nurse New York
New york state edition | july/august 2022
We are here. We will not be erased. p. 12
NYSNA Awarded NAACP Freedom Award, p. 7
2
New York Nurse july/august 2022
We’ve Prepared for This
Bargaining Impacting 26,000 Nurses to Begin this Fall
By Nancy Hagans, RN, BSN, CCRN NYSNA President
Advocating for patients. Advancing the profession.SM Board of Directors President Nancy Hagans, RN, BSN, CCRN nancy.hagans@nysna.org First Vice President Judith Cutchin, RN, MSN judith.cutchin@nysna.org Second Vice President Marion Enright, RN marion.enright@nysna.org Secretary Nella Pineda-Marcon, RN, BC nella.pineda-marcon@nysna.org Treasurer Jayne L. Cammisa, RN, BSN jayne.cammisa@nysna.org Directors at Large Matt Allen, RN, BSN matt.allen@nysna.org Reginalt Atangan, RN reginalt.atangan@nysna.org Marie Boyle, RN, BSN marie.boyle@nysna.org Seth B. Dressekie, RN, MSN, PMHNP, BC seth.dressekie@nysna.org Flandersia Jones, RN, BSN, MPH flandersia.jones@nysna.org Michelle Jones, RN, MSN, ANP-C michelle.jones@nysna.org Sonia M. Lawrence, RN, BSN sonia.lawrence@nysna.org
I
n a few months, 26,000 NYSNA nurses will go to 12 tables across New York and collectively bargain to improve working conditions, including staffing and safety challenges. NYSNA nurses have prepared for this moment, understanding that this is an opportunity to provide better care for patients and communities. When NYSNA nurses gather at bargaining tables this fall, we will be united in a shared commitment to winning the salaries, staffing, safety and security members deserve. We will go to the table understanding that a good contract for one set of workers is insufficient —we must raise the standard for all healthcare workers. This historic moment is an opportunity for healthcare workers to advocate for policies and practices that will benefit patients, communities and the healthcare profession broadly. That is because when health and hospital systems care for nurses, those nurses in turn care for patients. A sick nurse cannot provide optimal care, nor can a nurse who is overextended (from caring for more patients that is advisable) offer the level of care patients deserve. Negotiations therefore are about uplifting the entire community.
Benny K. Mathew, RN, MS, CCRN, CEN, SCRN benny.mathew@nysna.org
Prepared
Ari Moma, RN, MSA ari.moma@nysna.org
NYSNA has spent months preparing for this moment. Since last fall, we have held statewide bargaining conferences and other convenings to discuss best practices for bargaining, the development of campaign plans and strategies
Jean Erica Padgett, RN jean.padgett@nysna.org Regional Directors Southeastern Vacant Southern Aretha Morgan, RN aretha.morgan@nysna.org Central
Catherine Dawson,RN,CNOR,MSN catherine.dawson@nysna.org
Lower Hudson/NJ Margaret Franks, RN Western Steven Bailey, RN steven.bailey@nysna.org Eastern
Bill Schneider, RN, CCRN bill.schneider@nysna.org
Editor Jennifer R. Farmer Executive Editor Pat Kane, RN, CNOR Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2022, All rights reserved
We did not want nurses from different regions and employers to go into negotiations not understanding what is at stake or the power they have just by being united. for maximizing outreach with colleagues. We did not want nurses from different regions and employers to go into negotiations not understanding what is at stake or the power we have just by being united. We approach this moment with confidence and great clarity.
A Formidable Opponent Many of you may know that we are up against a well-organized machine. We will negotiate with management entities that have influence and reach at the local, state and national levels. In the same way that management’s reach extends to multiple levels of government, our reach must also be extensive and coordinated. That is why we continue to build on partnerships with larger unions such as National Nurses United (NNU), the largest union of nurses in the country. NNU has worked to advance the interests of direct care nurses and patients; unite all registered nurses together to gain influence in negotiations with the healthcare industry, governments and employers; and amplify the voice of direct care registered nurses. If we continue to strategize and dialogue with partners such as NNU as well as with healthcare professionals across regions and
employers, we know that we will be in the best position possible.
What Is Good for the Community Is Good for Us While management is more connected than ever, we know that they are no match for determined healthcare professionals who understand that our communities and our patients rely on us having a strong voice. Nurses with a strong voice are typically able to bargain better contracts, which helps ensure improved patient outcomes. Nurses who do not fear speaking up at work are more likely to flag issues that could become safety concerns if left unaddressed. The Economic Policy Institute found that “Where workers have been able to act collectively and through their union, they have been able to secure enhanced safety measures, additional premium pay, and paid sick time. Unionized workers have had a voice in how their employers navigate the pandemic, including negotiating for terms of furloughs or work-share arrangements to save jobs.” Additionally, unionized healthcare professionals are more likely to have healthcare benefits and more likely to work to keep healthcare costs down for the entire community. For instance, NYSNA has long advocated for Medicare For All, which would ensure all people could access safe, affordable and quality care. We care about the community in the same way we care about ourselves. As we enter this season, we do so knowing that we are prepared. We also do so knowing that one or two victories is insufficient; we must change the game for all healthcare professionals. That can only happen one contract and one relationship at a time.
NEW YORK NURSE july/august 2022
When We Say ‘Stronger Together,’ We Really Mean It
T
his year, we’ve witnessed persistent understaffing, burnout of healthcare professionals and widespread societal issues. From gun violence to restrictions on reproductive rights to efforts to limit the effectiveness of the Environmental Protection Agency in fighting climate change, there isn’t a shortage of issues competing for our time and attention. While the challenges before us are great, our hope in this moment is each other. We can accomplish more together than any of us could if we are alone. That is why NYSNA continually looks for opportunities to strengthen our relationship with other unions as well as with elected leaders. We have formed partnerships within the labor movement to advocate for action on the climate crisis, safety on the job and a stronger position during statewide bargaining. We have participated in lobby days with National Nurses United because it is important for elected leaders to hear from all of us (nurses) on the issues impacting our and our patients’ lives.
