Front row L to R – Stephanie Reid-Harden, Terry Leone, Sue Clements, Betsy Nulty. Second row L to R:
Alice Knittel, Gary Peoples, Rachelle Kozak and Carol Harrison. Missing from the picture are Mary Mansfield
and Kathy Boardman who were also on the Negotiating Committee.

Updates

Safety/Security Update

June 23, 2010

For the past several months our Union Safety Committee has been meeting with Management, Security and even the Philadelphia Police Department to improve the safety and security of Episcopal patients and employees. There has been lots of talk, but little concrete action for all of our efforts. Interestingly enough, we are not the only ones concerned about violence in the workplace. JCAHO, which is the final word on everything sacred in the hospital, is worried, too. On June 3, 2010 the Joint Commission issued a sentinel event alert entitled, Preventing violence in the Health Care Setting. Management may have placed this information in your mailbox on your unit. Take time to read it. It is almost as if JCAHO attended our meetings.

Of special interest is that the most frequently identified contributing cause of violence in hospitals over the last five years is Leadership, noted in 62% of the events, most notably problems in the area of policy and procedure development and implementation. Would you be surprised to learn that Temple does not have a violence prevention policy? Or that it's not written anywhere that there is a Zero Tolerance for violence? JCAHO would surely be disappointed in Temple, so as a union, we will do our best to help Temple reach JCAHO expectations. One way we can do that is by working with Temple to write violence-prevention policies and procedures and we will be asking Temple to meet with us to begin this process.

Another step we can take is reporting incidents of violence. During negotiations we were reminded of that old nursing adage: "If it isn’t written, it wasn’t done." In this case if it wasn’t documented, it didn’t happen. We are asking our members to help in the fight for a safe workplace by consistently documenting incidents of physical violence and verbal threats. On each unit we have the ability to file a MIDAS report that goes directly to risk management. We are also developing a union form for reporting violent incidents.

Members should also be aware that in the process of achieving a safer environment, policies may change or be more strictly enforced. Our committee has been working with management to develop new visitor passes for the ED that would limit the number of visitors and restrict access to the treatment areas. Issues with cell phones and other recording devices have also been discussed, but prohibiting cell phone use in patient care area will affect the staff as well.

We need all of our members to participate in improving the safety of our workplace by doing the following:

• Notify your manager/supervisor and fill out a MIDAS for any incident of violence
• Follow up at Industrial Health Services (IHS) at Episcopal or Temple if you are injured on duty
• Communicate with the police officers who are now signing a log in the ED once a shift. Developing a good working relationship may improve response time.
• Call security to intervene in the case of violent or threatening behavior.

Union Safety Committee Meets with Director of Nursing

June 9, 2010

On June 2, 2010 the Union Safety Committee met again with Director of Nursing, Barbara Gennello to continue the discussion of safety issues at Episcopal. The following are highlights of the meeting.

• Barbara Gennello invited Edgardo Jaminola, RN, MSN, Episcopal Clinical Psychiatric Nurse Specialist to the meeting to speak on applying the principals of early violence interventions. Edgar has an active role in our ART classes, but his role has been expanded to orientation in the CRC in order to understand the complexity of patient care and a safe environment. (5/2010 an In Service on Predictors of Violence hand out was given to CRC staff)
• A Protective Shield and the Green Posey Blanket are in the CRC. Edgar has provided an In Service to CRC Staff on the use of these protective devices. Doris Quiles, Director of Behavioral Health, has a special group looking into protective devices. Edgardo noted that the protective shield is for light objects being thrown. If one uses the shield for heavy objects, the one holding the shield may be injured. The tendency of the shield is to tilt back towards the head of the person holding the shield.
• ED/CRC needs to involve the physicians with managing the violent patient. Physicians’ involvement is needed to determine if the violent patient is to be medicated or discharged. There are too many incidents of physicians attempting to remove themselves from a violent situation while abandoning the nursing staff in unsafe situation.
• Controlling a safe environment is the role of Security. Often times the responsibility of maintaining a safe environment is being placed on staff and not security. Potential for violence is at the highest level at both points of entry (ED/CRC) into the hospital. In the CRC, the previous responsibility of the security guard has shifted to the nursing staff.
• CRC staff is mandated to leave the CRC for long periods of time as they escort discharged patient to the main lobby. The question remains: why is CRC staff responsible for controlling the environment in the lobby once a patient has been discharged from the CRC? The individual is no longer a patient and any inappropriate behavior in the lobby should be handled by security.
  CRC staff also has a new responsibility of completing the belongings sheets with staff from the inpatient units with all new admissions. CRC staff may be off the unit for up to 30 minutes for escorting responsibilities.
• Management noted that four new security guards have been hired. New security guards will have special training in violence intervention. Training may include the carrying of handcuffs. Management is asking for the Safety Group to provide a list of expectations for new security guards. New security guards will also be trained in Customer Services. All at the meeting agreed that our current Security Guards are excellent with the role of customer service, but there needs to be improvement in the primary role of controlling and maintaining a safe environment.
• Episcopal Campus should have a Zero Tolerance Policy for Violence. The following items were noted: Educating the patients, families and visitors that violence will not be tolerated; Request for charts to be flagged if patient has a history of violence towards staff; Staff ID without last name; Signs posted with rules of conduct for patients/visitors; Over head announcement regarding a Violence Free Zone and rules of behavior; Security guards at ED/Lobby with a record of names and photos of patients who assaulted staff; Reminder that patient’s being seen in ED/CRC may have a criminal history and could be fugitives.
• On 5/23/2010, at time of discharge, CRC patient punched security guard. Guard suffered a laceration inside his mouth. 26th Police arrived two hours after the incident. Once police arrived, they were not supportive towards hospital staff. Nursing Supervisor was present and supportive towards staff.
• Phone Company contacted for installing new Safe phones in CRC.
• On 6/2/2010, ED suffered an assault from a patient.
• Meetings will begin for Behavioral Health Nurse Managers and Physicians for improving safety on the units.
• Request for stronger involvement from ED/CRC nurse managers.
• Union has requested to review Security Management Plan and Annual Security Assessment. Also requested OSHA 300 log and the OSHA 301 log for the past three years. Management noted that by 6/15/2010 requested information will be presented.
• Noted that Episcopal Campus has more staff injures than TUH’s Main Hospital. Episcopal Campus staff also has more career ending injuries in comparison to the main campus. Contributing factor may be the presence of Temple Police and a higher level of security. Continues request for Temple Police to assist Episcopal Campus.

