AUGUST, 2010

Staffing shortage has been the common word nowadays. There is not a single day passes that I don’t hear a cry for help from most of our nurses. Adequate nurse staffing is one of the conditions that consistently influences a patient’s quality care.
Study has shown that quality of care is directly related to having sufficient numbers of Registered nurses to give patients the care they need,when they need it. Unfortunately, today nurses juggle a number of roles ….some of which were not on the horizon even two or three decades ago. Many of these “jobs within a job “ have evolved due to rapid advances in medicines and technology and the changing culture of health care.
In the last 10 years, positions such as case managers,clinical nurse leaders, PI specialist, informatics experts and different unit coordinators took away many of our direct patient care nurses. The limited amount of nurses left at the bedside spend half of their time documenting due to new technology.
It is troubling to even think that safe and quality care becomes secondary due to staffing shortage.
Leaderships need to wake up and address the issues before it is too late.

Evelyn

July, 2010
It is only the beginning of summer and the Northeast is experiencing a heat wave. I hope everyone is staying safe, cool and enjoying this change of weather.
It is not only the weather that is changing but the VA is making changes in the Health care settings throughout VHA that will involve new ways of interacting with patients and providing medical care. It will be a Health care Transformation that will enhance the Veteran and his or her family’s experience while continuing to focus on quality and safety. This initiative will require the VA to develop models of patient care that will educate and empower patients and their families, to ensure a holistic, Veteran –centered health care system, and greatly improve access and coordination of care.
Patient – Centered Care have different models and the local Medical Centers are free to choose the model that is applicable to their facility. Current models of Patient-Centered Care include but are not limited to Planetree, Green House, Disney, Relationship-Based Care, Institute for Family – Centered Care, Studer Group and Integrated Medicine. Whatever model the medical center choose, it has to be consistent with all of the National objectives of VHA. Furthermore, this new initiative will enhance the communication mechanism between the veteran and staff such as using a secure messaging, patient’s access to their own medical records, virtual medicine, My Health Vet and will change the way of delivering care to focus on patient’s involvement in health care decisions for a higher quality of overall care.
In the Primary care setting there will only be one model which is Patient Centered Medical Home (PCMH) which involves changing the present Primary care setting to a “Teamlets”. The “Teamlets” consists of a Primary care provider, a registered nurse care coordinator, clinical associate (LPN, HT) and an administrative associate (PSA / MC).
This change in the VA health care system will be challenging to our nurses but hopefully a very rewarding experience to each nurse who always value a quality and safe patient care to our veterans.

Evelyn

NAGE National President, David J. Holway, and NAGE Federal Program Director, Gina Lightfoot-Walker, visited Local R 3-19 on May 4, 2010.
During their visit they had an opportunity to meet with a few of the bargaining unit members and shared what was occurring on a National level. They took time to address questions from the members.
As we get ready to begin into Nurses’ Week, President Holway presented the following Proclamation to the Local.

Proclamation

Whereas, the week of May 6 -12, 2010 has been recognized Nationally as “Nurses’ Week”; and
Whereas, Nurses are assuming increasing responsibility and accountability for our Nation’s health care needs; and
Whereas, Nurses serve a most vital function in promoting and providing quality Health Care to all in a variety of settings; and
Whereas, the workplace environment and characteristics often hinders the voices of front line care providers; and
Whereas, without a voice in the workplace, Nurses ability are undermined; and
Whereas, the National Association of Government Employees (NAGE) serves as exclusive representative for the Registered Nurses employed within the VA Maryland Health Care System; and
Whereas, NAGE puts the interest of their members first;

Now, therefore, let it be resolved on this date NAGE Local R 3-19 is recognized a leading voice for Nurses, for the protection of Nurses’ right, and for promoting a more supportive work environment throughout the VA system.

David J. Holway Affirmed May 4, 2010
National President

Please stop by any of Local offices to see the proclamation.
NAGE is proud of all the NURSES and all the work they do for in providing health care & their support of this Chapter.

Evelyn

APRIL, 2010

As we are experiencing this Hot Spring weather, the Blizzard of 2010 is just a foggy memory for most of us. Although we would like to forget that horrendous winter we had, NAGE remains concern with the preparedness of VAMHCS in handling an emergency and disaster.

NAGE was flooded with many calls and complaints from our nurses on how the situation was handled by management during the Blizzard. NAGE decided to request a meeting with management which was held on March 12,2010. The Deputies for the Chief Nurse Executive met with a group of nurses.

