New York
nurse Long Island Edition | september/october 2019
the official publication of the new york state nurses association
Brunswick nurses see contract benefits, p. 3 RNs at Brunswick Hospital Center celebrate landmark wage increases.
H+H campaign heats up, pp. 7-10
2
New York Nurse september/october september 2019 2017
Global Youth Climate Strike
Judy SheridanGonzalez, RN, NYSNA President
Board of Directors President Judy Sheridan-Gonzalez, RN, MSN, FNP judy.sheridan-gonzalez@nysna.org First Vice President Anthony Ciampa, RN anthony.ciampa@nysna.org Second Vice President Karine M. Raymond, RN, MSN karine.raymond@nysna.org Secretary Tracey Kavanagh, RN, BSN tracey.kavanagh@nysna.org Treasurer Patricia Kane, RN pat.kane@nysna.org Directors at Large Anne Bové, RN, MSN, BC, CCRN, ANP anne.bove@nysna.org Judith Cutchin, RN judith.cutchin@nysna.org Seth Dressekie, RN, MSN, NP seth.dressekie@nysna.org Jacqueline Gilbert, RN jackie.gilbert@nysna.org Nancy Hagans, RN nancy.hagans@nysna.org Robin Krinsky, RN robin.krinsky@nysna.org Lilia V. Marquez, RN lilia.marquez@nysna.org Nella Pineda-Marcon, RN, BC nella.pineda-marcon@nysna.org Verginia Stewart, RN verginia.stewart@nysna.org Marva Wade, RN marva.wade@nysna.org Regional Directors Southeastern
Yasmine Beausejour, RN yasmine.beausejour@nysna.org
Southern
Sean Petty, RN sean.petty@nysna.org
Central
Marion Enright, RN marion.enright@nysna.org
Good afternoon Fearless Youth Warriors! I offer you the love, admiration and commitment that we, the 42,000 members of the New York State Nurses Association bring to this historic event. Why do I say warriors? Because war has been declared on our planet by greedy corporations who see profit instead of people, who embrace destruction instead of sustenance who are leading humanity down a path of total devastation… And we must fight them with every ounce of strength that we have. People ask me: Why are nurses concerned about the climate? What business is it of your union to get involved in something that has nothing to do with your profession? And we say, it has EVERYTHING to do with our profession, our union, our patients and our future. Who do you think rescues and cares for victims of... heat waves that cause untold deaths and serious heat related complications; wild fires that increase in severity as I stand here; floods that cause toxic molds, pneumonias, asthma, lung and heart damage; droughts that cause unprecedented food insecurity, starvation, malnutrition; fracking, pipelines, bomb trainsand diesel fuel exhaust that poison nature’s precious, life-sustaining gifts to humankind—our air, soil and water; super-hurricanes and typhoons that devastate whole populations and towns in a single day, obliterating islands in the global south, leading to long-term illnesses and creating conditions for new bacteria and viruses to thrive?
Lower Hudson/NJ Jayne Cammisa, RN, BSN jayne.cammisa@nysna.org
When Hurricane Sandy hit
Western
Chiqkena Collins, RN chiqkena.collins@nysna.org
Eastern
(Pending)
ALL OF THESE EVENTS lead to homelessness, depression, suicides and massive migration. The victims come to us desperate, lost, suffering, terrified, asking, “What happened? What kind of life can I look forward to now, now that I’ve lost everything…” When Hurricane Sandy hit New York and New Jersey, we were
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 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2019, All rights reserved
On September 20, over 4 million, mostly young people, demonstrated across the globe to demand that adults take definitive action to staunch climate change. An estimated 250,000 people marched in NYC.
We literally saw with our own eyes where the bodies were buried when there was no refrigeration in morgues and no roads or fuel for transport. Imagine watching your mom take her last breath before your eyes because she couldn’t get oxygen or a nebulizer for her emphysema—and then burying her body in your back yard... We saw this… An honorable profession
Greta Thunberg, international leader and the inspiration for the Youth Climate Strike, backstage with NYSNA President Gonzalez.
awakened to the enormity of the storm. And as we cared for folks whose health and lives were upended by it, we knew we had a moral responsibility to not only treat patients, but to research, comprehend and take a stand against the CAUSES of the climate catastrophes that are engulfing our world. We formed collectives of volunteers who were ready and willing to go to regions impacted by the deadly effects of climate change. We sent multiple teams to Puerto Rico and the Virgin Islands after Hurricane María and we continue to travel all over the world to do what we can to mitigate the horrific impact of these events.