Craving the Same Thing We understand that our power comes not only from engagement within our union but from a strong labor movement. Further, we surveyed thousands of members, and we know the driving priorities for healthcare professionals in New York are similar to the primary concerns of nurses in states around the country. From coast to coast, nurses are concerned about safe staffing, job safety and security, wages and benefits, and being able to provide quality care. Healthcare professionals and workers broadly are also intrigued by the strength that comes in numbers. When the nation witnessed epic organizing campaigns by workers at companies such as Amazon, Apple and Starbucks and massive strikes or near strikes by healthcare workers, those efforts were an indication that workers are hungry for the
benefits of a strong and unified voice on the job.
National Interests In many cases, the forces that workers, including healthcare professionals, are up against are national—not just regional or state-based. That is why healthcare professionals and other workers must advocate at every level of the government. For instance, this fall, NYSNA nurses will go to the bargaining table en masse. In total, more than 26,000 members will be at 12 different tables fighting for resources to better care for themselves and their patients. We have grown as a Union in density and strength. NYSNA nurses have weathered a global pandemic and utter mismanagement by hospital and health systems. We have been able to leverage our political power to get staffing ratios implemented statewide. Our fight continues as we head into bargaining for most of our facilities. This is the time to bring our influence to a national arena and strengthen our relationship with Labor allies.
Stay United The central message for our times is that healthcare professionals must increasingly find ways to unite together for the good of our patients, our communities and ourselves. We must build relationships within the labor movement, with elected leaders and within the community because no one can stand alone. Nor should we have to.
Even when times are tough, we must remember that there are multiple pressure points we can tap at the local, state and national levels to ensure the boss understands our demands and is inclined to meet them. We also know that to exert leverage during bargaining, we must be engaged with the union; internal organizing builds power on the shop floor for nurses and for the communities we serve. Union power will ensure that our engagement with the communities we serve is beneficial and life-changing.
Rays of Hope While we have seen many challenges, there have also been rays of hope. The safe staffing law is one such example. Staffing plans have been submitted, we are following up on concerns about the process and tweaking plans by facility. Upon its full implementation, the law will be a game changer in terms of keeping healthcare professionals and patients safe. And certainly, we will continue strategizing on other policies that could improve the nursing practice. Over the next few months, we will undertake a huge endeavor to fight for the best contracts ever, enforce staffing levels, and join the larger Labor movement on a local, state, and national level. To be victorious we must maintain hope and refuse to back down. We are calling on all members of NYSNA to join us in this fight.
By Pat Kane, RN NYSNA Executive Director
The central message for our times is that healthcare professionals must increasingly find ways to unite together.
3
4
New York Nurse july/august 2022
Meet Your Board Members
Margaret is always ready to listen and help others. She enjoys going back to Ireland as often as she can.
I
n several editions of the New York Nurse Magazine, we have highlighted members of the NYSNA Board of Directors. In this issue, we introduce Margaret Franks, RN, who joined the Board in June 2022. Learn more about her below.
Margaret Franks, BSN, RN, MEDSURG-BC
Margaret Franks is a registered nurse at Vassar Brothers Medical Center in Poughkeepsie. She became more active in NYSNA during the pandemic after seeing firsthand the effect it was having on her and her co-workers. She is passionate about safe staffing and is a member of both the Vassar and the NYSNA Statewide Staffing Committees. She has spent a considerable amount of time fostering relationships with local unions and politicians to help the nursing profession and is looking forward to working with her fellow NYSNA Board of Directors. Nursing is her second
career; she was a pastry cook/ baker before having her family, and she enjoys trying out new recipes on her co-workers.
What She Wants You to Know Margaret enjoys visiting her native Ireland when she can. She became an NYSNA member when she began working at St. Johns Riverside Hospital in 2016. Margaret transitioned to work at Vassar in 2018. She knows she is the nurse she is today because of all the nurses she has met and worked with along the way. She enjoys precepting and mentoring new nurses so they too can grow to love the profession as much as she does. Margaret is always
Margaret Franks, RN, Regional Director Lower Hudson
ready to listen and help others. She enjoys going back to Ireland as often as she can.
NYSNA Nurses Lament Supreme Court Decision in West Virginia v. EPA
T
he Supreme Court recently ruled, in a 6-3 opinion, to limit the Environmental Protection Agency’s (EPA) ability to regulate emissions from power plants, which would help address the climate crisis. The Supreme Court decision in West Virginia v. EPA will make it harder for the EPA to set effective standards needed to reduce greenhouse gas pollution from coal and gas fired power plants under the Clean Air Act. As a coalition partner with Climate Works for All, we join partners in expressing our disappointment with the ruling. As Climate Works for All said in a statement, “New Yorkers have been leaders in the climate movement, passing landmark cli-
mate legislation like the Climate Leadership and Community Protection Act (CLCPA) and the Climate Mobilization Act (Local Law 97) among others. This unfortunate decision means that it is now even more critical for state and municipal authorities to take aggressive actions on climate.”
Demands With oil and gas prices rising and the effects of climate change intensifying, it is imperative that Congress pass ambitious climate justice funding and jumpstart the transition to clean renewable energy. Mayor Adams should also push for an equitable implementation of Local Law 97 along with a cap on RECs at 10%. We also join organizations
With oil and gas prices rising and the effects of climate change intensifying, it is imperative that Congress pass ambitious climate justice funding and jumpstart the transition to clean renewable energy.
like the Sunrise Movement in urging the Biden administration to: l End the practice of leasing public lands and waters for fossil fuel production, l Stop the issue of permits for any new fossil fuel infrastructure, including pipelines, petrochemical plants, and export terminals, especially Line 3, Line 5 and the Mountain Valley Pipeline, l Declare a Climate Emergency, l Update and strengthening outdated standards limiting particulate matter, ozone, carbon dioxide, sulfur dioxide, mercury, coal ash, and tailpipe emissions, as well as lead and copper rules preventing contamination of drinking water, l Finalize new methane standards for new and existing oil and gas operations, and make these standards strong enough to cut methane pollution at least 65 percent below 2012 levels by 2025, and by l Direct the EPA to designate greenhouse pollutants as criteria air pollutants and set a sciencebased national pollution cap under the Clean Air Act.
