rights to fair labor practices. Our members are collaborating to bring you information on resources you may find useful in the not-too-distant future. Our economy is being tested, and we are all very fortunate to be employed and in good health. Without a contract, benefits like health insurance and a retirement plan may dissipate. It is important to know your rights, and one of the most urgent issues is the health insurance benefit in the contract. If a nurse experiences an involuntary termination of employment, the Consolidated Omnibus Budget Reconciliation Act of 1986, or COBRA, gives terminated or reduced-hour employees and their immediate families continued health insurance coverage at rates priced between that of active employment and individual coverage. (Note: You may not qualify for COBRA coverage if you were terminated for gross misconduct. ) continued on page 2 contents Being Prepared: We Prepare Because We Care Be Prepared for What Exactly? Strategies for the Proactive Registered Nurse What Has the Union Done?... 3 News You Can Use... 4 Assignment Despite Objection (ADO) Update... 4 NU is Part of History... 5 Family and Medical Leave Act.... 6

2 Be Prepared for What Exactly? continued from page 1 Not only is information on health insurance and benefits extremely important to our members, but your license itself is a very valuable asset. It is your employment lifeline. It is important to keep your primary state licensure up-to-date, but it can be worth your while to obtain or keep an endorsed license in Virginia and/or Maryland. Both states Board of Nursing Web sites contain information about license endorsement if you are currently licensed in the District of Columbia. If you are licensed in Virginia, Maryland, Delaware, or one of the other 20 compact licensure states, you can work in the other compact states without endorsement. physical health information. You can obtain that paperwork from your doctor or from the Occupational Health Department at WHC. Another important aspect of being prepared is having a financial advantage. While having a savings account at your bank is important, keeping your savings in a credit union may also be a beneficial move. Credit unions are available, notably the Healthcare Employees Mid-Atlantic (HEMA) Federal Credit Union located in Silver Spring, Maryland. Nurses United has copies of applications for this credit union if you are interested. If the contract between the employer and Nurses United is not renewed, or if you are not working at WHC for a period of time, the contact information below will be essential to have. Nurse agencies can be very helpful with assisting nurses to gain licensure in several states so that traveling nurses can practice in a multitude of locations. A few of these agencies are Progressive Nursing, Alliant Staffing, Quest Staffing Group, and Nurse Finders, Inc. On the Health Professional Licensing Administration section of the DC Board of Nursing Web site, you can search dozens of staffing agencies in the region. If you wish to register with these agencies, they will need your current vaccination and We are indeed nurses, and passionate about not just our jobs but our career and the future of our profession. As we engage in collective bargaining with the employer, the demonstration of our Patient First! attitudes may become visible through informational picketing or in other collective ways. If you wish to participate in such activism, Nurses United will support your decision to do so. If not, please respect those who wish to advocate for our profession and for our patients. We are strong, we are capable, and our voices will be heard! In solidarity! n Contact Information Alliant Staffing COBRA DC Board of Nursing hpla.doh.dc.gov/hpla DC Department of Employment Services HEMA Federal Credit Union Maryland Board of Nursing Nurse Finders, Inc Soliant Health Progressive Nursing (travel) Virginia Board of Nursing WHC Occupational Health Department Nurses United news Official Newsletter of Nurses United of the Managing Editor: Dottie Hararas, RN Nurses United of the 8737 Colesville Road, Suite 950 Silver Spring, MD Phone: Fax: Web Site: nursesunitedorg@aol.com Nurses United Officers Dorothy Dottie Hararas, RN President 5F, Patty Ronayne, RN Vice President 2G, Ext Stephen Frum, RN Chief Shop Steward 4H, Ruth Betsy Cerullo, RNC Treasurer Float Pool, Mary Smith, RN Corresponding Secretary NICU, Ext Marie Edelen, RN Recording Secretary 2G, Ext Geri Lee, RN Board Member L&D, Ext Josephine Owusu, RN Board Member 1E-IMC, Ext Lori Marlowe, RN Board Member 4D, Ext Please address all correspondence to Managing Editor, NU News Nurses United of the 8737 Colesville Rd., Suite 950 Silver Spring, MD The information in this newsletter is provided as a service to Nurses United members. It does not constitute legal advice. If you have a workplace problem, before you file a grievance or take legal or other action, please read the union contract and contact a shop steward or the chief shop steward. Copyright 2010 Nurses United of the All Rights Reserved The materials in this newsletter and on the Nurses United Web site are copyrighted. You may, however, use the material if in writing you credit Nurses United of the as the source. 2 Nurses United news