And so, our union, our nurses continue our work in our honorable profession inside the walls of our hospitals, on the mountainsides, and in marshlands, cities and jungles of our planet. But this work is only a Band-Aid on a gaping wound. Our planet is crying out to us to heal its wounds, to remove the cancer that is destroying the only body we have as a people, to save it from its ultimate destruction. We promise to work with each and every one of you, our youth, the unsung heroes of the universe. You hold the future in your hands and in your hearts. We stand by your side with our stethescopes, with our voices and with our bodies and souls, because saving the planet is saving ALL of our lives. And saving lives is our business!
NEW YORK NURSE/LI
Long tk Island
3
September/october 2019
Brunswick nurses see contract benefits
N
urses at Brunswick Hospital Center, a small facility in Amityville providing psychiatric care for adults, seniors and youth, negotiated a contract in January that guarantees expanded wages and benefits for nurses. Brunswick’s staff have historically been underpaid and ensured few benefits. However, the new contract included a 3.5 percent wage increase and a 3.5 percent increase in experience differentials. For some of the more senior nurses, this could amount to up to a $20,000 salary increase. The 36 nurses at Brunswick Hospital Center are now seeing the raises kick in, having received the first of their raises which are scheduled for every six months. Gina Sciammarella, RN, has been at Brunswick Hospital for over 40 years. Since 2005, she has worked in the psychiatric unit and mainly cares for adolescent boys. Regarding the newly ratified contract, Sciammarella said she particularly appreciates the 3.5 percent increase in experience differentials. Sciammarella says she saw the effects of previous wages and benefits on nurse retention.
“I think I am probably the nurse that has been here the longest,” she said. “Having worked here for 40 years, I believe I bring something different to the table given everything I have gone through already and done. It improves patient care. I feel like a role model for the newer nurses.” The support of NYSNA
Gina Sciammarella, RN
20 years. Everything after step 20 did not matter in terms of wages. The increase in experiential differentials rewards nurses who have dedicated a significant period of their life to working as an RN. Sciammarella explained that her experience has allowed her to learn best practices for patient care.
Sciammarella noted that NYSNA’s support was critical to negotiating the contract. Said Sciammarella: “NYSNA always back us up. They really try the best they can to help us. If there’s short staffing, they will back us up. You can write a letter of protest if you don’t agree with the staffing, and the union will back you up. The raise really is excellent.” “The union has been very supportive, and we appreciate the salary increase,” said Demars, RN.
Nurses and community members gathered in Holtsville on October 2 in a show of support for one of their own: Tracy Kosciuk, RN, professional caregiver-turned-candidate for the Brookhaven Town Council. Kosciuk, a three-decade veteran NYSNA member and current LBU President at St. Charles Hospital, has deep community roots and the unique perspective her nursing career promises to provide her as a policy maker.
Recruitment and retention
“Nurses would come here for experience,” she said, “but then they would leave as soon as they found another job because the pay, wages and benefits were so low.” “It was the support of NYSNA during the negotiations that allowed our employer to finally recognize that their ability to recruit and retain members was being hampered by their inability to provide good wages and benefits to nurses,” said Catherine Demars, RN, the chairperson of the local bargaining unit. “This was leading to a high turnover of nurses.” “We are starting to see more people come through the door as a result of wages being more competitive,” said Demars. “It allows nurses to be more responsive to their personal family needs.” Before this contract, the experience differential would plateau after
Tracy Kosciuk, RN for Brookhaven Town Council
Nurses settled their landmark contract this January.
NYSNA members at Brunswick Hospital Center
“Being a nurse is the perfect preparation for a seat on the town council,” she said. “That’s because patients share with us the stories of their lives…. And we care about our communities...keeping them healthy and protected.”
4
New York Nurse september/october 2019
Nursing has no boundaries
T By Jill Furillo, RN, NYSNA Executive Director
he Global Nurses Solidarity Assembly drew 1,500 people, mostly nurses, to San Francisco for three days commencing September 12. It was an extraordinary gathering. The event was organized by National Nurses United, the largest union of nurses in the U.S., with 185,000 members. NYSNA was honored to be invited and sent 35 participants representing upstate, downstate, public and private sector nurses. Truly an international effort, the Assembly hosted guests from 24 countries, all members of the global federation of nurses and healthcare workers unions, Global Nurses United. The problems we face, including austerity and privatization attacks on healthcare systems and other public services, the climate crisis, attacks on unions, safe nurse staffing and other nursing standards, and immigration and racial and gender justice issues—all were addressed and open to discussion.