NEW YORK NURSE
covid-19
july/august 2022
NY Nurses Speak Out as the U.S. Hits the One-Millionth COVID-19 death and as New York State Ranks 44 out of 50 in Hospital Safety
A
s we surpass the grim milestone of onemillion COVID-19 deaths in the U.S., New York nurses and healthcare professionals are still fighting for safer conditions and a stronger, more equitable healthcare system. Another sobering statistic: New York State ranks 44 out of 50 nationwide when it comes to hospital safety, according to Leapfrog’s annual rankings report, released recently. This is a reality that impacts the health and safety of all New Yorkers, and nurses say we must address the safe staffing crisis now. NYSNA members throughout New York are speaking out about what is really needed after more than two years of working through the COVID-19 pandemic. The stress of an overburdened healthcare system cannot continue to happen on the backs of frontline healthcare professionals, nurses, and staff.
On the Brink “Our members are experiencing exhaustion and mental health strain, compounded by the pandemic and critically low staffing levels,” explained NYSNA President Nancy Hagans, RN, BSN, CCRN. “Many members have been working overtime and through illness to ensure our patients have enough nurses for quality care. After every surge, we catch a breath and wonder why there are still not enough nurses and health and safety protocols in place after two years.” Hagans said it is time for real reform in how hospitals recruit and retain full-time nurses. But healthcare administrators across the state continue to undercut good nursing jobs by hiring temporary staff and travel nurses. It is now up to our employers and the elected leaders who sup-
port these mega-healthcare systems to do the right thing. Healthcare administrators across the state need to improve wages and benefits and ensure safe workplaces.
Making Excuses NYSNA Southern Regional Director Aretha Morgan, RN, BSN, said: “Hospitals make all kinds of excuses for why they cannot adequately staff for safe, quality patient care. It comes down to them putting profits over patients. At NewYorkPresbyterian, we have had to organize and fight for crisis pay, time off and health and safety protections— from Manhattan to Brooklyn to the Hudson Valley. We are still fighting for NewYork-Presbyterian to reopen inpatient mental healthcare services, which generate less profit for hospitals, but are essential in our communities.” For many NYSNA nurses, the COVID-19 pandemic has emboldened them to fight for their rights, their patients’ rights, and for health equity. There was a great deal of emotional whiplash from being hailed as heroes at the beginning of the pandemic, to then being furloughed, or asked for givebacks in contract negotiations, or ignored when speaking out for improved health and safety protections that are still needed in the ongoing pandemic.
Permanent Protections Needed Nurses recently testified, along with National Nurses United, in support of a permanent COVID-19 worker protection standard from the U.S. Occupational Safety and Health Administration (OSHA). NYSNA Western Region Director Steve Bailey, RN, said: “Two years into this crisis we should have a handle on how to protect healthcare workers and require healthcare employers to put effective controls in place to limit worker
This is a reality that impacts the health and safety of all New Yorkers, and nurses say we must address the safe staffing crisis now.
exposure. A lot of staff infected during the Omicron surge shows that my facility and many others are still not adequately protecting employees. Nurses have stepped up in the past two years because that’s what we’re here for, but we shouldn’t have to unnecessarily put our lives and health on the line to do our jobs. OSHA should make sure we don’t have to.” Recent data from the Bureau of Labor Statistics show that nonfatal workplace injuries and illnesses that resulted in registered nurses missing at least one day of work almost quadrupled from 2019 to 2020. Nurses believe that skyrocketing levels of exposure to harmful environments, overexertion and workplace violence have still not been adequately addressed by healthcare facilities and policymakers.
Exhausted Nurses in New York and throughout the country are also reporting exhaustion and mental health strain, compounded by the pandemic and critically low staffing levels. NYSNA nurses continue to call for hospitals and other healthcare facilities to hire more nurses and create plans to retain them. “We experienced so much loss of life during the pandemic,” said NYSNA Central Regional Director Cathy Dawson, RN, CNOR, MSN. “Some of us lost our colleagues or family members and are still recovering. While some employers tried to create spaces for frontline nurses to take mental health breaks or mourn a loss, that is just not possible when there are not enough nurses on a given shift. We continue to forgo even bathroom breaks to ensure our patients are cared for. It is a very unsustainable staffing model.” Over the last 20 years, over 40 hospitals have closed across our state. Many of them in communities that already lack access to care. Over half of all hospital beds in the state are controlled by just 12 large health systems. The concentration of resources, despite that narrative spun by hospital conglomerates, has yet to realize the benefits to our patients.
March to Remember, August 7, 2021
5
6
around our union
New York Nurse july/august 2022
NYSNA nurses attend CBTU Convention
NYSNA Nurses Attend CBTU Convention
O
ver Memorial Day weekend, the Coalition of Black Trade Unionists held their 51st International Convention in Los Angeles, California. There were over 700 attendees from over 15 different international unions in addition to Labor Leaders from Canada, Kenya and South Africa. NYSNA sent a delegation to the convention. President Nancy Hagans, RN. and First Vice-President Judith Cutchin, RN, were in attendance. “Attending the 2022 CBTU convention was a valuable learning experience for me as a labor leader,” said Judith Cutchin, RN, MSN, President, NYC H+H/ Mayorals Executive Council. “The workshops and networking with multiple labor leaders provided the knowledge and tools needed to be a change agent for
labor. The Theme” Power of the Past” highlighted the resilience of Black labor leaders across the nation. I’m looking forward to next year.” The convention covered a variety of topics and themes from the Cannabis industry to Voter Disenfranchisement. National Presidents from AFSCME and AFGE attended, as did a myriad of other Black labor leaders. NYSNA was the only delegation of nurses in attendance and was able to bring our perspective and issues to the table. NYSNA nurses connected with environmental leaders, political leaders, as well as international leaders. While gaining a lot from participating, the NYSNA delegation brought a lot to the table as well.
