Seachange Bulletin #114July 27, 2003Seachange Bulletin ArchivesEmail the editorSeachange Bulletin #114: AARN/California: Ratios, Power, Pensions Stop complaining, start hiring. That's the prescription for California hospitals that have resisted gearing up for new nurse-patient ratios set to take effect in January. Revised regulations will be released by the state Tuesday, but hospitals have had preliminary numbers since January, 2002. Big non-profit health care groups such as Catholic Healthcare West, Kaiser Permanente and the University of California system have moved since then to train and hire enough nurses to meet the higher levels of care mandated by the state Department of Health Services. Other hospitals, however, are lagging - and claiming they can't possibly find or afford enough registered nurses to meet the ratios. Nursing groups say the laggards are primarily for-profit chains. Locally, however, HCA-owned hospitals (San Jose Medical Center, Regional Medical Center and Good Samaritan) report they are recruiting as far away as Canada, increasing the size of their permanent staffs and emphasizing on-the-job training of new graduates. Everyone agrees recruiting more registered nurses in this highly competitive climate will cost millions. But some hospitals are succeeding, in part through creative methods such as offering tuition-free nurse training programs. There's no longer any doubt that more nurses mean better care. California horror stories about under-staffing are backed up by major studies reported in the Journal of the American Medical Association and the New England Journal of Medicine. Even the hospitals' own oversight agency, the Joint Commission on the Accreditation of Healthcare Organizations, agrees that inadequate nursing staffs lead to deaths and serious injuries. People care about this. Nurse-patient ratios have generated more public comment than any other topic in the history of the Department of Health Services. And hospitals have known that more nurses would be needed since Gov. Davis signed legislation back in 1999. Yes, there's a nursing shortage, but cyclical shortages have occurred for decades. It's no excuse. Revised regulations on nurse-patient ratios will be posted Tuesday at www.dhs.ca.gov. © 2003 Mercury News and wire service sources. All Rights Reserved. California Nurses Assn. Applauds Final RN Ratios Plan Hospital Industry Proposals to Erode Ratios Rejected by State California Nurses Association, July 1, 2003 <http://www.calnurses.org/cna/press/7103.html> The California Nurses Association today welcomed the release of the final regulations to establish new minimum registered nurse staffing ratios that all hospitals must meet by January 1, 2004 as a significant step towards improving patient care conditions in California hospitals and protecting patient safety. "A new era is dawning in which all California families should expect safer standards in California hospitals," said Kay McVay, RN, president of the 50,000-member CNA which sponsored the Safe Staffing Law and worked for 10 years to enact it. "The finish line is finally near. Every patient should be able to demand and count on receiving the registered nursing care they need, when they need it." In the package approved by Gov. Gray Davis and the Department of Health Services, state officials made critical decisions on some hotly contested issues regarding implementation of the CNA-sponsored law, the first such law in the nation which has been a model for RNs and legislators in other states. Among key decisions in the plan: Proposals by the hospital industry to erode the ratios in Emergency Rooms, Post-Surgical Recovery units, and for evening, night, and weekend shifts, were all rejected. State officials also rebuffed hospital efforts for further delays in implementation. Phased-in, improved ratios (fewer patients to nurses) in three hospital areas. As of 2008, ratios will be lowered in Step Down units, typically housing patients just transferred from critical or intensive care, Telemetry, where patients are on monitors, and other specialty care units, such as Oncology and Rehab. CNA was the only organization to present scientific data - based on 22 million patient discharge records, the DRG designations and patient acuity - along with thousands of RN testimonials to make the case for these reductions. Assurances that hospitals must adhere to scope of practice laws to protect patient safety. No RN may be assigned, or be responsible for more patients than the specified ratios. The regulations clarify the respective roles of RNs and LVNs, make it apparent that RNs and LVNs are not inter-changeable, and require that additional nurses must be assigned, as needed, by severity of patient illness. Hospitals are required to document staffing