New York
nurse Western NY Edition | february 2018
the official publication of the new york state nurses association
Judith Cutchin, RN, President, NYSNA H+H/Mayorals Executive Council
Standing for union solidarity pp. 5-6
equity for mental health care, pp. 3,13
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New York Nurse February 2018
STIGMA By Judy SheridanGonzalez, RN, NYSNA President
In Las Vegas in October 2017, Stephen Paddock killed 58 concertgoers — the worst mass shooting in modern American history. On February 14, 2018, staccato fire echoed through the halls of a Florida school, as ex-student Nikolas Cruz opened fire, leaving 17 dead. Government-sanctioned availability of personal “weapons of mass destruction” is the critical factor in mass killings, but the mental stability of perpetrators and environmental factors that intensify imbalances, cannot be ignored. Nurses, health workers, patients, and visitors have been besieged in recent times by extreme acts of violence in our facilities. What’s more ironic than the commission of such acts in a place where people come to be protected and cared for? How do we, as a society, process the outrageous phenomenon of patients assaulting caregivers?
Advocating for patients. Advancing the profession.SM Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP First Vice President Marva Wade, RN Second Vice President Anthony Ciampa, RN Secretary Anne Bové, RN, MSN, BC, CCRN, ANP Treasurer Patricia Kane, RN Directors at Large Kevin Donovan, RN Jacqueline B. Gilbert, RN Nancy Hagans, RN Tracey Kavanagh, RN, BSN Lilia V. Marquez, RN Sean Petty, RN, CPEN Nella Pineda-Marcon, RN, BC Karine M. Raymond, RN, MSN Verginia Stewart, RN Mary Ellen Warden, RN Regional Directors Southeastern Yasmine Beausejour, RN Southern Seth B. Dressekie, RN, MSN, NP Central Ethel Mathis, RN Lower Hudson/NJ Jayne Cammisa, RN, BSN Western Sarah Annabelle Chmura, RN Eastern Martha Wilcox, RN Executive Editor Jill Furillo, RN, BSN, PHN Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 x 159 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2018, All rights reserved
The roots of violence in our society are deep. Sociologists suggest many reasonable theories about why we see its proliferation in such unlikely settings as hospitals, concerts, schools, and houses of worship. Political and religious extremist ideology and the scapegoating of marginalized communities dangerously justify hate crimes. The gun lobby — citing the Second Amendment, when the real issue is to create huge profits for the weapons industry — promotes widespread access to military assault weapons, allowing for horrifically high death tolls. Social alienation and mental/behavioral health are important considerations as well. What snapped in the mind of Major Hasan, a US Army psychiatrist who killed 13 people at a military base in Texas? What was Paddock thinking when he methodically murdered 58 people who never dreamed that this concert would be their last? Nineteen-year-old Nikolas easily obtained an AR-15 rifle in spite of a history of mental illness and alarming social media posts. There’s an epidemic in our society that implicitly and explicitly condones violence. Violence is an insidious intoxicant, permeating all of our social, cultural, and political
structures. It’s ubiquitous in movies, tabloids, and social media. It’s implied in the unbridled increase — and profits generated — by international arms sales. It’s uncensored in children’s video games. It’s evident in the vitriolic language of certain elected leaders and in the actions of some of their supporters. There’s a cloud hanging over us — particularly among those hardest hit by budget cuts — whose toxic vapors seep into our collective consciousness, foretelling a dim future and promoting fatalism and cynicism. As dreams shatter, savings dwindle, and housing and job situations become precarious, folks get depressed…and angry. With frustration levels escalating,
it doesn’t take much to have a nervous breakdown — or to turn that anger inward, or outward. There are 295 mental disorders listed in DSM-5 and the increase in childhood mental illness has skyrocketed. Many of these illnesses include behavioral disorders and “dumping ground” diagnoses for unexplained symptoms. A CDC study revealed that more than 8.3 million adult Americans suffer from a serious mental illness — a statistically significant rise. The same study found that access to mental health professionals and treatment has simultaneously declined at alarming rates. With care unavailable due to lack of coverage, inadequate numbers of mental health professionals and treatment centers, and societal stigmatization, desperately ill people will often resort to self-medicating — thus the “dual diagnosis” of mental illness and substance abuse. The twin stigmas of these disorders — and the role of denial — exacerbate the already challenging dilemma of procuring effective intervention. Exhausted families and friends are more likely to aban-
don such patients, leaving them to find their own way in a hostile world. The result? An Urban Institute report reveals that 55% of male inmates in state prisons are mentally ill, as are a shocking 73% of female inmates! Our prisons are housing a huge percentage of very sick people who belong in treatment facilities. Instead they are perpetrators — but far more often victims — of violence in settings that only serve to worsen their situations. Those out in the streets find their way to ERs and Acute Psychiatric facilities. The impact on families and communities creates a frightening spiral of dysfunction. Untreated
illness, marginalization, reactive depression, and frustration can lead to violent acts committed against whomever is encountered. Health care workers are thus frequent victims of such violence and abuse. We’re on the front lines: accessible, available, and unprotected by our own institutions. This is why our demands for safety on the job are so linked to the crying need for a rational universal health system that treats mental illness (our bill: NY Health, would provide such care). Employers, who’ve generally shrugged off their responsibilities to protect us, must take immediate and long-term measures to prevent assaults and increase, not decrease, access to quality mental healthcare for our communities. Join NYSNA’s struggle as we demand protection on the job and expansion of mental health services. Join our fight for improved, expanded “Medicare for all,” the ultimate solution for mental health parity. Join us as we stand with our “youth of conscience” as they demand an end to assault weapon availability. An injury to one is indeed an injury to us all.
