Kaiser can't seem to figure out whether it's an organization devoted to patient care or an organization that tasks its lawyers and administrators with squeezing every dime possible out of its operations, regardless of the effect on its customers.
No, I'm wrong about that. Kaiser has definitely figured this out. Most employees understand the rules, but apparently Helen Raquipiso thought she was supposed to be concerned about patient welfare.
Kaiser Safety Worries Led to Firing, Nurse Says
By PHILIP A. JANQUART
Courthouse News Service
January 04, 2013
SAN MATEO, Calif. (CN) - A nurse was fired after blowing the whistle on unsafe patient care practiced at a San Francisco Kaiser Permanente hospital, she claims in San Mateo County Superior Court.
Helen Raquipiso began working as an assistant nurse manager for Kaiser Permanente's South San Francisco Medical Center in 2005, but alleges she was fired in 2010 for reporting unsafe "incidents" involving errors in medication distribution, patients being transferred to inappropriate care units and admissions violations.
Raquipiso worked during the evening shift and was responsible for the northwest, central east and southwest medical-surgical units, according to the complaint.
"Between mid-2009 and December 2010, she complained of various incidents that not only affected patient safety, but violated specific regulations governing patient care," the complaint states.
The incidents involved an error in dispensing "high alert medication," Kaiser employees transferring a stroke patient to Raquipiso's unit, which is not certified to care for stroke patients, and over-admitting patients, violating the hospital's 5 to 1 patient-to-nurse ratio requirements.
Raquipiso claims hospital staff retaliated against her for voicing the complaints, receiving a negative performance review, written warnings and placed on a performance improvement plan.
She says she was only given an incomplete, oral explanation of her performance evaluation, which was conducted January 2009, and that despite repeated requests, did not receive a written copy of the evaluation until a meeting held April 16, 2010.
"At this meeting, she was also given a 'notice of final warning' despite never having been given any previous warnings, written or otherwise," the complaint states. "Although this 'final' warning was ultimately withdrawn after Raquipiso complained, it was replaced with another written warning on or about Oct. 1, 2010."
She was ultimately fired for "failure to meet the required performance improvement expectations," according to the complaint.
She is suing for retaliation under California Labor Code and wrongful termination in violation of public policy. She seeks compensatory, consequential and punitive damages.
Andrew Agtagma of San Mateo, represents Raquipiso.
Showing posts with label nurses. Show all posts
Showing posts with label nurses. Show all posts
Saturday, January 5, 2013
Saturday, November 19, 2011
Kaiser doctors sue their nurses over CNA strike
I'm glad someone at Kaiser is standing up to unethical bosses.
Kaiser, docs sue nurses over walkout
San Francisco Business Times
by Chris Rauber, Reporter
November 18, 2011
UPDATE: Chuck Idelson, a spokesman for the Oakland-based California Nurses Association , didn't directly respond to the substance of Kaiser Permanente 's lawsuit in U.S. District Court. But he told the San Francisco Business Times late Friday that Kaiser allegedly is taking the step as part of plans for an East Coast expansion move, to New York, New Jersey and the Washington, D.C., area (where it already has a regional unit). "Kaiser has dreams of empire," Idelson said, and wants to fund its expansion on the backs of workers. He said that is CNA's only statement on the suit.
Kaiser Permanente’s Northern California hospital unit and medical group filed a federal lawsuit Thursday that would require the California Nurses Association to go to arbitration over its recent decision “to violate its contract by calling a strike," the health care system said Friday.
Kaiser is asking the U.S. District Court for Northern California to order the CNA into arbitration over what it called a “serious breach” of the union’s contract by a one-day, Northern California-wide strike against the nonprofit system Sept. 22 to 23.
Kaiser said the union’s contract, which went into effect Sept. 1, includes a “mutually agreed upon provision that prohibits work stoppages and strikes for the life of the three-year contract.”
The Oakland-based health care giant said it filed a grievance against the nurses’ union on Oct. 18, “using the dispute resolution process spelled out in the contract,” but that the union rejected the request Nov. 7, claiming the no-strike provision didn’t apply, because only CNA has a right to file a grievance. CNA said at the time it went out in sympathy with a short strike by the National Union of Health Care Workers, which walked out at a number of Kaiser and Sutter Health facilities.
Roughly one-third of the 17,000 CNA-represented RNs who work at Kaiser facilities in Northern California crossed picket lines and showed up at work during the late September work stoppage, according to Kaiser's Nov. 18 statement.
Kaiser sues California Nurses Association over strike
November 18, 2011
Kathy Robertson
Sacramento Business Journal
Kaiser Permanente has filed a lawsuit in federal court alleging the California Nurses Association violated a no-strike clause in its collective bargaining agreement when it called a statewide strike by Kaiser nurses in September.
Billed as the largest nurses’ strike in state history, CNA called a massive walkout Sept. 22-23 by as many as 22,700 nurses, including 17,000 at Kaiser, 5,000 at Sutter Health and 700 at Children’s Hospital in Oakland. Other workers at other unions joined the walkout, too.
CNA’s current contract with Kaiser — which went into effect Sept. 1 — includes a mutually agreed upon provision that prohibits work stoppages and strikes for the life of the three-year contract, Kaiser alleges in the lawsuit. The strike required Kaiser to hire hundreds of temporary nurses and additional staff, limit elective medical procedures and transfer critical care through special teams, all at considerable expense.
Kaiser filed a grievance against the union Oct. 18, requesting a discussion to address the issue using the dispute resolution process spelled out in the contract.