Shared experiences
Plenary Sessions at the Assembly included Global Health, Global Justice; Fighting Inhumane Immigration Policy; The Global Climate Emergency—The Fight for Environmental Justice. Breakout Sessions/Workshops were conducted on a range of topics, including Workplace violence, Veterans Health, and Racial and Gender Disparities in Healthcare and Organizing the Unorganized. Over the years NNU and NYSNA have shared our experi-
ences coordinating collective bargaining to build stronger contracts for nurses. In organizing the unorganized we achieved great success adopting many of their tactics. Pre- and post-Janus efforts to strengthen internal union organizations are underway at both NNU and NYSNA—taking on the corporate union-busting assault. NNU has supported our organizing campaigns—Albany Med a key example. NYSNA, in turn, has supported theirs, recently at Johns Hopkins Medical Center. Common ground
On the critical fight for universal healthcare, NNU was instrumental in launching the national campaign for Medicare for All. We are both a part of the Labor Campaign for Single Payer Healthcare. Here in New York, the New York Health Act, our state’s Medicare for All legislation, gains support. Recently, we were instrumental in helping Congressman Hakeem Jeffries reach a decision to sign on as a co-sponsor on HR 1384, the Jayaplan-Dingell House Medicare for All bill. NNU’s RNRN (Registered Nurse Response Network, which includes NNU members, other union RNs and non-union RNs) engages in disaster relief; we saw them in action after Katrina and in Haiti. They were here, volunteering in the aftermath of Hurricane Sandy. They were also coordinating relief in Guatemala and on the border—our nurses joined both these medical missions. In this way,
(r.) Jovana Woodley, RN, Coler Specialty Hospital & Nursing Facility
we were able to develop our New York Recovery Network (NYRN), now working with RNRN as well as launching relief missions of our own, most recently in Zimbabwe (see pages 12-13 for a report on our September mission there). The common ground we share with NNU/GNU is big and broad, and our two unions continue to coordinate on many issues: NYSNA members have been active in working in support of key NNUsponsored federal legislation, the Healthcare Workplace Violence Prevention Act and Safe Nurse Staffing Standards for Hospital Patients. We joined NNU members in support of the employee fairness act, on the right to organize, and to win a Robin Hood Tax on Wall Street speculation that would help fund programs like Medicare for All, for free college tuition, and for climate justice. As we look ahead to 2020, the united voices of nurses—in New York, around the nation and the world with NNU/GNU—are growing stronger and louder. Solidarity!
NEW YORK NURSE
5
september/october 2019 September/october
Before the NYS Department of Health
NYSNA testifies for safe staffing at the DOH
W
hen on September 20 NYSNA nurses testified in Albany before the New York State Department of Health (DOH) it was unprecedented: nurses giving formal testimony on safe staffing for nurses and caregivers in hospitals and nursing homes. The testimony is central to the DOH's study on staffing enhancements mandated in the 2019-2020 New York State Budget, taking safe staffing a giant step forward. NYSNA is not alone in bringing essential information to the DOH. Other unions participating in September with testimony of their own: CWA—District 1, Public Employees Federation, 1199SEIU (Nursing Home Panel), and 1199SEIU (Hospital Panel). It’s been a tremendous effort on many fronts, in coalition with community organizations, public health groups and other unions—who share a mission to protect patients.
Safe staffing needs to be statewide
The public meeting was unprecedented as NYSNA nurses gave testimony about safe staffing levels. Dr. David Curry, an Advanced Registered Nurse Practitioner at Champlain Valley Physicians Hospital in Plattsburgh and Professor Emeritus of Nursing at SUNY Plattsburgh with doctorate in Health Administration, shared his views. “I look forward to this staffing study being designed fairly and modeled to address the benefits safe staffing could bring to our hospitals through improved patient outcomes. The study must also address the serious workforce issues we face now and in the future,” he said. “As a nurse in a rural setting, I know how important healthcare is to my area, not just for my community’s health, but my community’s economy as well…. We’ve seen full service hospitals in rural areas close, or be converted into freestanding emergency departments that do not fully service the community’s needs,” said Curry. “That is why we need to think of safe staffing as an investment for
our community, both for improved patient care and patient outcomes and our community’s local economy. By accessing grants to expand RN training opportunities in critical areas of rural New York, we can train and deploy the next generation of nurses and healthcare workers that will be hired to meet the real staffing needs across the state. I hope this study will be designed to reflect these elements of nursing and the healthcare workforce in rural New York,” he concluded. Ari Moma, NP, of Interfaith Medical Center, also testified. “My hospital is one of three hospitals …is an important part of the DOH and the governor’s efforts to strengthen and transform access to quality care in Central Brooklyn. I believe that the governor’s efforts to transform healthcare in my hospital’s service area is a crucial first step to improving health outcomes for my patients and ensure that access to lifesaving medical care is available and affordable,” he said. “I believe that this study is an important first step towards understanding the staffing needs across the state.” NYSNA President Judy Sheridan-Gonzalez, RN, stated in her remarks: “We—and our patients—are grateful that the Department of Health is working diligently to fulfill its charge to develop regulations that will seriously enhance safer staffing ratios in our facilities…. Our union has successfully negotiated improved staffing ratios in many facilities,
The state legislature has tasked the DOH with completing the staffing study before the legislature reconvenes in January 2020. The next DOH hearing will take place on October 22 from 9:30 AM – 3:00 PM at 90 Church Street in Manhattan. In order to attend, you must contact your rep and pre-register at health.sm.StaffingStudy@ health.ny.gov. This is an important time for nurses to remain focused and remind the NYS DOH of how enhancing safe staffing will increase patient safety and save lives.
