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Posted By AURN,
Friday, February 3, 2023
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AURN fighting for workplace safety, management asserts that not everyone should have CNI
We met for our sixth bargaining session Wednesday, Feb. 1 at our ONA office in Tualatin. Members from departments across OHSU came to observe and support our bargaining team. They heard our opening statements about the importance of having new and improved
workplace violence prevention language in our contract. Our AURN President Elisa Youngman shared with management, “When events occur that impact a patient’s safety, such as a fall, pressure ulcers, or nosocomial infection, we call it a “never event”.
It is time we start treating events that impact a nurse’s safety, such as death threats, physical assault, and hate crimes as “never events”.”
Initially, the bargaining day felt productive. We felt supported and energized by our members’
presence however by the end, we felt unappreciated due to management’s Shift Incentives Proposal. We have proved our dedication to OHSU during the ongoing pandemic, dire staffing crises and much more, working endless overtime and extra shifts to keep
the hospital afloat. In response they presented a regressive proposal that felt disrespectful to our contributions. At the core of their proposal, management wants more power to determine if and when they offer increased CNI, and to offer increased
rates differently for one department or shift over another. For example, under their proposal management could decide to give one unit or cluster $50 CNI for months on end, while another could be kept at $25 CNI even if both were equally short staffed.
This is a real risk, as we’ve already seen management give MOV and other incentives to some units and clusters over others, while all units are unsafely staffed. Additionally, if units throughout the hospital are not prioritized to fill shifts, that
impacts everyone else as patients are boarded and throughput is impacted. When asked why management wants more discretion regarding CNI, they responded that “currently some are getting CNI who shouldn’t”. If this is an issue you feel strongly about,
please let your Contract Action Team (CAT) members know and find out how to get more involved! We are launching a petition to make sure management knows we stand together and will not be divided, be sure you and all AURN members sign it as soon as possible. Or
sign up now to get trained to become a CAT member. It’s time to stand together to show management how important these negotiations are to everyone.
Summary of Proposals:
AURN’s Workplace Health & Safety
We opened Article 26, Health and Safety, by adding a significant amount of new language to address the massive
amount of safety issues that so many of us experience. We proposed the formation of a new Nursing Health and Safety Committee, that would give nurses a voice in safety measures at OHSU. This committee would include frontline nurses and members of
management and would develop directives and recommendations related to workplace violence, infectious diseases, chemical hazards, security and physical safety, education and the development of signage addressing workplace violence. Additionally, we
added language to support in-person workplace violence prevention training, access to copies of OSHA/Worker and Student Injury Reporting System reports, assessment of unit geography and patient population, and much more.
• We added a section
related to suicide prevention resources and awareness, which includes 24/7 immediate crisis intervention through the Employee Assistance Program (EAP).
• To further imprint the importance of nurse safety, we added a section for the emergency
department addressing the need for consistent DPS presence and that every patient/visitor should be scanned by the metal detector every time they enter, including patients that arrive by ambulance (via wand as soon as is feasible).
• For
other parts of the hospital, we added a section that requires proper staffing for code greens 24/7, which includes specially trained social workers, cognitive behavioral nurses, and case management nurses. We added a definition for code green that
will expand it to mean any behavioral incidents involving violence or immediate precursors to violence, regardless of their form.
• To appropriately help nurses who experienced workplace violence, we added that a root cause analysis would
occur where all involved parties would be invited to participate. For those who need time off after being assaulted, we added that the nurse could receive the rest of their shift off and an additional 3 days of paid time to explore workers' compensation
and other needs.
Management’s Shift Incentive Proposal
Management finally gave us a response on CNI & shift incentives.
• They are proposing $25 for CNI, and $35 for a special advanced CNI, however, they proposed
that they should get full discretion on which shifts, units, and clusters would qualify for higher rates of CNI for any length of time. This would allow them to give $50 or even $100 CNI to one unit or cluster while only giving $25 to another unit
for any length of time.
• OHSU management was clear they don’t want resource nurses to qualify for CNI, but they offered that those nurses could pick up additional shifts above their minimum required shifts (MRS) without a financial incentive.
• They only want to define a shift as 8 hours rather than 4 hours for increased CNI.