CNA rejected the request Nov. 7, claiming the no-strike provision does not apply to sympathy strikes and that only the union has the right to file a grievance under the contract, court documents allege.
Kaiser seeks a court order compelling the union to arbitrate Kaiser’s grievance.
CNA spokesman Chuck Idelson said the union has a strong history — known to Kaiser — of providing support for other unions.
Kaiser, docs sue nurses over walkout
San Francisco Business Times
by Chris Rauber, Reporter
November 18, 2011
UPDATE: Chuck Idelson, a spokesman for the Oakland-based California Nurses Association , didn't directly respond to the substance of Kaiser Permanente 's lawsuit in U.S. District Court. But he told the San Francisco Business Times late Friday that Kaiser allegedly is taking the step as part of plans for an East Coast expansion move, to New York, New Jersey and the Washington, D.C., area (where it already has a regional unit). "Kaiser has dreams of empire," Idelson said, and wants to fund its expansion on the backs of workers. He said that is CNA's only statement on the suit.
Kaiser Permanente’s Northern California hospital unit and medical group filed a federal lawsuit Thursday that would require the California Nurses Association to go to arbitration over its recent decision “to violate its contract by calling a strike," the health care system said Friday.
Kaiser is asking the U.S. District Court for Northern California to order the CNA into arbitration over what it called a “serious breach” of the union’s contract by a one-day, Northern California-wide strike against the nonprofit system Sept. 22 to 23.
Kaiser said the union’s contract, which went into effect Sept. 1, includes a “mutually agreed upon provision that prohibits work stoppages and strikes for the life of the three-year contract.”
The Oakland-based health care giant said it filed a grievance against the nurses’ union on Oct. 18, “using the dispute resolution process spelled out in the contract,” but that the union rejected the request Nov. 7, claiming the no-strike provision didn’t apply, because only CNA has a right to file a grievance. CNA said at the time it went out in sympathy with a short strike by the National Union of Health Care Workers, which walked out at a number of Kaiser and Sutter Health facilities.
Roughly one-third of the 17,000 CNA-represented RNs who work at Kaiser facilities in Northern California crossed picket lines and showed up at work during the late September work stoppage, according to Kaiser's Nov. 18 statement.
Kaiser sues California Nurses Association over strike
November 18, 2011
Kathy Robertson
Sacramento Business Journal
Kaiser Permanente has filed a lawsuit in federal court alleging the California Nurses Association violated a no-strike clause in its collective bargaining agreement when it called a statewide strike by Kaiser nurses in September.
Billed as the largest nurses’ strike in state history, CNA called a massive walkout Sept. 22-23 by as many as 22,700 nurses, including 17,000 at Kaiser, 5,000 at Sutter Health and 700 at Children’s Hospital in Oakland. Other workers at other unions joined the walkout, too.
CNA’s current contract with Kaiser — which went into effect Sept. 1 — includes a mutually agreed upon provision that prohibits work stoppages and strikes for the life of the three-year contract, Kaiser alleges in the lawsuit. The strike required Kaiser to hire hundreds of temporary nurses and additional staff, limit elective medical procedures and transfer critical care through special teams, all at considerable expense.
Kaiser filed a grievance against the union Oct. 18, requesting a discussion to address the issue using the dispute resolution process spelled out in the contract.
CNA rejected the request Nov. 7, claiming the no-strike provision does not apply to sympathy strikes and that only the union has the right to file a grievance under the contract, court documents allege.
Kaiser seeks a court order compelling the union to arbitrate Kaiser’s grievance.
CNA spokesman Chuck Idelson said the union has a strong history — known to Kaiser — of providing support for other unions.
Tri-City Hospital board member Charlene Anderson's nursing license: revoked/stayed/probation
John Graham:
While I agree with her probation and stayed revocation for what she did, I don't think Charlene Anderson should be a member of the Board until she has successfully completed her probation. Nurses are held to a very high standard and members of the State Board of Registered Nursing should be even more squeaky clean. It is not fair to the thousands of of other nurses who somehow find the time to get their charting properly done even when they are busy or understaffed. If she is as wonderful a nurse as many have commented, then she needs to do the right thing and resign from the Board in order avoid the appearance of corruption and double standard for members of the governing Board in her profession. I have seen many fine nurses in this state fired or had their licenses revoked for much less.
"...The state nursing board voted Thursday to accept the recommendation of an administrative judge to revoke her license, then stay the revocation and place her on probation... The board hands down stayed revocations to about 100 of the state’s 390,000 registered nurses each year.
"Anderson’s “failure to document the disposition of narcotics is a very serious matter,” Walker wrote. “'If she did not administer the medications to patients, she created a potential for harm by depriving them of prescribed medications. If she did administer the medications to patients, she created a potential for harm by creating a risk for over-medication.'”
Tri-City official gets probation as nurse
Three-year penalty stems from undocumented drugs
Aaron Burgin
SDUT
Nov. 18, 2011
The state Board of Registered Nursing has put Tri-City Healthcare District board member Charlene Anderson on three years probation for failing to account for prescription painkillers while she worked at Scripps Memorial Hospital in Encinitas in 2006.
Anderson, who was elected to the Tri-City board in 2008, was accused of failure to account for 23 Percocet tablets, seven Vicodin tablets and three tablets of Tylenol with codeine removed from a hospital dispensing machine from May to August of that year. Scripps fired Anderson a month later.