mental health equity
NEW YORK NURSE february 2018
NYSNA members and supporters calling for mental health equity and other pressing issues at the doors of the NYS Department of Health, Albany, February 17
At the doors of DOH
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ur March and Rally on February 17 at the 47th Annual NYS Black, Puerto Rican, Hispanic and Asian Caucus Legislative Conference in Albany focused on the need to bring equity to mental healthcare in the state and to stop budget cuts affecting these essential healthcare services. The March culminated at the doors of the NYS Department of Health. There, members and supporters showed hundreds of cards and petitions calling for equity in the treatment of patients with mental and behavioral health illnesses and for full and fair funding of health services for mental and behavioral health patients. The disparity in the treatment of these patients is a top priority for NYSNA. We cannot, as patient advocates, allow for the continued inattention to their healthcare needs (see p.13). Worsening budget cuts
NYSNA President Judy SheridanGonzalez, RN, spoke forcefully about the issue of meeting the healthcare needs of these patients. “Great disparities fall hardest on marginalized populations: people of color in particular and the poor in general,” she said. “But in no substructure is the inadequacy of the system more prevalent than in
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the area of mental and behavioral health. Recent budget cuts have worsened an already difficult situation, depriving these patients of needed services as this arena does not serve as a lucrative profit center for healthcare facilities. Nurses and caregivers,” she added, “are demanding not only mental healthcare equity with other disease entities, but improved, therapeutic and universal treatments for the rising numbers of seriously ill patients with mental and behavioral disorders.” Hard hit public hospitals
Especially hard hit in this critical healthcare crisis are the public hospitals, including Bellevue in Manhattan and Jacobi Medical Center in the Bronx. The large patient population with mental and behavioral health issues are shifted in large numbers to the public system, putting an enormous strain on these hospitals. And outpatient services are not meeting current needs of New Yorkers, who then end up in the Emergency Departments of the public system. Against this sober and serious backdrop, there was an outpouring of shared experiences and calls to action by NYSNA members from across the state: those from the Health and Hospitals facilities in NYC; from Western New
York healthcare facilities, including Erie County Medical Center and Terrace View Long-Term Care. Med-Surg RNs Dana Bellido-Clark and Yolanda Periera spoke to the reality that many patients have a type of mental health component to their condition, sometimes not readily apparent. Periera noted that mental health remains “a big stigma within the community, and throughout society in general,” making it a condition even more difficult to address. Chiqkena Collins, RN, a Medical ICU nurse at ECMC, spoke to the fact that RNs are often the first line of healthcare professional patients see, and are their strongest advocates. Mental health conditions may often remain undiagnosed (or misdiagnosed), she explained, and advocacy in the mental health area is just another focus for RNs in the quality care and treatment of patients. Steve Bailey, RN, a NeuroBehavioral Unit and Long-Term care staff member at Terrace View, noted the chronic problem RNs face with mental health treatment: difficulty in accessing psychiatric resources and services. This past week’s school shootings in Florida (see column, p. 4) brought the issues of mental health and gun violence to the forefront once again. Marion Enright, RN, Nathan Littauer Hospital, spoke about how that tragedy was a stunning reminder to nurses once again in “an ongoing process of advocacy for our patients.” She noted how short staffing at New York’s hospitals puts RNs at a continual disadvantage to provide for their patients, with emphasis on identifying and meeting mental health needs. NYSNA First Vice President Marva Wade, RN, shared these remarks. “The mental health needs of New Yorkers are growing, and in communities of color and in poor neighborhoods these care needs are not being met by a wide margin.” She added, “Our recent experiences on Staten Island, at Jacobi Medical Center, Montefiore and at New YorkPresbyterian Hospital, and others, all have or are threatened with cutbacks and shutdowns in mental healthcare services…. Without comprehensive care, including mental health treatment, these patients end up in the ERs, often having delayed treatment and showing up even sicker.”
NYSNA President Judy SheridanGonzalez, RN, addressed the Albany rally.
“We need mental health equity. Recent budget cuts have worsened mental and behavioral healthcare. Depriving patients with mental health issues of much-needed services will just worsen an already fragile situation.” Cynthia McGarry, RN Syosset Hospital
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end gun violence
New York Nurse february 2018
Listen to our children
T By Jill Furillo, RN, NYSNA Executive Director
*Every year on average 17,102 American children and teens are shot in murders, assaults, suicides, suicide attempts and unintentional shootings.
he shooting massacre of 17 people in February at Marjory Stoneman Douglas High School in Parkland, Florida, sent yet another shockwave through the nation. Access to weapons, in particular assault rifles, has surpassed crisis levels, leaving communities submerged in confusion, doubt, shock, and fear. But students are now responding. They are banding together in a leadership role, seeking center stage in this absolutely critical debate. All eyes are on them.