Bylaws are Due August 5 and Resolutions, September 19 Amendments to the NYSNA Bylaws must be received by the NYSNA Secretary no later than August 5, and resolutions must be received by September 19. Convention Delegates can mail proposed amendments to: NYSNA Nella Pineda-Marcon, Secretary 155 Washington Ave, 4th Floor, Albany, NY 12210 Or e-mail them to info@nysna.org with the subject line: “Bylaws Amendment”. Convention Delegates can mail proposed resolutions to the same mailing address above or email
resolutions to info@nysna.org with the subject line: “Resolution.” For Convention Delegates who plan to mail bylaws or resolutions, please write “NYSNA” and indicate whether it’s a Bylaw amendment or Resolution on the envelope. As nurses and healthcare professionals, we’ve faced down many challenges over the past 18 months. It’s been difficult, but as a union we’ve never been stronger or more united. Let’s take advantage of this opportunity to share, learn, and strategize together as union sisters and brothers.
NEW YORK NURSE
7
july/august 2022
St. Anthony’s Nurses Win First Contract
O
n Thursday, June 30, St. Anthony Community Hospital nurses turned out to ratify their first union contract. After escalating their organizing efforts and delivering a petition to management signed by hundreds of
community members, nurses finally won a fair first contract. Contract wins include increases in new wage scale, retro pay, education assistance, increased differential pay, and more! Congratulations St. Anthony’s nurses!
St. Anthony’s Nurses Win New Contract
Aileen Gunter (center, white shirt) and fellow nurses pose for picture outside Catskill CCU
Nurses and Healthcare Professionals Keep Catskills CCU Unit Open for Care
I
n a victory for nurses, healthcare professionals, and patients, the State Department of Health rejected Garnet Health Medical Center-Catskills’ plan to close the county’s only critical care unit! Congratulations to all the NYSNA nurses and 1199SEIU healthcare professionals who spoke out against the closure and defended quality patient care in Sullivan
2022 Nursing Standard of Practice and Certification Statewide Review Courses! Bargaining Retreat egister now, bit.ly/cert-
R
County. We’re also grateful to Assembly Member and healthcare champion Aileen Gunther who advocated alongside us to protect patient care. Healthcare workers know that cuts to essential health services can put patients at risk and our demands for healthcare access and equity for Sullivan County were heard loud and clear.
reviews, for a Nursing Standard of Practice and Certification Review Courses to learn about current nursing standards of practice for a particular specialty or to prepare for the certification examination in your specialty. This is a great time to set your 2022 certification plan and put it into action! Please see all the 2022 scheduled nursing practice sessions, download and share the recently updated calendar, and view the Continuing Education page to sign up for a workshop today.
NYSNA Awarded NAACP Freedom Award
N
YSNA received the New York State Branch NAACP Freedom Award at the NAACP’s annual Freedom Fund Dinner. The Freedom Fund recognizes efforts of emancipation and civil service. NYSNA was recognized for the union’s unwavering efforts to keep New Yorkers healthy and safe. Monley Adams, RN; Monique Jenkins, RN; Michelle Jones, RN; NYSNA President Nancy Hagans, RN; NYC H+H/Mayorals Executive Council President Judith Cutchin, RN; and Aretha Morgan, RN accepted the award from New York NAACP Branch President Hazel Dukes on behalf of the 42,000 NYSNA nurses and healthcare professionals who fight for healthcare, racial and social justice.
NYSNA nurses receive award from NAACP
H
ave you participated in a Statewide Bargaining Retreat? These retreats build members’ skills to organize, build power and bargain. They are especially important for executive committee/bargaining committee members whose contracts expire in 2022. Sign up with your rep for an upcoming online retreat: Tuesday, Sept. 20, 2022, at 7:30 p.m.
8
New York Nurse july/august 2022
NYSNA Nurses Testify at AG Letitia James’ Hearing on New York’s Mental Health Crisis
O
n June 22, NYSNA nurses submitted testimony for New York State Attorney General Letitia James’ hearing on the mental health crisis. The testimony came amid Black Indigenous People of Color Mental Health month. Irving Campbell, RN, PMHNP-BC, and Ezra
Maurer, RN, testified before the committee. They highlighted how the loss of inpatient psychiatric beds has negatively impacted communities, and how that mental health void has taken a great toll on communities of color and low-income communities. Their testimony is outlined here:
Ezra Maurer
A staggering 60% of adults and almost 50% of youth ages 8-15 with a mental illness received no mental health services in the previous year.
My name is Ezra Maurer, and I am testifying today on behalf of the New York State Nurses Association (NYSNA). NYSNA represents more than 40,000 nurses for collective bargaining and is a leading advocate for universal health care coverage for all New Yorkers. I am a registered nurse with over six years of experience working in in-patient, acute care psychiatric care units. I began working at the Health Alliance Hospital Mary’s Avenue Campus in-patient psych unit in Kingston six years ago, but for the last two years I have been reassigned to the psychiatric inpatient unit at the Mid-Hudson Valley Division of Westchester Medical Center in Poughkeepsie due to the closure of the psych units at Health Alliance. I have a personaL commitment to working in the mental health field and to providing vital mental health services to the people in my local community. New York is currently experiencing a serious mental health crisis that has been worsened by the stress of the COVID pandemic. In addition, because of a state policy priority to reduce expenditures on acute care beds for the treatment of psychiatric patients, we find ourselves without enough resources and beds to provide the care that our patients need. Since 2000, the state of New York has reduced state psychiatric hospital in-patient capacity by more than 20%. At the same time, public and private hospital psych beds were cut from 6,055 in 2000 to 5,419 in 2018 (12%). The reasons for the bed reductions include: l State budget cutting efforts and downsizing of hospital system bed capacity; l Poor reimbursement rates by
Ezra Maurer participated in a press conference announcing a victory at Hudson Valley.