3 What Has the Union Done? Stephen Frum, RN 4H, Chief Shop Steward Background: For over 30 years, nurses at the Washington Hospital Center have belonged to a union. When introducing the Union to new members, I make a point of telling them that their Union, Nurses United, is the only organization they will belong to in the workplace that is completely controlled by staff nurses and works on behalf of those staff nurses. This is an important concept of a union: independence and advocacy for working people. However, day after day, in the usual course of events, it can be difficult to see what the Union is doing. It is even possible for someone to think that the Union is no longer needed. A few reminders of the many accomplishments by the Union over the past years are appropriate. I ll summarize some of them here: Historically the Union won some important gains in the past, and we continue to defend them every contract negotiation session. They include the following: Power to negotiate with the employer over wages, hours, and working conditions Representation of members facing discipline, discharge, and discrimination A wage scale with no cap unlimited upward hourly wage Percentage-based shift differentials When a member was not paid for attending BLS class, Union intervention through a grievance corrected the error the member was paid correctly after the Union s grievance was filed. Nurses in the Women and Infants Division were upset about working conditions and bullying by management. The Union circulated a petition, demanded meetings with management, and is following through to ensure that working conditions improve and working conditions become safer than they currently are. From time to time, management has incorrectly posted or allocated positions in the Hospital. We have often been able to reverse these errors and ensure that the contract is followed. Of course, the Union doesn t win all the cases we file, but we put our best resources into representing our members when it is clear that a wrong on the employer s part needs to be addressed. The contract language is one of the best securities we have. Its language with the correct interpretation is worth fighting for since we all benefit from the issues guaranteed in the collective bargaining agreement. As this newsletter goes to press, we will have negotiation dates selected, and our team will be thoroughly prepared to sit across the table from the employer as we advocate for the nurse the most important aspect of the patient s health, safety, and recovery. During this critical time of negotiations, we should all take time to get to know the contract language and suggest ways it could be improved. Your team, along with the strength, unity, and solidarity of our membership, is the best way for us to be successful at the negotiation table. Your concrete suggestions will help us improve upon and make the contract stronger. We look forward to hearing from you. n Permanent shifts (days, nights, and evenings) and the WIN program. More recent gains are also important to highlight: When the Hospital eliminated some staff nurse positions on 3NW a few months ago in a way that disregarded seniority, the Union filed a grievance and forced the employer to respect seniority in position changes. Three members were disciplined for absence from work. A shop steward filed a grievance and was able to have the disciplinary actions overturned. Management refused to allow a member to transfer to another department. Following a grievance meeting, management permitted the member to transfer. Recently management attempted to implement a policy that would have prevented WHC employees from having any visitors (of any type) while in the Hospital. We met with management and expressed our concerns, and the draft policy was pulled back. Martina Hall and Geri Lee Nurses United news 3

4 News You Can Use Sue L Heureux, RN, MS, CCRN Putting the patient first is the foundation of our profession, much more than just a hospital-acquired catch phrase. But when there is a sudden loss of cabin pressure we must put the oxygen masks on ourselves first so we can survive and save the lives of those entrusted to our care. We are incapacitated when we don t have a significant voice in our own practice. The practice of nursing is caring for patients, especially at times when they are unable to care for themselves. This is advocacy at its highest level. There is no other profession so intimately involved with another s humanity. Implementing RN-to-patient staffing ratios that include patient acuity measurements is an imperative that has been shown to improve patient safety, help solve the nursing shortage, and provide a cost-effective solution for hospitals (see Article 30.3(a) in our current collective bargaining agreement states that the Hospital shall maintain a system for determining nurse staffing and patient assignments that will utilize the staffing guidelines of the American Nurses Association. These ANA guidelines state that nurse staffing ratios need to be required by legislation but the number itself must be set at the unit level with RN input based on factors including