In this issue:

1. Conference Committee Minutes
2. DOH visits to Skagit
3. Staffing Committee Update
4. Happenings in Olympia
5. New Hire Nurses
6. Recognized Certifications
7. IT Glitch with Dietary Orders
8. Hospital Construction: Station Square & Outpatient Surgery Center
9. Extra shift incentive MOU update
10. Local Unit Meeting
11. Coffee Hour

Nurse Conference Committee

Your elected officers attend a meeting with management and HR every other month to discuss issues that have been brought forward by all of you. Our next scheduled meeting is April 19, 2023. .

We are doing these as a hybrid meeting, in person and virtually. There will be another update following that April meeting. If you have any issues on your unit you would like addressed, please contact one of your officers or Sue Dunlap directly and we would be happy to address on your unit's behalf.

New for this update! The NCC minutes will now be posted on the WSNA webpage for everyone to access and read at your leisure. The minutes will be posted in the folder labelled “Other” on our documents page. This is a great way to keep informed on all the things happening and how your elected officers are working on your behalf to address concerns. Here is the link to the documents page and the associated QR code. We will have the QR code on stickers for the next local unit meeting so that you can put on the back of your badge and access quickly and easily. Use the link for https://wsna.to/skagitdocs.

Department of Health Visits

The department of health conducted unannounced visits to both Skagit and Cascade hospital in response to complaints received. However, they are also doing this throughout the state to advise hospital leadership of their increased focus on patient care particularly for boarded patients. Department of Health is mandating that all patients who have been admitted to the facility receive inpatient standards of care no matter where they are located. Of course, this will greatly impact areas where patients are being boarded.

The emergency department is the hardest hit at this time as they keep a large portion of the admitted patients within their department as boarders. WSNA met with leadership to discuss this change in working conditions as the nurses were instructed, they now needed to provide inpatient care, do inpatient charting including admission assessments, releasing MD orders etc. The challenge is that the nurses in the ED do not routinely do this type of work, supplies that are common on the floor are not readily available within the emergency department and of course there is the challenge when the ED experiences a surge or influx of emergency patients.

Unlike the floor, they do not have any control in the ED of who walks in the door or comes in by ambulance. Boarded patients should be kept at the same ratio as the inpatient units have on their staffing plan. Historically this has not happened, and the ED nurses have had boarded patients plus the emergency department patients. I know we can all appreciate that every 15 minutes vital signs may not happen if the nurse is busy doing CPR on an ED patient or attending to a trauma patient. We had some great discussion with leadership about how this should be approached and addressed. As part of this we also requested that all the staff be made aware of the unique care situation in the emergency department and that everyone extend grace to their nurse siblings if documentation is not as complete as the inpatient nurses may be used to seeing or expecting. Watch for additional information that may be coming out from leadership about this issue.

The officers were able to arrange and attend two emergency department nurse’s local unit meetings and hear directly from the nurses what they are experiencing with regards to this change in their expected work. As a reminder to everyone, WSNA is the sole representative of the nurses at Skagit and ANY change that affects a nurse's hours, wages and/or working conditions MUST be bargained with the union.

If you are presented with something that meets these criteria during a staffing meeting, it is completely appropriate and acceptable to politely ask if this has been vetted through the union first. Then please follow that up with an email to one of the officers or directly to your nurse representative Sue Dunlap outlining what was presented. Chances are if you have not heard about this upcoming change, it was not brought to WSNA first and we need to move on these items quickly. Our first step when hearing about changes is to conduct a unit meeting to hear from all of you so you will be aware of what leadership is going to present or propose. We are here to help so do not hesitate to reach out! We are finding that the majority of the time, leadership has not been made aware of the contract requirements and are generally more than willing to have these meetings with us.

Nurse Staffing Committee

Every meeting we ask for an update from the staffing committee. This is a standing agenda item. Currently what we are hearing is that there is less than desirable attendance to this meeting by the nurses on the committee. However, we did politely point out that the current staffing law requires management to find replacements if the nurses are working and allow them to attend. This meeting is paid time and while the nurses exercise due diligence in notifying when the meetings are scheduled for, it is leadership’s responsibility to find coverage and have these nurses attend. Members of this committee are responsible for creating the units staffing plan and then reviewing and discussing staffing concern forms.