Florida students in the aftermath of the Parkland killings
#NeverAgain
Students from the Parkland school have given scores of interviews and gained hundreds of thousands of followers on Twitter. A group visited the White House and the Florida State Capitol. They’ve challenged senators and congressional representatives on live television and gone viral in videos with pleas
“It’s time for victims to be the change that we need to see.” During the shooting, Sam Zeif, a senior, exchanged text messages with his 14-year-old brother, Matthew, who was in a classroom one floor up. Matthew’s teacher, Scott Beigel, was shot dead after ushering students to safety. Sam later shared the exchange
2,737 kids die from gun violence
1,606 are murdered *Source: Brady Campaign To Prevent Gun Violence
Cameron Kasky, a junior, was part of a group text that began after the shooting and became a way for friends to support one another and discuss how to respond to the violence. He and other students went on to start the “Never Again” movement. Kasky started a GoFundMe page, too, and that effort has raised nearly $2 million for the March for Our Lives in Washington, D.C., on March 24 and for sister marches across the country. See details on the March here bit.ly/marchForOurLives. “States for Gun Safety”
to prevent another slaughter. We should sit up, pay close attention to and support the #NeverAgain movement. David Hogg, a senior who directs the school’s television station, interviewed other students about the shooting while they were under lockdown. “We’re children. You guys are the adults,” he said. “You need to take some action and play a role. Work together, come over your politics and get something done.” Hogg now has more than 389,000 followers on Twitter. Emma Gonzalez, a senior in Parkland, gave an impassioned speech at a Ft. Lauderdale rally. “Every single person up here today, all these people should be home grieving,” Gonzalez said.
on Twitter, where it was “liked” more than 150,000 times. “I didn’t plan for them to go viral,” said Zeif. He was among the group of students invited to the White House to meet with President Trump. “I just wanted to share with the world because no brothers, or sisters, or family members or anyone should ever have to share those texts with anyone.” Weapon of war
Zeif lost Joaquin Oliver, a friend he described as “practically a brother.” “I turned 18 the day after” the shooting, Zeif told the president. “Woke up to the news that my best friend was gone. And I don’t understand why I could still go in a store and buy a weapon of war.”
In the immediate aftermath of Parkland, four governors stepped forward, including Governor Cuomo. He and others announced the “States for Gun Safety” coalition to combat gun violence. The coalition will advance a multipronged effort to try to bring a halt to sales of murderous weapons. “New York is joining with New Jersey, Connecticut, and Rhode Island to take matters into our own hands,” said Cuomo. “Not only will this groundbreaking partnership take new steps to prevent illegal guns from crossing state lines, but by forming the nation’s first Regional Gun Violence Research Consortium, we will be able to better inform policymakers nationwide on how to keep their communities safe.” Our nation’s young people are taking a leading role in protecting the public’s health.
NEW YORK NURSE
labor unity
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february 2018
NYSNA rallies for union solidarity
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n Saturday, February 24, NYSNA joined with thousands of other union members in New York City and tens of thousands across the nation — from Buffalo to Chicago, Ohio and California — in support of our rights to have strong and powerful unions in advance of the upcoming Supreme Court case Janus v. AFSCME Council 31. The many in attendance were jubilant, yet determined. NYSNA nurses joined substantial delegations from TWU, SEIU 1199, AFSCME DC37, and the Uniformed Fire Officers Association (UFOA). Among the many different elected officials in attendance were Governor Cuomo, NYC Mayor de Blasio, Attorney General Eric Schneiderman, NYC Public Advocate Tish James, State Comptroller Tom DiNapoli, and others.
Jennifer Minto-Hinton, RN, Metropolitan Hospital, “I
am here to support all unions as they fight for all working people. In New York, we are union strong and I am here in solidarity. We have to protect our rights that we enjoy here.”
Array of union speakers
Dozens of speakers, representing virtually all area unions, made it clear that everything we know as working people is under attack. As Mario Cilento stated, “The CEOs
and corporate special interests behind the Janus case know when working people join together, they have the power to improve
(L-R) NYSNA Treasurer Pat Kane, RN; NYSNA Board Member Lilia Marquez, RN; NYSNA Secretary Ann Bové, RN; behind Bové, NYSNA Board Member Vergina Stewart, RN
their wages, benefits, and working conditions and that is exactly what they are afraid of. They will Continued on page 6
Vivian Tabaranza, RN, Bellevue, “I’m here
because we have to have strong unions in the public sector. Who will look after our patients If we won’t? We are nurses, we are NYSNA.”
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New York Nurse february 2018
Union solidarity Continued from page 5
Unions make us strong! I am a registered nurse and a proud union member of the New York State Nurses Association. We are 40,000 strong across the state. I work in a great public hospital system: the New York City Health and Hospitals. Our doors are open 24 hours a day, 7 days a week to all in need of care. You don't have to show an insurance card. No need to show a Green Card. No need to show cash. If you are sick, we are here to care for you. And that’s union care. Skilled union care.
not silence our voice, not now, not ever!” NYSNA nurses echoed Cilento’s statements with their enthusiastic presence at the rally, where members from both the private and public sector made clear that we are not going to give up our rights. For nurses, the rights being threatened include fair discipline, pensions, safe staffing, and workplace safety. We will fight to protect our standards. Labor rights threatened
Meanwhile, the New York Times on February 25, published, “Behind a Key Anti-Labor Case, a Web of Conservative Donors,” by reporters Noam Scheiber and Kenneth Vogel, on the forces footing the bill for the case. The Times’ article described a broader and concerted effort to weaken the power of all working people. U.S. income inequality is the highest in over 80 years and more workers lack the security of real pensions, yet billionaires are pressing their campaign, coming down on the best tool we have: strong unions.