public and private payers for psychiatric services; l The drive by private hospital systems to increase revenues by converting psych beds to provide more expensive services such as surgical, cardiac, cancer and other specialty care. The COVID crisis has made the situation worse. The pressures of the crisis have caused an explosion in people needing psychiatric care, including in-patient care, but the State has directed or encouraged hospitals to convert non-critical inpatient beds to ICU and acute care beds to treat COVID patients. This situation gave many hospitals the opportunity or excuse to temporarily or permanently close their psych units and reduce beds. Hundreds of those psych beds remain closed and have not been restored, even though the need for COVID treatment beds is now greatly reduced. In my facility in Kingston, I have personally experienced the impact of the COVID
crisis and the ongoing closure of our 40-bed in-patient psych unit and the 20-bed detox unit. On April 2, 2020, we received notice that our psych and detox units would be temporarily closed to serve as emergency COVID overflow units. I and the other staff were then transferred to work at the psych unit of the Mid-Hudson Valley Division of Westchester Medical Center in Poughkeepsie. To my knowledge, our unit was never actually used for COVID overflow patients. Instead, it appears that the building was closed and our transfer to Poughkeepsie allowed the hospital to begin its planned construction of new hospital facilities that are to replace our existing campuses in Kingston. The closure of our 40-bed psych unit eliminated all inpatient psych beds in Ulster County, forcing the 200,000 residents to seek in-patient care at other locations much further away — we are the only hospital in Ulster County with certified psych beds and our Continued on page 14
NEW YORK NURSE july/august 2022
One Union, United to Win
Statewide Bargaining Conference
R
egister now for our first, big in-person bargaining retreat and “We Love NY Nurses” campaign kickoff on Thursday, Aug. 18 from 8:00 a.m.–4:00 p.m. at the Sheraton Hotel in New York City. Join us for: l Official Bargaining Kickoff Action l Classes l Bargaining Prep l Campaign Planning l Public-Private Strategy Discussions All Bargaining Committees and Contract Action Team members (CATs) are invited and are eligible
Thursday, Aug. 18 | 8:00am-4:00pm The Sheraton New York Times Square Hotel, Metropolitan Ballroom, 2nd floor 811 7th Ave (53rd St.) New York, NY 10019 for reimbursement for overnight accommodations at the Sheraton New York Times Square Hotel at the double occupancy rate for the evening of August 17 when booked under the NYSNA room
block by calling 888-627-7067 and mentioning code NYS Nurses or by using the following link book.passkey.com/e/50356339. Parking will be reimbursed for members driving to this event.
For additional details and to reserve your spot today go to:
www.tfaforms.com/4987136
NYRN Completes Medical Mission Trip to El Salvador
T
he New York Relief Network (NYRN) recently concluded Mission #44 to El Salvador. It is estimated that 4 out of 10 inhabitants of El Salvador live in poverty, without access to water, food and sanitation services. Many children in El Salvador cannot attend school for geographic reasons or because they must work to support their families. According to the United Nations, more than 25% of Salvadoran children are forced to carry out a remunerated activity. They work as domestic servants, street vendors or on coffee or sugar cane plantations.
Consequences of Poverty The problem is even more significant in rural areas, where 62% of children must work and more than 55% of families live in poverty. Many families live on less than $1 a day, so they cannot meet their needs. Children often start working at age 6 or 7. Often the money these children bring home is essential to their families’ survival. A group of seven volunteers from NYRN worked with a local support group of labor union representatives for the enormous success of
this first NYRN medical mission to El Salvador. In three days, the group provided healthcare to 406 patients in the remote, rural areas of Sonsonate, including many children from impoverished families and members of the Mother Land tribe. The volunteers also provided care in San Bartolo, a rural municipality of Zacatecoluca, the birthplace of José Simeón Cañas, the local hero who fought with Spaniards for the emancipation of enslaved people in Central America in 1825 and finally in the peripheral neighborhood of the capital San Salvador.
Incredible Opportunity Medical missions offer an incredible learning opportunity and rewarding experience for individuals while they serve communities in many parts of the world. There are several opportunities to join NYRN missions. If you are interested in serving in this capacity, sign up online: https://nysna. salsalabs.org/nyrn/index.html?
Or consider making a charitable contribution to support NYRN missions. For more information, email Rony Curvelo at rony.curvelo@nysna.org. And stay tuned for details on future medical missions. Visit the NYRN Facebook page to see pictures from the mission to El Salvador.
nurses
9
10
New York Nurse
single payer
july/august 2022
America’s Egregious For-Profit Healthcare System By NYSNA’s Single Payer Committee
E The hospitals are described as “safety net hospitals” because they tend to have uninsured or underinsured individuals and must depend on additional state or federal dollars to keep the doors open.
very nurse understands the principles of homeostasis: In biology, homeostasis is the state of steady internal, physical and chemical conditions that living systems maintain. It is the condition of optimal functioning for the organism and includes many variables, whereby every system and function in the body is positively or negatively affected by every other system’s health and function. But how many times have nurses thought about our healthcare system using this same model and thought process? One area nurses are taught to keep a blind eye to is a patient’s ability to pay for our care. We have all chanted, “Every patient is a VIP,” and few things make our eyes roll harder than a patient, family or — worse yet administration — admonishing us because a patient has money, better insurance or some other type of connection that makes them feel a sense of entitlement.
Inequitable System Treating patients differently based on health insurance in a system that is fragmented and that ties access to care to employment is outdated,
inequitable and ineffective. Our commercial, for-profit system leaves many underinsured or uninsured. And that reality is a failure in a part of the healthcare system that has long had devastating effects on all the other aspects and systems that struggle to bring this organism that is the American healthcare system to homeostasis. It is for that reason that every nurse needs to be a strong advocate for universal healthcare and specifically for the New York Health Act, which would guarantee all New Yorkers’ access to healthcare and leave no under- or uninsured patients!