patient acuity (which) treats nurses as professionals and empowers them at last to have a decision-making role in the care they provide. Nurse Patient Ratios in California OR/trauma patients in ED 1:1 ICU/NICU/PACU/L&D/ICU patients in ED 1:2 Step down 1:3 Antepartum/ED/telemetry 1:4 Medical/surgical 1:5 Postpartum (women only)/psych 1:6 As this newsletter goes to press, we are preparing for contract negotiations at a critical and exciting time for nursing. We have developed our own survey and put it on our Web page at so you can fill in your priorities for upcoming negotiations. Your input and participation in the negotiation process is the key to our success. The seven nurse members of Nurses United s negotiation team are our advocates for those matters that are most important to us. So help them by completing the important 2010 NU Negotiation Survey. We have had 24 rolling membership meetings in December, January, and February as another way to hear what is on your minds and to prepare priority issues for negotiations. There will be 12 more such meetings in March and April in addition to our general membership meeting on Wednesday, March 3, 2010, from 4:00 p.m. to 6:30 p.m., which is the annual meeting where our NU budget is presented and ratified. We hope you will find the time to attend one of these forums, since our unity and strength is the key to our success during negotiations. You can help by getting involved. Your participation does matter. We look forward to hearing from you and seeing you at one of the upcoming meetings. n Assignment Despite Objection (ADO) Update Mary C. Smith, QPCC Co-Chair, NU Corresponding Secretary First, thank you once again for filing Assignment Despite Objection (ADO) forms. We recognize that this is one more item to complete on your already very busy shift. You should be proud of yourselves for advocating for your patients! That said, your voices are heard. The staffing crisis is on the Labor Management Committee agenda. The ADOs have been taken to the Labor Management Committee, with Elizabeth Wykpiscz in attendance, showing documentation that staffing conditions and patient acuity are compromising the delivery of safe patient care. On January 27, 2010, the Quality Patient Care Committee (QPCC) met to review the ADOs, and Kathleen Chapman, assistant vice president, Human Resources, was in attendance. The QPCC is in the process of revising the ADO form in an attempt to streamline the process to make it a more valuable tool for obtaining data and to hopefully make it easier to complete. In the near future, an online version of the ADO form will be available. Also, with the help of Lori J. Marlowe (NU board member) and Jon Brundage (NU IT specialist) the ADOs are being entered into a database. The information obtained from the ADOs will be extrapolated to hopefully provide the necessary documentation to illustrate the staffing crisis/patient acuity that contribute to the compromise of the delivery of safe patient care. Our patients are at the forefront of all we do they are our primary concern, and we want to continue to give them the best we have to offer. As always, continue with what you do best, and that is delivering optimal, safe patient care. Your ADOs are being addressed, and with persistence, safe staffing will become a reality. Thank you. n 4 Nurses United news

5 NU Is Part of History many others fought against dangerous, abusive working conditions Megan Honor Caine, RN ployers. It took direct, courageous action, such as work stoppages N and measly pay by joining together and struggling against their emand strikes, to make change. urses United is part of the rich history of organized labor in the United States. Today our Union exists in a climate of shifting politics around healthcare and unions. As an independent union, we have the benefits of being self-directed and focused, but perhaps we also lose sight of the larger context of our place in history and the current world. Working people organizing themselves into unions for the purpose of improving working conditions started in the United States in the late 1700s. Miners, mill workers, dockworkers, shoemakers, and The benefits and decent working conditions that many workers enjoy today did not happen by chance or through the generosity of employers. People lost their lives fighting for the eight-hour workday. The weekend, healthcare benefits, safe working conditions, and nondiscriminatory workplace practices are all hard-won accomplishments by organized labor people like us nurses, fighting for what s right. In the mid-1970s, registered nurses at the Washington Hospital Center were fed up with the management s unfair practices and decided to take action. Some of us remember this time period. Nurses were hired at different pay rates, not related to their experience; they were fired when their pregnant bellies began to show; their wages were capped after five years; and they worked in an environment filled with discrimination and disrespect. It took one year, five months, and a 32-day-long strike just for the Hospital to agree to terms of a collective bargaining agreement contract with the nurses. Over the past 32 years, nurses at Washington Hospital