Every year America celebrates National Nurses Week from May 6, National Nurses Day, to May 12, the anniversary of Florence Nightingale's Birthday.  I think this year's theme "Nurses: Making a Difference Every Day" enables us to communicate how important nurses are to patient safety and quality care.  Many times our patients express their gratitude for the comfort we provide, but nurses are not always recognized for the important work they do with their patients.  I had the opportunity recently to hear Suzanne Gordon speak at a VHA CNO Conference.  She shared the story of how surprised she was (years ago) when she had her first child.  Her expectation was that her OB was going to be taking care of her while she was in labor, but through her experience at this time she learned what nurses did, and it was an eye opening experience for her. 

 Nurses are not known for publicly touting the great things we do for our patients, we don't consider what we do to be anything special.  From monitoring the medical condition to identify if the patient is stable or becoming unstable to assessing their response to both the medical plan and nursing plan for care, and for being a patient advocate when the patient needs you to be their voice, I want to thank CMC's nurses for the work you do for our patients 24/7. 

You might have missed the news about the RNs at Cedar campus (the former UMC) filing a decertification petition asking for an election to remove CNA as their representative.   

I was surprised when I opened the Fresno Bee this morning (March 13, 2008) to the headline “Community aims to oust nurse union.”  Surprised because I had been informed yesterday about the National Labor Relations Board (NLRB) fax—a one-page decertification form filed by the Cedar campus RNs and a notice of a hearing on the matter.  But more than surprised, I was dismayed that the headline the paper chose to run did not reflect the facts.   The headline incorrectly depicts that CMC is leading the effort to “oust” the union, when in fact; the petition was filed by the nurses at the Cedar Campus.  

I, along with other hospital administration, don’t have much information about the nurses’ request to decertify the union, but I have heard that RNs on the Cedar campus are upset about CNA holding up raises we gave to other Community nurses last fall and the opportunity to be rewarded and recognized for their leadership through participation in the RN Career Ladder.  I can understand how the Cedar campus nurses might be unhappy with the union, especially if they do not feel that CNA is representing them as they would like to be represented or if they feel that CNA is holding up compensation they deserve.  They have every right to request decertification—just as nurses have a right to vote differently in an election.

Unfortunately the issue of CNA representation has to be played out in what can be a slow process. Any election to decide representation is strictly between CNA and the RNs at Cedar campus with the NLRB overseeing the process. Administration can only provide assistance when asked.

I want to assure you as Community’s Chief Nursing Officer, I echo CEO Tim Joslin’s statement in today’s article about supporting nurses’ rights to freely make their own decisions about unions.  And I second his sentiment: “We believe that we can achieve more through collaboration (with our nurses) rather than confrontation.”  Clarification is mine.

Such events can distract us from the more pressing and important work we do at Community caring for the health of our community, working to advance the nursing profession, and creating a top-notch workforce and workplace.

I would hate to see the pending election on this union issue polarize our wonderful staff. We have so many other great things to focus on here at Community with our career opportunities for nurses, new technology, and expansion plans at all our hospitals. And we all know patient care truly takes a team effort with all of us pulling together.   

If you’re curious about the dates or would like more details about this decertification petition, make sure to read the full story at http://www.medwatchtoday.com/1476.htm  

Finally, I welcome your questions and comments.  Please don’t hesitate to stop me in the hall when I am doing rounds or send me a comment through my blog. 

In June 3, 2007 Fresno Bee, there was an article about the recently passed Assembly Bill 1559 which would require Community College nursing programs to implement merit-based policies.  The article discussed local community college response and highlighted a near straight-A student who is hoping her name is picked in the lottery for the nursing program at Fresno City College.

The topic in this article is something that nursing leaders have discussed with our community college leaders many times.  In fact, the Paradigm Program was developed in 1999 to address some of our frustrations when hospital staff, who are committed to nursing already through their work in the hospital, were not lucky enough to be selected by the lottery system 3 - 4 semesters.  Through the Paradigm Program, our staff who meet the qualifications of Fresno City are able to move into a Paradigm slot if they are not selected through the lottery.  As of April, 2007, 118 additional RNs (Community employees) have graduated and passed their State Boards through the Paradigm Program.  Two years ago, however, we did increase our GPA requirements from 2.5 (required by the college) to 3.0 for Community's Paradigm applicants because we had a number of Paradigm students who were unable to keep up academically with the program, and graduates who were never able to pass their state boards. 

In this time of a critical shortage of RNs to care for the patients in our valley, when there are 16 - 20 candidates for each nursing student slot available, we must work together to ensure the right candidates are selected for the programs and that there is support for those students who need it during the program to prevent drop outs when possible.  I participate in the San Joaquin Valley Education Consortium, funded by the governor which has identified 4 strategies to increase graduating RNs by 250 each year beginning January 2008.  It is important to ensure the right candidates are selected for our nursing programs to increase the odds that each will successfully complete the program to ensure we will have enough nurses to care for those who need them in our valley.

I support the concepts in AB 1559, which is endorsed by the California Hospital Association, although details of what "merit-based policies" are not clear.  I hope that Nursing Leaders along with Community College Leaders will be able to work together to design the best implementation if this legislation becomes law.  That is still to be determined since the bill has only passed the Assembly but still has a ways to go.  

Congratulations to all of CRMC & UMC staff for the successful transition of services to the CRMC campus.  The many months spent in planning for the move event and consolidation of services was evident as Monday, Tuesday and Wednesday unfolded.  Thank you to all the teams who worked so hard to make this a success!  I was honored to work beside the nursing staff on second floor at CRMC Tuesday, April 17.  It was fun to participate by doing MAR reconciliation for the patients who arrived from UMC, but also stressful to make sure that the orders had carried over correctly!  And I know our nurses do this everyday...

The teamwork on second floor was great to see, and I applaud everyone who had a part on this unit, throughout units in both hospitals, and the support from all at CMC who contributed to the success of this endeavor.    

Each week I speak to the new RN and LVN nursing staff at orientation.  One thing I talk about is our value of patient safety and our goal to continuously improve our processes.  I discuss that as an RN Student 36 years ago I learned patient safety.  Everyone wasn't talking about patient safety in those days, but I learned how to safely provide care in every procedure and practice I was taught.  We didn't have the National Patient Safety Goal (NPSG) of using 2 patient identifiers, but when giving medications we learned to call the patient by name and check the patient's ID band against our med card.  (Some of you might remember those med cards!) 

 I recently experienced patient safety and the 2 patient identifiers from the patient's point of view when I had an outpatient surgery at CCMC.  Although the nurses knew me personally, each and every one of them followed our policy on patient identifiers.  I was impressed by their professionalism, explaining that, although they knew me, this was for my safety.  As I went through the process, first of pre-op testing, then the outpatient procedure, I was sure that the staff had the right patient for the right procedure in the right place at the right time with the right equipment!  

One of our nurses stopped me in the hallway to tell me she had not seen any comments posted on my blog, so I thought I'd let you all know how comments are handled in CMC's Blogs.  Your comments will come to me and I will take excerpts from or refer to them as I continue to make entries. Some comments may also help me create new entries, so keep them coming! 

Thanks to those who have sent me comments.  It was uplifting to hear from Verna Cobern, an RN from Short Stay, who sent in an upbeat message about the upcoming transition of UMC to CRMC and Laura Valenzuela, RN from Radiation Oncology sent in a wonderful message about how Ellen Austin has been a mentor to her.  As a staff nurse identified this is a great way for communication and I look forward to hearing from you.