Safe Patient Outcomes and Social Justice One of the most egregious negative outcomes of the current forprofit system is the development of a two-tier healthcare system, where there are “rich” and “poor” hospitals and nursing homes. Of course, there are fancy names such as “safety net” hospitals for the latter. Safety net hospitals and nursing homes tend be either urban hospitals in communities of color and working-class areas or in rural settings. People with “good”— that is, private — insurance are welcome at those hospitals, but the reverse is not always the case. In today’s healthcare, instead of calling it
Campaign for New York Health, August 25, 2021, rally to #PassNYHealth at the Fair
“segregation” or “redlining,” we say, “Sorry, you are out of network.” The hospitals are described as “safety net hospitals” because they tend to have uninsured or underinsured individuals and must depend on additional state or federal dollars to keep the doors open. Because reimbursement for services is low or nonexistent, providers are taught to err on the side of cost instead of on the side of caution. Additionally, safety net health systems have difficulty paying staff a competitive wage, or the staff receive much heavier assignments once they receive a competitive wage. As a result, the staffing ratios suffer at these facilities. As we know, more nurses equal better care.
Safe Staffing As stated, lower reimbursement for services makes facilities struggle to offer competitive wages and benefits. Although government funds and grants offset some of the losses, that money is often a fraction of what would make up the gap. It is also very unpredictable, and somehow, inexplicably, some of the richest hospital systems find their way to some of that money. Facilities hate unpredictable funding, and it is one of the reasons they are often reticent to give raises, especially over the course of multiple years. Another way that facilities attract workers is a competitive benefit package. Unfortunately, most benefits have a monetary value as well and come out of the same pocket that is competing with the raise in wages. A predictable, level playing field would make many of our facilities more competitive in recruiting and retention. In addition, when we talk benefits, the most expensive one is the healthcare the employer provides to staff, which makes up about 30 percent to 40 percent of payroll costs. Our current system is very unpredictable and is at the whim of for-profit insurers; if they want to raise rates or cut coverage they can. NYSNA has 80-plus contracts being negotiated this year. Nurses should pay attention to how much energy and resources go into preserving and defending healthcare.
NEW YORK NURSE
11
july/august 2022
SCOTUS Ruling Limiting Reproductive Rights Sparks Concerns and Protests
T
his has been a heavy season. In addition to the COVID-19 pandemic, dangerous under-staffing at healthcare facilities, and senseless mass shootings and gun violence, many Americans were gutted when the U. S. Supreme Court ruled in Dobbs v. Jackson Women’s Health to overturn Roe v. Wade. The Supreme Court disrupted nearly 50 years of reproductive health protections when it made this monumental decision. With no legal right to abortion guaranteed nationwide, each state will now determine women and pregnant people’s rights to healthcare, including abortion. That there are no exceptions in cases of rape and incest is particularly cruel.
Immediate Pain Unfortunately, several states (13) had trigger laws meaning abortion would be banned within 30 days of Roe v. Wade being overturned. The procedure is now banned or mostly banned in Utah, Arizona, Texas, Oklahoma, South Dakota, Louisiana, Arkansas, Montana, Wisconsin, Ohio, Tennessee, South Carolina and Alabama. It may also soon be banned in states such as Mississippi, North Dakota, Wyoming, and Idaho. In 20 states, including New York, and the District of Columbia, abortion is legal and likely to be protected. NYSNA members have always been proud to defend women’s rights and advocate for health equity and universal access to healthcare. As nurses and healthcare professionals in New York State, we have an important role to play in guaranteeing and expanding reproductive healthcare for all New Yorkers and for patients from other states who seek our care. This is not just about access to abortion, but reproductive freedom. In recent years, as states around the country began restricting women’s access to abortion services, New York’s healthcare professionals responded with compassionate, quality care. We expect that this ruling will increase demand on
New York’s public and private sector healthcare facilities. NYSNA is committed to working with our elected leaders to strengthen our healthcare system to provide women and pregnant people the quality care they deserve.
Bodily Autonomy Healthcare is a human right, and abortion is healthcare. The right to bodily autonomy is a key principle nurses learn from our earliest days in nursing school and this belief guides our work to provide dignified care to every patient. We are deeply disappointed that the Supreme Court has failed to uphold our human rights, and we believe their decision today will cause harm to thousands of pregnant people, children, and families throughout the country. The U.S. already has one of the highest maternal mortality and infant mortality rates of any high-income nation, and our maternal mortality rates are rising. Maternal mortality rates are alarmingly high for Black mothers and babies. For instance, the CDC reported that “In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for nonHispanic White women (19.1) Rates for non-Hispanic Black women were significantly higher than rates for non-Hispanic White and Hispanic women.” We fear the court’s ruling will further increase healthcare disparities and deepen this public health crisis.
Forced Motherhood The decision in Dobbs v. Jackson Women’s Health is likely to force motherhood on persons who would choose otherwise. It will have a profound impact on vulnerable communities. As NYSNA President Nancy Hagans, RN, BSN, CCRN has said, “This legal decision will deeply impact marginalized communities, especially women and people of color. No one should be forced into labor or into making dangerous choices. As a union predominantly of women, we under-
stand how important it is to make your own reproductive choices. Economic, social, and reproductive justice are inextricably linked, and we must all do our part to fight for these rights.” Echoing this sentiment, the Rev. Dr. Cari L. Jackson, director of spiritual care and activism, Religious Coalition for Reproductive Choice, said, “The Religious Coalition for Reproductive Choice is the child, if you will, of the Clergy Consultation Service that was formed in the 1960s. These women understood that women have a divine right to make decisions about their own bodies. They knew that patriarchy and domination were not going to end in this country and formed the Religious Coalition for Reproductive Choice. We know now, as they knew then, that patriarchy and this tendency towards domination is destructive. Moreover, there is also a strong movement for theocracy that would replace democracy. This is an issue of religious freedom, of class and of economics. This decision really subjects, sentences, and predestines pain and generational poverty. We must address these issues all together.” For many of us, the overturning of Roe v. Wade is deeply troubling. There have also been coast to coast protests, as concerned individuals and families make their voices heard. We must work so it is only a temporary set-back in our progress as a people. We are more committed than ever to working to uphold women’s rights and reproductive freedom here in New York, while continuing to work together for a future where women and pregnant people’s rights and quality healthcare for all is guaranteed — everywhere.