resulting in better outcomes and, ultimately, cost savings as well. Why is that? “Hospitals with consistently appropriate staffing have far fewer cases of RN burn-out, demoralization, abandonment of the institution—and even, the profession. Such facilities are able to retain experienced nurses, and see greatly enhanced patient satisfaction and successes.” The right thing to do
There is no way our fight for safe staffing could have come this far if it were not for the tireless efforts of countless nurses speaking out with determination and in a united voice: “Safe staffing saves lives!”
“
I look forward to this staffing study being designed fairly and modeled to address the benefits safe staffing could bring to our hospitals through improved patient outcomes. The study must also address the serious workforce issues we face now and in the future,” Dr. David Curry, ARNP, PhD, Champlain Valley Physicians Hospital
6
New York Nurse september/october 2019
Contract wins with ratios in Brooklyn and on Staten Island
“I Kingsbrook Jewish Medical Center ratification vote
“
I feel happy that my patients are going to get the care they really need. It’s not really about me— it’s about giving the patients the care they deserve.” Christine Toomer, RN, Interfaith Medical Center
RUMC contract ratified, Oct. 7
feel happy that my patients are going to get the care they really need. It’s not really about me—it’s about giving the patients the care they deserve. With safe staffing ratios, nurses won’t feel burnt out trying to meet all the goals they need to meet.” These are the words of Christine Toomer, RN, Interfaith Medical Center, on winning their contract. Toomer and her fellow nurses ratified their contract on September 9. Other hospitals where NYSNA nurses fought hard and won contracts with ratios were Kingsbrook Jewish Medical Center on September 24 and Wyckoff Heights Medical Center on June 14. “Despite pushback from management, our NYSNA committee was able to forge ahead after almost one year of intense bargaining and we won ratios,” said Vivienne Phillips, RN, of Kingsbrook. “We also trail-blazed by fighting for ratios at our skilled nursing facility,” added Phillips.
“Safe ratios will assist nurses to work together with RUMC to provide the community with safe patient outcomes. The nurses fought hard to raise the bar for the SI community’s health care,” said Eileen Fitzgerald, RN, who served on the Bargaining Committee. “Retirement benefits, included in the contract through the VEBA program, were also something we fought for and wouldn’t give in until we got something in the contract,” said Christine Toomer. “As we retire, we would like to know there is something there to help hold us down. You work so hard for all these years, it’s something you feel entitled to. You give 100% to your organization, you feel like they would give you something back.” Safe staffing above all
Every private sector facility that bargained in Brooklyn, Queens,
and Staten Island in 2018/2019 now has ratios, or is actively building ratios, and/or will be building ratios over the life of their agreements. This is an outcome amidst immense economic pressure from what are largely safety net, underfunded, and under-resourced employers. The nurses in Brooklyn and at RUMC demanded that every patient be treated with the same safe ratios—regardless of ability to pay. These contracts demonstrate the extraordinary commitment of NYSNA’s safety net facility nurses to safe staffing. As of today, all private sector hospitals have expedited, binding arbitration over all staffing violations. This constitutes a stricter enforcement mechanism than California law provides under its ratio law.
Latest wins at RUMC
Richmond University Medical Center won their hard-fought contract on October 5. “RUMC Nurses came together like never before and that is what made administration realize we were not to be taken lightly,” Diane Donaghy, RN, LBU Chair, Labor and Delivery. “Our amazing info picket and overwhelming strike vote forced RUMC management to agree to ratios and retiree health.”
Interfaith Medical Center nurses with their Memorandum of Agreement
Wyckoff Heights Medical Center nurses with their Memorandum of Agreement
New York
nurse special edition – NYC H+H/Mayorals| september/october 2019
the official publication of the new york state nurses association
public nurses say patient care comes first! pp. 8-10
8
New York Nurse september/october 2019
NYC Care catching on!
