nurse New York
western NY edition | january 2020
Western New York leaders step up, p. 3 Western New York leaders get together at Convention
Take Medicaid off the chopping block, p. 4
Medical Mission Thailand, p. 8
Viruses old and new, p. 10
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New York Nurse january 2020
EMPIRE
By Judy SheridanGonzalez, RN, NYSNA President
Advocating for patients. Advancing the profession.SM 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 Nancy Hagans, RN nancy.hagans@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 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 Lower Hudson/NJ Jayne Cammisa, RN, BSN jayne.cammisa@nysna.org Western Chiqkena Collins, RN chiqkena.collins@nysna.org Eastern Vacant Executive Editor Pat Kane, RN, CNOR Executive Director Editorial offices located at: 131 W 33rd St., New York, NY 10001 Phone: 212-785-0157 Email: communications@nysna.org Website: www.nysna.org Subscription rate: $33 per year ISSN (Print) 1934-7588/ISSN (Online) 1934-7596 ©2020, All rights reserved
H
istory has an uncanny way of repeating itself, but not always in ways we expect. The existence of the Roman Empire has been used as a metaphor for many years. “Nero fiddled while Rome burned” is based on the fact that the unpopular and decadent emperor did little while 70% of the city burned in 64 A.D., leaving more than half the population homeless. To distract the public from his disregard for the disaster’s impact, he scapegoated the Christians for the fire—who were summarily arrested and executed. He subsequently built his Golden Palace and gardens in land cleared by the fires. Scientists today point to a similar phenomenon: some of the most powerful “empires”—including our own current administration--who are influenced (and financed) by fossil fuel magnates also “fiddle” while our planet burns, building their own modern-day fiefdoms. The role of climate change in the devastating effects of (formerly “natural”) disasters is undeniable (in spite of the few “climate deniers” who stand to gain huge profits from the coal and petroleum industries). Transitioning to sustainable energy forms would create more jobs, safer jobs, for those displaced from coal mines and oil fields. Similarly, transforming our health care system into one that provides universal access to all--dramatically weakening, even eliminating, health industry predators: Insurance, Big Pharma and ForProfit Facilities-would necessitate the creation of many productive jobs (more staff to care for patients) for those displaced from these industries. But this would only be possible if the public controlled both energy and health care and demanded that displaced employees be trained and supported for the transition. Budget cuts, economic woes, and the proliferation of low paying
jobs and the new “precarious sector,” have replaced “good jobs” (with pensions, benefits, family supports). This is not the fault of immigrants, marginalized communities or “greedy unions.” These changes in our society’s social fabric are the result of the extraordinary redistribution of wealth that occurred in this country over decades: l CEO salaries jumped 940% from 1978 to 2018. l T he average worker’s salary increased by only 11.9% in that same time period. l 50 years ago, a US CEO earned 20 times as much as the typical worker. l Today, the CEO earns 354 times as much. l Share of wealth in the US, 2016: top 1% =39%; top 10%=77%; bottom 90%=23%. l This is also reflected in the dramatic shift in the tax bracket for the super-wealthy which dropped from 91% in 1955 to 37% in 2019. Income inequality in all other developed countries pales in comparison. Inequity in the US looks more like Rome in Nero’s time, than it looks like Denmark or Japan. Northwell, Montefiore and Mount Sinai are the top three private employers in NYS. Among the top 20 private employers in NY, eight are health systems (empires) including: NY Presbyterian, NYU Langone, Memorial, Cornell and Rochester Med. The top 10 by region include: Finger Lakes: Carestream, Rochester; Hudson Valley: Crystal Run & Nyack (Montefiore), Orange County Regional; Capital Region: Albany Med, Ellis, St. Pete’s;
Southern Tier: Arnot Ogden, Lourdes, United Health Services; Central: Crouse, Loretto Health, St. Joseph’s; Western: BlueCross BlueShield, Kaleida, Mercy; Mohawk Valley: A.O. Fox, Bassett, Faxton-St. Luke’s, St. Elizabeth, St. Mary’s; North Country: CantonPotsdam, Claxton-Hepburn, CVPH, Samaritan. In 2016, 120 hospital executives and MDs in these Health Care “Empires” were paid at least $1 million with additional bonuses up 13% over only two years. A chunk of that money goes to support candidates, along with their Corporate PACS and Lobbyists. What does this mean to us as Nurses? We can’t compete financially with these corporate billionaires and enterprises. What we do have are our numbers—and the moral high ground. We are the voice of the disadvantaged, the disabled, the disenfranchised, the underserved, the marginalized, the homeless and the uninsured. We raise our voices against the Death Spiral of draconian Medicaid cuts, decreases in mental health beds and services, hospital closures, bed reductions, and mergers and acquisitions focused on the bottom line rather than the needs of patients. All of these cuts result in staffing reductions rather than the ratios and improvements we have fought for over the years. Our power to foment positive change is only limited by our own dearth of imagination, willingness to fight, and level of organization. We remain the most respected profession in the country. We thus have a responsibility to fulfill the public’s trust with action. Getting involved in the union is just the beginning.