Center have continued to fight for better work conditions and the ability to provide the best patient care possible. Health and education leave, a pension, shift differentials, the Weekend Incentive Nursing program, recognition of years of experience nursing outside the United States, workplace safety improvements, and a fair and reliable pay scale were all hard won. This is not a fight that reaches an end point and stops. For nurses, as well as other workers, it is an ongoing struggle to maintain what we have gained and continue to improve our working conditions. There are many unknowns in healthcare today. New healthcare legislation is in the works, and its potential impact on hospitals is unclear. For now we must keep in mind that it is up to us as registered nurses to continue to improve both patient care and our working conditions. No one else will do this work for us. The labor movement in the United States has lost some momentum and power in last few decades, although there is growth among nurses unions. The recent merger of unions, including the California Nurses Association, Massachusetts Nurses Association, and the United American Nurses, borrowed our name and created the National Nurses United, a self-labeled RN Super Union. Their goals include the organization of nonunion RNs and passage of patient care reforms, such as a national nurse-to-patient ratio. While our Union is not affiliated with this larger group, it is exciting that they are working for the changes we want. Our Union is something to be proud of, and we should recognize it as a work in process that needs tending. It is up to each of us NU 2010 Negotiation Team: Martina Hall, Megan Caine, Lori Marlowe, Stephen Frum, Geri Lee, Dottie Hararas, and Greg Pelletier to envision the work environment we want, and then to make that a reality. n Nurses United news 5

6 Family and Medical Leave Act Eileen Dufton, NU Shop Steward [Editors note: The article below by Nurses United shop steward leave during a 24-month period to care for a family member with a Eileen Dufton is a good review of our rights and obligations under serious health condition or following the birth or adoption of a child. the federal and DC versions of the Family and Medical Leave Act (FMLA). Members are encouraged to read article 16 of our contract to gain additional knowledge about their leave rights and obligations. Some specific things that are important: the procedure for requesting a leave is now outlined, medical and family leave can be for one year, leaves can be requested for even more time, and the Hospital should pay its portion of insurance premiums during leaves that are covered by DC or federal FMLA.] What Is FMLA? When Are You Eligible to Receive DCFMLA? To qualify for DCFMLA, you must meet the following requirements: You must have been employed at WHC for at least one year without a break in service. You must have worked at least 1,000 hours (an average of 19 hours per week) during the 12-month period immediately before the requested leave. FMLA stands for the Family and Medical Leave Act. It was signed Types of Leave into law in 1993 and entitles eligible employees to take up to Medical Leave You may take continuous or intermittent medical 12 weeks of unpaid, job-protected leave in a 12-month period for leave for your own serious medical condition. In determining what specific family and medical reasons. constitutes a serious health condition or continuing treatment under the DCFMLA, courts rely on the FMLA regulations and case law. On November 17, 2008, the Department of Labor published the Where reasonable job safety concerns exist, WHC may require a first-ever amendments to the FMLA. They provide more clarity fitness-for-duty certification before you are allowed to return to work. for employers, employees, and healthcare providers about their responsibilities and rights under FMLA; the amendments also Family Leave Family leave may be taken for the birth, foster provide new military family leave. care placement, or adoption of a child. Leave must be taken within Some states and the District of Columbia have laws that are more comprehensive than FMLA and further extend the leave and/or add 12 months of birth or adoption. It may also be taken to care for the serious health condition of a family member. to the requirements. The DCFMLA, the District of Columbia s Family Military Caregiver Leave A spouse, daughter, parent, or and Medical Leave Act, provides 16 weeks (80 days) of job-guar- next of kin may take up to 26 workweeks of leave to care for a anteed medical leave every 24 months to qualified employees with member of the Armed Forces, including a member of the National serious health conditions. It also provides up to 16 weeks of family Guard or Reserves, who is undergoing treatment, recuperation, Greg Pelletier, Megan Caine, and Dottie Hararas 6 Nurses United news