The right to bodily autonomy is a key principle nurses learn from our earliest days in nursing school and this belief guides our work to provide dignified care to every patient.
Sources https://www.washingtonpost.com/ politics/2022/06/24/abortion-statelaws-criminalization-roe/ https://www.cdc.gov/nchs/data/ hestat/maternal-mortality/2020/ maternal-mortality-rates-2020.htm
12
New York Nurse
pride
july/august 2022
NYSNA Nurses participate in Pride Parade
O
n June 26, NYSNA nurses joined friends and family for NYC’s annual Pride Parade. See photos from the event here.
NYRN Thailand
NEW YORK NURSE july/august 2022
New York Relief Network Concludes Mission #45 to Thailand
T
he New York Relief Network recently concluded mission #45 to Thailand. This was the second medical mission to Thailand. On the first day, nurses cared for 107 patients, including children and adolescents from the orphanage in the rural community of Faisal. They also provided services to the entire surrounding community. At the beginning of 2020, just before the start of the Pandemic, the NYRN carried out the first Medical Mission to this region. During that visit, in addition to medical care, volunteers donated 20 bunk beds for a total of 40 beds, and during the most recent mission, NYRN donated 15 mattresses. As safety is a primary concern, all patients were tested for COVID-19, with no positive results.
With Completion Of Medical Mission 45, NYRN Volunteers Have Provided Health Care To 2,110 Underserved Patients in the Last Six Months.
Visiting the Kayan Tribes Over the course of the trip, the Medical Mission reached, for the second time, the Kayan tribes, also known as the “Long-Neck people.” The “Long-Neck people” live in the eastern mountainous region of Myanmar and Thailand. Our team provided care to 97 tribe members. Centuries old, the Kayan tribes make up more than 5 million people. Community-oriented, generous, and innovative, they scratch out a living as subsistence farmers in the mountainous jungle, where few resources are leftover for education or healthcare. The Kayan tribe has some of the world’s highest maternal mortality rates (MMR) and under-5 child
mortality rates (U5M). A lack of public health and access to healthcare can have deadly consequences for mothers. In Thailand, they are migrants not recognized as refugees by the Thai authorities. They mostly cannot work legally, live elsewhere in Thailand, and have no access to education and healthcare.
Our Work Matters At the end of our mission, the tribe leader thanked us for everything we had done for the second time. She shared that they were starving and asked if we could
provide them with some food (rice and vegetables). Our team bought two bags of rice and plenty of vegetables for the whole tribe for one week. Pictures can be accessed on the NYRN Facebook page: https://www.facebook.com/ NYReliefNetwork NYRN volunteers provided health care to 2,110 underserved patients in the last six months. Our next Medical Mission #46 is to the Mexico Border — from July 6 to 10.
13
14
New York Nurse july/august 2022
New York’s Mental Health Crisis Continued from page 8
The closure of the psych units in Kingston was a big problem for our patients and their families.
census was consistently at 35 or more beds (or at about 80% of capacity). With the closure of our unit, local patients who needed in-patient psych treatment were instead referred or transferred to the Poughkeepsie site (about 40 minutes by car). Others were being referred to the Westchester Medical Center psychiatric units in Valhalla (about 1 ½ hours by car) or to Bon Secours in Port Jervis (about 1 1/3 hours by car). The closure of the psych units in Kingston was a big problem for our patients and their families. The other facilities with psych beds were much further away, required a lot more travel time, and required them to have access to a car to make the trip to visit their loved ones. Many of our patients would travel to the Poughkeepsie site, which was closer to Kingston, to avoid the chance that if they came in through the Emergency Room that they might be admitted and transferred to the units in Valhalla or Port Jervis. They preferred the relatively closer site in Poughkeepsie. The long distances to the alternate sites also lead to a waste of ambulance and transport resources. When a patient is evaluated in Kingston and deemed needing of in-patient service, that patient is then transported via ambulance to Poughkeepsie, Valhalla or Port Jervis accordingly. I have had conversations with the ambulance staff, and they say that when they have to transport to these facilities from their local service area that they are effectively taken out of service for an hour and a half to 2-1/2 hours for the round-trip transport. This takes away from anyone else in the local area who might have to rely on an ambulance for an emergency transport to the hospital for any reason. As I noted earlier, the now closed mental health units in Kingston included a 40-bed acute care psych unit and a 20-bed detoxification unit. The Poughkeepsie site to which we were transferred also operated a 40-bed psych unit and shortly after
we were transferred they added 15 psych beds, bringing the total to 55 beds. That means that until our unit is reopened, there are 25 fewer psych beds in the Hudson River region and 20 fewer detox beds. There are currently no inpatient psych beds available for our patients in Ulster County. In addition, it is our understanding that the newly constructed hospital in Kingston will be reducing the current in-patient psych unit capacity from 40 beds to 20 beds — we will have a permanent loss of 20 psych beds in Ulster County when the new hospital building is opened. The state must take immediate action to address the ongoing mental health crisis and to restore psychiatric in-patient capacity to meet the needs of New Yorkers, including the following steps: l Significantly increase the Medicaid reimbursement rates for in-patient psychiatric care to make them competitive with other procedures; l Require all hospitals to re-open all psychiatric beds that were “temporarily” closed during the height of the pandemic, with strict timelines and oversight; l More tightly control the approval process for permanently closing psych units or beds and implement a moratorium on closure applications; l Seek federal approval to allow Medicaid to reimburse providers of long-term psychiatric care patients; l Increase the total numbers of psychiatric in-patient treatment beds to comply with generally accepted standards for available beds on a per capita basis. I look forward to working with
you to increase psychiatric bed capacity in Ulster County and statewide to meet the mental health needs of our people and to improve the care of patients suffering from acute mental illness in my community. Thank you for providing me with the opportunity to share my concerns and testify today.
