May 26, 2011

Nurses advocate for better staffing, safer conditions

Source: NYSUT Communications

NYSUT's health care professionals teamed up with nurses from PEF and 1199 on May 24 to fill the Legislative Office Building, the capitol and convention center with a sea of gold t-shirts proclaiming "Save NY Nurses." Their quest: safe patient-staffing ratios for hospitals; safe patient handling; no mandatory overtime for home care nurses; and a school nurses in every building in New York's Big Five cities.

"Roll right in with scenarios that show why these issues are relevant," said Anne Goldman, NYSUT board member and special nursing representative to the UFT. "We're the first line of defense for the people we care for."

At a luncheon with nurses from all the unions, many lawmakers pledged support. Senator Kemp Hannon, R-Long Island, who noted that $2.4 million was taken from health care in this year's state budget, is sponsoring the safe staffing bill.

Assemblyman Richard Gottfried, D-New York, said nursing is the heart of health care and there should be enough of them in the workplace to provide a safe environment.

Assemblywoman Aileen Gunther, D-Monticello, is sponsoring the school nurse bill and the anti-mandatory overtime for home care nurses, and told nurses she is "counting on you to be the messenger."

"When we band together it makes a difference," NYSUT Vice President Kathleen Donahue, who oversees health care, told the nurses.

Many of the nurses woke between 3 and 4 a.m. in order to board a bus in New York City and come to Albany to volunteer as lobbyists for the day.

NYSUT members were able to show through first-hand experience how enacting the bills will save money and health for both patients and nurses.

By providing safe patient handling, hospitals will reduce risk of injuries to patients and staff, saving money in health care, surgeries and time missed from work.

"I have been injured twice in the last year," said UFT member Howard Sandau, a nurse at Lutheran Medical Center – both times while lifting patients. He required surgery and time out of work.

"We're suffering. We need help," he said.

NYSUT advocates hospitals providing mechanical lifts for patients. Lifting people who are overweight, immobile, frail and elderly, or amputees are just a few examples of potential problems. Nurses who continuously lift and pivot also risk arthritis later on. Elderly patients who are moved by sheets risk having their skin sheared, nurses explained.

Assemblyman Rory Lancman, D-Queens, sponsor of the safe patient-handling act, said when people think of workplace safety, they think of construction sites, coal mines or oil rigs, "but hospitals can have significant safety issues."

Senator Michael Gianaris, D-Queens, who serves on both the health and codes committees, expressed surprise at the harm that can be caused by moving patients without lifts, and said this bill is one where "I can probably have the most relevance."

Safe patient-staff ratios are a concern in most hospitals, where safe ratios need to be based on the acuity of the patients on that floor. One downstate nurse said when she was a new nurse she was put on a rehab floor as the sole nurse for 15 patients.

"I don't disagree with you there should be some sort of guidelines; but what should they be?" Assemblyman Steven Cymbrowitz, D-Brooklyn, asked.

"You need management and the union working together on that," said Cynthia McDaniel, UFT home care nurse. Ratio examples are 2-1 for ICU and 4-1 for medical-surgical units.

On an average floor, when a nurse cares for more than eight patients, the liklihood a patient becomes sicker increases, nurses said.

Safe patient-staff nursing ratios are also important because patients are coming into the hospital more critically ill than in the past, said UFT nurse Renee Setteducato. People put off seeking help because they might be underinstured or not insured at all; some are frightened of the shortage of care in the hospital or the expense, nurses said.

"Patients are staying home longer to avoid the hospital, going to the hospital sicker and being sent home quicker," said UFT visiting nurse Raquel Webb Geddess. She spoke out against mandatory overtime for home care nurses, who were exempted from the law prohibiting mandatory overtime for nurses that was passed several years ago after successful advocacy by NYSUT. Home care nurses are often called and asked to stay later than scheduled, or pick up another patient.

"It's November. It's dark. You're on foot," Geddess said, often walking around dangerous neighborhoods. Many reported working three hours of overtime a day and finishing record-keeping at midnight. With hospitals discharging patients faster, home care is now akin to a medical-surgical unit, one nurse said.

Other visiting nurses told Senator Mark Grisanti, R-Buffalo, about being called out regularly during the night to care for patients in need – after working all day and knowing they have to report to work again in the morning. For nurses in rural areas, this means driving long distances while fatigued. Home care agencies should hire nurses strictly for night, on-calls hours, eliminating a situation that creates hazards for patients and nurses.

"Sleep studies show that driving drowsy is worse than driving drunk," said Ann O'Hara, school nurse and member of the Syracuse TA.

School nurses, too, face working conditions that are often unsafe, since many work in numerous buildings, or have student caseloads of more than 1,000 students.

Again, families lacking insurance create more demand.

On Monday mornings, said O'Hara, students are lined up and parents have left messages.

"Sicknesses have been saved up. It's a little overwhelming," she said. School nurses deal with earaches, stomach upsets and headaches, but also allergies, asthma, obesity, seizures, depression, and special-needs students with serious medical conditions.

Keeping kids healthy keeps them in school, she said. "It's a barrier to education and a barrier to health care without enough school nurses," she said.

School nurses, said Goldman, need to let lawmakers know "This is the IEP (Individualized Education Program) for life!"

Lawmakers were told stories about a student on a bus with allergies who ate a milk product, and was met at the bus by a nurse with an EpiPen, saving his life; another student who had a stroke in the nurses' office.

O'Hara told about a girl who came from gym class not feeling well, and she detected an unusual heart murmur, then contacted the girl's parents. Two weeks later the girl had cardiac surgery, O'Hara said, and the cardiologist sent O'Hara a note telling her that her catch saved the girl's life.