assignments, including the licensure of the direct caregiver for every patient for every unit for every shift, and keep the records for one year, steps that will help the state monitor and assure compliance with the law. McVay noted that many CNA-represented hospitals have already hired hundreds of additional RNs in preparation for implementing the law, and as a result of unprecedented CNA gains in compensation, retirement security, and workplace improvements intended to enhance retention of current experienced RNs and recruitment of new RNs. CNA, which has campaigned since 1992 to enact safe RN staffing ratios, will work with RNs across the state to monitor enforcement of the law and encourage hospital compliance. CNA has also sponsored a new bill, AB 253, to help assure compliance. Introduced by Assembly member Darrell Steinberg (D-Sacramento), the bill authorizes state health officials to conduct unannounced inspections, and provides for fines of up to $5,000 a day, on hospitals that continue to maintain unsafe RN staffing after final implementation of the ratio law. For the specific ratios by hospital unit and more background on the law: <http://www.calnurse.org/finalrat/qandafinalrat.pdf> Fact Sheet on RN Staffing Ratio Law California is the first state in the US to establish minimum RN-to-patient ratios for hospitals. The ratios are based on AB 394, sponsored by the California Nurses Association and signed by Gov. Gray Davis in October, 1999. Today's announcement of the final regulations to implement AB 394 culminates a 10-year campaign by CNA to improve RN staffing in California hospitals to protect patient safety, and reverse the effects of a decade of hospital restructuring that eroded patient care conditions and produced a hospital nursing shortage. All hospitals must be staffing with the minimum ratios as of January 1, 2004. Many CNA represented hospitals have already hired hundreds of additional RNs in preparation for implementing the law, and as a result of unprecedented CNA gains in compensation, retirement security, and workplace improvements intended to enhance retention of current experienced RNs and recruitment of new RNs. What the Law Does AB 394 establishes specific numerical nurse-to-patient ratios for acute care, acute psychiatric and specialty hospitals in California. The ratios are the maximum number of patients that may be assigned to an RN during one shift. The law requires additional RNs be assigned based on a documented patient classification system that measures patient needs and nursing care, including severity of illness and complexity of clinical judgment. AB 394 also restricts the unsafe assignment of unlicensed staff and the unsafe assignment of nursing staff to hospital clinical areas where they do not have demonstrated competency, training, and orientation. The specific ratios: AB 394 required the state Department of Health Services to establish the specific ratios for specific hospital units. In 2002, the DHS issued the proposed regulation to implement AB 394, including the specific ratios for every hospital unit, and held public hearings. On July 1, 2003, Gov. Davis and the DHS issued the final regulations incorporating extensive testimony presented during the hearings and public comment, including from 500 CNA RNs who testified in the hearings, and nearly 25,000 RNs whose letters were submitted by CNA to the DHS. Why the Law was needed The purpose of the law was to address the growing crisis in patient care in California hospitals caused by managed care and market based decisions on hospital care that resulted in California having among the worst RN staffing in the nation and a growing exodus of RNs out of hospitals creating a serious nursing shortage. CNA campaigned for 10 years to get the law enacted, including the largest gatherings of RNs in California history, major rallies drawing thousands of RNs to the Capitol. California's law was the first (and still only) ratio law in the nation. It is the single most effective response to protecting patient safety in hospitals and reducing the nursing shortage. The California law is considered a national, even international model, and has generated extensive attention from the national media and RN organizations around the world. How the ratios will protect patients Safe RN staffing is the single most essential element to safe patient care in hospitals. In the last year alone: JCAHO, the Joint Commission on Accreditation of Hospital Organizations, announced that inadequate staffing precipitated one-fourth of all sentinel events - unexpected occurrences that led to patient deaths, injuries, or permanent loss of function - reported to JCAHO the past five years A New England Journal of Medicine study documented that improved RN-to-patient ratios