Happy New Year

While our 2023-2026 contract is being finalized, here are some of the highlights taking effect in 2024:

• April 2024, wage raise of 4.5% (this is in addition to your 2024 anniversary month step increase).
• NEW to Rest Between Shifts – Effective 3/31/24, RBS premium of 1.5x will apply to the entire subsequent shift with different rest requirement shift lengths applying.
  Shift Length    Rest Requirement
  8                        11
  10                     10
  12                       8
• Effective January 2024 - Safe Staffing Premium.  $5/hour if a nurse has a patient assignment in excess of the staffing standard in the state-submitted staffing plan for two continuous hours, the nurse receives the premium for all hours worked.
  
  Charge Nurse: if the employer decides the charge needs to take a patient assignment or an additional charge assignment (on units with 2 charge nurses), the employer can either remove the charge assignment or the charge is eligible for the premium for time worked with a patient or second charge assignment for 2 continuous hours
  
  NOTE: Premium will not be paid as a result of unscheduled absences (WA-Sick and planned FLMA excepted)
• Callback Effective first full pay period following 3/31/24, Nurses will receive a minimum guaranteed payment of 3-hour period *each* time a nurse is called back (that is, the 3-hour payments are “stacked”).
  
  Break Nurses
  • Effective 5/1/24, the break buddy system will not be the primary method of providing break relief and will only be used as a last resource. Specifically, the break buddy system will be a last resource to ensure meals and breaks are provided on a unit, as defined in the unit’s meal and break plan.
  
  • Unit management with input by the bargaining unit staffing committee representative will create a meal and break process for their unit.
  
  • Break relief nurses shall have similar skills, scope, and competencies and shall not have a patient assignment.
  
  • Units who select to use flex RNs for meal and break coverage may continue to do so as part of their unit meal and break plan.
  
  • Plan(s) shall be submitted to the hospital staffing committee no later than April 1, 2024 and shall be reviewed during the April 2024 staffing committee meeting for its approval.
  
  • Upon approval by the staffing committee, or effective May 1, 2024, leaders shall implement the meal and break plan(s).
  
  • If a unit misses more than 20% of breaks during a quarter, or is utilizing the buddy system or flex nurses more than 20% of the time, the HSC will review to determine if there are systemic issues on the unit leading to these problems. HSC can make recommendations to the unit on how to meet the plan.
  
  Staffing.
  No implemented team nursing or any other change without going through the Staffing Committee.
  
  All units will have a free charge RN and many will have flex nurses as well. These additional and current positions will be applied to the 2024 staffing plans
  
  ▪ The Hospital will present any proposed changes to any staffing care model (i.e. team nursing/an integrated care model) to the HSC in accordance with the staffing law, RCW 70.41.420.
  
  Note: The Integrated Care Model is currently being trialed on part of 7 Dally. Weekly team meetings are taking place as this model is being trialed. Monthly updates are communicated with the Staffing Committee. 
  
  Currently:
  • Med/Onc will continue to maintain a flex RN.
  • Post Surgical/Ortho-Surgical will continue to maintain a flex RN.
  • Observation will continue to maintain a free charge nurse.
  • PCU will continue to maintain a flex RN.
  
  No later than 6 months after ratification (by 12/29/23):
  • Observation will get a flex nurse.
  • Inpatient Rehab will get a flex nurse
  • NICU will get a free charge nurse who will also be the receiver and can assist with providing meals and breaks.
  • START will get a free charge nurse who will also provide meals & breaks
  
  Note: Not all units have been staffed according to this plan; however it is a work in progress and as staffing levels improve, these free flex and free charge assignments are to be fulfilled.

You can view a copy of the contract highlights on this page.

Conference Committee Meeting Highlights December 21, 2023

WSNA Officers and Nurse Rep meet with Nursing Leadership and HR once a month to discuss current issues.

1. RMC Challenges. We continue to bring up issues with RMC such as denying open shift availability; then paging out open shifts an hour or two later.

Lack of effective communication with RMC and the House Supervisors and Charge Nurses. CNE Kristi Hartway has acknowledged the problems and states there is a plan for improvement.

1. Healthy At Work and Well Beats.  It had been announced to staff that these programs are sunsetting. We inquired about the contract language. Nurses will have the option of participating in a MultiCare sponsored Wellness Plan. Those who choose not to participate will be subject to health insurance premium surcharge. MultiCare will maintain minimally a $30/month discount benefit to premium through the life of the ’23-’26 Collective Bargaining Agreement. Our Labor & Employee Relations Manager is aware of this and is currently working on this issue. New program coming in January 2024 is called Support Linc.
2. Mandatory Call-Back in the Family Birth Center. WSNA asserts that if management sends nurses home due to low census, they cannot mandate them to go home on Standby (in units where Call and Standby are not requirements of employment).  The nurse may volunteer to be on Standby with the possibility of being called back in on Standby-Callback Status 1.5X pay. Leadership agreed that if there is assistance needed in-house, nurses may volunteer to be helping hands, do regulatory audits, or do educational requirements as opposed to being sent home on low census if they desire.
3. Staffing units per contract requirements. CNE Kristi Hartway says it’s always the goal to follow the contract; but currently we don’t have the staffing numbers. When we can do it, we will do it.  Kristi believes we should always have a free charge and ideally a free flex too.

Staffing Committee Meeting Highlights December 21, 2023

7 Dally Pilot Update - Have been trialing 2 pods of 6-8 patients, utilizing RN,LPN and CNA team. Plan to expand trial to 3-4 pods with the hopes of bringing in the virtual nurses for added support. Good Sam leaders and 3 Staffing Committee RNs visited MultiCare Deaconess hospital in Spokane in early December to visit with staff there who have been utilizing the Integrated Care Model. They felt they got honest feedback from the staff; many of whom expressed anxiety about the model initially, but as the kinks got worked out, felt positive about the new model. They say the virtual nurses help a lot with admissions and discharges.

2024 Staffing Plans - HPPD (Hours Per Patient Day) were presented for each unit, along with the contractual requirements for free charge and free flex. The matrices were not broken down, as that will be the mission for each Unit Based Staffing Committee. The voting members of the staffing committee approved the 2024 plan with the exception of the newly combined 5 Dally CVICU/MS ICU who still need more discussion on staffing needs on this floor.

ADOs - Assignment Despite Objection. Leaders reviewed their Staffing Complaint Forms from November/December. The plan will be for unit based staffing committees to review and follow-up with their ADOs and report out to the Hospital Staffing Committee each month.

Questions/Comments, feel free to contact one of your WSNA Officers or Nurse Representative Janet Stewart jstewart@wsna.org.