Do you know how to access and complete your internal staffing concern form? Do you know who your units representative is on the staffing committee? Do you know where your staffing matrix is posted? It should be posted so that it is visible to staff as well as patients and visitors. In addition to the standard matrix, the unit should also have posted who is working that particularly shift in those roles so that it is obvious if the matrix is being met or not. Liz Rainaud is the nurse co-chair of this committee and please feel free to email her with any issues on your unit. If your unit is not represented at the staffing committee and you would like to assist, likewise please email Liz so she can note that and let the other officers know of your interest. At this time, in accordance with the law, all staffing committee members are appointed by your officers and must be WSNA members in good standing.

In follow up to that, Kristen Hanson has been the representative for CCU and has done a fabulous job representing all the nurses from that area. She brings great wisdom and experience and creative solutions to issues on that department. She has tendered her notice to step down from the staffing committee. Please let her know how much she has been appreciated for the extra work she has put in and pass along a thank you! And if you are interested in participating, please reach out to Liz Rainaud or Sue Dunlap – we would welcome you on the team!

Legislation

As a follow up to the staffing committee, WSNA is once again working with our other union siblings in a coalition to propose new staffing laws. You likely will be receiving the updates and information via email on how this is going. It is a long grueling process, but we have the best team at work in Olympia championing this for you. Please pay attention to these emails especially if there is a specific ask i.e., email your legislator. Often these are very quick and easy to do but have a big impact. If you would like more information on how to be involved in this side of WSNA just shoot a quick email to Sue Dunlap.

New Hire Nurses

After a couple of years of virtual new hire orientation we are now back to doing in person presentation to the new hired nurses! This is a contractual item, Every nurse new to Skagit is entitled to 30 minutes of paid time to attend a discussion about WSNA and what it means to be a member and what we do. We are so excited to do this in person again! During this time, we discuss the extended benefits of membership with WSNA including complimentary premiere membership with ANA as well as our national union affiliate AFT. The benefits to this is extensive! As well, we provide them with links to the contract and all MOU documents, advise them of their Weingarten rights (on your WSNA Blue RN Badge buddy) as well as provide contact information for all the officers and your nurse representative. This is a super fun casual event, and it is so great to get to know our new nurses. So, here’s an ask!

You do not have to be an elected officer to participate in New Hire Orientation! If you are someone who is naturally warm and welcoming and think this would interest you please email Sue directly or our assigned organizer Zach Seikel at ZSeikel@wsna.org and we would love to have you! If you are just curious OR you did not get this presentation, likewise, send us an email and we would love to have you at our next new hire. The new hires are held at the business center every other Monday at 4:30 pm. If this is something you would like to assist with, we would welcome that and provide full training and support. Personally, I love doing this and challenge everyone to bring a nursing scenario because I bet I have a story that would go with that scenario! (Benefits of having been a nurse for 37 years.)

Recognized Certifications

At our last NCC (Nurse Conference Committee) meeting, Kaycee brought the list of certifications that are eligible for cert pay premium. Again, this is a contractual item, but each department has their own unique list of certifications that are eligible for this increase in pay. Sometimes it is helpful to know in advance which department recognizes which cert as you may look for a change and/or internal transfer to another position. The certification list lives with your manager on your unit and all you need to do is request a copy and they will provide that for you. Likewise, HR has this in their records. WSNA did request that leadership look for a central location on the intranet that every nurse can access to view at any time, and they are going to look into that possibility and bring back to our next meeting.

IT Glitch with Dietary Orders

Recently one member discovered and reported a phenomenon that occurs with ordering dietary trays / meals. Apparently, in this one case, a patient ordered his dinner tray with plenty of time for it to be processed. However, the patient needed to go to surgery the next day and a physician order was entered for NPO after midnight. For whatever reason when that order was released, it cancelled out the dinner tray! And the patient never received the requested meal. Slightly upsetting since they weren’t going to be able to eat anything after midnight! Huge shout out and heart felt thanks to the dietary crew who stayed over to prepare a tray for this patient – their efforts were gratefully appreciated! However, keep that in mind if you have an NPO order come up as this may affect the meals remaining in the day prior to that midnight cut off time. Leadership promised to research this with IT to look for a solution moving forward.