Topping the list of anti-union forces are the Koch brothers and ultrarich industrialist Richard Uihlein. “The Uihleins,” reported the Times, “appear to be preoccupied with state employee pensions and the unions that negotiate them.”
All of this points to a ferocious fight that lies ahead. But as the thousands of working people showed this weekend, our best weapon is people power. In the coming days, we are prepared to exercise it.
What makes our public hospitals strong is our union and the unions of our sisters and brothers. We make sure that quality patient care is at every public hospital. That quality is derived from union power. I know. I have worked at Woodhull Hospital in Brooklyn for 27 years. And I was born and raised in Brooklyn. This is our city. We are a union city. So, before anybody thinks they can take the union power that keeps our public hospitals safe and quality high, and makes our city great, I say: Think again! We are united for our patients! We are united for our communities! We are united for our city and for this country! We are united because we are union! –Judith Cutchin, RN, President, NYSNA H+H/Mayorals Executive Council (pictured above)
Governor Andrew Cuomo
“You have always been with me, and I will always Mayor Bill de Blasio be with you.... And I can “Now, I’ve got no illusions tell you this—if we stand about the Supreme Court together nobody can beat —not a single one—but us, never. And I promise New York City will stand you as long as I am with labor and demand governor of the state of the Supreme Court respect New York, the state of New the rights of labor all over York is going to have the this country!” back of organized labor.”
Public Advocate Leticia James
“Today and everyday I stand with our unions and our workers demanding they get the rights and fair treatment they have long deserved. We’ll never stop fighting back.”
New York
nurse special reprint | february 2018
the official publication of the new york state nurses association
‘Janus Case’ is
S E S R U N r o f WRONG WAGES
Average worker in a RTW* state makes
$6,109 less per year than a worker in a free bargaining state.
13%
15.3%
in RTW states compared to 12.8% in free bargaining states.
HEALTH BENEFITS
POVERTY RATE
RISK OF WORKPLACE DEATH
49%
of people younger than age 65 in RTW states are uninsured, compared to 9.4% in free bargaining states. The infamous Janus case was heard at the U.S. Supreme Court on February 23. The decision will likely be announced in June. The New York Nurse is reproducing this Special Edition from
more likely in RTW states. *Right to Work (RTW) source: AFL-CIO
April 2017 as an educational tool for members to use. The Janus case constitutes a Right to Work law in all public sector workplaces, including our public hospitals.
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New York Nurse february 2018
Right to work: Wrong for nurses!
R
Our union in action: Members from Western New York at NYSNA's March 28 RN Advocate Training
ight to work is a head-on attack on the existence of unions, threatening to undermine job security and a healthy and secure retirement for all working people. And while we at NYSNA are fortunate to work in New York state, a state without right-to-work laws, even here, right-to-work (RTW) is not an impossibility. At the federal level right now right-to-work is being debated. Make no mistake, unions are under serious attack. We at NYSNA cannot allow right-to-work to stand. RTW has devastating consequences on unions’ ability to collect dues. These funds support union leaders and staff, union governance, legal representation, legislative lobbying, political campaigns and pension, health, wealth and safety funds. In effect, RTW allows workers to have elected union representation by majority vote, BUT: l employees in unionized businesses cannot be compelled to join the union; l workers who opt out — or free riders — need not pay full dues, or in some instances, any dues whatsoever to the union; and l unions are prohibited from collecting other fees from employees who opt out of union membership. These are significant setbacks. When large numbers of free riders opt out, a union can lose its ability to function effectively in a workplace, and may even dissolve. This is bad for our nurses, bad for working people, and bad for America. Unions are America’s best hope
Bar none, since the Industrial Revolution, organizations of workers, labor groups and now our unions have been the most effective advocates for working Americans. They have been in the vanguard of the fight against poverty and greed and for safe working conditions, a good standard of living, healthy communities, and a secure retirement for ALL. Our unions built America and helped make it prosperous, providing tens of millions of workers with job security, good wages and safer work places. In these times, it is critical that
NYSNA stand united and help keep America strong for workers. NYSNA’s history dates to 1901 and the role of nurses in building unions in the healthcare sector is on-going, a pillar of New York’s healthcare system. Our union today is 40,000 strong and along with other unions, NYSNA is out there building coalitions for progressive policies and social justice, with a high profile presence n Albany and in Washington, D.C. Our unions play a leading role in raising the minimum wage, ensuring healthcare access, enacting paid leave laws, protecting the environment, enforcing safe staffing and much more. NYSNA is there every step of the way. National Labor Relations Act
In 1935, President Franklin Delano Roosevelt ushered in the National Labor Relations Act (NLRA), a comprehensive federal law compelling employers to recognize unions and collectively bargain with their workers. Without this mechanism, strikes and boycotts were frequent and large, the primary ways for most workers to advance their interests. Collective bargaining expanded worker power and is the key to our ability to win fair contracts. NYSNA used the NLRA in 1957 to establish its economic and general welfare collective bargaining arm. Over the past three years, NYSNA
has exercised its right to bargain collectively, scoring big wins in the public and private sectors. We excel at it. Our contracts are outstanding and NYSNA’s growth reflects our professional skill at using the collective bargaining law. Union growth Labor organizing was fueled by the National Labor Relations Act. Just two decades after its passage, more than a third of American workers were union members. These rapidly escalating ranks allowed working people to win their fair share of the pie. They upped their wages and added unprecedented healthcare and retirement packages as a hedge against the setbacks of old age, illness and unemployment. And they won contractual protections as well, greatly strengthening worker rights to employment in a fair workplace. Union productivity was high and translated into strong profits for employers. Right to Work Without a doubt, a federal rightto-work law will present a serious challenge to union security gained in critical victories over the course of a century. All the costs of collective bargaining — research, legal, and administrative — are funded by dues-paying union members. And so, too, are grievances, which require money for fact-gathering and support. In RTW states free riders
Average Annual RN Wages Union RNs earn 25% more than non-union RNs nationally.