• Nurses must work 4 extra shifts in a schedule to get the increased CNI.
• When asked about fairness about which departments would
receive CNI, management said “currently some departments are getting CNI that shouldn’t”.
Our nurses in the bargaining room were disappointed to see a proposal like this being presented. As more members talk about it, we are hearing widespread
frustration around this issue of how to fairly compensate nurses for their significant contributions to work extra shifts to properly staff our units.
Kirk Constantine from the Critical Care Float Pool stated: “Fairness is very important
to me. When acute care and ambulatory were not receiving CNI, but our EDs and ICUs were, many of our members were angry and frustrated. The ED nurses need the borders to be placed in the hospital. This proposal does not help with throughput and isn’t
a realistic approach to supporting our patients throughout their care. How is this going to help better staff our units? We will not let OHSU divide our nurses.”
Article 15 & 18 Management Counter Proposals
Management
also presented us responses to proposals that we made on Article 15- Leaves of Absence and Article 18- Seniority. They partially accepted our changes to jury service, confirming that jury duty absences will not count as an occurrence. They accepted
our changes to the Peace Corps section, accepting a 27-month absence without pay, which is in compliance with the Peace Corps. They also largely accepted language we proposed regarding domestic violence and expanded the section by calling it “Leave
and Protections for Victims of Certain Crimes”. They added that bereavement leave cannot rollover to the next calendar year nor be cashed out. While we are appreciative of the movement made here, these are mostly smaller changes.
Tags:
Article 15
article 18
bargaining update
CNI
health
Jury duty
safety
shift incentive
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Posted By AURN,
Thursday, January 12, 2023
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Over 120 nurses gathered to show their support for our first in-person Bargaining Kick-Off event Wednesday, Jan. 11. It was a sea of purple in the standing-room-only crowd that met with management at the table. Our new AURN shirts really stand out! Without
a doubt, the large member turnout was responsible for the speechlessness of OHSU Management when we presented our bargaining platform based on
the survey results. More nurses than ever completed the bargaining survey this year and your responses and support created this powerful session.
Our biggest win of the day was that management largely agreed to our enhanced CNI proposal, and after further discussion and counter-proposals, we reached an agreement! The expanded $46 CNI MOU will be extended until April 9 with clarifications made to the scheduling and curtailment process to increase fairness. Additionally, the current pediatric incentive to fill shifts during vacations is extended to the entire hospital. Read the full new MOU.
The working during vacation incentive, allows nurses to receive a bonus for picking up any shift during the week of vacation where accruals were also used to fill FTE. We also added two more Wellness Days for 2023. Those who haven’t
been able to use their wellness days (from your current vacation/sick leave banks) would still be able to use them before April 9, 2023.
Having so many nurses show up to support us inspired our team! Management clearly treats us better when you are present. Due to this, we encourage you to observe a bargaining session! Our next in-person session at OHSU is on January 25. View our full schedule.
As Ryan McIntosh, RN from ED Observation stated:
“It’s harder for management to disrespect a room full of 100 people versus a group of 12, so please show up!”
These are our top priorities that we presented to management:
- Staffing
- Workplace Safety
- Retention and Recruitment
- Justice, Equity, Diversity and Inclusion
- Moral Injury
Bargaining team members shared their stories and the experiences of their colleagues to impress upon OHSU Management that our members stand united in our bargaining priorities.
One of the most inspiring moments of the day, was when we presented a proposal with our Labor and Delivery nurses, stating that the mandatory call be changed to voluntary call and should not be used to support baseline staffing. A united group of L&D
nurses shared their experiences to explain that mandatory call is not a solution, that no other hospitals in the region have mandatory call, and this requirement is preventing recruitment of experienced nurses. Guest speakers from L&D conveyed to
management the dire situation they are in with mandatory call being used to fill baseline staffing in direct violation of our current agreement. When baseline staffing is not funded by the hospital administration, our nurses are left to care for the
most acute laboring mothers and their babies in the state without safe levels of staffing.
In the late afternoon, management presented counterproposals on Article 2-Association Privileges and Limitations, Article 22-Grievances and Arbitration, Article 25-Transportation and Parking, and CNI Incentives.