Anderson, 61, expressed regret for the incident in a prepared statement and said she would not step down from the board.
“I regret my apparent lack of complete documentation five years ago at Scripps when after correctly removing medications ... and correctly administering them to the patients, I apparently did not complete documentations on the chart in some cases,” she said. “My patients were not and have not ever been harmed and my nursing practice has been enhanced by this negative experience.
“Am I going to resign? Absolutely not. I did nothing wrong that affects my tenure on the Tri-City board,” she said.
The state nursing board voted Thursday to accept the recommendation of an administrative judge to revoke her license, then stay the revocation and place her on probation.
That action is one step short of outright revocation, said a spokesman with the state Department of Consumer Affairs, which oversees the nursing board. The board hands down stayed revocations to about 100 of the state’s 390,000 registered nurses each year.
The judge in the proceeding, Robert Walker, said that while Anderson’s actions were very serious, there was no evidence that patients were harmed by her actions. He noted that she had a nearly complaint-free record in her 20 years as a registered nurse.
Walker also noted that Anderson was not accused of taking the drugs or failing to give them to patients — just not properly charting them. [Maura Larkins comment: It would be next to impossible to find out what happened to those pills. The state didn't find Anderson innocent of consuming the drugs; it just couldn't prove anything, so it didn't charge her. “If she did not administer the medications to patients, she created a potential for harm by depriving them of prescribed medications. If she did administer the medications to patients, she created a potential for harm by creating a risk for over-medication...On the other hand, there is no evidence that (Anderson) actually harmed any patient,” Walker wrote.]
Anderson’s “failure to document the disposition of narcotics is a very serious matter,” Walker wrote. “If she did not administer the medications to patients, she created a potential for harm by depriving them of prescribed medications. If she did administer the medications to patients, she created a potential for harm by creating a risk for over-medication.”
“On the other hand, there is no evidence that (Anderson) actually harmed any patient,” Walker wrote. [Maura Larkins comment: Whew! Both Charlene and her patients were lucky that no harm occurred.]
Walker denied the state’s request to recover $46,456 from Anderson as restitution for investigation costs. The judge said the state did not properly substantiate its costs.
The State Attorney General’s office filed the administrative complaint against Anderson in January 2010, four years after the incidents occurred.
A four-day administrative hearing akin to a criminal trial was held in July. Anderson’s attorney argued that she wasn’t able to chart the medication because the hospital’s postpartum unit, where Anderson worked, was too busy and understaffed.
State authorities alleged that understaffing was not an excuse.
As part of her probation, Anderson must submit to mental health and psychiatric testing after Walker expressed concern that Anderson knew the rules and still failed to abide by them.
“Is there a medical problem that caused her to forget to do things she intended to do?” Walker wrote. “Because the evidence suggests these concerns, protection of the public requires that there be a professional assessment of the respondent’s ability to practice safely.”..
While I agree with her probation and stayed revocation for what she did, I don't think Charlene Anderson should be a member of the Board until she has successfully completed her probation. Nurses are held to a very high standard and members of the State Board of Registered Nursing should be even more squeaky clean. It is not fair to the thousands of of other nurses who somehow find the time to get their charting properly done even when they are busy or understaffed. If she is as wonderful a nurse as many have commented, then she needs to do the right thing and resign from the Board in order avoid the appearance of corruption and double standard for members of the governing Board in her profession. I have seen many fine nurses in this state fired or had their licenses revoked for much less.
"...The state nursing board voted Thursday to accept the recommendation of an administrative judge to revoke her license, then stay the revocation and place her on probation... The board hands down stayed revocations to about 100 of the state’s 390,000 registered nurses each year.
"Anderson’s “failure to document the disposition of narcotics is a very serious matter,” Walker wrote. “'If she did not administer the medications to patients, she created a potential for harm by depriving them of prescribed medications. If she did administer the medications to patients, she created a potential for harm by creating a risk for over-medication.'”
Tri-City official gets probation as nurse
Three-year penalty stems from undocumented drugs
Aaron Burgin
SDUT
Nov. 18, 2011
The state Board of Registered Nursing has put Tri-City Healthcare District board member Charlene Anderson on three years probation for failing to account for prescription painkillers while she worked at Scripps Memorial Hospital in Encinitas in 2006.
Anderson, who was elected to the Tri-City board in 2008, was accused of failure to account for 23 Percocet tablets, seven Vicodin tablets and three tablets of Tylenol with codeine removed from a hospital dispensing machine from May to August of that year. Scripps fired Anderson a month later.
Anderson, 61, expressed regret for the incident in a prepared statement and said she would not step down from the board.
“I regret my apparent lack of complete documentation five years ago at Scripps when after correctly removing medications ... and correctly administering them to the patients, I apparently did not complete documentations on the chart in some cases,” she said. “My patients were not and have not ever been harmed and my nursing practice has been enhanced by this negative experience.
“Am I going to resign? Absolutely not. I did nothing wrong that affects my tenure on the Tri-City board,” she said.
The state nursing board voted Thursday to accept the recommendation of an administrative judge to revoke her license, then stay the revocation and place her on probation.
That action is one step short of outright revocation, said a spokesman with the state Department of Consumer Affairs, which oversees the nursing board. The board hands down stayed revocations to about 100 of the state’s 390,000 registered nurses each year.
The judge in the proceeding, Robert Walker, said that while Anderson’s actions were very serious, there was no evidence that patients were harmed by her actions. He noted that she had a nearly complaint-free record in her 20 years as a registered nurse.