$75,000
$60,000
Source: Lance Compa, Cornell University, CNNMoney, Feb. 24, 2015
NEW YORK NURSE
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february 2018 pay no union dues but reap all the benefits of union contracts. They let others foot the bill for contract negotiation and enforcement. They threaten the life of the union by refusing to contribute to its coffers. The end of collective bargaining could undercut the many benefits achieved for NYSNA members: fair wages, raises, benefits – including retirement and healthcare – and the protection of patients through safe staffing provisions and overall conditions in the facilities.
Union advantage: Health and pension benefits Union members are 28% more likely to have employer-funded health care and 54% more likely to have an employer-funded pension plan than non-union workers.
53.9%
28.2%
Taft-Hartley In 1947, the federal government enacted the Taft-Hartley Act, amending the NLRA. Taft-Hartley was a way to demobilize labor by imposing limits on its ability to strike. And under Taft-Hartley, states were allowed to pass RTW laws that banned agency fees — money the unions used for collective bargaining and other essential aspects of union representational activity. Within a year, 12 states had RTW on their books. By 1960, the total had climbed to 19, largely in the South. Proponents of RTW claim it helps workers by protecting their Constitutional rights to freedom of association and speech. This is a specious argument because these protections are already afforded under federal labor law. No one can be forced to join a union as a condition of employment and union fees collected from non-union workers cannot be used for political purposes if the worker opts out. Proponents also claim that RTW creates jobs and the resulting economic benefits by fostering business friendly environments. The facts tell a very different story. Non-partisan analysis of Department of Labor and Census Bureau data found that workers in RTW states earn less, are far less likely to have health and pension benefits, are poorer and are far less likely to be union members. RTW is promoted as a strategy for attracting new businesses to a state precisely because it lowers wages and benefits, weakens workplace protections, and decreases the likelihood that employers will be required to negotiate with their employees. In fact, analysis by the Economic Policy Institute found that RTW laws have no significant impact on attracting employers to
Source: Economic Policy Institute, The State of Working America, 12th Edition
a particular state and have not produced job growth. Further, by cutting wages, RTW laws threaten to undermine job growth by reducing the discretionary income people have to spend in local retail stores, real estate, construction, and service industries. Economists estimate that $1 million in wage cuts translates into an additional six jobs lost in the economy. RTW fervor died down in 1960 and entered a long period of hibernation with only four additional states passing RTW laws between 1960 and 2010. RTW is back
After five decades, RTW found new life after the 2010 mid-term elections, posing a threat to America’s unions. There are currently 28 states with right-to-work laws on the books and the numbers are growing fast. Since January, two states — Kentucky and Missouri — have passed RTW laws. This renewed RTW movement has powerful new advocates, among them the Koch brothers, industrialists whose vast fortunes in energy production and market speculation have played a leading role in funding RTW support. (Koch Industries revenues are in excess of $125 billion annually, making this enterprise among a handful of the most profitable in the nation). Americans for Prosperity and the American Legislative Exchange Council
(ALEC), just two among scores of organizations funded by the Kochs and their allies on the right, organized winning strategies for enacting RTW laws. By the end of 2012, 15 states had passed laws restricting the collective bargaining rights of public employees along with their ability to collect money from non-union members to pay for collective bargaining costs.
There are currently 28 states with right-towork laws on their books.
Why the courts matter
The same anti-union forces that pushed for Taft-Hartley and state RTW laws have filled the annals of American history with benchmark labor law cases, but the one most relevant to unions today is Abood vs. Detroit Board of Education. In Continued on page 10
Our union in action: SIUH nurses and supporters met to review bargaining survey results on April 19.
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New York Nurse february 2018
Just say no Every 20 years, by directive of the New York State Constitution, a question appears on every voter’s ballot: “Shall there be a convention to revise the constitution and amend same?” It’s an option worth preserving. However, there’s nothing to be gained right now by revising our State’s Constitution In fact, the opposite. Right-to-work proponents are pushing hard for a rewrite. They are promoting this agenda using slogans, such as “a chance to end the dysfunction in Albany.” These slogans say nothing, but have broad appeal. This does not bode well for unions. “Have no doubt,” State Senator Diane Savino (D, 23) warned a group of Staten Island University Hospital nurses recently, “should voters elect to hold a constitutional convention, worker protections and rights will be among the first things on the chopping block.” So voters beware. Right-towork proponents know that our legislature and governor are union friendly, and almost any bill curtailing union rights would be dead on arrival in Albany. But that doesn’t stop the rightto-work folks from peddling their influence in indirect ways. And a constitutional convention is just such a venue. It provides the opportunity to rewrite laws and make inroads into New York, one of the strongest union states in the country. Most New Yorkers are likely unaware of RTW efforts to use a constitutional rewrite to further their agenda. In February 2017, a poll, conducted by the Siena College Research Institute, found that of all union members surveyed, 57 percent think a constitutional convention is a good idea. We need to spread the word that a Constitutional Convention may subvert worker rights.