western
NEW YORK NURSE january 2020
Western New York leaders step up
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urses at Erie County Medical Center (ECMC) are taking the concept of “We are the Union” to a whole other level. Last fall, members participated in open bargaining, which was a first at the facility. Many of those members—both Delegates and rank and file members who dropped in on a bargaining session, are now running in competitive Delegate elections—another first at ECMC! Delegates step up
“This is a really exciting time,” said Chiqkena “Kena” Collins, RN, NYNSA Western Regional Director and ECMC Executive Committee member. “The last time we had Delegate elections, it wasn’t that competitive, but now people are campaigning like in a real election, even making posters and coming in on their free time. The members are lucky to have so many people fired up about making ECMC a better place!” Delegate positions are open for day and night shift on each unit. Delegates are unit leaders who have a strong knowledge of the contract, represent ECMC at NYSNA’s annual Convention, and help members with day-to-day problems. Delegate candidates who collect the most signatures from their unit will be appointed by the ECMC Executive Committee. ECMCwide elections for the Executive Committee are taking place on February 26. Release Time Reps hit the floor
Members are also taking their leadership to the next level as Release Time Representatives, a new program that was won in the latest contract. Kena Collins, RN, was the first nurse to do a tour as an ECMC Release Time Rep, dedicating 24 hours a week for one month to her new role. “Being a Release Time Rep taught me to be really flexible for
Kena Collins, RN, opens up about what it means to be a leader and a union activist
the members and the needs of the day,” explained Collins. “You may come in with a plan, but then have to shift gears quickly. You go behind the scenes and get a different perspective doing this work than you get when focusing just on patient care, or just on your unit. I learned so much about labor law and why we approach certain issues in a particular way.” During her time as Release Time Rep, Collins tried to touch as many members as possible, combining rounding on the floors with designating a consistent time that she would be available in the cafeteria. She felt it was important to create a safe space for nurses to come talk and raise problems that they may not have the time or inclination to do when busy working on their floor or near their supervisor. “We are the union”
Collins’ advice to future Reps was, “Everybody has things they know they’re good at, but use this opportunity to stretch yourself and do the things you don’t feel as strong or comfortable doing. You don’t have a lot of time, but you can learn a lot and accomplish a lot if you use the time wisely.” Shawntres Currin, RN, served as Release Time Rep after Collins, and Kevin Donovan, RN, just began his tour. One of the benefits of building more leaders at ECMC is that there can be a shift in the way the Administration perceives the members and the union. When management sees that NYSNA Reps are working with Release Time Reps, Executive Committee members and Delegates together to solve problems, it can raise the level of respect for all members. That unity in addressing issues and pushing forward an agenda will be what’s needed to implement and build upon the recent contract victory.
To join the ECMC/TVLTC conversation on Facebook, visit https://www.facebook.com/groups/eriecountynysna/
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New York Nurse january 2020
Take Medicaid off the chopping block As front line nurses,
By Pat Kane, RN, CNOR, NYSNA Executive Director
and as New Yorkers committed to healthcare as a human right, we are inextricably connected to the Medicaid program. More than a quarter of New York State’s population—26%—is covered by Medicaid and Children’s Health Insurance Plus.* In the nation, overall, Medicaid covers one in five low-income Americans. It is the principal source of long-term care coverage for Americans. Hospitals, community health centers, physicians, nursing homes and jobs in the healthcare sector—all receive substantial support from Medicaid. It is, simply put, part of the bedrock of healthcare funding in the United States.
ACA and Medicaid
Under President Obama’s Affordable Care Act, the importance of Medicaid to the people’s health only grew, as the law allowed states to extend Medicaid
In NY, Medicare Covers:
61% of adult Medicaid enrollees are working in NY
50% of children with special health care needs are covered by Medicaid in NY
2 in 9 adults, ages 19-64 2 in 5 children 5 in 8 nursing home residents 4 in 9 individuals with disabilities 1 in 4 Medicare beneficiaries
to people previously outside its financial ceiling. This meant that Medicaid could be offered on a pro rata basis. So while the enabling statute put a cap of 133% of the federal poverty level, states could raise the cap but require those at 150% of poverty, for example, to pay a small fee for their Medicaid coverage. The ACA initially covered all Medicaid costs incurred by this expansion and this year, 2020, federal support was reduced to 90%. But that does not include the state’s contribution. Prior to the ACA, federal law excluded impoverished adults without children, but here in NYS childless adults below 138% of the federal poverty level are eligible for Medicaid. To get your arms more fully around this healthcare program in this state, consider this: in New York, two in nine adults ages 19-64 are covered by Medicaid, same for two in five children and four in nine individuals with disabilities. Also, one in four Medicare beneficiaries receives Medicaid, so-called “dual beneficiaries”: the elderly poor. More than half of all Medicaid spending for long-term care in the U.S. is now for services provided in the home or community that enable seniors and people with disabilities to live independently rather than in institutions. Seeking a cut of $2.5 billion
Most Medicaid enrollees in New York—61%—are working. Even with gains in minimum wage, there are New Yorkers working full-time who qualify. Last, half of children with special healthcare needs are covered by Medicaid in this state. All told, 75 million Americans received Medicaid in 2017. (See charts on this page.) Uninsured and working full-time but not able to afford health insurance...Children whose families cannot pay for their health coverage...Elderly who receive Medicare but are so poor that they cannot get by…but for Medicaid. Now comes the hard part. There is pressure here in NYS to cut
