October 2021, I was informed by J. O’Dea that the hospital intended to reorganize CVICU & MSICU into one unit. Their stated reasoning was …” that it was to improve our ability to offer high quality, safe patient care to those patients currently cared for in the MSICU and CVICU, and to improve both patient and team member satisfaction…”
HPAE sent an information request regarding the reorganization. Included in the request was the orientation plan, which once received proved to be inadequate. Subsequently we requested a meeting and discussed with O’Dea the major impediments to the reorganization, i.e.
- Totally different specialties
- Inadequate orientation
- Forcing nursing staffs into areas that they had no interest in working
- The high turnover rate in both units
It was suggested that the hospital seek volunteers to cross-train to both areas. Mr. O’Dea’s response was ‘…the decision to reorganize the MSICU and CVICU into one ICU and do not plan to discuss alternatives to reorganization at this time.”
Nurses in both units have written to and spoken to all levels of management to no avail. Representatives came to JNPC to speak to the issue, with no avail. I, on behalf of the staff, have requested innumerable meetings with Kathy Kaminsky, to no avail. The turnover rate continues to rise. The orientation is severely lacking and the safety of nurses and patients is at risk.
I have held several ZOOM meetings with CVICU & MSICU nursing staff since October 2021. All written memoranda on the reorganization have been shared with the nursing staff of both units.
RECENT ACTIONS TAKEN
HPAE has filed a complaint with the Department of Health (DOH). DOH regulations call for “….a cardiac surgical intensive care service or recovery room dedicated specifically to patients from the cardiac surgical services.” DOH regulations also call for a proper plan for staff education, orientation of new staff and evaluation of such.
HPAE has provided the DOH with the orientation plan, task checklist and schedules.
WHAT THE STAFF NEED TO ADDRESS when investigators come to the unit.
- Patient flow of the unit
- Speak to orientation process
- Consistency of orientation or lack thereof
- Consistency of preceptor or lack thereof
- Preceptor – number of orientees at one time
- Preceptor – EH staff or agency
- The knowledge behind the tasks
- The performance of the task
- Verifiable documentation that the nurse possesses the skill and education to treat the patient.
HPAE has also filed a complaint with the Board of Nursing and Consumer Affairs. The role of the Board is to protect the public of this State. The Board will hold nurses to their professional and ethical responsibilities and to the social contract which their licenses reflect. Both these agencies are only concerned with the safety of the public. That is the focus of HPAE’s complaint.
WHAT STAFF NEED TO ADDRESS if the Board calls for a hearing is your concerns for the safety of the patients as the orientation is not adequate and fragmented which will negatively impact patient safety.
Just to be clear – EH has the right to reorganize units (contract 5.06). Union’s responsibility is to enforce the contract. Part of that enforcement is to look at alternatives to the reorganization and the orientation process. EH is unwilling to look at alternatives and is providing an inadequate orientation process.
I understand your frustration and even feelings of helplessness. HPAE has provided you with your licensure responsibilities under the Nurse Practice Act. These are the standards which govern your practice. It’s understandable how difficult it is when faced with the pressure by management, to be ‘flexible’ and to state your position. But that is what you must do. You must practice nursing according to licensing standards, not based on a feeling of belief that EH will protect your license.
Any questions, comments please contact me at firstname.lastname@example.org or 973-851-9487.
Alice Barden, President HPAE Local 5004