Irving Campbell Dear: Attorney General James have been a registered nurse for over 20 years and recently fulfilled my dream of becoming a Psychiatric Mental Health Nurse Practitioner. I have been practicing in the community, serving those diagnosed with Serious Mental Illness (SMI). I am also a proud New York State Nurses Association (NYSNA) member and a mental health advocate. I would like to thank you and your office for this opportunity and forum to speak on such an important topic. I am unfortunately too well aware of the dangers that come when our communities do not have adequate access to mental health care, namely inpatient psychiatric beds. Before the pandemic, I worked for eight years in the inpatient psychiatric unit at New York-Presbyterian Brooklyn Methodist Hospital (NYPBMH)—before seeing many institutions, including NYPBMH, repurpose their psychiatric units to take in COVID-19 patients. I understood the need at the time, but years later, many of these beds have not been reinstated despite vaccines, other medical advancements, and decreased COVID-19 hospitalization rates. Most clearly, these beds remain inaccessible because they are primarily used by those whom Medicaid insures, and the reimbursement rates for these individuals are extremely low. The loss of inpatient beds includes the 52 beds at New YorkPresbyterian Brooklyn Methodist Hospital, which were accessible to the people of Brooklyn, NYP Allen, and Northwell Syosset, to name a few. Unfortunately, this created a mental health void for the community and surrounding communities, including many communities of color and those with lower socioeconomic status.
I
NEW YORK NURSE july/august 2022
NYSNA nurses advocate to keep Psych beds. Irving Campbell (far right)
The pandemic helped expose the need for these inpatient beds. The National Institute of Mental Health states that 18.5% of adults experience mental illness annually, 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental health condition at some point during their life; for children aged 8–15, that estimate is 13%, 20% of state prisoners and 21% of local jail prisoners have a recent history of a mental health condition, 70% of youth in the juvenile justice systems have at least one mental health condition. A staggering 60% of adults and almost 50% of youth ages 8-15 with a mental illness received no mental health services in the previous year. At the same time, AfricanAmericans and Hispanic-Americans used mental health services at about half the rate of CaucasianAmericans in the past year. You may wonder how this equates to real dollars; well, mental illness costs America $193.2 billion in lost earnings per year. Mood disorders, including major depression, and bipolar disorder, are the third most common cause of hospitalization in the U.S. for youth and adults aged 18–44. Suicide is the 10th leading cause of death in the U.S., the third leading cause of death for people aged 10–24, and the second leading cause of death for people aged 15–24. More than 90% of children who die by suicide have a mental health condition. Two million peo-
ple with mental illness are booked into jails each year. While incarcerated, at least 83% of jail inmates with a mental illness do not have access to needed treatment, and as a result, their conditions worsen. Many are released with no continued access to mental health care. All statistics show the need for inpatient psychiatric beds as we have seen an increase in anxiety and depressive disorders, substance use disorders, and suicidality. In addition, children are affected where the suicide rates for those under 18 increased tremendously during the pandemic. Children not only experienced grief and loss, but isolation due to our city being on lockdown and not having enough psychiatric beds. As a medical professional, I witnessed the direct need at my facility, patients with active suicidality waiting for 96 hours in an overcrowded emergency room for an inpatient psychiatric bed only to be transferred to as far away as Westchester Medical Center away from their community and support systems. Unfortunately, this was not a select few but rather the norm. Throughout my institution, we cared for and are still caring for patients who would generally be on the inpatient psychiatric unit, now on medical-surgical units while not receiving care from trained psychiatric mental health nurses.
The need is glaring; we continue to see New Yorkers experience mental health symptoms daily with very few places to go. The city has promoted NYC WELL and Governor Hochul spoke of millions of dollars going directly towards psychiatric beds; however, this has yet to be seen. New YorkPresbyterian Brooklyn Methodist states that they will resume inpatient psychiatric services potentially in September of this year. They have invested millions of dollars into remodeling a unit only to bypass the certificate of need process. They intend to cut two beds on one unit while remaining noncommittal when or even if the other unit will reopen. The institution has however remained committed to using that unit as an ICU unit for COVID-19 patients. One would think that we have learned our lesson after witnessing the increase in violence, suicide rates among children, and an indisputable need for inpatient psychiatric beds. Yet, we continue to penalize those with mental illness and lack of resources. Unfortunately, this often leads to incarceration and not receiving the necessary care. Worse, we have innocent victims such as Michelle Go, who was pushed in front of a train by a man who is believed to have a psychiatric history. You may ask what can be done. My simple answer is to immediately reopen all inpatient psychiatric units that were closed in relation to the pandemic. We can also push to enact bills that will hold institutions such as NYP accountable for purposely keeping these beds away from those who need them the most. It is the least we can do for those members of our community who require access to mental health beds. History has shown that we lose countless beds every year, never to come back, but now is the time we must respond to the mental health crisis and put an end to the loss of beds, for if we fail to do this, the future of our children and those we love will be at risk. Thank you once again for this opportunity to contribute to this discussion. I look forward to other forums such as this in the future. Sincerely, Irving Campbell R.N., PMHNP-BC
They have invested millions of dollars into remodeling a unit only to bypass the certificate of need process.
15
NEW YORK NURSE july/august 2022
Non-Profit US Postage Paid NYSNA
131 West 33rd Street, 4th Floor New York, NY 10001
INSIDE
SCOTUS Ruling Limiting Reproductive Rights Sparks Concerns and Protests, p. 11
NYSNA Nurses Testify at AG Letitia James’ Hearing on New York’s Mental Health Crisis, p. 8