Medicaid by as much as $2.5 billion in the coming year. Governor Cuomo’s Executive Budget for the coming year has a gap of $6.1 billion, of which more than $4 billion is identified as a Medicaid gap, a “structural gap” that exceeds the state’s self-imposed “Medicaid Global Cap” limiting annual increases in state Medicaid spending. The Governor’s budget appoints a new Medicaid Redesign Team (MRT II) to propose reductions in Medicaid cuts of $2.5 billion. (As of this writing, that target reduction has come down by $1 billion, as a result of Comptroller Tom diNapoli’s efforts in identifying waste, fraud and abuse in the past four years. If verified and accepted by Governor Cuomo, that still leaves $1.5 billion in Medicaid cuts for the next year.) Unrelenting fiscal pressure
The new budget allows for only a 3% annual increase in the healthcare costs for the poor, a limitation that experts say could “dramatically affect in-home care.” So, likely we will be back at the cutting exercise a year from now because costs are bound to go up more than 3%. This constant fiscal pressure on Medicaid is a shame. There remain today in New York hundreds of thousands of residents who are ineligible by a small factor and go without care. We should be working towards greater healthcare inclusion, not exclusion. Medicaid funds ought not to be on the chopping block. “[W]hat’s going on here,” says Assemblyman Richard Gottfried, “… is an old Albany tradition… trying to cut health care for needy New Yorkers.” A healthy population requires less healthcare services, as we know all too well. But, as a state and a nation, we have to get healthy before we reap the savings. Besides, even the slightest glance at the skyline, or leafing through an architectural magazine, or watching celebrity news and you cannot help but conclude: this is a time of great wealth in the state and the nation. Cutting Medicaid is a sin. *CHIP provides low-cost health coverage to children in families that earn too much to qualify for Medicaid but not enough to afford private insurance.
A word from our members
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NEW YORK NURSE january 2020
Karine Raymond, RN
H
ow did you decide to become a nurse? As a child growing up I wanted to be a famous fashion designer. When I came to the US I was creating a name for myself, participating in shows in my city of Nottingham. I had also secured a number of commissions for items I had designed. I look back at that time and smile as I have fond memories of defying my mother’s suggestions to pursue a career in nursing. My mum was part of the historic Windrush generation. She left the warm, sunny climate of Jamaica to pursue a career in nursing in England at the time when nurses were in short supply. I had other ideas for myself! Funny how life turns out. I don’t see myself in any other profession other than as a cardiac cath lab nurse, a super-gratifying specialty. Who knows? Maybe when I retire I’ll design nicer hospital attire for our patients. Nurse and organizer. How did you get there? I became involved in organized labor by accident. I believe as a woman of color you’re continually and forever fighting the battle of defense from injustice. You’re always demanding recognition. I remember being asked to represent nurses at the Weiler Campus. I did not think I had the skill set but was assured by my colleagues and then President/Chairperson Pat D’Lillo, RN, and our rep at the time, Mike Hertz, RN,that I absolutely had the skill set. They said that I had a particular way about me. Besides, all I would be doing was handing out flyers. Any nurse can do that! That’s how I became involved: I knew how to stand up for myself. I figured I had nothing to lose, put my best foot forward, and the rest is my story. How many hats do you wear? First and foremost, I am an RN working full time in the cardiac
cath lab at the Weiler Campus of Montefiore Medical Center. But I wear a number of hats in our union of 43,000 registered nurses. I am the chairperson of the bargaining unit at Weiler, where I assist in protecting the sanctity of our contract and the rights of nurses and patients. I also serve on the board of directors as second vice president. In this role I assist the entire team at NYSNA in developing and implementing a strategic plan for the organization heavily focused on the needs of the nurses. I also respond to the day-to-day running of the organization. I am a pension plan trustee for the NYSNA pension, as well. This role is equally near and dear to my heart. I believe that after a nurse has retired she deserves to live with financial dignity. It is my honor to assist in this role. From your perspective, what does NYSNA do? Our union is not just a union that negotiates a contract for its members, it is also charged with ensuring education to advance the profession and safety in every environment our nurses work and our patients visit. It is politically active—working to pass bills and address issues that not only benefit nurses and patients but the communities in which we work. Our union is very active in the conversations and activities around climate change, as we know that this is supremely detrimental to communities—especially communities of low-income and color. We have seen the devastation that occurs all over the globe when the weather’s ferocity is unleashed. We have developed and participate in medical missions that help to alleviate some of the suffering of our brothers and sisters across the earth. Returning nurses from these medical missions report a profound sense of giving, their perspectives about nursing and outlook on the human condition forever changed. Participation on medical missions is paid for by the nurses on the
Chinyere Onwumelu
“Respect for one another, despite our differences, make the Safe Staffing for Quality Care Act a reality.”
letters
Karine Raymond, RN
trips—a testament to the generosity of the nurses. What is NYSNA’s future? I want to see a move forward to strive for greater things and to become more unified. Respect for one another, despite our differences, make the Safe Staffing for Quality Care Act a reality. We need enough nurses to do our jobs and to be able to deliver safe care to every patient irrespective of their status in life. We can do this if we ALL do our part—large or a small—and join together in solidarity.
