As you are aware, WSNA reached a landmark Rest Break Settlement Agreement with SJMC in 2016. Since that time, WSNA and SJMC have been meeting quarterly, per the agreement, to discuss implementation of the agreement. This has been our ongoing opportunity to continue our involvement in and monitoring of our rest break relief systems and processes.

April 3, 2019 Rest Break Settlement Meeting Report
WSNA Local Unit Officer and Safe Staffing Committee Co-Chair Linda Burbank, WSNA Senior Director of Labor Christine Watts and Nurse Representative Pat McClure met with Jill Karon-Ross and Sharon Royne for our quarterly Rest Break Settlement meeting.

Distribution of unclaimed monies
Our first order of business was final payment distribution of the unclaimed monies of back pay owed to the nurses because of the Rest Break Settlement agreement. Per the settlement agreement, any unclaimed funds are split 50/50 between their choice of foundation for each CHI and WSNA. As a result, a disbursement of $87,000 was received by the Washington State Nurses Foundation towards nursing scholarships.

Rest Break Compliance reports
We reviewed the information request data submitted by WSNA at our previous meeting in January. These Rest Break Compliance reports included missed breaks quarterly data for 2018. Of those units we looked at:

• 50% had seen a slight decrease in the number of missed rest breaks recorded, and 50% had a slight increase over last quarter.
• Of significance, we noted that there has been an increase of 46% in number of missed breaks in Critical Care 6^th floor since last quarter and a 91% increase in the number of missed breaks since first quarter of 2018.
• On average, for the units we examined, there has been a 20% increase in the number of missed rest breaks recorded.

We all acknowledged that while looking at this data is helpful to some extent, more exploration is needed to eliminate the glaring mismatch between what the recording of missed breaks seems to indicate, versus what we are hearing loud and clear from the nurses. We are in a staffing crisis. Nurses are documenting their concerns for staffing on ADO’s/Staffing Concern forms in alarming numbers.

Rest Break Relief nurse positions
We examined the number of Rest Break Relief nurse positions the hospital has allocated to each specific unit covered by the Rest Break Settlement, which is currently 27.8 FTEs, comparing that number of FTE to currently open/unfilled FTEs. There were 6.55 open Rest Break Relief positions as of the date of this meeting. We discussed at length some of the challenges, as well as the successes, with the Rest Break Relief program. Our mutual concern does include difficulty in filling positions and maintaining an effective system.

The hospital does recognize the need to respond to our requests to shift some of the FTEs from areas that do not have need for FTE allocation, to other units. There is, for example, FTE allocated for the now closed rehab unit. Management has also suggested reallocating currently allocated FTE from night shift in ED. There is a need to increase the FTE allocations in units that are obviously suffering with the need for additional Break Relief nurses; namely, the med surg units. Reallocation and consideration to possibly add additional FTE is underway. The hospital is committed to filling all open Rest Break positions as quickly as possible and continuing to assess and evaluate the need to shift or possibly add additional resources. WSNA is continuing to monitor the progress of the Rest Break Relief staffing system. We have requested additional information to assist us with this, such as production of reports of occurrences when Rest Break Relief nurses are pulled to cover other staffing needs beyond break relief.

Importance of filling out Staffing Complaint/ADO form
We discussed the need for nurses to continue to document their missed breaks appropriately, without fear of retaliation, which is specifically prohibited in the settlement agreement. Staffing Complaint/ADO forms are being completed by numerous nurses. WSNA will continue to push for appropriate response from management by ensuring our Staffing Committee is fully functional and our concerns are being heard and acted upon.

You can do your part by completing an on-line Staffing Concern/ADO form for every shift you miss your break at https://www.wsna.org/ado

Questions? Contact your WSNA local unit officers, or WSNA Nurse Representative Hanna Welander at 206-575-7979, ext. 3035 or hwelander@wsna.org.