Many issues were raised by the nurses such as lack of accommodations, limited transportation to bring the nurses in ,lack of food, rudeness and unprofessionalism of the NOD, disorganized staffing of the unit, disparity of treatment to nurses in regards to granting leave compare to other hospital employees and generally the overall concerns that this VA was not prepared at all although the weather forecasts indicated the upcoming blizzard. Management’s response was disheartening to NAGE and to our Collective Bargaining members.

Joint Commission Emergency Management Standard EM.02.02.07 comes to play with this situation.The standard sets a variety of provisions on how a hospital manages staff roles and responsibilities during a disaster.The idea is that an organization and its staff must be able to adapt from normal routines when dealing with an emergency. Another Joint Commission standard requires hospital to annually review the findings of their “ Hazard Vulnerability Analysis”. This analysis weighs the risks of a given emergency against the likelihood of it happening, and then ranks the resulting consequences.

Per request of the VAMHCS Director, NAGE sent him a memo outlining the concerns of the nurses that was discussed in the March meeting with Nursing Service. NAGE is waiting for management’s response outlining their position in improving the VAMHCS Preparedness for emergency.

Evelyn

MARCH, 2010

On December 9, 2009, President Obama signed an Executive Order 13522 creating Labor-Management Forums to improve the delivery of Government Services. This Executive Order is similar to a Clinton-era mandate that establishes government-wide Labor Management Partnerships .

The Executive Order 13522 requires a creation of a labor –management forums at the Agency level and a National Council on Federal Labor-Management Relations that will report directly to the Executive Branch. The National Council will be led by the Deputy Director of the Office of Management and Budget and Director of Office of Personnel Management. David Holway, NAGE’s National President was one of the union leaders appointed by President Obama to the National Council.

The order would require the National Council to pilot programs that would test bargaining over permissive subject in a small group of agencies. The council will evaluate the programs, which must be established within 150 days of the date of the order. The order also restores requirements that agency leaders and union officials undergo training in cooperative bargaining and dispute resolutions tactics. It also requires the agencies to provide the union with “pre-decisional” information on workplace matters including those not subject to collective bargaining. The National Council and the created labor management forums in the agency level will provide guidance for all sides to work towards a stronger and more effective federal government. This will also enable the union to elevate complaints at the agency level to the attention of the National Council.

Evelyn

February, 2010

As the New Year started, Americans are hopeful that it will be a better year economically and reverse the recession we encountered last year. Only Mother Nature knew that another devastation will affect us once more. The earthquake that hit Haiti and the loss of many lives deeply affected many Americans. Although it did not happen in this country, almost everyone are willing to help and support the Haitian people. Our own nurses went on a compassionate and helping mode and many started volunteering to be deployed. Many were willing to give uptheir own time for humanitarian reasons. NAGE together with SEIU Nurse Alliance per a special request from the White House started coordinating with the International Medical Corp and Partners in Health in deploying nurses to Haiti. Our effort was met with resistance and non support of the VAMHCS management. It was so disheartening and I don’t have enough words to express my disappointment with the employer we work for. NAGE with the support of our dedicated members will continue to support and uphold our compassionate and humanitarian nature no matter what adversity hinders us.

Evelyn

December, 2009

As we approach the conclusion of the year 2009, I would like to extend my sincerest gratitude to all our members who continue to believe and support this union. It has been almost 3 years since I became the President of this union, and I can’t remember a day that it was not a challenge.

A challenge that I believe it’s worth fighting for, knowing that the fight will champion the rights of our nurses. Along with me are Jim, Manny, Joyce and Dee, our dedicated and hardworking executive board members. With their support, patience and perseverance, I believe we are a much stronger union today. As we enter a New Year, I continue to hope that some of our wishes will come throu

I Wish You, Your Family and Loved Ones “ A VERY HAPPY HOLIDAYS and A PROSPEROUS

NEW YEAR”.

Evelyn

NOVEMBER, 2009

As we look around us, we notice a different palette of colors of lush yellow, red and orange. A chilly and crispy morning air signifies that autumn has finally arrived. This dramatic change suggests that an important celebration is coming. Most of us are looking forward to this special time of the year that brings the joy of family gatherings and catching up with happenings in our busy life.

Work is always not too far away from our mind even as we enjoy these yearly festivities. Changes are continuously dominating our work environment. There will be many changes in the VAMHCS as we start the year 2010. For a start, the Dimension of Nursing Practice has been collapsed from 9 dimensions to 4 and due to start in January, 2010. The new dimensions are Practice, Professional development, Scientific Inquiry and Collaboration. In reality, the other 5 dimensions did not go away but simply incorporated within the new 4 dimensions. Another change is in our Outpatient Clinics. All outpatient clinics will be redesign for a Veteran –Centric healthcare model and infrastructure to help veterans navigate the healthcare delivery system and receive coordinated care. This process is being started in the Baltimore Primary Care Clinic and will be expanded to the other outpatient clinics within the VAMHCS. There will also be an implementation of a new flow sheets that will help in patient assignments and level of care. An Electronic hand Off communication are being piloted in some VA facilities and will be evaluated for implementation . Another VA initiative is the installation of lifts in every patient’s room to prevent injuries to our nurses and other medical help. As changes occur within the VAMHCS, NAGE has been actively conscientious in protecting the rights of our bargaining members.