NY Nurse wants your voice Letters may be on any topic, but must be less than 200 words and are subject to editing. You must include your name, however you can request that we not publish it.
Write to us: Letters/NY Nurse 131 West 33rd Street NY, NY 10001
email:
NYNurse@nysna.org
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nysna voices
New York Nurse january 2020
Leading the charge for Medicare For All
N By Marva Wade, RN
urses are at the front lines of a growing movement calling for a universal, singlepayer ‘Medicare for All’ system. Let’s be clear that NYSNA is advocating for a much-improved version of Medicare to be expanded to all residents. The nurses’ proposal is one that actually meets the healthcare needs of our patients: it is universal with more comprehensive benefits, and is much more affordable than the Medicare program as we know it. Public support surging
Without meaningful reform, the US healthcare system will continue getting more expensive, more confusing, less fair, and more deadly.
Without meaningful reform, the US healthcare system will continue getting more expensive, more confusing, less fair, and more deadly. Patients are so frustrated by the cost of insurance and care that public support for an improved ‘Medicare for All’ system is surging: to 70% in some public opinion polls. Recently, we welcomed the ACP—the second largest physician organization representing 150,000 physicians—in endorsing ‘Medicare for All’. Debate on Medicare for All centers on an unfounded assumption: that insured Americans are satisfied with their coverage. Nor has debate accurately quoted the real costs to Americans of their insurance versus an improved Medicare system.
The most expensive and harmful option is to do nothing. 1 in 4 Americans delay care because of cost, a cancer diagnosis is likely to bankrupt you, 1 in 10 Americans know someone who died because they couldn’t afford the care they needed, and nurses and doctors report burnout from the incredibly burdensome paperwork keeping us from providing quality care. I was an OR nurse for 39 years. I loved my work and the patients I took care of. What I didn’t like knowing some patient’s surgery was cancelled, rescheduled or delayed because insurance companies had DENIED coverage for a much needed indeed life-saving procedure. When talking about Medicare for All with NYSNA members, I have heard a lot of nurses speaking about the challenges their patients face. Every day, we see our patients make heartbreaking choices between getting the care they and their children need or paying rent, buying insulin or buying food. Big costs with insurance
One patient without insurance coverage is too many, and in our state alone over 1 million people are still without any coverage at all. Nationally, over 28 million are uninsured. Those of us lucky enough to have coverage through our jobs often face prohibitive costs when we do use our insurance—
copays, deductibles, and ever increasing premiums. Turns out there is a better way to cover everyone, lower costs, and make sure money is invested into quality care and care giving jobs: Medicare for All. True comprehensive care
Medicare for All will cover every single resident with high quality care. The system saves money by streamlining the administration and bringing down costs on drugs and medical equipment. The substantial savings can then be used to provide high quality care to every resident. Benefits of our proposed ‘Medicare for All’ system are more comprehensive than any existing public or private insurance plan, covering all medical care, dental, vision, hearing, and long-term care and support services. There will be no copays or deductibles keeping people from accessing needed care. We won’t greet patients at the hospital and clinic with, ‘how are you going to pay for this?’ But rather, ‘how are you feeling today?’ Now is the time to spread the word about ‘Medicare for All.’ We want to hear from you. If you are interested in telling your healthcare story, or learning more about the Medicare for All proposal nationally or in New York State, please reach out to katie.robbins@nysna.org or me at marva.wade@nysna.org. We’d love to hear from you!
Correction We failed to properly identify a nurse member, Deborah Gatson. She is Deborah Gatson, RN, MSN. We apologize. Marva Wade, RN, (right), joins a Medicare for All rally in NYC. Supporters across the country are turning out on what many consider the single most important issue of our time.
NEW YORK NURSE january 2020
2019: a year of victories NYSNA
nurses swept through the state last year with one stunning contract win after another. Contracts reflected safe staffing, unprecedented wage increases in the public sector, expansion of release time reps, retiree health gains and other member empowerment programs. In New York City, more than 10,000 members from New YorkPresbyterian Hospital, Mount Sinai Hospital, Mount Sinai West and Mount Sinai St. Luke’s, and Montefiore Medical Center combined forces to win what the New York Times called a “landmark” staffing deal. The contracts provide for the filling of vacant FTEs and the route to ratios with expedited review. Allocation committees created by the contracts are hard at work filling the ranks with RNs. Safe staffing gives our nurses the working conditions needed for quality patient care. Most significantly, it brings equality to patient care by bringing a standard of care to all patients. Our commitment to patients is fundamentally about equality. There is no compromise on patient care. “Precedent-setting”
“It was a historic, landmark contract with staffing grids that reflect ratios that are enforceable,” said Anthony Ciampa, RN, 1st vice president of NYSNA and release time rep at New York-Presbyterian. “This is a precedent-setting model that should be followed throughout the state. This is a victory because nurses are exercising a real say in our working conditions by allocating where we determine that we need nurses most. This is no longer management’s exclusive prerogative. It is a testament to what we do when we are united.” Facilities in Brooklyn, Queens and Staten Island ratified new contracts with major gains, including nurse-to-patient ratios in many contracts for the first time, including Brooklyn Hospital, Wyckoff Heights Medical Center, Interfaith Medical Center, Kingsbrook Jewish Medical Center, Richmond University Medical Center and Maimonides Medical Center.