RTW: Wrong for nurses! Continued from page 9
1977, this Supreme Court ruling proved to be a double-edged sword for labor. The court ruled that union shop clauses did not apply to government jobs, delivering a severe blow to labor’s fastest growing sector. Public workers could no longer be required to join unions. And subsequently, other states enacted laws further restricting public sector bargaining rights. However, there was good news. The Supreme Court unanimously upheld the right of public-sector unions to charge agency fees to workers who opt out of membership — thereby allowing unions to charge non-members fees for “collective bargaining, contract administration, and grievance adjustment purposes.” Proponents of RTW want Abood overturned. And recent cases, such as Freidrichs vs. California Teachers and Janus vs. AFSCME, look to do just that. In both cases, RTW forces argued that there is no line in the public sector between political and non-political activity. Therefore, under the First Amendment, all union activity in the public sector should be deemed “political” and dues should not be required from nonunion workers. Freichrichs was effectively blunted
Our union in action: Peconic Bay Medical Center members voted to ratify a new contract on April 20.
last year by a split court, but Janus has since picked up the ball. Backers of these cases, such as the National Right to Work Foundation, promote them in friendly terms, invoking First Amendment terms like “freedom of association” and “freedom of speech.” But these freedoms are not threatened by public union activity. Their real motive here is to undercut unions, allowing more control by management. Stifling workers’ voices
The ultimate aim is to destroy unions once and for all by denying dues needed for effective member advocacy. This effort would strip
workers of their workplace rights and stifle their voices in the political arena, stunting advocacy for health and safety, environmental protections, and other laws that protect the public’s health. Needless to say, bigger profits would be had in an America with unions in demise. For NYSNA nurses, reduction of dues for the range of services and activities that make our union such a vital part of the health and civic life of New York would be a terrible loss. It would undercut our collective bargaining that leads to concrete benefits as well as threaten the solidarity of our nurses and the patient advocacy at the center of our profession.
Median Hourly EarningS by Region, Union vs. Non-Union, 2015-2016 $31.59 $22.65
$22.51 $19.22
$17.00
USA
$26.44
$25.96
$25.00
$24.16
NYs
$18.00
NYC Metro
NYC (5 boroughs)
U.S. Current Population Survey, Outgoing Rotation Groups, 2015 – June 2106, all occupations
Union
Non-Union
NYS, excl. NYC
NEW YORK NURSE
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february 2018
SIUH nurses say NO! to Off-Island profits!
M
ore than 200 NYSNA members carried out a spirited info picket at Staten Island University Hospital during the afternoon and early evening on February 28. The members are demanding safe staffing levels, a voice for all nurses on issues such as patient care and workplace safety, and retiree health security.
Members were joined by “Mr. Moneybags,” who delivered a very clear message in behalf of nurses and the communities they serve: Northwell Health must re-invest its profits into the people of Staten
Island instead of giving payouts to its executives who live Off-Island. SIUH nurses are determined to achieve a fair contract that allows for quality care for Staten Island’s residents.
Maria Areza, RN, PACU, “I just want to provide quality care first. With Northwell, the emphasis has gone from the bedside to the computers. We need more nurses everywhere.”
Helene Lapolla, RN, Rehab, “I’m holding this candle to shine a light on Northwell’s lack of concern for the nurses and patients of Staten Island. I want safe staffing and to retire with dignity.”
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New York Nurse february 2018
Medicare for All town hall a hit
NYSNA
“
I’d like to get out of the business of providing health insurance, so I can focus on running my company, while having the peace of mind that my employees have quality, affordable healthcare.” MCS Industries CEO Richard Master
(L-R) NYSNA RNs Judith Cutchin, Flandersia Jones, Peter Pacheco, Patricia James, and Kim Behrens.
