In this update:

• COVID update
• MOU
• Staffing Update
• Crisis Staffing
• Grievance Update
• Call Departments “Sting List”
• Kronos
• Coffee Hour
• Note from your Nurse Rep

COVID update

We are seeing effects of highly transmissible Omicron and increased numbers of patients who are testing positive on inpatient units. What we know is that the increased transmissibility means carriers are likely spreading unknowingly to others. The CDC has recommended N95 or KN95 for daily wear as the best protection, citing that protection is greater even than then level 3 surgical masks. Skagit has stated they have non fit tested N95 available for use and they have adequate supply lines to continue to provide this level of protection. Employees can be fit tested at anytime at Employee Health please see your intranet for hours of operation and how to arrange that.

Recently, the CDC and the Washington State Department of Health has issued new guidance in response to staffing issues that will permit COVID+ workers who are asymptomatic to work. Please note however that the ruling states clearly only if the nurse is WILLING to work in that status. Obviously, this was created for the benefit of staffing and not necessarily reflective of what is best for you as the worker. Please do what is best for your own health and the health of those around you when/if asked to come back to work early if you tested positive.

A quick note about PAPR and CAPR use. These forms of PPE at Skagit are verified to filter inhaled air and are great protection for the wearer. Please also be aware that the devices used at Skagit do NOT filter exhaled air. So, if the wearer is COVID positive, the PAPR or CAPR will not protect those in the environment from potential virus that is being exhaled by the wearer. Given this information, we have asked leadership if they are planning to implement a change in their PPE recommendations for use and are awaiting their reply.

In addition, however, PPE use must remain in Best Practice Utilization despite what staffing level the hospital is at (conventional, contingency or crisis staffing mode). Skagit does have a PPE committee that looks at burn rate, utilization and supply lines and meets monthly at this time so if any issues are encountered regarding PPE, please - in addition to following your internal reporting process - email your nurse rep who can address at the PPE committee meeting.

The MOU

We are pleased to report that the MOU negotiated with increased pay and extended to March 31, 2022 has been utilized with great frequency. We are also aware that staff from all departments are reaching out and signing up for MOU shifts house-wide. Please note that the MOU shifts are separate and distinct from bonus shifts. What’s the difference? Bonus shifts are contractual and may be offered to .6 FTE or greater at any time during the life of the contract. MOU shifts are strictly related to COVID staffing and are open to ALL staff including per diem nurses. Who is NOT covered under the MOU or bonus shifts? Travel nurses are NOT covered under the contract and therefore are not eligible for this pay.

It is highly recommended that each nurse obtains in writing verification of what their incentive pay will be whether bonus pay, or MOU pay. You can obtain that via text or email but have that on hand so that if payment is omitted for some reason, we have that verification as we attempt to recoup that money. If there are any issues, please contact one of your elected officers or your nurse representative.

Staffing

We are working hard and aggressively in tackling this issue within Skagit. We were able to secure additional money for the MOU extension. We have proposed to management a true retention bonus that would provide some monetary compensation to those employees who have worked through this pandemic. The proposal is under consideration currently.

Thank you for completing staffing concern forms. We recognize there will be many as we face this crisis staffing situation, but they do protect your license and provide valuable information the staffing committee can utilize to improve the staffing situation. We will be announcing new staffing committee members soon so please watch for that and look to see who is representing your unit on the staffing committee.

WSNA is actively working on passing house and senate bills designed to significantly improve staffing and the function of the staffing committee as well as improve accountability to hospitals to provide adequate staffing.

Pass Safe Staffing Legislation – Take Action Now

Text “WSNA” to 52886

House Bill 1868 and its companion Senate Bill 5751 call on lawmakers in Olympia to:

• Pass safe staffing standards that will protect us from dangerously high patient loads
• Enforce existing overtime and meal and rest break laws
• And hold employers accountable with enhanced enforcement mechanism.

Take action to pass our bill

Text "WSNA" to 52886 to receive the latest action and stay up to date on how you can help. From contacting your legislators to sharing information with your colleagues, actions take less than one minute and have a powerful impact.

For a detailed summary of the legislation use the link button below.

Crisis staffing

You have heard from leadership that Skagit is in a crisis staffing mode at present. The Washington state department of health has created a guide for hospitals to use during these times:

To their credit, Skagit has been doing some of these measures already including cancelling of elective procedures to allow staff to be utilized where the need is the greatest. Please note the contract provisions still hold true about orientation and training to units you do not normally work. It is absolutely acceptable to state “I want to help my co-workers and am willing to work but I have not been trained or completed competencies to perform XX or care for XX. Is there some other work that I may do?” Again, please reach out to one of your officers or your nurse representative for questions or concerns.

The document from the Department of Health calls out some very specific things to consider when in crisis staffing mode. It is reasonable to ask questions when told this information. Questions can include:

1. How does this status affect how we deliver care?
2. How and when has this been communicated to our patients and family members?

If you review the document, you will see that along with staffing assignments there is an expectation that duties will be decreased to allow nurses to continue to provide the care their patients need. That may be in the form of abbreviated assessments and documentation. That may also be in the form of non-medical staff performing duties within their skill set to assist i.e., runners or task assignments. It is not unreasonable to ask leadership what expectations they have communicated to patients and families regarding participating in their own care in this time of crisis staffing to help alleviate the burden on staff.

Grievances

Skagit is blessed with two outstanding grievance officers who represent you in matters where the contract has been violated. We have recently won in issues regarding incorrect pay and incorrect discipline imposed on nurses. Please remember your Weingarten rights! WSNA has new badge buddies which have these rights printed on the back – if you need one or even some to hand out to your co-workers, please let us know. We will get them to you. (Bonus: These new badge buddies also have a QR code on the back that you can scan, and it will take you immediately to the fillable staffing concern form to submit – slick and easy!)

