NEW YORK NURSE: January 2008
by Mark Genovese
Jaclyn (not her real name), an RN at a metropolitan New York hospital, just wants to take care of her patients.
After 22 years, nobody knows her patients better. But new rules have been issued by a “process improvement” team made up of managers, employees, and a consultant. Some of the rules – such as the script for interacting with patients – are merely an annoyance, but the “code of conduct” they want her to sign has her worried.
Use of “employer-initiated committees” to make changes in the workplace is on the rise in healthcare. Although some employers have been fair about improving an organization’s performance, others use them to bypass the union and nurses’ bargaining rights.
These joint teams sometimes bring about improvements that previously have been denied to the union. Some even draw up their own contracts.
A committee at Mount Sinai Hospital proposed paying RNs for their time while they take certification exams. “Although it’s a good benefit, to unilaterally implement it would be a violation of the contract.” said one RN.
Montefiore Medical Center RNs were given a checklist with instructions to say: “Is there anything else I can do for you?” An evaluator checks this afterward. If nurses indicate they said this phrase when they didn’t, it could be considered fraudulent documentation.
A “service excellence” program at Staten Island University Hospital took a deceptively soft approach, offering nurses balloons and candy. Delegate Assembly Vice President Pat Kane, who was LBU president at the time, said, “When we saw that SIUH management had added breach of ‘service excellence’ standards to their discipline policy, we notified our NYSNA representatives about this change in terms and conditions of our employment.”
NYSNA has received reports of:
“It took a while to educate members about how management was using this committee to violate their rights,” said one Montefiore RN. “When members find out these committees are by, of, and for management it jostles them.”
“Management says its goals are to increase patient satisfaction, improve patient outcomes, and maintain a healthy work climate,” said Lorraine Seidel, NYSNA Economic & General Welfare (EGW) director. “What nurse feels she shouldn’t agree?”
“There’s nothing wrong with brainstorming,” added Barbara Conklin, senior associate EGW director. “But a committee that acts as a parallel structure to the union may be unlawful.”
Pressure particularly comes through training grant planning committees. Although NYSNA had a say in the use of the Training and Upgrading Program funds in the late 1990s, this money is now gone. New initiatives are coming out of funds that are directly controlled by employers and non-nurse unions.
Should an LBU officer accept an invitation to be on an “employer-initiated” committee?
RNs should determine if management is trying to control meetings or is suggesting that the team has greater authority than a union committee. They should check whether a consulting firm such as the Studer Group or Six Sigma is on hand, and ask if RNs can get copies of minutes.
Most of what these teams seek can and should be done through the union’s labor/management committee, so the line needs to be drawn. Conklin said, “RNs can say ‘I’m not discussing this matter with you because it’s a mandatory subject of bargaining.’”
If management is really concerned about patient satisfaction, they should consult NYSNA, she added. “Nurses are already experts. And there already is a plan in place – it’s called a contract. Patients will be satisfied if there are enough nurses and support staff and if management respects nurses’ professional judgment.”