reduces rates of pneumonia, urinary infections, shock, cardiac arrest, gastrointestinal bleeding, and other adverse outcomes. No similar links were found for LVNs or other nursing staff. Research in the Journal of the American Medical Association found that up to 20,000 patient deaths each year can be linked to preventable patient deaths. For each additional patient assigned to an RN the likelihood of death within 30 days increased by 7 percent. Four additional patients increased the risk of death by 31%. No similar findings were associated with improved ratios for LVNs or other staff. Where will the RNs come from to meet the ratios? DHS has projected that California will need 5,000 RNs to meet the ratios that go into effect in January. That is the same number of RNs who graduate every year from California's 72 schools of nursing. The approach of the ratios is already having an effect on overcoming the nursing shortage. In the past fiscal year, the number of RNs increased by 4% -- the largest increase since 1989, reports the Board of Registered Nurses. The number of exam applicants increased by 18% and the ratio of RNs entering and exiting the state continues to make a dramatic change with 1,664 more RNs coming into the state than leaving. In the three years since the law was signed, according to BRN data, applications for RN licenses from new graduates and from RNs outside California, has grown from 22,372 applications in fiscal year 1999-2000 to 27,551 in fiscal year 2000-2001 to 32,368 in fiscal year 2001-2002. In Victoria, Australia, ratios were enacted in 2001. By February 2002, the full-time RN workforce had increased by 16.5 percent. The real key to meeting the ratios is for hospitals to hang on to the RNs they already have. Many CNA-represented hospitals have taken big strides by enacting significant improvements, though collective bargaining with CNA, in retirement security, compensation, and improved patient care conditions. More background information is available at <http://www.calnurse.org>. New rules for nurse staffing proposed They aim to comply with a '99 law cutting the patient load, but questions remain. Lisa Rapaport, Sacramento Bee, July 2, 2003 <http://www.sacbee.com/content/business/story/6960793p-7909943c.html> State regulators proposed new rules Tuesday to reduce the number of patients treated by nurses in many critical care wards, as California prepares to enact the nation's first nurse-to-patient staffing ratios for hospitals. The staffing law, signed by Gov. Gray Davis in 1999, required the state Department of Health Services to decide how many patients every nurse should treat in each hospital unit. Two critical questions remain unanswered as regulators put the finishing touches on the rules scheduled to take effect in January: Will hospitals have enough nurses to comply with the law? And will regulators have the power to impose fines to enforce it? ... Senate Health Committee Approves Key Bill to Enforce Landmark RN Staffing Ratio Law California Nurses Association, July 2, 2003 <http://www.calnurses.org/cna/press/7203.html> One day after state officials announced the final plan to implement a law sponsored by the California Nurses Association requiring safe RN staffing ratios in California hospitals, the State Senate Health and Human Services Committee Wednesday afternoon approved a new CNA-sponsored bill to strengthen hospital industry compliance with the ratios. AB 253, introduced by Assembly member Darrell Steinberg (D-Sacramento), establishes tough penalties, including fines of up to $5,000 a day, on hospitals that continue to violate the ratio law. The law also extends the ability of state health officials to conduct unannounced inspections. The bill passed the Assembly in June. The ratio law, AB 394 requires minimum RN staffing for all hospital units, and is a critical measure to restore the patient safety net in California hospitals. All hospitals will be required to meet the staffing levels by January 2004, and with the release of the final ratios on Tuesday, the state is moving forward with that deadline. "Enactment of AB 253 would send a clear message to hospitals and the public that the state will not tolerate unsafe staffing and willful violation of the ratio law that puts patients at risk," said CNA President Kay McVay, RN. CNA Regulatory Policy Specialist Vicki Bermudez, RN told the Senate Health Committee that the enforcement bill as a critical component of completing the work begun with the ratio bill. Recent studies in the Journal of the American Medical Association and the New England Journal of Medicine, documenting improved patient safety with safe RN staffing, demonstrates that Californians have waited long enough for safe, effective RN ratios. "California hospitals have had five