Walker also noted that Anderson was not accused of taking the drugs or failing to give them to patients — just not properly charting them. [Maura Larkins comment: It would be next to impossible to find out what happened to those pills. The state didn't find Anderson innocent of consuming the drugs; it just couldn't prove anything, so it didn't charge her. “If she did not administer the medications to patients, she created a potential for harm by depriving them of prescribed medications. If she did administer the medications to patients, she created a potential for harm by creating a risk for over-medication...On the other hand, there is no evidence that (Anderson) actually harmed any patient,” Walker wrote.]
Anderson’s “failure to document the disposition of narcotics is a very serious matter,” Walker wrote. “If she did not administer the medications to patients, she created a potential for harm by depriving them of prescribed medications. If she did administer the medications to patients, she created a potential for harm by creating a risk for over-medication.”
“On the other hand, there is no evidence that (Anderson) actually harmed any patient,” Walker wrote. [Maura Larkins comment: Whew! Both Charlene and her patients were lucky that no harm occurred.]
Walker denied the state’s request to recover $46,456 from Anderson as restitution for investigation costs. The judge said the state did not properly substantiate its costs.
The State Attorney General’s office filed the administrative complaint against Anderson in January 2010, four years after the incidents occurred.
A four-day administrative hearing akin to a criminal trial was held in July. Anderson’s attorney argued that she wasn’t able to chart the medication because the hospital’s postpartum unit, where Anderson worked, was too busy and understaffed.
State authorities alleged that understaffing was not an excuse.
As part of her probation, Anderson must submit to mental health and psychiatric testing after Walker expressed concern that Anderson knew the rules and still failed to abide by them.
“Is there a medical problem that caused her to forget to do things she intended to do?” Walker wrote. “Because the evidence suggests these concerns, protection of the public requires that there be a professional assessment of the respondent’s ability to practice safely.”..
Monday, September 26, 2011
Hospital plays labor hardball, locks out nurses, and patient dies
Nurses called a one-day strike, but the hospital locked them out for days.
Thousands of nurses return to work at Alta Bates
By Angela Woodall
Oakland Tribune
09/27/2011
Thousands of nurses returned to work Tuesday after a five-day labor dispute that turned deadly for one cancer patient.
The cloud of Judith Ming's death hung heavily over the returning staff at the Alta Bates Summit Medical Center in Oakland, where the 66-year-old died Saturday morning after a dietary supplement apparently was introduced into her intravenous line.
The Alameda County Coroner's Office has not yet completed the autopsy on Ming, who suffered from ovarian cancer. The fill-in nurse who police said made the error was questioned and released Saturday. She is 23 years old and from Louisiana.
One Alta Bates Summit veteran nurse said she and her colleagues did not think highly of the 500 replacements provided by Alabama-based Advanced Clinical Employment Staffing, which the medical center relied on for five days when it locked out the regular nurses, who had declared a one-day strike Thursday.
The Alta Bates Summit nurse, who asked not to use her name because her husband works for a public agency, said her colleagues are concerned that the staffing firm sent inexperienced nurses. "It's such a sad situation," the nurse said. "I feel really bad for her."
The nurse said the replacements could not have had adequate training before taking on their responsibilities at the hospital because there was "no one here to train them" on the sophisticated equipment and computer programs now used in medical care, or show them where equipment,
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medications and other items are kept.
In addition, the replacement nurses had to work 12-hour shifts five days in a row. Usually, nurses are not required to work more than two to three 12-hour shifts at a time.
Standing outside the entrance to Alta Bates Summit in Oakland, hospital spokeswoman Carolyn Kemp said Tuesday that 40 percent of Alta Bates Summit's 1,800 staff nurses stayed on duty during the strike and worked side by side with the replacements. The fill-ins had experience in the area they were assigned and received an orientation the day before being deployed and again the day they began, according to Kemp.
"Everybody is a professional," she said.
The medical error is so basic that it has baffled nurses because the dietary supplement, Glucera, is labeled, should be taken orally or through a feeding tube and looks nothing like IV fluids. Ming may have had an abdominal feeding tube, but the two pieces of equipment do not fit with each other and look completely different.
An Advanced Staffing employee reached by telephone said the company plans to issue a statement soon but otherwise did not comment.
Advanced Staffing and Summit Medical Center were named as defendants in a 2006 lawsuit brought by the family of an 80-year-old woman who died because, according to the family, she did not receive oxygen. Advanced Staffing denied all allegations at the time but had provided the traveling nurse named in the suit. The lawsuit was settled in 2009. The nurses's license in California expired in January 2010, according to the California Board of Registered Nursing.
Advanced Clinical Employment Staffing, the employee said, required the hospital to sign a five-day contract. Only 500 of the 1,500 referred by Advanced Staffing were accepted, she added.
Kaiser Permanente, one of 30 hospitals affected by the strike, signed a one-day contract with American Mobile Healthcare and RNRx Medical Staffing Inc., according to the California Nurses Association. In all, 23,000 nurses in 30 hospitals went on strike.
Alta Bates Summit, like other California hospitals, routinely calls on replacement nurses to fill in for personnel on leave or on strike. They help bridge California's strict patient-to-nurse ratio requirement, the only one in the nation, which varies depending on illness, severity and complexity of required treatment.
Death of Oakland woman killed by nursing mistake prompts controversy, investigations
By Sean Maher and Jeanine Benca
Mercury News.com
09/26/2011
OAKLAND — The 66-year-old woman who died at a hospital after receiving care from a temporary replacement nurse was identified by the coroner's office Sunday as Oakland resident Judith Ming.