Union Fights for Zero Tolerance for Violence

May 19, 2010

The recent violent attack on one of our members, Gary Peoples, has strengthened our resolve to address the safety/security problems that plague our campus and to push for real action NOW. This attack came only a few short weeks after a mental health worker was beaten, fell and lost consciousness. The level of violent behavior continues to escalate as criminal behavior is being treated as mental illness. We have come to believe that dealing with violent behavior is part of our job. NO MORE! It is time for management to issue a zero tolerance for the violent behavior of patients who are not suffering from a real psychiatric disorder.

During contract negotiations we asked to have a Temple police officer stationed on our campus – someone with the authority to intervene in the case of violent criminal behavior.
Temple said “No.” Instead they agreed to form a labor/management “study group to identify problems and to propose solutions.” The group has met, problems have been identified and recommendations have been made to the Associate Hospital Directors. Management has responded too, in a mostly positive manner, but we have yet to see the concrete changes that need to happen. We need action now before another staff member, a patient or a visitor is seriously injured.

CRC/ED WORK GROUP: MANAGEMENT RESPONSE TO RECOMMENDATIONS

May 13, 2010

On Friday April 29, 2010 union representatives of the CRC/ED Work Group, Betsy Nulty, Gary Peoples, Mary Mansfield and Joyce Winfelder met with Associate Hospital Directors Tim Ward and Luanne Kline. The purpose of the meeting was to hear management’s response to the recommendation made by the labor/management work group to improve safety and security in the ED and CRC.

Mr. Ward responded to the recommendations as follows:

• TUH does not presently have a Workplace Violence Policy. Barbara Gennello, Assistant Hospital Director of Nursing, will be working with Sally Dillon, TUH ED manager, to develop ED policies on violence. Once policies are developed they can to tailored to meet the needs of the CRC and behavioral units.
• Employee ID badge to exclude last name: Management has requested an exception from JACHO to exclude last names since Episcopal is primarily a psychiatric/behavioral facility and as such would be eligible for such an exception.
• The work group has already met with Captain Cram from the 26th Police district to improve communications and response time from the police. The Captain has already initiated a log book in the ER for officers to stop in and sign once a shift. Captain Cram requests a “quid pro quo” and requests that patients who are in police custody be seen as quickly as possible so the officers can get back on the street. He also promises a quicker response to problematic CRC patients who refuse to leave the hospital premises after they have been discharged. 911 calls from the 911 must be explicit, eg. 'Assault on staff'.
• We do not have Temple police and therefore do not have the same level of security. A higher level of security at present would mean the use of handcuffs which upper management will not approve at this time.
• David Kisella, Security Director, will continue to stress to security staff the need to round in the ED and address potential problems and to monitor who enters the ED (patients must have ID bands and family members must have visitor passes). There will be a follow up meeting on 5/14/10 to determine when and how many visitors will be permitted to patient rooms. Dave will also be responsible for the posting of visible signs prohibiting photos, videos or recording devices. New cameras are being installed in the ER with improved resolution.
• Patients who have been brought in by Fire Rescue will be “wanded” by security after triage and nursing assessment.
• Management is looking at the possibility of TVs in the ED patients' rooms to occupy patients while they are waiting to be seen by a physician.
• Management recognizes the space restrictions and potential dangers of visitors in the CRC. ED security will communicate with the CRC staff for permission to send up family members/visitors with the patient.

Local 5106 comments on the strike at Temple University Hospital.