RNs Kim Behrens, Judith Cutchin, Patricia James, Flandersia Jones, and Peter Pacheco proudly attended the national Medicare for All town hall hosted by Senator Bernie Sanders on January 23 in Washington, D.C. The historic event reached over one million viewers, broadcasting through progressive digital media channels with large followings. Earlier this session, Sanders introduced a detailed proposal for Medicare for All (S.1804) in the U.S. Senate, which garnered a record number of Senate cosponsors, many of who are likely 2020 presidential contenders. The Town Hall served to educate the public about how a Medicare for All system would work. Build on what works
The U.S. spends more on healthcare than any other country in the world, while leaving nearly 30 million people without insurance. Millions more are under-insured and unable to afford the healthcare they need because of costly copays and deductibles. Sanders argues the solution to our healthcare crisis is to build on what works in the U.S. healthcare system: Medicare. For over 50 years, the U.S. Medicare program has enjoyed incredible popularity and success,
now covering over 55 million seniors and people with disabilities. Sanders’ proposal expands Medicare to cover every resident of the U.S., while making important improvements to the benefits package to include vision and dental, and eliminating most out-of-pocket costs for beneficiaries. People would have free choice of providers, and get the care they need when they need it without fear of going bankrupt. When asked why such a system is necessary, Sanders stressed, “We have a health system designed to make enormous profits for insurance and drug companies. Disease prevention is not very high on their list of priorities.” NYSNA has long agreed with this position, and was one of the first organizations to endorse the concept of universal Medicare. After many years of advocacy, the public is now polling in greater numbers in support of Medicare for All, recognizing the benefits when compared to the privatized, forprofit system. Medicare's improvements
Since its enactment, Medicare has made incredible improvements to the health and economic security of older Americans. Today, people over 65 pay about 13 percent of their health expenses directly out of pocket. In 1966, before Medicare, they paid 56 percent. Medicare lift-
ed people out of poverty. By ensuring access to care; Medicare has contributed to a five-year increase in life expectancy at age 65. Medicare performs very well compared with private insurance coverage: Medicare beneficiaries are less likely to report not getting care, less likely to experience burdensome medical bills, and less likely to report negative health coverage experiences than those under 65 insured by employer plans or individual insurance. Good for business
The town hall highlighted a less publicized argument: Medicare for All is actually very good for business. A panel of business owners argued it is time to end the practice of tying healthcare to employment. They spoke about the burden and expense of trying to provide quality health insurance to their employees, but feeling at a disadvantage to their competition that cuts costs on health insurance. MCS Industries CEO Richard Master stated, “I’d like to get out of the business of providing health insurance, so I can focus on running my company, while having the peace of mind that my employees have quality, affordable healthcare.” The doctors and nurse who spoke at the event addressed the need for a healthcare system that can handle the challenges of the 21st century population health needs, ranging from the prevention and management of chronic health conditions, the opioid epidemic, and the effects of climate change. Stan Brock, founder of Remote Area Medical Clinic, emphasized what NYSNA nurses know too well: “In the era of climate change and disaster relief…it’s bringing on new healthcare issues, and the people suffering more than anybody else are the poor and underserved.” Those who watched the event were left knowing that Medicare for All is an economic and moral imperative. To that end, NYSNA will continue its advocacy for this critical reform. To watch a recording of the Medicare for All town hall, visit: www.youtube.com/ watch?v=lezXTpEFzJ8
NEW YORK NURSE/NYC
public health
February 2018
Patients and frontline staff suffer due to crisis in psychiatric care
C
uts in uts in psychiatric units are causing a crisis situation in hospitals throughout the state. At public hospitals — Jacobi Medical Center in the Bronx, Bellevue and Metropolitan hospitals in Manhattan, and at Erie County Medical Center (ECMC) in Buffalo — the strain on psychiatric services is enormous. Another factor in this escalating healthcare crisis are overcrowded ERs at Montefiore and a planned closure of a psych ward at Presbyterian. These and other cuts in behavioral health treatment give patients fewer care options. And for nurses they can mean increasingly difficult and hazardous working conditions. The treatment cutbacks are not a new phenomenon. Between 2009 and 2012, for example, 28 states and the District of Columbia slashed their mental health funding by a total of $1.6 billion according to the National Alliance on Mental Illness. The Treatment Advocacy Center reports that the number of psychiatric beds decreased nationally by 14% between 2005 and 2010. EDs overwhelmed
Lack of adequate, ongoing mental healthcare has led to a crisis in hospitals’ emergency departments. Because of scarce community and outpatient mental health resources, many patients reach an acute level of mental illness that requires hospital care. Others arrive in the ED because there is simply no other place to go for care. At the Montefiore Moses campus, there can be 20 or more psychiatric patient holds in the medical ED. These are over and above the five ED beds designated for psychiatric observation. Many patients wait for days to be placed. Through it all, there is one nurse assigned to the “overflow” without a tech to manage these patients. Threats and assaults are common. These frightening conditions are mirrored in the Montefiore pediatric ED, where children with behavioral health issues are penned in an area that parents have taken to
Montefiore Medical Center, Bronx
calling the “kennel.” Children can wait in the chaos of an ED for days until an inpatient psychiatric bed can be found for them. This is not just a New York City phenomenon. Katrina Reynolds, RN, from ECMC reports that, “Our CPEP is overwhelmed by patients on a daily basis. ECMC Behavioral Health serves the entire county — that’s over 1,200 square miles. And we get patients from other counties as well. This degree of overcrowding leads to a nontherapeutic environment for our patients and dangerous working conditions for staff.” In addition to the situation in emergency departments, dangerous conditions for both behavioral health patients and staff exist on inpatient behavioral health and med surg units due to overcrowding, understaffing, and inadequate training. Jacobi Med Center in crisis
Following a devastating assault of a nurse on an inpatient behavioral health unit at Jacobi Medical Center, nurses described conditions that are reaching a crisis level. Understaffing of all job titles has meant that physicians’ orders for 2:1 patient observation for the most violent patients are not always followed. And Behavioral Health Associates, who are highly skilled at de-escalation and patient restraint, are in short supply, thus putting staff at risk of assault. Nurses are also acutely concerned about the lack of training and specialized care plans for special needs patients such
as those with intellectual disabilities. These patients do not always respond to psychiatric medication or typical behavior modification techniques. They often spend extended periods of time in behavioral health units because there is not an adequate reserve of residential facilities in which to place them. Nurses as advocates
In February, Behavioral Health nurses at Jacobi Medical Center met with hospital management to protest the conditions that are leading to an increase in assaults on staff, including understaffing and the lack of adequate care plans for special needs patients. After a NYSNA member was severely injured by one of these patients. Yvonne Walker, RN at Jacobi, reported, “In psych we have longterm patients who, because of budget cuts, can’t be discharged into an appropriate residential facility. We need a better system.” And at Columbia Presbyterian NYSNA members are working with community activists to prevent the elimination of psychiatric beds at the Allen Pavilion. In February, their organizing resulted in Community Board 12 adopting a resolution that opposes the closing of the 30-bed psychiatric unit. “Management can do more, they have to do more,” NYSNA VP Karine Raymond, RN, stated. “No one facility can solve the nationwide mental healthcare crisis, but concrete steps can be taken to improve care and reduce safety hazards.”