years to prepare," since the law was signed in 1999," Bermudez noted, chiding hospitals that "have not done their job who now want to be permitted to avoid complying with the law." ... Implement the RN staffing ratio law now! Sherri Stoddard, RN, San Luis Obispo Tribune, July 14, 2003 <http://www.sanluisobispo.com/mld/sanluisobispotribune/news/editorial/letters/ 6300658.htm> As of Jan. 1, 2004, California hospitals will be required to be staffed according to the minimum ratios approved by Gov. Gray Davis and the Department of Health Services (DHS). The ratio law, AB 394, requires minimum RN staffing for all hospital units, and is a critical measure to restore the patient safety net in California hospitals. All hospitals will be required to meet the staffing levels by January 2004. The final regulations are out and proposals by the California Nurses Association (CNA) to protect RN professional practice and patients are a key part of the rules hospitals must follow to comply with the CNA-sponsored Safe Staffing Law. California hospitals, including hospitals in SLO, have resisted gearing up for new RN-to-patient ratios set to take effect in January (and signed into law in 1999) are complaining now they can't find nurses. As a registered nurse who works here in San Luis Obispo and as an elected leader in the California Nurses Association, I say to the hospital industry and their administrators - stop complaining and start hiring. ... Organizing/Negotiating: Los Angeles hospital fights formation of nurses union <http://www.sfgate.com/cgi-bin/article.cgi?f=/news/archive/2003/04/12/state054 0EDT0034.DTL> Associated Press, April 12, 2003 Los Angeles - One of the largest private hospital in the western United States will once again challenge its nurses' decision to join a labor union. Cedars-Sinai Medical Center said it plans to appeal a March decision by the National Labor Relations Board ordering the hospital to recognize the union. The hospital will appeal the decision to the board's Washington headquarters. A final ruling could take months. California Nurses Association called the hospital's move a flagrant effort to delay negotiations. "The delay process is a time-honored method that some employers try to use to in effect continue to stifle and harass their employees," said Chuck Idelson, a spokesman for the union. "They are doing everything they can to stall and achieve through legal machinations what they failed to win at the ballot box." ... Palomar-Pomerado RNs See Record Gains in First Agreement 30% Pay Boost, New Pension Plan, Staffing Improvements California Nurses Association, May 19, 2003 <http://www.calnurses.org/cna/press/51903.html> Registered Nurses at Palomar Medical Center in Escondido and Pomerado Hospital in Poway in northern San Diego County have achieved landmark improvements in their first ever collective bargaining agreement, the California Nurses Association reported today. Highlights of the pact include average pay increases of 30% over three years - with an immediate average salary boost of 22% - plus additional annual pay based on RN experience, a new defined benefit pension plan, and numerous staffing gains, such as a tight ban on the dangerous practice of mandatory overtime. The agreement, affecting 725 RNs in the Palomar Pomerado Health, California's largest district hospital, should help raise standards for RNs and patients throughout Southern California, as well as assisting PPH retaining experienced RNs and recruiting new nurses, said CNA. With the agreement Palomar Pomerado RNs will now be the highest paid registered nurses in San Diego County, with experienced RNs earning up to $36.80 per hour, and advanced clinical RNs paid up to $37.91, said CNA. ... Deborah Burger, RN Elected President of California Nurses Association, Pledges to Continue CNA's Patient Advocacy Path California Nurses Association, May 20, 2003 <http://www.calnurses.org/cna/press/52003.html> Deborah Burger, RN, a long time leader in the California Nurses Association, has been overwhelmingly elected as the next President of CNA, the state's largest organization of registered nurses and the largest and fastest growing independent nurses union in the US. Currently the CNA vice-president, Burger will assume the presidency of CNA in September. She will succeed Kay McVay, RN, who has served the past four years as CNA President, the full term allowed under CNA bylaws. Burger was elected with 81% of the votes of CNA members in results announced Monday. In a post election statement, Burger pledged to continue the direction of the current leadership which, she said, "has made CNA the most respected, premiere RN professional organization and union in the country. I'm proud to receive the support of CNA RNs," said Burger. "Everyday we work to