T “
Because of the antiimmigrant rhetoric ... coming from the federal government right now, we are seeing fewer immigrant patients come to H+H. That makes NYC Care an even more important resource at this time.” Valerie Bowers, RN, Kings County Hospital
hanks to the work of nurses and other caregivers, and support from the community and local government, a comprehensive initiative to guarantee healthcare for more New Yorkers, NYC Care is off to a strong start. Anchored within the NYC Health + Hospitals system, the program aims to cover the 600,000 uninsured New Yorkers who are ineligible for health insurance or cannot afford it. The program has caught on quickly in the Bronx—already serving and enrolling 5,000 formerly uninsured patients. The City advertised NYC Care with paid and earned media, and launched a hotline and website for people interested in signing up: 646-NYC-CARE or NYCCare.nyc. Community partners joined nurses in making NYC Care a success—doing direct outreach to bring patients and potential patients into the NYC H+H system NYC Care enrollees are entitled to a prompt primary care appointment, specialty care appointment if needed, laboratory, X-ray, hospitalization, affordable medication, mental health services, and addiction services—all carried out
by frontline nurse, doctors and caregivers. 300,000 to access
NYC Care launched on August 1, 2019, in the Bronx with $25 million in dedicated funding. The program will be rolled out in Brooklyn and Staten Island in January 2020, and is expected to cover all five boroughs by the end of that year with anticipated annual funding of $100 million. In NYC H+H hospitals and clinics, nurses are on the frontlines of NYC Care, enrolling eligible patients in MetroPlus, an integrated system of primary and acute care providers, and directing other patients to NYC Care. The City estimates that approximately half of the 600,000 uninsured New Yorkers will access NYC Care because of their income or immigration status. Direct outreach
“I’m encouraged that already half of the enrollment goal of 10,000 members in the Bronx was reached just two months into the program,” said Anthony Feliciano, director of Commission on the Public’s Health System. “This further demonstrates how necessary it is to make
In the words of Judith Cutchin, RN On September 13, NYSNA Board Member Judith Cutchin, RN and President, H+H/Mayorals Executive Council, gave a presentation at the Global Nurse Solidarity Assembly, with 1,500 nurses from around the world participating. Her topic: Racial and Gender Disparities. She drew upon background materials for the campaign, Healthcare Justice for the Other New York. Excerpts are below.
I
am very proud of New York City’s public hospital system. The total number of registered nurses in the system exceeds 8,500. We are currently in contract negotiations with New York City. Our campaign is called Healthcare Justice for the Other New York. New York City is special with regard to public health: we have 11 public hospitals. They are consid-
ered the backbone of care for New York City. The public hospitals l are 20% of inpatient discharges citywide. l account for 50% of uninsured inpatient discharges. l 80% of all uninsured hospital clinic visits are in the public system, that’s 700,000 uninsured.
Continued on page 10
NYSNA Board Member Judith Cutchin, RN, President, NYSNA’s H+H/Mayorals Executive Council, at Global Nurse Solidarity Assembly, September 13, 2019
high-quality, affordable healthcare accessible to New Yorkers who often are not given a viable option to live their healthiest lives.” The New York Immigration Coalition, one of NYSNA’s close community allies, had affiliates involved in the roll-out of NYC Care. On October 4, NYIC’s Director of Health Policy, Max Hadler, said, “We are excited to see NYC Care move closer to fulfilling its mission of being a citywide program for all uninsured New Yorkers. Strong enrollment and engagement—even in the face of relentless attacks from the federal government on New York’s immigrant communities—demonstrate the power of the inclusive message that accessible health care is a right for all.” Important resource
Valerie Bowers, RN, a member of the H+H Negotiations Committee and a recently-retired nurse leader at Kings County Hospital said, “Because of the anti-immigrant rhetoric and policy proposals like ‘public charge’ coming from the federal government right now, we are seeing fewer immigrant patients come to H+H. That makes NYC Care an even more important resource at this time. Like all H+H initiatives, we need to make sure it is adequately funded and staffed so we can deliver on our mission of delivering quality care for all New Yorkers.”
NEW YORK NURSE
9
September/october 2019
(L to R) Anthony Feliciano, CPHS Director; Ray Briggs, RN, Coney Island Hospital LBU President; Sonia Lawrence, RN, H+H/Lincoln LBU Vice President; and Valerie Bowers, RN, Negotiations Committee and retired Kings County Hospital, outside the offices of Council Member Mark Levine.
Nurses gain political support for the other New York NYSNA
nurse leaders at NYC Health + Hospitals/Mayorals are busy at the bargaining table—and at City Hall—working to win a contract that delivers healthcare justice for the other New York. On September 24, Valerie Bowers, RN, Sonia Lawrence, RN and Ray Briggs, RN, joined with our community ally Anthony Feliciano, Director of the Commission on the
Public’s Health System (CPHS), to meet with Council Member Mark Levine, Chair of the Health Committee. Council Member Levine indicated his strong support of our efforts and offered his advice as our campaign progresses. On October 1, nurse leaders Judith Cutchin, RN, Alizia McMyers, RN, Valerie Bowers, RN, Marion Parkins, RN, Rose Green, RN, Jalisa Saud, RN, and
NYC Council Member Mark Levine, Chair, Committee on Health, has pledged his support for the campaign, Healthcare Justice for the Other New York.