As we approach the end of the year 2009, let us remember the many blessings we have received throughout the year.

HAPPY THANKSGIVING TO YOU AND YOUR LOVED ONES!!!!!

Evelyn

October,2009

After World War 11, Congress created the Title 38 personnel system to hire medical professionals to treat the returning soldiers. In 1978, Congress passed the Civil Service Reform Act (CSRS) identifying the VA medical professionals covered by this reform act.

For several years following the enactment of the CSRS, it was the shared belief of the VA, unions, and FLRA that the VA had a duty to bargain with the unions on the conditions of employment for the VA medical professionals. In 1991, due to a court ruling,Congress enacted Section 7422 to provide the VA medical professionals with essentially the same Title 5 labor relations rights held by other federal employees. Under the 38 U.S.C,section 7422, covered VA medical employees such as the Registered nurses,doctors,anethetists, dentists and etc. can negotiate,file grievances and arbitrate disputes over working conditions excepts "any matter or question concerning or arising out of the following:

a) Professional competency or conduct ( direct patient care or clinical competency)
b) Peer review,
c) establishment,determination or adjustment of employee compensation

The legislative history made it clear that Congress viewed " Direct patient care" as medical procedures not issues that affect the veterans indirectly such as implementation of CWS, pay scale, unsafe patient to nurse ratio and many other issues that is being viewed by the VA medical professionals as unfair treatment. VA management has interpreted these exceptions very broadly and refuse to bargain anything related to working conditions.
In the last few years, bargaining rights of the Title 38 employees basically disappeared due to non support of the reigning administration.
In 2009, there has been an increase interest from the new VA Secretary to get the VA management and the unions to start talking and clarifying the true intent of the Congress when this law was enacted. Through Labor National Partnership with VACO, a Work Group was formed to work collaboratively and formulate recommendations to the Secretary of Veterans Affairs that will improve knowledge, understanding, and consistent use of 38 U.S.C section 7422. NAGE believes that with the support of Secretary Shinseki, VA management is willing to work with its labor partners to eliminate even the appearance of bias or inappropriate use of the 38 U.S.C.& 7422 exclusions.

The work group is schedule to meet this month and NAGE is being represented by Jim Barton, Vice-President of Local R3-19.

Evelyn

AUGUST,2009

NAGE R3-19 Local Executive Officers and the VAMHCS Chief Nurse Executive
and her deputies meets on a quarterly basis to discuss issues and concerns of our Collective Bargaining members. Most of these concerns were previously discussed with their respective Nurse Manager and Associate Chief Nurse Executive without any clear resolutions to the problems.
On July 8th a meeting was held and here are the few concerns discussed:
Management at Perry Point attempted to discontinue the compressed tours in some
units. After filing a grievance, a mutual agreement was reached wherein the 10 hour tour will not be utilized at this time and compressed tours are limited to a combination of 12 and 8 hours shift. This will be more beneficial in delivering a safe and quality care to our veterans.

DFAS, the new payroll system, is problematic especially when there is a corrected time card. It takes a few pay periods and as much as 6 months to correct it. Management is still trying to figure out how to fix this particular problem.

Short staffing remains an issue all over the VAMHCS and lately, NAGE has been getting many calls that it is unsafe to practice nursing due to shortage. A couple of years ago,
nursing was allocated 100 positions and they were filled . At present, nursing service has a vacancy of 30-40 FTE and rising.
Job dissatisfaction is also in the rise. NAGE is concern that management is not doing enough recognition for the nurses dedication and commitment. The alternate work schedule of 36/40 was also mentioned and NAGE is encouraging management to pilot it in some units.

VAS Tech/ Lawson, a computerized self scheduling was being piloted in Baltimore and Perry Point. A software problem occurred and the system was out for a few weeks. There is not enough data to evaluate the effectiveness and efficiency of this new initiative.

NAGE is also concern that there are a few Nurse Manager positions that are vacant and the positions are not posted. The CNE assured the union that management will recruit for these vacant position as soon as possible.

As VAMHCS started their journey to Magnet Status, NAGE is hoping that management will be more receptive to the needs and concerns of our staff nurses…...

" To have a Safe and Best Working Environment in delivering care to our Veterans"

Evelyn