protect our patients and preserve our practice. This election was an endorsement of our patient advocacy program." ... Palomar-Pomerado RNs Approve Stellar First Contract Landmark Pay, Pension, Staffing Improvements Cited <http://www.calnurses.org/cna/press/52303.html> California Nurses Association, May 23, 2003 In a landslide vote Wednesday and Thursday, Registered Nurses at Palomar Medical Center in Escondido and Pomerado Hospital in Poway in northern San Diego County have overwhelmingly approved their first ever collective bargaining agreement, the California Nurses Association reported today. The agreement, affecting 725 RNs in the Palomar Pomerado Health system, California's largest district hospital, features huge improvements for RNs and patients, especially notable for a first contract. "This will definitely assist PPH in recruiting and retaining experienced RNs," said Pomerado RN Maribeth Markle. "I am proud to be a part of an organization, CNA, that seeks to protect, promote, and empower nursing as a profession. It's about time we take care of ourselves professionally and have a voice in what can guide and preserve our future as nurses." "With our first contract," said Palomar Emergency Room RN Donna Johnson, "we made significant gains in wages and compensation." "More importantly, our voice will be heard clearly when we advocate on our patients' behalf. CNA provides us with the mechanism and protection to ensure the delivery of quality and safe patient care that our patients deserve," Johnson added. ... Health-care workers to vote on contract John Berhman, San Diego Union-Tribune, June 20, 2003 Escondido - More than 1,300 service and technical employees in the Palomar Pomerado Health district have reached tentative agreement with administrators on their first union contract. It would provide an average salary increase of 20 percent over three years. If approved, employees would receive a 9 percent salary hike immediately, and the remaining 11 percent over the next two years. The proposed contract would cost the district about $5.1 million over the three years, $2.5 million the first year and $1.3 million each of the following years. The workers, represented since February by the Caregivers and Healthcare Employees Union, will vote on ratification of the contract Wednesday and Thursday. "We expect overwhelming ratification from the employees," said Joanne Jung, a spokeswoman for the California Nurses Association, which works closely with the service and technical employees union. The seven-member hospital board is scheduled to consider the contract July 14 and also is expected to approve it. The district's more than 700 registered nurses approved their first union contract last month, giving them an average 30 percent salary increase over three years. District nurses joined the CNA last year. ... Labor Board Charges Cedars-Sinai with Violating RNs’ Rights on Gag Clause Rule California Nurses Association, July 3, 2003 <http://www.calnurses.org/cna/press/70303.html> The National Labor Relations Board has indicted Cedars-Sinai Medical Center in Los Angeles for violating the rights of its registered nurses with a gag clause policy that threatens the RNs with termination or other discipline for violating an illegal "Confidentiality Policy" and advocating for patients, the California Nurses Association reported today. In a charge filed this week, the NLRB set an August 11 trial date in Los Angeles before an administrative law judge. Upholding unfair labor practice charges filed by CNA, the NLRB found that Cedars "has been interfering with, restraining, and coercing employees" in the exercise of their constitutional, federally protected labor rights. Earlier this year, Cedars began requiring RNs to sign a "confidentiality" agreement that includes a ban on discussing employee salary information. The hospital would not discuss what it calls its "business information," but which is widely interpreted to inhibit the ability of RNs to speak out to protect patient safety. The new policy was introduced at roughly the same time that the California Labor Commissioner began investigating widespread payroll fraud at Cedars, raising suspicion that the new policy amounts to a gag agreement designed to discourage employees from talking to CNA or state investigators about payroll issues. That investigation is ongoing. ... New Agreement Provides Wage Increases, Retiree Health Plan Improvement, for RNs at Washington Hospital in Fremont California Nurses Association, July 10, 2003 <http://www.calnurses.org/cna/press/71003a.html> Registered Nurses at Fremont's Washington Township Hospital District reached a tentative agreement yesterday with hospital management for a new collective bargaining contract that includes a 12% wage increase over the next 