Patricia Tyrell, RN, along with CPHS’ Anthony Feliciano, met with Council Member Daniel Dromm, Chair of the Finance Committee, who expressed his strong support for NYC H+H/Mayorals nurses in contract negotiations. Council Member Dromm understands the importance of stable financing of NYC Health + Hospitals/Mayorals in delivering quality healthcare to all New Yorkers.
(L to R) Patricia Tyrell, RN, NYPD LBU Vice President; Valerie Bowers, RN, Negotiations Committee and retired Kings County Hospital; Alizia McMyers, RN, Harlem Hospital LBU Vice President; Judith Cutchin, RN, NYSNA NYC H+H/Mayorals Executive Council President and NYSNA Board Directorat-Large; Council Member Daniel Dromm; Rose Green, RN, Release Time Representative; Jalisa Saud, RN, Release Time Representative; CPHS Director Anthony Feliciano; and Marion Parkins, RN, Harlem Hospital LBU President.
10
New York Nurse september/october 2019
In the words of Judith Cutchin, RN Continued from page 8
“
Our union underscores that the public system treats all patients, no matter their immigration status, no matter their insurance or ability to pay. Judith Cutchin, RN
Half of all Medicaid patients receive their care in the public system. The population of NYC is approximately 8.5 million. It has the largest population of African American residents of any U.S. city: two million. The city also has the largest population of black immigrants, 686,000. African Americans in NYC rely heavily on the public hospital system. New York City is home to Wall Street, which churns out trillions in revenue for the nation’s wealthiest, and has an outsized influence on NYC. Despite the massive wealth of Wall Street, New York City’s poverty rate is approximately 17%. In 2017, the share of NYC’s African American population living at or near the poverty rate was 43%. Life expectancy in NYC’s poorest neighborhood, which is almost entirely African American is 74.4 years. In Manhattan, adjacent to the financial district, life expectancy of the largely white population is 85.9 years. Black New Yorkers are about 3 times as likely to die from diabetes as white New Yorkers. African Americans in NYC are 60% more likely than whites to have a stroke leading to permanent disability. They are two times more likely than whites to have Alzheimer’s Disease. Black New Yorkers die from both colon cancer and health disease at younger ages than white New Yorkers. Ninetyfour percent of elevated lead cases in NYC come from paint and affect non-white children. Central Harlem, a black neighborhood, has the highest percentage of lead poisoning. In the South Bronx, home to working class blacks and Latinos, asthma hospitalization rates for children are 14 times higher than in largely white communities of lower Manhattan. According to city data, if all New Yorkers had services equal to the wealthiest … 4,000 deaths could be avoided each year. Infant mortality of blacks in NYC is
2-3 times that of whites. If the infant mortality rate of black New Yorkers were the same as that of whites … then 200 fewer babies would die each year. What is the condition of healthcare resources for the African American population of New York City? Many of the city’s public hospitals are in the poorest neighborhoods that have relatively few other local healthcare providers. They serve a disproportionate number of underinsured and uninsured people. Public hospitals l provide most of the Level I trauma care. l form the network of first responders to epidemics and unusual outbreaks. l provide care for the City’s jail inmates and prison staff. l function as community hospitals in many underserved neighborhoods – largely African American – providing a lifeline to the uninsured. are the primary source of care for those suffering from psychiatric and substance abuse disorders and illnesses. The New York City Department of Health reached this conclusion in a recent study: Institutionalized racial discrimination in the past, combined with economic structures in the U.S., may have created social conditions for entire populations today that are unfavorable to health. The public system is nearly $1.8 billion in the red. In contrast, the private system in New York City employs 108 executives each earning more than $1 million a year. The total compensation for these executives is $234 million annually. Caring for the unprofitable
Here is a critical point: The public system carries the private system by caring for a majority of the uninsured and for half of the Medicaid patients (at reimbursements below cost). And the public system provides Level I trauma care, at a high cost. It is widely acknowledged that the private hos-
pitals funnel unprofitable patients to the public hospital system. What is NYSNA doing to address these disparities and to ensure that all New Yorkers receive quality, safe care? Our union underscores that the public system treats all patients, no matter their immigration status, no matter their insurance or ability to pay. We only ask one question: How do you feel? We have campaigned at local, city and state levels for safe staffing ratios because this is the great equalizer: a guarantee that quality, equal care for all our patients is our highest priority. Our union calls for full and fair funding for healthcare for all safety net hospitals as part of our campaign, Healthcare Justice for the Other New York. We have called upon the federal government to provide full and fair funding and make no cuts to care for uninsured, for Medicaid patients and for federally funded health centers. Finally, our members campaign for Medicare for All, at the state and federal levels. Our members recognize that Medicare for All would induce equality into a system that is profoundly unequal in its distribution of resources and outcomes. Our public hospitals would be reimbursed at new, enhanced Medicare rates established by the new system, so caring for the uninsured and for Medicaid patients would no longer result in losses. African Americans, and others, receiving care in public hospitals and other safety net facilities struggling to receive adequate resources would be “upgraded” by a Medicare for All system, as reimbursements would both support and help build and fund their healthcare facilities. NYSNA nurses are committed to equality with regard to healthcare resources and we reinforced this paramount goal on our units where we provide care, at our internal meetings where we organize efforts in our hospitals, and with communities where we live and work.