ers for member education throughout contract campaigns. On Long Island, members from St. Catherine of Siena Medical Center, Syosset Hospital, Southside Hospital, Plainview Hospital, Parker Jewish Rehabilitation, St. Charles Hospital, Peconic Bay Medical Center, and Long Island Jewish Valley Stream attended steward training to enhance their bargaining skills. Public sector wins
Nancy Hagans, RN
Nurses at Flushing Hospital Medical Center in Queens won their contract, as did Richmond University Medical Center on Staten Island. “We had a very good sense of unity at our hospital,” said Nancy Hagans, RN and NYSNA Treasurer, who works at Maimonides. “A lot of community organizations supported us because we shared information with them on the issues. We also shared that information with members and their families and with local businesses, as well. The threat by management to take away long-term disability coverage got a very strong response from us. Everyone in our LBU knows someone who needs this coverage. This issue alone was a rallying cry. We won a strong contract!” Another major employer, Northwell Health, inked deals at several hospitals, including Staten Island University Hospital. The latest contract win was at Vassar Brothers Medical Center, where nurses just ratified a new contract in January 2020. Building bargaining power
NYSNA developed two three-hour trainings-- one for Negotiating Committees and one for Contract Action Teams (CATs). The CATs became the major driv-
In August, nurses at Erie County Medical Center in Buffalo signed their deal. Then came a contract win with NYSNA’s largest LBU, more than 8,500 nurses at New York City Health + Hospitals and Mayorals agencies. Their deal sets out ratios in the contract itself, and includes significant increase in salaries that begins to close the gap between public sector and private sector nurses. “We spent a lot of time preparing and negotiating with management,” said Verginia Stewart, RN and NYSNA board member, who works in the public system at Metropolitan Hospital Center. “It was obvious that our team – staff and members – was well informed. In the end, we achieved a good contract. To me, the staffing ratios within the terms of the contract was a major step forward. A majority of members with whom I spoke were extremely satisfied. I am very proud of the care we administer to patients every day at NYC Health + Hospitals.” Great contracts for every nurse Still, we have ground to cover. Our brothers and sisters at Albany Medical Center have joined forces with other Capital Region nurses at Ellis Hospital and Bellevue Woman’s Center. Massena Memorial Hospital nurses are fighting management that, in a blatantly move, pulled out of a contract. Nurses at New York-Presbyterian Brooklyn Methodist Hospital are preparing to take a strike vote after months of stalling and disrespect on the part of management at the bargaining table. We will not rest until all hospitals where NYSNA nurses care for patients sign contracts that guarantee safe, quality care for all patients.
Verginia Stewart, RN
Anthony Ciampa, RN
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medical misson
New York Nurse january 2020
Medical Mission Thailand
T
he first mission in 2020 was to Thailand with the participation of 12 NYSNA members who provided health care to 698 patients. The nurses reached the impoverished communities in the mountainous region of Chiang Mai, in the north part of the country close to the border of Myanmar and Laos. This region is home to the renowned Kayan Tribe, known as the “Longneck” or tribe of giraffe women. On the first day, the team visited the community of Mueng, providing healthcare to patients of all ages, including many students from the school where we actually set up the temporary clinic. The Cayan people
The next day we traveled about two hours to the remote area of Chiang Mai to care for the Kayan people, a sub-group of the Red Karen people. The Kayan tribes are originally from Myanmar and became a “tourist attraction” in Thailand, as a result the girls and women wearing traditional brass coils around their necks. The girls start wearing these brass coils from the age of five, and more are added as they get older. Due to political turmoil in the late 1980s between the Karen National Liberation Army and the military dictatorship in Yangon, and the violence that ensued, many of the Kayan people fled to Thailand and set up in refugee camps. Virtual human zoo
Conditions for the Kayan are very poor. They have little to no access to schools, roads, electricity, or any healthcare. Girls with rings around their necks will never get to experience life outside of these makeshift villages. The women live in a virtual human zoo, and the Thai government does not allow them to leave and seek work or higher education. For the record, this was the first Medical Mission EVER to a Kayan tribe by any international or local organization. Next, our nurses had a full day of clinic work at the FASAI Home,
an orphanage located about 30 minutes from Chiang Mai. The residents from the surrounding area came seeking care by our team of health professionals. Besides providing healthcare, our team donated 20 bunk beds to 40 children and teenagers, who were
sleeping on the floor. No more! This first Medical Mission in 2020, as all previous ones, gave the nurses an extraordinary chance to learn about an exotic culture, different methods to treat a variety of diseases, and human behavior.
NEW YORK NURSE january 2020
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public health
New York Nurse january 2020
Viruses, old and new
The information in this article is accurate as we go to press. Updated information is posted regularly on the NYSNA website at www.nysna.org. For further information, contact the NYSNA Health & Safety Representatives at healthandsafety@nysna.org or call 212-785-0157.