2 years, advancement opportunities and an enhanced retiree health benefit. The California Nurses Association (CNA) represents 500 registered nurses who work in the district's hospital and service centers, providing medical care for the residents of Fremont, Union City, Newark and part of Hayward in Southern Alameda County. The union's elected negotiating team made major strides in their contract, and will recommend acceptance of the tentative agreement by the bargaining unit, a sharp contrast to negotiations two years ago that ultimately settled but not without the threat of possible job action. "Two primary goals were to build on our already-competitive wages and to negotiate gains to help retain RNs, and we successfully accomplished that," stated Melody Hall, an Operating Room RN and bargaining team member. She added that "it's also admirable we were able to complete our bargaining in such a timely manner." The RNs won an additional pay gain for long-term nurses, providing a 3% increase at 25 years of service. "It's a particularly important incentive," notes Hall, "since many RNs at Washington have been here for a very long time." The existing retiree medical insurance plan was negotiated to now allow RNs who retire with 30 years of service to receive the plan at no cost from 55 to 65 years of age. Hall stated that "RNs are already thinking about how to focus their efforts two years from now on further improving retiree medical benefits." ... Nurses, hospital agree to contract Board to approve Tom Anderson, The Argus, July 11, 2003 <http://www.theargusonline.com/Stories/0,1413,83%257E1971%257E1506625,00.html> Fremont - Washington Hospital and the union representing its nurses have reached a tentative agreement on a new contract calling for nurses to receive a 12 percent raise over the next two years. Negotiations with the California Nurses Association, which represents 500 registered nurses at Washington, took less than a month. "We were able to come to an agreement ... in a relatively quick manner," Washington CEO Nancy Farber told hospital directors at their meeting Wednesday. Washington's labor relations haven't always been so smooth. Two years ago, nurses threatened a 10-day strike. "It's been years since it has been this easy," union representative Kim Waldron said Thursday. "I think the general nursing shortage of California has something to do with it." ... RNs at San Pedro Hospital Vote to Join the California Nurses Association California Nurses Association, July 14, 2003 <http://www.calnurses.org/cna/press/71403.html> A two-day election at San Pedro Hospital in Southern California, conducted by the National Labor Relations Board, was capped by a vote count today with the California Nurses Association (CNA) winning representation of 200 Registered Nurses at the hospital. RNs first approached the nurses association in early 2003 and, by May 2003, CNA had filed for the election. The hospital is owned by the Little Company of Mary, a subsidiary of Seattle-based Providence Health System. "This is a vote for justice on behalf of our patients," said Lora Smith, an RN for six years in the Critical Care Unit at San Pedro. "We'll now have the ability to speak out about the quality of care that's delivered to our patients, and have CNA's support behind us." Smith predicts that CNA's presence will also attract more RNs to the hospital, an additional benefit for patients as well as for the nurses. ... San Pedro RNs to unionize Karen Robes, Long Beach Press Telegram, July 14, 2003 <http://www.presstelegram.com/Stories/0,1413,204~21474~1512781,00.html> San Pedro - Registered nurses at Little Company of Mary-San Pedro Hospital narrowly voted, 72 to 65, on Monday to unionize 162 RNs. Ballots from the two-day election were counted by the National Labor Relations Board in Los Angeles. "It was close, but I'm really, really happy," said Phyllis Whitmore, a 29-year veteran registered nurse. "We'll finally have a voice.' Nurses said they plan to address several issues, including patient care, retirement and wages. About half of the RNs are older than 40, Whitmore said. In January, RNs approached the California Nurses Association, which represents 50,000 of their ranks at 150 facilities throughout the state. ... Hospital nurses vote to unionize Workers at Little Company of Mary facility vote to affiliate with the California Nurses Association. Lee Peterson, Torrance Daily Breeze, July 15, 2003 <http://www.dailybreeze.com/content/news/nmbnurses15.html> San Pedro - Registered nurses at Little Company of Mary-San Pedro Hospital have voted by a margin of seven votes to form a union, a ballot count by the National Labor Relations Board determined Monday. The decision by nurses to join the California Nurses Association at the hospital formerly