NEW YORK NURSE September/october 2019
Solidarity with EMTs and paramedics
T
he members of NYSNA pride themselves on providing care to ALL New Yorkers. This could not be done without the hard work and dedication of emergency medical technicians (EMTs) and paramedics. On September 25, NYSNA Board Member Anne Bove, RN, spoke at a rally on the steps of city hall on behalf of fellow nurses in extending support for EMTs and paramedics. In New York City, they are also part of the Fire Department of New York (FDNY), which provides more and more medical care. That’s reflected in the training for EMTs in NYC, which includes how to: l rush into burning buildings, l aid firefighters, l brave an active shooter (to reach the wounded), and l endure assaults from patients. Add to this list all the necessary requirements of giving advanced and life-saving care onsite and during transport of patients.
While they are a skilled workforce inside FDNY, the difference in pay and benefits with firefighters is very substantial.
Base pay for EMTs lags
There are 4,100 paramedics and EMTs in NYC. Medical calls, not fire calls, make up most of the FDNY work. While they are a skilled workforce inside FDNY, the difference in pay and benefits with firefighters is very substantial. In 2018, more than 80 percent of the 1.7 million incidents to which FDNY responded were medical. But base pay for EMTs lags. After five years on the job: l EMTs receive $50,604 annually; l paramedics receive $65,226 annually; l firefighters earn $85,292 annually. Regarding benefits, EMTs and paramedics (who come in contact with sickness) receive 12 days of sick time per year. Sick days for firefighter are unlimited. Firefighters, however, are more likely to die on the job than paramedics or EMTs.
NYSNA board member Anne BovĂŠ, RN, at EMT rally, City Hall, September 25
EMTs and paramedics regularly encounter hazards similar to those faced by police and firefighters. The injury rate of EMTs and paramedics is three times higher than the national average of the general population, according to a 2013
University of Maryland study. Assaults on paramedics and EMTs in NYC increased by nearly 50 percent between 2015 and 2018, according to a testimony from EMS Chief James Booth before the NYC Council.
11
12
New York Nurse september/october 2019
Medical Mission Report: Zimbabwe
Zimbabwe Mission RNs: Patricia James, Kings County Christine DiLeo, Northwell Syosset Karen Davis, ECMC Heather McCartney, St. Luke’s Ashley Bishop, Bellevue Rose Mourdoukoutas, Northwell Southside Marie Boyle, Northwell Southside Mary Engelbert, Northwell Southside Destiny Johnson, Health Alliance Kingston (non-member) Yana Jeffers, non-member
T
he African country of Zimbabwe is undergoing a harsh economic crisis. With annual inflation running at 300 percent, the local
currency is devalued daily. The shortage of fuel keeps drivers waiting in line for hours and when they do get to the pumps they pay between $7-18 for a quarter gal-
lon of fuel. The economic crisis has affected the food supply, resulting in the worst food insecurity in recent memory, say residents. The severe cash shortage has reduced the use of ATMs. Therefore, most banks have resorted to internal transfers. The economic upheaval has also hit pharmacies, where critical drugs are in short supply. Even essential medicines are challenging to find. The most challenging
To make matters worse, millions of people, mostly in rural areas, have been left without water and electricity because there is no money to keep the treatment plants and power generators working. This was the most adventurous and challenging medical mission to date. The nurses faced many obstacles, but they persevered in an extraordinary effort. These were the conditions encountered by 10 dedicated NYSNA nurses and Dr. Michael Touger upon their arrival in Zimbabwe for NYSNA’s International Medical Mission in 2019, which brought our missions total to eight this year. Day one
On the first day, the group was received by the CEO of the Harare Hospital, the largest in the country, and nurses visited several departments. Next to the hospital
medical mission tk is the School of Nursing. The students welcomed our delegation. RNs Patricia James, Rose Mourdoukoutas, Marie Boyle and Heather McCartney were invited to lecture on different subjects, and nurses and others were very engaged. The team then traveled by car (for 9 hours!) to the remote southernmost part of Zimbabwe near the border with Mozambique for two days of medical mission work. Patients walk up to 15 miles
The region was devastated in March by Cyclone Idai, which killed hundreds of people and left thousands homeless. The two districts hit hardest were Chimanimani and Chipinge, and that's where the nurses focused their work. The team divided in two and visited two communities each day, with a total of four villages and 697 patients cared for in two days. The patients from the communities had to walk up to 15 miles for medical help. Next the group went to Chipinge where they lived in a forest lodge halfway up a mountain. The lodge had no running water and no electricity for most of the time. For the two days nurses spent there, they had to be transported for two hours on poor-quality gravel and earth roads to reach communities. It has been, so far, an extraordinary trip with nurses standing up to the difficult daily challenges in order to bring essential healthcare to hundreds.