Influenza Our old friend flu is back and filling hospital emergency rooms. According to the CDC, between October 1, 2019, and January 18, 2020, there have been between 7 to 10 million flu-related medical visits and 140,000-250,000 flu hospitalizations. Emergency departments throughout the country are often filled beyond capacity, so flu surge can put a severe strain on hospital resources. And overcrowded EDs mean airborne infectious diseases such as flu can quickly spread to nearby patients. The U.S. Department of Health & Human Services/CMS and NYS Department of Health provide guidelines healthcare facilities should consider in determining their ability to handle a patient surge due during flu season. (See flu surge check list, bottom right.)
2019 Novel Coronavirus (2019-nCoV) A new coronavirus, in the same virus family as SARS and MERS, has recently emerged from Wuhan, China. The virus is believed to have started in a live animal market (though this has not yet been confirmed) and quickly mutated from animal-to-human transmission to human-to-human transmission. The disease is spreading rapidly throughout China and confirmed cases have been found in other countries, including the U.S. (as of this writing there are 5 confirmed U.S. cases—2 in CA, 1 in WA, 1 in AZ and 1 in IL). All cases so far have emanated from direct travel to Wuhan. It is believed that the incubation period may be as long as 14 days, and the disease may be transmissible during that time even if the infected person is asymptomatic. Much is still unknown about transmission, but it is most likely transmitted through contact and airborne droplets.
There are currently several cases under investigation for 2019-nCoV in New York State. All have had specimens sent to the CDC for testing and several are awaiting test results. As of the writing of this article, there have been no confirmed cases of 2019-nCoV in NYS. Persons under investigation
The CDC recommends that patients who meet either of the following criteria should be evaluated as a “person under investigation” (PUI) for 2019-nCoV: l Fever AND symptoms of lower respiratory illness (e.g., cough, shortness of breath) and, in the last 14 days before symptom onset, l A history of travel from Wuhan, China OR l Close contact with a person who is a PUI for 2019-nCoV while that person was ill l Fever OR symptoms of lower respiratory illness and in the last 14 days before symptom onset had close contact with an ill, laboratory-confirmed 2019nCoV patient Healthcare worker protection
Is Your Facility Prepared for Flu Surge?
The modes of transmission for 2019-nCoV are not fully understood, therefore the CDC and WHO recommend that providers caring for patients who meet either PUI criteria should follow infection prevention and control guidelines including: l Place surgical mask immediately on the patient l Evaluate patient in a private room with the door closed (ideally an airborne infection isolation room if available) l Healthcare personnel entering the room should follow standard, contact and airborne precautions l Healthcare personnel coming within 6 feet of the patient should use eye protection (goggles or face shield), gown, gloves and N95 respirator l Refrain from touching eyes, nose, mouth l Wash hands frequently
For more information or questions, please contact the NYSNA Health and Safety Representatives at healthandsafety@nysna.org.
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january 2020
Agency Fee Objection Policy NYSNA’s agency fee objection policy, which will be published annually in the January edition of New York Nurse, works as follows: 1. To become an objector, a non-member who is represented by NYSNA shall notify NYSNA. Such objection must be in writing, signed by the non-member and mailed to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001. The objection must be postmarked within 30 days of resignation of membership, or, if the non-member did not resign within the prior twelve months, in the month of February. A nonmember employee who initially becomes a bargaining unit member after February in a particular year and who desires to be an objector must submit written signed notification to the NYSNA Membership Department within thirty (30) days after the employee has become subject to union security obligations and been provided with notice of these procedures. Public sector employees may revoke their dues deduction authorization and resign membership in accordance with applicable law and the terms of any signed dues deduction authorization card. 2. Agency fees payable by nonmember objectors will be based on NYSNA’s expenditures for those activities undertaken by NYSNA to advance the employment-related interests of the employees the Union represents. These “chargeable” expenditures include: preparation for and negotiation of collective bargaining agreements; contract administration including investigating and processing grievances; organizing within the same competitive market as bargaining unit members; meetings, including meetings of governing bodies, conferences, administrative, arbitral and court proceedings, and pertinent investigation and research in connection with work-related subjects and issues; handling work-related problems of employees; communications with community organizations, civic groups, government agencies, and the media regarding NYSNA’s position on work-related matters; maintaining membership; employee group programs; providing legal, economic, and technical expertise on behalf of employees in all work-related matters; education and training of members, officers and staff to better perform chargeable activities or otherwise related to chargeable activities; and