Ming's death reverberated both inside Alta Bates Summit Medical Center and out Sunday. Nursing union leaders painted her as the victim of a staff lockout that prompted the hospital to cut corners by hiring replacement nurses who weren't up to par. Hospital administrators, on the other hand, said the death was an "extraordinarily rare" but extremely serious tragedy, promising cooperation with multiple investigations and asking that the death not be used for political means in the two parties' ongoing contract battle.
The hospital had temporarily hired 500 replacement nurses to continue service when the California Nurses Association staged a one-day strike Thursday, but had signed them to a five-day contract, sending staff nurses who'd gone on strike home when they arrived for work Friday.
A cancer patient at the Alta Bates Summit Medical Center since July, Ming died early Saturday morning a few hours after investigators say one of the replacement nurses, who'd come from Louisiana, administered a "nonprescribed dosage of medication."
"If I was taking care of that patient, it would not have happened at all," said Alicia Torres, an oncology nurse with 27 years of experience and one of those
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who went on strike Thursday. She said she works in the same unit where Ming died and that replacement nurses "are not familiar with the policies and procedures, or with the equipment, because equipment will vary from hospital to hospital. So they're thrown in there without the proper training."
Dr. Steve O'Brien, the hospital's chief medical officer, said the death was the most serious possible tragedy, but that the policy of using replacement nurses was not clearly to blame.
"One hundred percent of every aspect of the situation, we're looking at," he said. "This is a tragedy, a significant medial error. There is nothing more serious."
Asked if he was concerned about the legal ramifications of an apology the hospital issued Saturday, O'Brien said, "There are people who will later look at the legal issues. I'm glad that's not my job. My job is to make sure our patients get the safety and medical care they deserve."
As for using replacement nurses: "Everybody working in this facility is qualified to work here," O'Brien said. He said the hospital uses replacement nurses every day, and all of them meet or exceed California's professional standards, which he described as especially rigorous.
Bruce Fagel, a longtime California medical malpractice attorney who is also a licensed medical doctor, said having replacement or temporary nurses working in hospitals for extended periods increases the risk of medical mistakes that harm patients.
Since 2007, California hospitals have been required to inform the state Department of Public Health within 24 hours of so-called "never events" -- 28 medical errors deemed inexcusable by the National Quality Forum. The health department must then immediately launch an investigation, and if wrongdoing is determined, the hospital can be slapped with tens of thousands of dollars worth of fines.
Since the law was passed, the California Department of Public Health has collected $4.6 million in fines from hospitals for incidents resulting in patient death or very serious injury, said Fagel, a 30-year veteran malpractice attorney. Still, with no real means of enforcing hospitals to disclose incidents, many cases go unreported, he added.
Of the 50 or so malpractice cases resulting in death or catastrophic injury that his firm handles annually, Fagel estimates 10 percent involve errors made by a traveling, or temporary nurse.
"Traveling nurses get into trouble more frequently because they don't understand the system, who to access in terms of the chain-of-command," Fagel said. "When you have replacement nurses, especially in large numbers, nobody is there to supervise them, and these are people who don't work together regularly ... it's a setup for these types of problems where a medical error can lead to a patient's death."
Because there is no way for hospitals to screen every fill-in, they often rely on the registry to perform the screenings for them. The registries also arrange for the fill-in nurses to get licensed in whatever state they will be working.
At Alta Bates, backups work alongside staff nurses to make sure they get up to speed, O'Brien said.
He declined to name the firm with which the hospital contracts, but union leaders said they believe it to be Alabama-based Advanced Clinical Employment Staffing. Nobody answered the phone there Sunday, but the outgoing voice message said, "We are working on ... going to the California strike beginning Sept. 22..."
September 25, 2011
Patient died during Calif. nurse labor dispute
By JOHN S. MARSHALL
The Associated Press
...The nurses union planned a candlelight vigil at the hospital, with nurses calling on Sutter Health, the operator of Alta Bates, to end the lockout and for the state to investigate what union officials called "safety violations" in the patient's death.
About 23,000 nurses across California walked off the job Thursday in a one-day strike at 33 not-for-profit hospitals run by Kaiser Permanente, Sutter Health and the independent Children's Hospital Oakland. They had planned to go back to work Friday, but were locked out when they tried to return to work at Sutter hospitals, according to union officials.
Sutter officials said they entered into contracts with replacement nurses that required they pay the replacement nurses for a minimum number of days.
"Once a strike is called, it would be financially irresponsible for hospitals to pay double to compensate both permanent staff and replacement workers," Sutter Health said earlier in the week.
The lockout was scheduled to end Tuesday.
Thousands of nurses return to work at Alta Bates
By Angela Woodall
Oakland Tribune
09/27/2011
Thousands of nurses returned to work Tuesday after a five-day labor dispute that turned deadly for one cancer patient.
The cloud of Judith Ming's death hung heavily over the returning staff at the Alta Bates Summit Medical Center in Oakland, where the 66-year-old died Saturday morning after a dietary supplement apparently was introduced into her intravenous line.
The Alameda County Coroner's Office has not yet completed the autopsy on Ming, who suffered from ovarian cancer. The fill-in nurse who police said made the error was questioned and released Saturday. She is 23 years old and from Louisiana.