known as San Pedro Peninsula comes as part of a recent wave of health-care worker unionization in California. With about 160 RNs on staff, the vote was 72-65, with six challenged ballots that weren’t counted. Because the challenged ballots were not enough to change the outcome of last week’s two-day election, the NLRB found that the vote was in favor of the union. Nurses who supported the union said they believe the union’s presence will increase their voice in the hospital. As part of the wide-scale organizing of nurses in the state, it will also help recruit new nurses to the profession and the hospital, they said. "A lot of us are old-timer nurses who have been there for 20 years-plus and we were probably the core behind this," said Phyllis Whitmore, a 29-year veteran of the San Pedro hospital who works in the gastrointestinal lab and in ambulatory care. "We’ve seen a lot of changes." Whitmore said that as the facility has become part of bigger and bigger chains, the nurses have had less of a voice. The hospital converted to a Catholic facility when it joined the the Little Company of Mary chain in 1992. Little Company of Mary became part of the Providence Health System in 1999. Nurses said that with a greater voice, they could help improve care at the hospital. ... Huge Pension, Pay Gains for 3,500 RNs at 9 Catholic Hospitals New Master Pact Covers SF, Sacramento, Santa Cruz Facilities California Nurses Association, July 18, 2003 <http://www.calnurses.org/cna/press/71803.html> Some 3,500 Registered Nurses at nine Northern California hospitals that are part of the Catholic Healthcare West system won sweeping improvements - including one of the best pension plans for RNs in the nation - in a major contract settlement, the California Nurses Association announced today. A tentative agreement was reached with CHW, the largest Catholic hospital chain in the Western United States, at about 4 a.m. Friday. Strengthened retirement security was a major concern for the RNs - and the RNs won dramatic gains in pension, along with pay increases of 14% over two years for most of the RNs, expansion of health benefits and a ban on mandatory overtime for those who did not already have those provisions, and other gains. CNA Executive Director Rose Ann DeMoro praised CHW for its "commitment to working with CNA and its RNs to enhance nursing standards in their hospitals and expanding the RN workforce." CHW and CNA, she noted, have been working together for months on programs to provide new scholarships for RN students and retraining other hospital workers to become RNs, "and now CHW has agreed to an outstanding contract that will significantly enhance retention of career RNs already working in CHW hospitals." The agreement must still be ratified by RNs at the nine facilities. They are St. Mary's Medical Center and St. Francis Memorial Hospital in San Francisco, Sequoia Hospital in Redwood City, Dominican Hospital in Santa Cruz, Mercy General Hospital and Methodist Hospital in Sacramento, Mercy San Juan in Carmichael, Mercy Hospital of Folsom, and Woodland Healthcare in Woodland. In addition, the pension benefits will be extended to RNs at Bakersfield Memorial Hospital, another CHW hospital whose RNs are represented by CNA. Further, CHW has agreed to negotiate the same pension plan for CNA represented RNs in Los Angeles and other Southern California hospitals later - and to make the pension portable, any CHW RN who transfers to another CNA-represented CHW hospital will be able to bring with them the full pension credits they have earned. The CHW pension plan is especially notable for providing a higher rate of benefits for long term RNs who have many years of service in CHW. "It rewards the career RNs for a lifetime of caring for others," noted DeMoro. ... RNs improve contract San Francisco Chronicle, July 19, 2003 <http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2003/07/19/ BU223095.DTL&type=printable> Registered nurses at nine Catholic Healthcare West hospitals reached a tentative agreement Friday that includes pay increases of up to 14 percent over two years for most nurses and improvements in their pension plan. The agreement must still be ratified next Thursday by the 3,500 nurses at the hospitals, which include St. Mary's Medical Center and St. Francis Memorial Hospital in San Francisco, Sequoia Hospital in Redwood City and Dominican Hospital in Santa Cruz. The previous contract expired June 30, but no strikes or other job actions were taken. The California Nurses Association, which represented the nurses, praised the proposed contract and described the improved pension plan as one of the best in the country for registered nurses. Under the agreement, a nurse at the top scale, with 25 years experience, could earn about $95,000 a year