Read More

ED/CRC Safety-Security Work Group

March 2010

During contract negotiations, our team fought for better security especially in the high risk areas of ED and CRC. Part of our contract settlement was the establishment of a labor-management “work group” that would identify problems in these two areas and offer solutions. At a recent meeting, union representatives, Betsy Nulty (ED), Gary Peoples (CRC), Joyce Windfelder (CRC) and Mary Mansfied (ED) discussed the following issues with management representatives, Barbara Gennello (DON), Dave Kisella (Director of Security), Lisa Broious (ED manager) and Jay Johnson (CRC manager). The information was then presented to Associate Hospital Directors, Tim Ward and Luanne Kline. The AHDs will respond within thirty days.

1. Develop guidelines for workplace violence prevention on the Episcopal Campus
2. Develop a “zero-tolerance” level for abuse and harassment towards employees, patients and visitors
3. Develop a working relationship with the 26th police district, providing the hospital with priority status if assistance is required
4. Provide Episcopal Hospital with the same level of security that is provided at Temple University Hospital
5. In both the ED and CRC, post “acceptable rules of behavior” for both visitors and patients. Install an electronic advertisement board to inform patients/visitors about unit specific rules and what behaviors will not be tolerated.
6. Increase involvement of nursing supervisor during violent incidents and negative interactions between staff and visitors/patients
7. Increase the “level” of security provided by the security department. If this is not possible, change the security provider to a different company.
• Guards need to have a “police mentality” instead of a “meet and greet” mentality
• Provide an armed guard at the ED entrance
• Increase the number of guards assigned to the ED and CRC
• Develop a structured orientation for guards including written policies for the unit/area where they are assigned
• Allow guards to have a “hands-on” approach if needed
• When guards are performing inspection of the ER, truly roam through department instead of fraternizing and “just signing the book”
8. Change employees badges to contain the employees first name and last initial
9. Specifically in the ER
• Enforcement of the visitor policy by both staff and security
1. No more than 2 visitors at a time
2. Must remain in the patient’s room
3. Must have ‘visitor’s pass’
4. No children under age 18
• Enforcement of the cell phone policy
1. No cell phone use by either staff, patients or visitors
2. Post signs that prohibit cell phones or other recording devices (i.e. Cameras, recorders)
3. Visitors using cell phones will be asked to return to the waiting room
• Security will not allow patients/visitors to verbally harass staff at doorway to either treatment area or triage door.
1. No loitering outside of treatment area or triage
2. Patients will not be permitted to wander into the treatment area to inquire how much longer he/she will have to wait to be seen
• All patients who arrive via fire rescue will be “wanded” on arrival to the treatment area
• Provide TV’s in each patient room to keep patients occupied while waiting
10. Specifically in the CRC
• a. Involve nursing supervisor in all administrative discharges (patient refusing to leave hospital)
• b. Develop a standardized, specific, flow sheet for guards when searching possessions for both 201 and 302 patients
• c. All patient searches must be completed by security.
• d. Female CRC staff members will not perform searches
• e. Provide the CRC with an attending physician 24/7
• i. Discharges can be done at any time of the day or night
• ii. Residents do not have the ability to complete discharges without attending approval
• iii. Standard of care in other CRC’s
• f. Increase the number of guards in the CRC
• g. Patients must wait for discharge paperwork completion before being discharged
• h. Nursing supervisor to complete Stat 13 record
• i. When a patient who refuses to leave the hospital is discharged, ensure that the patient has left the hospital grounds
• i. Patients are currently only removed from hospital, but still linger on hospital premises
• j. Improve Philadelphia police department involvement for criminal behaviors

To all of our members,

We knew going into negotiations this time that it would be a real challenge. We saw the “Last, best and final” offer that Temple made to the nurses and techs on the main campus: No pay raise the first year; 2% the second and third years of the contract; the same medical plan options as ours but with much steeper increases in employee co-pays, and give-backs of benefits that our members have never had. The Temple nurses and techs continue to work under their expired contract while they decide their next steps. Read More

Contract Ratification

On Friday, Feb. 19, 2010 sixty-eight nurses and techs attended a general membership meeting to hear the terms of the new agreement and to cast their votes for or against it. Both contracts were overwhelming approved. The Tech vote was 24 yes; 0 no; The RN vote was 40 yes; 4 no. Members received a summary of the agreement at the meeting or in the days following the vote. New contracts will be printed and officers and reps will distribute them to the members as soon as they are available. Read More

Review Your Benefits

As the new contract takes effect, it is a good time to review your benefits and to verify that you have what you need to protect yourself in the case of a short term disability, long term disability or even retirement. Read More

Ask your Union Rep

If you are out on a medical leave how long will Temple hold your job? Read More

Newsletters

The Frontline Newsletter - July 2010
The Frontline Newsletter - May 2010
The Frontline Newsletter - March 2010
The Frontline Newsletter - January 2010

Local Officers List

President - Elizabeth Nulty
Vice President - Sue Clements (RN Unit); Isaac Gary Peoples (Tech Unit)
Secretary/Treasurer - Carol Harrison
Grievance Chair - Sue Clements (RN Unit); Isaac Gary Peoples (Tech Unit)

HPAE Staff Rep - Sue Clements (215) 335-1140
HPAE Support Staff - Lorraine Loiacono 201-262-5005 ext. 123

Officers and Representatives