One Alta Bates Summit veteran nurse said she and her colleagues did not think highly of the 500 replacements provided by Alabama-based Advanced Clinical Employment Staffing, which the medical center relied on for five days when it locked out the regular nurses, who had declared a one-day strike Thursday.
The Alta Bates Summit nurse, who asked not to use her name because her husband works for a public agency, said her colleagues are concerned that the staffing firm sent inexperienced nurses. "It's such a sad situation," the nurse said. "I feel really bad for her."
The nurse said the replacements could not have had adequate training before taking on their responsibilities at the hospital because there was "no one here to train them" on the sophisticated equipment and computer programs now used in medical care, or show them where equipment,
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medications and other items are kept.
In addition, the replacement nurses had to work 12-hour shifts five days in a row. Usually, nurses are not required to work more than two to three 12-hour shifts at a time.
Standing outside the entrance to Alta Bates Summit in Oakland, hospital spokeswoman Carolyn Kemp said Tuesday that 40 percent of Alta Bates Summit's 1,800 staff nurses stayed on duty during the strike and worked side by side with the replacements. The fill-ins had experience in the area they were assigned and received an orientation the day before being deployed and again the day they began, according to Kemp.
"Everybody is a professional," she said.
The medical error is so basic that it has baffled nurses because the dietary supplement, Glucera, is labeled, should be taken orally or through a feeding tube and looks nothing like IV fluids. Ming may have had an abdominal feeding tube, but the two pieces of equipment do not fit with each other and look completely different.
An Advanced Staffing employee reached by telephone said the company plans to issue a statement soon but otherwise did not comment.
Advanced Staffing and Summit Medical Center were named as defendants in a 2006 lawsuit brought by the family of an 80-year-old woman who died because, according to the family, she did not receive oxygen. Advanced Staffing denied all allegations at the time but had provided the traveling nurse named in the suit. The lawsuit was settled in 2009. The nurses's license in California expired in January 2010, according to the California Board of Registered Nursing.
Advanced Clinical Employment Staffing, the employee said, required the hospital to sign a five-day contract. Only 500 of the 1,500 referred by Advanced Staffing were accepted, she added.
Kaiser Permanente, one of 30 hospitals affected by the strike, signed a one-day contract with American Mobile Healthcare and RNRx Medical Staffing Inc., according to the California Nurses Association. In all, 23,000 nurses in 30 hospitals went on strike.
Alta Bates Summit, like other California hospitals, routinely calls on replacement nurses to fill in for personnel on leave or on strike. They help bridge California's strict patient-to-nurse ratio requirement, the only one in the nation, which varies depending on illness, severity and complexity of required treatment.
Death of Oakland woman killed by nursing mistake prompts controversy, investigations
By Sean Maher and Jeanine Benca
Mercury News.com
09/26/2011
OAKLAND — The 66-year-old woman who died at a hospital after receiving care from a temporary replacement nurse was identified by the coroner's office Sunday as Oakland resident Judith Ming.
Ming's death reverberated both inside Alta Bates Summit Medical Center and out Sunday. Nursing union leaders painted her as the victim of a staff lockout that prompted the hospital to cut corners by hiring replacement nurses who weren't up to par. Hospital administrators, on the other hand, said the death was an "extraordinarily rare" but extremely serious tragedy, promising cooperation with multiple investigations and asking that the death not be used for political means in the two parties' ongoing contract battle.
The hospital had temporarily hired 500 replacement nurses to continue service when the California Nurses Association staged a one-day strike Thursday, but had signed them to a five-day contract, sending staff nurses who'd gone on strike home when they arrived for work Friday.
A cancer patient at the Alta Bates Summit Medical Center since July, Ming died early Saturday morning a few hours after investigators say one of the replacement nurses, who'd come from Louisiana, administered a "nonprescribed dosage of medication."
"If I was taking care of that patient, it would not have happened at all," said Alicia Torres, an oncology nurse with 27 years of experience and one of those
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who went on strike Thursday. She said she works in the same unit where Ming died and that replacement nurses "are not familiar with the policies and procedures, or with the equipment, because equipment will vary from hospital to hospital. So they're thrown in there without the proper training."
Dr. Steve O'Brien, the hospital's chief medical officer, said the death was the most serious possible tragedy, but that the policy of using replacement nurses was not clearly to blame.
"One hundred percent of every aspect of the situation, we're looking at," he said. "This is a tragedy, a significant medial error. There is nothing more serious."
Asked if he was concerned about the legal ramifications of an apology the hospital issued Saturday, O'Brien said, "There are people who will later look at the legal issues. I'm glad that's not my job. My job is to make sure our patients get the safety and medical care they deserve."
As for using replacement nurses: "Everybody working in this facility is qualified to work here," O'Brien said. He said the hospital uses replacement nurses every day, and all of them meet or exceed California's professional standards, which he described as especially rigorous.
Bruce Fagel, a longtime California medical malpractice attorney who is also a licensed medical doctor, said having replacement or temporary nurses working in hospitals for extended periods increases the risk of medical mistakes that harm patients.
Since 2007, California hospitals have been required to inform the state Department of Public Health within 24 hours of so-called "never events" -- 28 medical errors deemed inexcusable by the National Quality Forum. The health department must then immediately launch an investigation, and if wrongdoing is determined, the hospital can be slapped with tens of thousands of dollars worth of fines.
Since the law was passed, the California Department of Public Health has collected $4.6 million in fines from hospitals for incidents resulting in patient death or very serious injury, said Fagel, a 30-year veteran malpractice attorney. Still, with no real means of enforcing hospitals to disclose incidents, many cases go unreported, he added.