overhead and administration related to or reflective of chargeable activities. Non-chargeable expenses are those of a political nature. The term “political” is defined as support for or against a candidate for political office of any level of government as well as support for or against certain positions that NYSNA may take, which are not work-related. The following are examples of expenditures classified as arguably non-chargeable: lobbying, electoral or political activities outside of areas related to collective bargaining; litigation expenses to the extent related to non-chargeable activities; and member-only activities. 3. NYSNA shall retain an independent auditor who shall submit an annual report verifying the breakdown of chargeable and arguably non-chargeable expenditures and calculating the percentage of arguably non-chargeable to chargeable expenditures (the “fair share percentage”). The auditor’s report shall be completed promptly after the conclusion of the fiscal year. The report shall be provided to any non-member who submits an objection. 4. Non-members and new employees will be given the foregoing explanation of the basis of the reduced agency fees charged to them. That explanation will include a list of the major categories of expenditures deemed to be “chargeable” and those deemed to be arguably “non-chargeable.” 5. The fees paid by non-member objectors shall be handled as follows. (a)Newly-Hired Non-Members. NYSNA will place or maintain in an interest bearing escrow an amount at least equal to the agency shop fees remitted by newly-hired nonmember(s) (or by an employer on behalf of newly-hired non-member employee(s)). A newly hired nonmember employee will be mailed a copy of this Policy. The non-member will have the later of the date he/ she is subject to the obligations of the union security clause or thirty (30) days from the date of mailing to remain a non-member, object or to join NYSNA. If the non-member employee joins NYSNA, then the full agency shop fee remitted on his/her behalf is credited from the escrow account to the Association’s general treasury. If the newly-hired employee does not join NYSNA and does not file an objection within the thirty-day objection period, then the escrowed amount will be credited to NYSNA’s general treasury. If the newly-hired non-member timely
objects, an amount at least equal to the fair share percentage shall continue to be escrowed pending resolution of a challenge (if any) by the objector. Once the challenge is resolved, the amount of the nonchargeable balance plus interest will be returned to the non-member from the escrow. (b) Resignation. In the case of an employee who resigns NYSNA membership (or who continues in non-member status) and who timely objects, NYSNA will place or maintain in an interest-bearing escrow account an amount at least equal to the fair share percentage of the agency fees received from the nonmember or employer on behalf of the non-member and the non-member is permitted to challenge the fair share fee percentage during the thirty (30) day period noted in the annual publication of the Association’s objection procedure. If the non-member files a timely challenge, amounts at least equal to agency fees collected from the non-member employee or employer will continue to be placed or maintained in the escrow account pending resolution of any challenge. If the non-member does not file a challenge within the challenge period, then the fair share fee amount will be credited to NYSNA’s general treasury and the balance (if any) paid to the non-member from the escrow plus interest. 6. A non-member objector may file a written challenge to the calculation of the fair share fee and percentage, challenging any of the items of the expenditures as chargeable. Such a challenge must be submitted within thirty (30) days of the date the non-member objector is provided an explanation of the basis of the reduced agency fees and initiation fees charge to them. Such a challenge must be in writing, signed by the non-member and sent to the NYSNA Membership Department at 131 West 33rd Street, New York, NY 10001. If NYSNA does not agree with the challenge either as to the expenditures or as to the percentage of amount of dues to be paid, it will notify the timely objecting non-member in writing that he/ she has thirty (30) days thereafter to request arbitration; and if he/she fails to do so within that time, then such non-member waives the right to arbitration. A request for arbitration must be in writing, signed by the person filing the request, and sent to the NYSNA Executive Director,
131 West 33rd Street, New York, NY 10001. 7. If more than one challenging non-member objector timely requests arbitration, NYSNA will consolidate all such challenges into one annual arbitration proceeding. NYSNA will provide an impartial arbitration proceeding through the American Arbitration Association and will pay the administrative costs and the arbitrator’s fees. The challenger will be responsible for any fees associated with his or her representation at the hearing. 8. NYSNA will administer this policy in a manner that is consistent with the objectives of the policy and the applicable federal and state law to provide a fair and equitable procedure regarding nonmember employees. NYSNA reserves the right to change the policy set forth above.
Beck Notification If you are represented for collective bargaining by NYSNA, you have the right to be or stay a nonmember and pay an agency fee equivalent to dues. If you choose to be a nonmember, you are entitled to object to paying for activities unrelated to the association’s duties as a bargaining agent and to obtain a reduction in fees for such activities. If you submit a timely objection, the agency fee that you will be required to pay will include costs incurred by the union for expenditures related to collective bargaining, contract administration, grievances and arbitration, and other matters affecting wages, hours, and other conditions of employment. In 2019, the most recent calendar year for which a calculation was done, the agency fee charged to timely non-member objectors represented 87.69% of the dues amount for that year. If you choose to be a nonmember, please be aware that you will deny yourself the opportunity to exercise the full rights and benefits of union membership. Full membership rights include, among other things, the rights to: (1) vote on acceptance or rejection of proposed contracts covering your wages and working conditions, thereby ensuring your input on issues central to your working life; (2) participate in development of contract proposals; and (3) vote for your union officers. A copy of NYSNA’s agency fee objection policy is published annually in the January edition of the New York Nurse. You can also request a copy from NYSNA’s Membership Department.
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New York Nurse january 2020
Puerto Rico Medical Mission
I
nitially, the medical mission to Puerto Rico (January 22-27) was scheduled to visit communities located in the mountains of Utuado where, since hurricanes Maria and Irma, the inhabitants continue suffer from lack of health services. However, several earthquakes hit Puerto Rico, forcing some to leave their homes and sleep on the streets. Unsurprisingly, a climate of tension and stress set in, further increasing the demand for medical health services. NYSNA nurses on the mission experienced two earthquakes with magnitudes 3.4 and 4.1, respectively.