in the first year of the contract. A staff nurse with 11 years experience would earn $80,000 in the first year of the agreement. ... RNs at 9 Catholic Hospitals Overwhelmingly Approve New Master Pact, Join 35,000 CNA RNs in Winning Dramatic Gains in Pension and Pay California Nurses Association, July 25, 2003 <http://www.calnurses.org/cna/press/72503.html> Registered Nurses at nine Northern California Catholic Healthcare West hospitals ratified a new contract by a 92% majority Thursday, the California Nurses Association announced today. The pact covers 3,500 RNs in San Francisco, Sacramento and Santa Cruz area facilities, providing dramatic pension gains, a 14% pay increase over two years, improved health benefits and a ban on mandatory overtime. CNA Executive Director Rose Ann DeMoro praised the nurses for their "resolve and commitment in hammering out this historic agreement. They were clear from the outset that any new contract provisions should help retain experienced nurses and improve patient care and that is just what they achieved. Given this was the first master agreement negotiated with CHW and the recalcitrant stance of other hospital chains, this agreement should be noted for the nurses ability to articulate the important issues and CHW’s willingness to listen and act on the nurses concerns." "In the last few weeks I experienced the power of coming together with one voice," said Barbara Williams, RN a member of the CNA negotiating team who works at Dominican Hospital. "It was obvious from the beginning that the RNs on our team were dedicated nurses who could articulate their concerns with heart and intelligence for the patients they cared for and their co-workers and our professional obligations." ... Nurses OK new pact Fatter pension benefits and 14% pay raise provided George Raine, San Francisco Chronicle, July 26, 2003 <http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2003/07/26/ BU261146.DTL> Registered nurses at nine Catholic Healthcare West hospitals in Northern California have overwhelmingly approved a two-year master contract, their union, the California Nurses Association, said Friday. The CNA said the contract contains "dramatic gains in pension and pay." A Catholic Healthcare West spokesman, Terry Lightfoot, said the company, too, is gratified with the results. "We are pleased to have a contract that will increase our ability to recruit and retain nurses in the future," he said. The voting was 92 percent in favor of the contract, for which negotiations began in April, the CNA said. The pay increase is retroactive to July 1 and new pension benefits become effective Jan. 1. Improving pension benefits has been the union's primary goal in recent negotiations, because pensions are "at the center of our ability to attract and retain nurses," said Liz Jacobs, a CNA spokeswoman. She said the CNA has now negotiated pension improvements for 35,000 of the 50,000 registered nurses the union represents at 150 hospitals throughout the state. These pensions are defined, with guaranteed amounts of money, "since 401(k)s just don't cut it, certainly given everyone's experience with volatility in the market," Jacobs said. Pensions will be calculated on a formula using current age and years worked at Catholic Healthcare West. For example, a 52-year-old registered nurse with 10 years of service will be able to retire at age 65 with monthly payments that are nearly 30 percent of his or her current salary. A 26-year-old RN can retire at age 65 with 70 percent of his or her salary. ... Web Directory: AARN <http://www.aarn.org> Australian Nursing Federation <http://www.anf.org.au> California Nurses Association <http://www.calnurse.org> Canadian Federation of Nurses Unions <http://www.nursesunions.ca> CCDS <http://www.cofc.org> Irish Nurses Organisation <http://www.ino.ie> Labor Party <http://www.thelaborparty.org> LabourStart <http://www.labourstart.org> Maine State Nurses Association <http://www.mainenurse.org> Massachusetts Ad Hoc Committee <http://www.massadhoc.org> Massachusetts Green-Rainbow Party <http://www.massgreens.org> Massachusetts Nurses Association <http://www.massnurses.org> MASS-CARE <http://www.masscare.org> New York Professional Nurses Union <http://www.nypnu.org> New Zealand Nurses Organisation <http://www.nzno.org.nz> PASNAP <http://www.pennanurses.org> PNHP <http://www.pnhp.org> Québec Nurses’ Federation <http://www.fiiq.qc.ca> Revolution Magazine <http://www.revolutionmag.com> Seachange Bulletin <http://www.seachangebulletin.org> Southern Arizona Nurses Coalition <http://SAZNC.homestead.com> Union Web Services <http://www.unionwebservices.com> United Health Care Workers <http://www.uhcw.org> FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. 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