Of the 50 or so malpractice cases resulting in death or catastrophic injury that his firm handles annually, Fagel estimates 10 percent involve errors made by a traveling, or temporary nurse.
"Traveling nurses get into trouble more frequently because they don't understand the system, who to access in terms of the chain-of-command," Fagel said. "When you have replacement nurses, especially in large numbers, nobody is there to supervise them, and these are people who don't work together regularly ... it's a setup for these types of problems where a medical error can lead to a patient's death."
Because there is no way for hospitals to screen every fill-in, they often rely on the registry to perform the screenings for them. The registries also arrange for the fill-in nurses to get licensed in whatever state they will be working.
At Alta Bates, backups work alongside staff nurses to make sure they get up to speed, O'Brien said.
He declined to name the firm with which the hospital contracts, but union leaders said they believe it to be Alabama-based Advanced Clinical Employment Staffing. Nobody answered the phone there Sunday, but the outgoing voice message said, "We are working on ... going to the California strike beginning Sept. 22..."
September 25, 2011
Patient died during Calif. nurse labor dispute
By JOHN S. MARSHALL
The Associated Press
...The nurses union planned a candlelight vigil at the hospital, with nurses calling on Sutter Health, the operator of Alta Bates, to end the lockout and for the state to investigate what union officials called "safety violations" in the patient's death.
About 23,000 nurses across California walked off the job Thursday in a one-day strike at 33 not-for-profit hospitals run by Kaiser Permanente, Sutter Health and the independent Children's Hospital Oakland. They had planned to go back to work Friday, but were locked out when they tried to return to work at Sutter hospitals, according to union officials.
Sutter officials said they entered into contracts with replacement nurses that required they pay the replacement nurses for a minimum number of days.
"Once a strike is called, it would be financially irresponsible for hospitals to pay double to compensate both permanent staff and replacement workers," Sutter Health said earlier in the week.
The lockout was scheduled to end Tuesday.
Saturday, September 24, 2011
Kaiser nurses strike in northern California: "Kaiser recorded a $1.6 billion profit for the first six months of 2011" but has inadequate staff
"The bottom line is we don't have enough staff," she said, adding that Kaiser recorded a $1.6 billion profit for the first six months of 2011. "With profits like these, Kaiser can provide staff to see patients in a timely and ethical manner.
"We helped Kaiser earn this money, we should be rewarded for it."
See related: patient dies during lockout of nurses.
See all Kaiser Permanente posts.
Sutter, Kaiser nurses go on strike
By Melissa Murphy
The Reporter (Vacaville)
09/23/2011
...Kaiser Permanente nurses -- who are represented by the California Nurses Association and have settled their own contract -- said they were striking for their own reasons and not out of sympathy for Sutter nurses.
It just happened that on the same day Sutter nurses staged a one-day walkout, Kaiser nurses took a supportive
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Gateway Realty Agent John Wilkerson
stance for Kaiser mental health workers, about 1,500 of whom are represented by the National Union of Health Care Workers (NUHW) in Northern California, said Brenda Tolbert, a marriage and family therapist with Kaiser.
"They are not striking their own contract," Tolbert said. "The nurses are here to support the mental health workers. We wanted a stronger voice to protect our patient care."
In a letter to Kaiser nurses printed in The Reporter and other newspapers, Northern California Regional President Gregory Adams and Executive Medical Director Robert Pearl asserted that Kaiser is bargaining with NUHW in good faith.
They also noted the agreement with the nurses represented by CNA states, "There shall be no strikes, lockouts or other stoppages, or interruptions of work during the life of this agreement."
Tolbert said hundreds of people stood unified at the corner of Vaca Valley Parkway and Quality Drive in Vacaville on Thursday. Some 50 were mental health workers, the others were nurses who walked off the job and chose not to be paid that day.
One reason for the strike, Tolbert explained, is to stand up for better patient care.
She added that patients have to wait five to six weeks for an appointment when state law says it should be only up to a two-week wait.
"The bottom line is we don't have enough staff," she said, adding that Kaiser recorded a $1.6 billion profit for the first six months of 2011. "With profits like these, Kaiser can provide staff to see patients in a timely and ethical manner.
"We helped Kaiser earn this money, we should be rewarded for it."
At the picket line in front of Kaiser in Vacaville, Aretha Franklin's song "Respect" played on loud speakers, followed by Tom Petty's "Won't Back Down." Dressed in red T-shirts, union members and nurses waved signs that read "Some Cuts Don't Heal," "Fair Contract Now" and "Kaiser is Not Thriving."
Other reasons for the strike include changes to a health plan and retirement packages. Some of those changes will occur in 2013, others in 2014.
Sitting in the shade on the picket line, Rivka Kaplowitz explained that she has been a psychologist with Kaiser for 15 years and she is shocked the health-care provider wants to eliminate benefits for her husband. Kaiser also has proposed giving her only $100 per month toward health-care benefits, she said.
"Who will take me at that rate? They sure won't take me," she said as she pointed to the Kaiser hospital in Vacaville. "I don't get it. You're a health-care provider and you're cutting health care? It doesn't make sense."
As a psychologist, it pains Kaplowitz to see her patients only once every six weeks.
"It's good therapy to see them more often," she said. "I love my job and my patients. The work we do is essential."
Roy Chaffee works at the Kaiser call center in Vallejo and decided to support the NUHW strike in Vacaville even though he is represented by a different union.