Hospital New Construction

Station Square
We received reports from the new Station Square location that there are some significant deficits in the supplies and building layout challenges. There were some that would require only minor adjustments be made but some impact the work these providers are doing daily. This list was provided to leadership so that improvements would be made as quickly as possible. (Example: Urgent care was missing a vial of Narcan, so none was available in case of emergency.) Unfortunately, leadership had promised that all staffing would be in place prior to opening and that has not occurred, resulting in increased wait times for patients in urgent care particularly. This is being addressed with leadership.

Outpatient Surgery Center

Things are moving forward with construction of the outpatient surgery center We are expecting a more complete report out from the OR leadership staff at the next NCC meeting however it was reassured to everyone present that the nurse positions in this new location are indeed all WSNA positions. Leadership was also advised that the hiring process would need to occur in conjunction with the current CBA and we would need to look at dates to incorporate negotiations for this new facility and the staff. It was also pointed out that the new center is a very attractive option for many OR staff currently in inpatient roles because of the lack of on call requirements and asked them to seriously reconsider their approach to on call nurses currently in the OR. In addition, WSNA requested information on the new locations staffing plans, proposed schedules, and assurance that adequate staffing would be in place prior to opening reminding them of the issues now faced at station square.

Extra Shift Incentive MOU

We have been engaged in ongoing back and forth discussion and negotiations with leadership about the extra shift incentive MOU. The hospital has expressed a desire to reduce the number of travelers at the hospital and as such have proposed some additional language to the existing MOU that would permit nurses to sign an agreement to work a certain number of extra shifts above their FTE. This agreement would go for 12 weeks and at the end of the 12 weeks the nurse would receive a lump sum payment. They would not receive MOU payment on the day of the extra shift. The manager would decide what shift and day the nurse would work and preschedule them for those shifts. If the nurse has to call out for any of her shifts, then there is a reduction in the final payout.

WSNA is not in agreement with this proposal and presented a counter proposal which management has rejected. During this time, we have been polling the nurse members on our WSNA private Facebook group to see what the nurses want. The answer has been overwhelmingly against this proposal by management. Nurses would like to be paid for the work that they do and want the autonomy of being able to decide when they can pick up the extra shifts. This is completely reasonable!

This is still an ongoing negotiation. and nothing has been determined. We will continue to update as things move along. In the meantime, the current MOU is active and currently through March 18, 2023. Because the state of emergency related to COVID has expired, any significant changes such as leaderships new language would need to be voted on by all the WSNA member nurses at Skagit. Leadership has been advised of this. Please watch your email inboxes for updates and if you are a member of the Facebook group you will get this information much sooner.

If you are not a member, please visit the group and request to join. You must be a WSNA member to join this private group. Application forms are found on the WSNA website and are electronic submission. Here’s the link to the Facebook Group - https://www.facebook.com/groups/skagitrns.

Local Unit Meeting

We had our first in person local unit meeting in January! It was well attended, and it was so great to see so many faces and units represented. We are wanting to continue these! All questions are welcome and additional updates will be provided. Stay tuned for invitations and updates as we will be planning another one very soon with a potential action that will be aimed at fixing the staffing issues!

Coffee Hour

Every month on the fourth Thursday morning at 0800 hours come join us for a coffee and snack on us! We meet at Whidbey Coffee on Marketplace in Burlington. Just look for the standup WSNA stand on a table. Order what you would like and let the barista know it is for the nurses or Sue. We will answer any questions about anything related to Skagit and WSNA. In addition, we usually have someone present who can walk you through how to interpret your paystub which I swear takes a degree in hieroglyphic interpretation at times! We would love to see you there!

Say a thank you to your elected officers who work on your behalf every day!

Questions: Contact your nurse representative Sue Dunlap at sdunlap@wsna.org or your organizer Zach Seikel at ZSeikel@wsna.org