NEW YORK NURSE September/october 2019
It has been, so far, an extraordinary trip with nurses standing up to the difficult daily challenges in order to bring essential healthcare to hundreds.
13
14
New York Nurse september/october 2019
Albany Med RNs fight for fair contract and safe staffing
I Bargaining to start at CVPH NYSNA Nurses at the University of Vermont Health Network, Champlain Valley Physicians Hospital are gearing up for bargaining. With a just completed a bargaining survey and recently elected executive committee, a fair contract will be achieved that enables nurses to maintain the best care for their patients.
NYS AFL-CIO President Mario Cilento
n a move to mobilize support for a fair contract and spread awareness about low staffing numbers and unsafe ratios, RNs at Albany Medical Center had their first picket outside the hospital since their historic organizing victory culminated in a landslide vote to unionize in 2018. Since then, support for the nurses has only grown. The informational picket, held on September 25, was the latest effort to send management a message: AMC is a union hospital and management must settle a fair contract. The action received significant media coverage, including a front page story in the Times Union. Why the picket mattered
Nurses were energized and eager to make their voices heard. Imani Anderson, a registered nurse in the Cardiopulmonary Surgical Unit, was inspired by the strength of fellow nurses at the picket. “It feels great to be a part of something as powerful as this. I love my union and being a part of making change that you usually only see on TV,” she said. Mary Moshier, an operating room RN, joined her fellow nurses on the picket line after noticing issues with retention. “In my time here at AMC, I keep watching nurses leave for other facilities. I am picketing so that we can get a contract that allows for the staffing our patients need,” she said. The number one concern for nurses at AMC is safe staffing ratios. Kathryn Dupuis, an RN in the maternity ward, said, “I love the fact that we take care of such high-risk patients, but it gets really
Assemblywoman Carrie Woerner
Nurses on the picket line
scary when you’re afraid to end your shift and go home because you know there’s just not enough nurses to go around.” Curtis Strife, RN, agreed: “It’s a domino effect. We end up in situations where we stretch the limits of our license to make sure our patients are taken care of.” After Strife’s patients are delivered from the OR, they are supposed to recover for an hour before making their way to another floor. However, those floors are often short-staffed, creating a backlog in the OR. Instead of a permanent solution, Strife says the hospital relies on floaters. For the patients
Dupuis said the true focus of the hospital must be on the community. “This is not just about the nurses. This affects the entire community. We want people to be able to go to Albany Medical and get the kind of
care we would want for our families to get, and you can’t do that without good staffing,” she said. She continued, “People tell me, ‘Don’t go in, don’t stay late, they won’t fix it until you stop working overtime.’ I’m like, ‘You tell that to my patients.’ The bottom line is it’s my conscience. I got into this to help people.” At the end of the day, all of the RNs expressed concern primarily for their patients. Longtime Albany Med RN Nancy Levandowski said, “I’ve worked in Labor and Delivery at AMC for 32 years. I am loyal to this hospital, but I am more loyal to my patients and their safety. AMC needs to listen to the people at bedside.” Dupuis agreed, “I love my job. I love my patients. But that’s just it. We’re all here because we love our patients and we’re scared to death something is going to happen.”
AMC RNs showed there is strength in numbers.
NEW YORK NURSE september/October 2019
New York City – Safe staffing ratios achieved in
Brooklyn Hospitals.
westchester /hudson valley
– NYSNA members
at three Montefiore facilities in Westchester and the Hudson Valley push for staffing ratios and retiree benefits.
Around the state 9
capital/north country
– Albany Medical Center
nurses hold a picket to demand safe staffing ratios and a fair contract.
central region
– Samaritan Medical Center NYSNA
members welcome nurses to new roles on the convention delegate committee.
NYC's public nurses campaign for healthcare justice for the other New York
western region
– Nurses at Erie County Medical
Center overwhelmingly vote to ratify a new contract with significant gains.
staten island – Big contract win with wage gains and staffing ratios at Richmond University Medical Center.
15
NEW YORK NURSE
Non-Profit US Postage Paid NYSNA
september/october 2019
131 West 33rd Street, 4th Floor New York, NY 10001
1 Long
INSIDE
Nursing has no boundaries, p. 4
Medical mission to Zimbabwe, pp. 12-13 Solidarity with EMTs and paramedics, p. 11