[D]angerous conditions for both behavioral health patients and staff exist on inpatient behavioral health and med surg units due to overcrowding, understaffing and inadequate training.
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New York Nurse
Healthcare
February 2018
No one should have to wait until they win the lottery to see a doctor, or die because they couldn’t afford care.
Donald Savastano, 51, pictured holding the ceremonial check for his lottery winnings. Previously unable to afford healthcare, Savastano passed away just 23 days after hitting the jackpot.
W
A million dollars too late
e’ve all dreamed of winning the lottery or asked ourselves, “What would I do with a million dollars?” For Syracuse resident Donald Savastano, the answer to that question was simple—finally see a doctor. Savastano won a million-dollar grand prize from his Merry Millionaire scratch-off ticket in January. He hadn’t felt well for a while and since he didn’t have health insurance, he never went to a doctor. When he was finally able to afford medical care, Savastano received the terrible news that he had stage 4 cancer. He died just 23 days after hitting the jackpot.
A human right
Every human being in this country deserves quality healthcare. Basic medical care is a human right, not a privilege. Yet the sad truth is that there are millions of people just like Savastano who can’t afford even a simple doctor’s visit. In recent years, the cost of medical care has continued to balloon, leaving basic care beyond reach for many Americans. According to the Centers for Medicare & Medicaid
Services, in 2016 it cost $10,348 to provide the average American with access to medical care. Plainly put, the high cost of care is killing people. It’s clear that the need has never been greater for a just and equitable healthcare system. Universal and guaranteed
That’s why New Yorkers in every corner of the state are joining the Campaign for New York Health, a statewide coalition founded by NYSNA and dedicated to passing universal, public healthcare. Local organizing committees are up and running across New York, including in Rochester, Buffalo, and Syracuse, as well as rural areas in between. These committees regularly host public events, film screenings, conduct outreach to the community, and pressure legislators to support the New York Health Act (A4738/ S4840). Right now, Upstate advocates are coordinating a canvassing project, speaking directly with hundreds of New Yorkers to gather real stories about their personal experiences with the healthcare system. Often, what comes to the forefront are the financial barri-
ers to care that result in unmet health needs. Geneva businessman Greg Lavin has been very involved in outreach to the community. “It’s striking how many ordinary Genevans have suffered from the high costs of medical care—unnecessary costs,” he said. “I believe a New York, state-run medical system is possible—even likely.” New York State has never been so close to winning universal, guaranteed healthcare. Together, we can put an end to the horrors of delayed and denied care for people who cannot afford to pay. Standing together
No one should have to wait until they win the lottery to see a doctor, or die because they couldn’t afford care. The New York Health Act has passed the NYS Assembly three years in a row, and nearly a majority of the State Senate is now in support. With nurses standing together, we can make this legislation a political reality. Join the Campaign for New York Health by visiting www.nyh campaign.org.
NEW YORK NURSE
15
february 2018
NYC
long island
Around the state 9 Nurses around the state signed on to protect scope of practice Our scope of practice is a reflection of the patient advocacy that is both inherent in our work as RNs and a matter of licensure, and results in the high quality of care we provide each and every patient.
westchester /hudson valley
capital /north country
correction central region
staten island
In our January issue on page 4 we incorrectly identified DACA children as born in this country when, in fact, they are NOT born in this country.
NEW YORK NURSE
Non-Profit US Postage Paid NYSNA
february 2018
131 West 33rd Street, 4th Floor New York, NY 10001 5 Western
INSIDE
2018 NYSNA Lobby Day
Monday, April 23 | Albany
Nurses Lobbying for Safe Staffing to Improve Patient Outcomes There’s a staffing crisis in New York. And the Federal government and Wall Street are out to weaken nursing practice and undercut patient care.
Union solidarity, pp. 5-6
Join nurses from across New York to raise the alarm in Albany at NYSNA’s 2018 Lobby Day. Tell lawmakers to support the Safe Staffing for Quality Care Act (S.0330/A.01532) Stand up to defend and strengthen our nursing practice and Scope of Practice Protect New York Healthcare from budget cuts Speak up for NY Health, a law to guarantee healthcare for all New Yorkers
Listen to our children, p. 4
Contact your NYSNA Delegate or Rep or go to bit.ly/nysnalobby2018 See you in Albany!