Local union support
For all these reasons, a team of 15 nurses, two doctors, and 3 volunteers, in addition to the personnel responsible for the organization and logistics, formed an ad hoc emergency medical mission that served for over a period of three days attended to 300 people in the Utuado region, victims of hurricanes Maria and Irma, as well as the communities of Guanica and Yacuo, victims of the recent earthquakes. It was an extraordinary and gratifying experience. Locally, NYSNA's team had the support of two unions: UGT and SPT. Their participation helped to make this second NYSNA mission of 2020 a major success.
medical misson
NEW YORK NURSE january 2020
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New York Nurse january 2020
A great tribute to nurses and midwives
T Without meaningful reform, the US healthcare system will continue getting more expensive, more confusing, less fair, and more deadly.
his year NYSNA is proud to stand with the World Health Organization (WHO) in celebrating 2020 as the “International Year of the Nurse and the Midwife” in honor of the 200th birthday of Florence Nightingale. Like Florence Nightingale, the founder of modern nursing and a social reformer of the highest caliber, our nurses—43,000 strong— are caregivers on the frontlines of some of New York’s most impoverished communities. NYSNA recognizes the need for the highest quality healthcare for everyone, and that nurses and midwives are, as WHO has said, “essential to the achievement of universal health coverage.” Without it, all communities remain vulnerable to infectious illnesses and higher mortality rates. A broad mission
Almost 200 years ago, Nightingale, a nurse, was the first to recognize this. She linked stabilizing the health of the British army in India to stabilizing the health of India’s people, as she campaigned to improve sanitary conditions for all. Our nurses in New York honor this tradition, fighting alongside other medical providers, for access to healthcare for all New Yorkers, against toxic dumping, for improved air quality, against greenhouse gases and for the redress of other social, environmental and economic conditions that contribute to poor health in our communities. As the World Health Assembly has noted, nurses and midwives are well-positioned to identify these concerns. We are “the people who
devote [our] lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs. [We] are often, the first and only point of care in [our] communities.” We know first-hand the urgent needs of the communities we serve. Nine million nurses needed
Today there is a worldwide nursing shortage. “The world needs nine million more nurses and midwives,” according to WHO, “if it is to achieve universal health coverage by 2030.” Our members stand with WHO in calling for a welltrained and educated nursing and midwife workforce worldwide who “receive pay and recognition com-
mensurate with the services and quality of care” they provide. Like the UN High Level Commission on Health Employment and Economic Growth, we see this investment as the trifecta of “improved health outcomes, global health security, and inclusive economic growth.” As of 2019, more than one million New Yorkers were without healthcare. As professionals, we join with the World Health Organization in calling for access to healthcare on behalf of the poor and uninsured in New York, in the United States, and around the globe, and we remember Florence Nightingale, who introduced trained nurses into the workhouse system in Britain, providing for the first time for healthcare for Britain’s poor.
NEW YORK NURSE
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january 2020
nyc
– Mount Vernon Hospital is open for care. Its
corporate parent, Montefiore, wants to downsize it. But members and the community, religious leaders and local politicians...all are working to keep this vital facility open.
central region
– St. Elizabeth Medical Center
nurses hold their own in negotiations, as short-staffing reaches intolerable levels.
Around the state 9
capital/north country
– The nurses of Albany Medical Center, Bellevue Woman’s Center and Ellis Hospital unite in the face of employers’ hard line negotiations. The nurses are feeling their power.
nyc h + h /mayorals
westchester/hudson valley – Mount
Vernon Hospital sits on the southern border of Westchester County. It serves a city of 70,000 and is essential to the health of the communities. Nurses and allies are determined to keep it open for care.
– Public hospitals
and clinics are essential to the healthcare needs of millions of New Yorkers. Q&A with Judith Cutchin, RN, President, NYSNA’s NYC H+H/Mayorals Executive Council.
long island
– Peconic Bay Medical Center
nurses make a sweet deal with a management looking to cooperate, not aggravate.
staten island
– Patients are in hallways at
Staten Island University Hospital. Flu, norovirus and poor management are to blame.
NEW YORK NURSE
Non-Profit US Postage Paid NYSNA
january 2020
131 West 33rd Street, 4th Floor New York, NY 10001 5 Western
2020 NYSNA Lobby Day tuesday, MARCH 3 | Albany
Nurses – Tell Albany:
Protect Quality Care for ALL Communities! We are the voice for patient care in New York. There’s a healthcare crisis in our state. Corporate-driven healthcare policies have led to hospital closures, and compromised patient care. The steep cuts proposed in the State’s healthcare budget threaten to make the situation worse. Join nurses from across New York to sound the alarm in Albany at NYSNA’s 2020 Lobby Day.
To register https://www.nysna.org/sites/default/files/ attach/add/2020/01/2020lobbyDay-regFlier.pdf
letters
NY Nurse wants your voice With next month’s issue, we are inaugurating a section dedicated to your letters. We encourage your participation in sharing ideas, and we will respond. Letters may be on any topic, but must be less than 200 words and are subject to editing. You must include your name, however you can request that we not publish it.
Write to us: Letters/NY Nurse 131 West 33rd Street NY, NY 10001
email: NYNurse@nysna.org