He said if Kaiser is willing to attack the smaller unions with huge cuts, it's only a matter of time before the bigger unions will see cuts, too.
"These cuts are absolutely crazy," he said. "It's unnecessary and unprecedented. We're standing up for the patients; we're not going to sit idly by."
Chaffee said the union and those supporting its members want to keep fair wages and health-care benefits in place and protect the staffing numbers. He added that Kaiser's profits should be reinvested in the organization.
The morning wasn't without confrontation.
Before the strike started, CNA Chief Nurse Representative Melanie Alvarado said she tried to speak to the nurses on the night shift, to see that all patients were handed over to other certified nurses called in to relieve the Kaiser nurses.
"They prevented me from speaking to my nurses," she said. "They're not allowed to do that."
Alvarado, who is a Kaiser charge nurse for adult and family medicine, said the union will likely file a complaint against Kaiser because of that action.
Nearly 200 nurses between the Kaiser location in Vacaville and the satellite clinic in Fairfield walked off the job to join picket lines.
Alvarado said that, although CNA members have a good contract with Kaiser, they believe the health-care provider is picking on a little guy.
"There is no reason to do this," she said of the cuts.
"We helped Kaiser earn this money, we should be rewarded for it."
See related: patient dies during lockout of nurses.
See all Kaiser Permanente posts.
Sutter, Kaiser nurses go on strike
By Melissa Murphy
The Reporter (Vacaville)
09/23/2011
...Kaiser Permanente nurses -- who are represented by the California Nurses Association and have settled their own contract -- said they were striking for their own reasons and not out of sympathy for Sutter nurses.
It just happened that on the same day Sutter nurses staged a one-day walkout, Kaiser nurses took a supportive
Advertisement
Gateway Realty Agent John Wilkerson
stance for Kaiser mental health workers, about 1,500 of whom are represented by the National Union of Health Care Workers (NUHW) in Northern California, said Brenda Tolbert, a marriage and family therapist with Kaiser.
"They are not striking their own contract," Tolbert said. "The nurses are here to support the mental health workers. We wanted a stronger voice to protect our patient care."
In a letter to Kaiser nurses printed in The Reporter and other newspapers, Northern California Regional President Gregory Adams and Executive Medical Director Robert Pearl asserted that Kaiser is bargaining with NUHW in good faith.
They also noted the agreement with the nurses represented by CNA states, "There shall be no strikes, lockouts or other stoppages, or interruptions of work during the life of this agreement."
Tolbert said hundreds of people stood unified at the corner of Vaca Valley Parkway and Quality Drive in Vacaville on Thursday. Some 50 were mental health workers, the others were nurses who walked off the job and chose not to be paid that day.
One reason for the strike, Tolbert explained, is to stand up for better patient care.
She added that patients have to wait five to six weeks for an appointment when state law says it should be only up to a two-week wait.
"The bottom line is we don't have enough staff," she said, adding that Kaiser recorded a $1.6 billion profit for the first six months of 2011. "With profits like these, Kaiser can provide staff to see patients in a timely and ethical manner.
"We helped Kaiser earn this money, we should be rewarded for it."
At the picket line in front of Kaiser in Vacaville, Aretha Franklin's song "Respect" played on loud speakers, followed by Tom Petty's "Won't Back Down." Dressed in red T-shirts, union members and nurses waved signs that read "Some Cuts Don't Heal," "Fair Contract Now" and "Kaiser is Not Thriving."
Other reasons for the strike include changes to a health plan and retirement packages. Some of those changes will occur in 2013, others in 2014.
Sitting in the shade on the picket line, Rivka Kaplowitz explained that she has been a psychologist with Kaiser for 15 years and she is shocked the health-care provider wants to eliminate benefits for her husband. Kaiser also has proposed giving her only $100 per month toward health-care benefits, she said.
"Who will take me at that rate? They sure won't take me," she said as she pointed to the Kaiser hospital in Vacaville. "I don't get it. You're a health-care provider and you're cutting health care? It doesn't make sense."
As a psychologist, it pains Kaplowitz to see her patients only once every six weeks.
"It's good therapy to see them more often," she said. "I love my job and my patients. The work we do is essential."
Roy Chaffee works at the Kaiser call center in Vallejo and decided to support the NUHW strike in Vacaville even though he is represented by a different union.
He said if Kaiser is willing to attack the smaller unions with huge cuts, it's only a matter of time before the bigger unions will see cuts, too.
"These cuts are absolutely crazy," he said. "It's unnecessary and unprecedented. We're standing up for the patients; we're not going to sit idly by."
Chaffee said the union and those supporting its members want to keep fair wages and health-care benefits in place and protect the staffing numbers. He added that Kaiser's profits should be reinvested in the organization.
The morning wasn't without confrontation.
Before the strike started, CNA Chief Nurse Representative Melanie Alvarado said she tried to speak to the nurses on the night shift, to see that all patients were handed over to other certified nurses called in to relieve the Kaiser nurses.
"They prevented me from speaking to my nurses," she said. "They're not allowed to do that."
Alvarado, who is a Kaiser charge nurse for adult and family medicine, said the union will likely file a complaint against Kaiser because of that action.
Nearly 200 nurses between the Kaiser location in Vacaville and the satellite clinic in Fairfield walked off the job to join picket lines.
Alvarado said that, although CNA members have a good contract with Kaiser, they believe the health-care provider is picking on a little guy.
"There is no reason to do this," she said of the cuts.
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