7 or therapy for a serious injury or illness incurred in the line of duty while on active duty. Parental Leave A maximum of 24 hours of parental leave per year is allowed to employees to attend school-related events. You must give 10 days advance notice. This leave is unpaid unless you elect to use available personal leave. If you are only using parental leave, you are not to lose any employment benefits or seniority before or during the time of absence. Your manager may deny the leave only if providing the request would disrupt the normal activities of your unit. What Is a Serious Health Condition? A serious health condition is defined in the act as a physical or mental illness, injury, or impairment that involves inpatient care in a hospital, hospice, or residential healthcare facility or continuing treatment or supervision at home by a healthcare provider or other competent individual. It involves more than three consecutive days of incapacity plus two visits to a healthcare provider. The two visits must occur within 30 days of the beginning of the period of incapacity, and the first visit to the healthcare provider must take place within seven days of the first day of being incapacitated. Geri Lee With respect to chronic serious health conditions, the new regulations define periodic visits as at least two visits to a healthcare provider per year. Who Is Considered a Family Member? to care for a parent, son, or daughter with a serious health condition; to deal with an employee s own serious health condition; The DCFMLA provides a more extensive definition of family member than federal law does. A family member is defined as when medically necessary for planned/or unanticipated medical treatment of a covered service member; or a blood relative, for the birth and care of a newborn child or for placement of a spouse, a child for adoption or foster care with employer s approval. a person the employee has legal custody of, Depending on the circumstances, an employer may require an a child who lives with the employee and for whom the employee taking intermittent leave to transfer to an available alter- employee assumes parental responsibility, or nate position, on a temporary basis, if that position better accommodates periods of leave than the employee s regular position. a person who lives with or has lived with the employee in the past year and with whom the employee maintains a WHC may require a fitness-for-duty certification before the employ- committed relationship. ee returns to work. The regulations provide a definition of committed relationship that Employee Notice Obligations focuses on economic interdependence. You must follow Washington Hospital s usual and customary call-in What Is Intermittent FMLA? Generally, intermittent leave, or reduced schedule leave, is provided when medically necessary for an employee s own serious health condition or for caretaking of a qualified family member with a serious health condition. The same 16 workweeks are provided within a 24-month period. FMLA leave may be taken intermittently or on a reduced leave schedule procedure. Be sure to say you are using FMLA when calling the staffing office! You are required to provide at least 30 days advance notice when the need for FMLA is foreseeable. If you become aware of the need for FMLA leave within less than 30 days, you must advise WHC that same day or the next business day. continued on page 8 Nurses United news 7

8 Family and Medical Leave Act continued from page 7 You must also make a reasonable effort to schedule medical appointments during times that do not disrupt the operation of your unit, such as your days off from work. Light Duty The new regulations make it clear that light duty does not count against your 16-week FMLA leave entitlement, even if you are voluntarily performing the light duty assignment. Medical Certification Process The new regulations recognize the passage of the Health Insurance Portability and Accountability Act (HIPAA). If WHC needs to contact your healthcare provider, the WHC representative must be a healthcare provider, a human resource professional, or a management official, but in no case may it be your direct supervisor. WHC may not ask your healthcare provider for additional information beyond what is required by the certification form. In addition, if WHC deems your medical certification incomplete, the Hospital must specify in writing what information is lacking and give you seven calendar days to obtain the required information. WHC may request recertification of an ongoing condition every six months. Paid Leave DCFMLA leave is unpaid, but you may choose to substitute accrued paid time off. If you take paid leave while on DCFMLA, the paid leave and the FMLA run concurrently. You are not allowed to tack on a full 16 weeks of unpaid DCFMLA after your personal leave is exhausted. However, an employer subject to DCFMLA regulations may not require you to use your paid leave while on DCFMLA. Maintenance of Health Benefits WHC must maintain your group health insurance plan while you are on FMLA leave. If you contribute to healthcare premiums, you must continue to pay for your portion of premiums while on leave. WHC is not required to maintain any other employee benefit while you are on FMLA leave. The information that you read here is general in nature and not meant to be a substitute for specific legal advice from an attorney or advice from Employee Life Services at WHC. n Nurses United of the 8737 Colesville Road, Suite 950 Silver Spring, MD 20910