Excerpts from our bargaining platform presentation:
Staffing
- The pandemic impacted nurses at OHSU with poor staffing and health-compromising situations.
- Meal and break requirements are not being followed despite clear contract language agreed to in the last bargaining round.
- Management is denying our staffing related grievances, forcing us to go to arbitration.
- There are many open positions. Some units are down by 60% on nights. We need to make OHSU desirable with compensation, safe staffing, and respect.
- Our patient population is becoming much more acute and intense. We need acuity and intensity to be recognized and to staff accordingly.
- Moral injury starts even before our shifts start. Co-workers frequently text us saying “please come help.”
- No beds or pillows for a 95-year-old patient who was stuck on a gurney for 48 hours.
- In the ED, we had three stymied patients waiting-very complex acuity.
- “I was forced to do a pelvic exam in an elevator, and we are amputating digits in hallways. The ED nurses did not sign up for this!”
- 12-24 hour wait times. Patients laying on the waiting room floor due to the wait and we are unsure if they are OK. The acuity is higher than ever in the waiting rooms.
- The ED cannot maintain a 3:1 ratio and the rest of the hospital is failing as well.
- The moral injury continues when we try to go to sleep. An ONA leader asks, “how many people have a hard time going to sleep?” Nearly every nurse in the packed room raises a hand.
Workplace Safety
- Nurses are facing violence in the workplace without proper systems and support in place to keep them safe. In one incident, MDs walked by a nurse being attacked and DID NOT intervene. There was no time to even debrief. The charge nurse did not get
notified that their nurse was assaulted until days later. This is a core indicator of how desensitized staff have become to a complete lack of safety.
- ED nurses have used their body many times to protect patients from other patients in the waiting room.
- Nurses submit 6-7 PSIs (Patient Safety Incident forms) per day and do not hear back on any of them. Too many band-aids being applied.
- There have been threats of gun violence in multiple departments, a recent arson event in the ED, and a car was almost driven into the ED. In these incidents the lack of a proper emergency response to keep staff safe was shocking.
- Safety for our nurses is safety for our patients, our community, for you (administration) and us. We had to prepare our families for the fact that we may lose our life due to caring for patients during the pandemic.
- We need a new contract. We want to stay.
Retention and Recruitment
- OHSU has been offering MDs, NPs and PAs $500 for a 4-hour helping hands shift, which would have been better filled by ancillary staff or nurses, since we can do every aspect of the work. We complained and were told it would never happen again, yet
it did again in December. Why wasn’t this offered to us?
- Travelers getting incentive shifts before us is unacceptable.
- We have bargained many side letters over COVID, but our asks for things that would truly retain nurses were refused by management. Nurses are leaving since they don’t feel supported or respected for their loyalty to OHSU.
Justice, Equity, Diversity and Inclusion
- When sexual harassment cases went public, you (administration) spent 6 million dollars for a report that proved that all the cases were already reported to HR. You didn’t need to spend 6 million to demonstrate that, you needed to have listened to
us to begin with.
- Racial epithets have been thrown at nurses by patients. There has been physical violence. At best those patients are banned for 30 days but they are still allowed to come back even though nurses repeatedly complained about the patients’ illegal behaviors.
- Violence starts with microaggressions. When we report them, we don’t get resolution. Signs are not enough.
- On Juneteenth we got 7.2 hours, yet many people of color still had to work 12 hours and the rest of us didn’t even get to take the 7.2 hours off due to short staffing.
- The accommodations requests for nurses with disabilities are backlogged by several months. This is a disservice to our members who are struggling in their current positions.
Moral Injury
- Nurses are set up to fail before they even arrive for their shift; and they know this. Getting calls from their peers, who are desperate to have enough staff to safely care for patients impacts every nurse. It’s demoralizing knowing you either come
in to be set up to fail or stay home leaving your peers to fail and patients in unsafe conditions.
- The lack of follow-through on reporting compounds the moral injury.
- When a nurse needs a meal or break to process all this, it doesn’t happen.
- Nearly every nurse raised their hand when asked “who in the room has had difficulty sleeping.”
Tags:
bargaining update
cni
csi
labor and delivery
moral injury
ohsu
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