It is critical that you “invoke these rights” when you are called into a meeting with your manager for discussions that may result in discipline. You have a right to representation at investigatory meetings and your officers are skilled at making sure you are represented well and fairly in those meetings. Also, to note, you may invoke these rights at any time in the meeting. So, if a casual conversation begins to feel uncomfortable, it is well within your right to ask about potential disciplinary action in accordance with those Weingarten rights and request representation. Please do not leave a meeting or refuse to meet as this can be interpreted as insubordination which is a termination level offense. However, once you have invoked your rights, you are not required to answer their questions without representation present and we advise listening and taking notes and clearly and calmly stating something like “with all due respect I decline to answer until I have representation”. Lastly but most importantly, reach out to an officer or your nurse representative as soon as you can so that we may assist you.

Call Departments “Sting lists”

WSNA was made aware of the presence of so-called “sting lists” within those departments who have mandatory pre-scheduled call. We have heard several explanations for this extra list that is designed to provide call coverage in the event a nurse has to cancel her call shift at the last minute. We do appreciate that call shifts are required to be covered by someone, however, management has multiple methods they can use to find this coverage. We do appreciate that leadership has stated they seek volunteers first and trust that is indeed the practice. We do not agree with the premise of mandating someone to pick up the call shift because they are next up on this sting list. We are currently still in discussion in our Nurse Conference Committee about this issue.

At our last meeting we heard that the list is posted in the department “so everyone can see who has volunteered for extra call shifts”. While I trust the intent is to be complimentary, this approach can also be perceived as potentially shaming especially if someone must make special arrangements and/or efforts to fulfil their call obligation and is not able to pick up these extra call shifts. Your team would love to hear your perspective on this. Please send an email to one of your officers or your nurse representative with your thoughts to consider as we continue to engage leadership on this topic.

Kronos

Skagit Hospice is currently doing a scheduling pilot utilizing the scheduling platform associated with Kronos. Hospice has not historically utilized Kronos and this was just recently implemented in their department for their timecards. Hospice staff were chosen to pilot the scheduling platform. Hospice is unique in all manner of ways and if there was ever a department where this would be successful it will be hospice. Management’s intention is to utilize this house-wide, but they have no plans to implement yet, and we were reassured at NCC (Nurse Conference Committee) that the hospice pilot will go for a minimum of 4 scheduling cycles and that they were planning on trialing in other departments and work out any issues before considering rolling it out house-wide

WSNA has some very real concerns with Kronos. We have uncovered instances of missed break options not even being offered to staff when they clock out. We have heard from Mark Young in payroll that the Kronos program “works absolutely perfectly” (direct quote) yet when we did an information request for one nurse in one department for 2 months only, we discovered that 53% of the time this nurse worked, a paper correction form was required and even then, was not always paid correctly. In addition, the charge nurse break sheet in this department which is supposed to be critical to demonstrate Skagit compliance with the rest break law was only completed 17% of the days this nurse worked. Of those completed, only 0.06% were completed correctly and thoroughly. This is exceedingly worrisome. Please contact us ASAP if you find in your review that you have not been paid correctly. And we will update everyone as we are actively following up on this issue.

Coffee Hours

A note from your nurse rep:

I have deeply missed seeing you all and connecting with you all one on one. My intention was to schedule out regular cafeteria times to allow people to drop by, have a chat, discuss any concerns, or answer any questions at least monthly. Then COVID hit and we entered the era of zoom meetings. Even new hire orientation has now moved to the virtual platform which has negatively impacted my ability to relate personally to each of you.

Last year, we trialed a New Nurse Coffee Hour. Often new hires have questions about various topics that come up during their first 1-2 years at Skagit. We have been scheduling small group get togethers at Whidbey Coffee on Marketplace in their little conference room.

This has been SO great for all of us! We have been able to meet, answer questions and connect. Special thanks to DeeAnn Wolf from the OR who graciously attends and goes through how to read your paystub (Lord knows it really is complicated to decipher at times) which has been reported to be quite helpful.

We will continue these get togethers through the year, so if you have a newer nurse on your unit be sure to extend the invitation to them. Currently the plan is the second Thursday of every month at 0800.

Not a “newer nurse” but want to attend? You are welcome! Please sign up at this link (so we can abide by capacity regulations with social distancing):

**Disclaimer** If the new nurses have not submitted for membership, we may not have their home email or cell phone on record, and they will not receive an invitation. Please steer them to contact me as they are most welcome at this event. And the coffee is on me!

Your officers and I are planning a local unit meeting soon and will likely extend that to two different time frames to accommodate the various schedules you all have. Please stay tuned for that announcement. At this time, it will by necessity be virtual. I would love to see you all. If you have any questions or would just like to connect, please shoot me an email and I would be happy to make the time for you.

Please pay attention to the staffing legislation information coming from WSNA. We need your support for these bills to pass. A simple email to your representative helps tremendously and helps even more when you personalize with your own story that will resonate with that legislator. You may receive an invitation to sign in support of a bill. This literally takes maybe 1-2 minutes of your time it is SO easy to do but holds tremendous power. Our house bill had over 1600 signature in support while the hospital association who is fighting this in a very big way only had approximately 600 signatures. This is noted and called out in the hearing and makes a big impression. We need more! Check back frequently on the legislation page at www.wsna.org for updates and information.

Many of you have talked, texted, or emailed with our WSNA Organizer, Annie Mansfield. Annie has been instrumental in organizing events and communicating with all of you. She has been the lead on our new hire orientation, and we couldn’t ask for a better welcome to the new staff. Annie is (unfortunately for us) leaving to pursue a new life with her fiancé in Maine. We are SO sad to see her go but at the same time very excited for her as well as very grateful for all she has done at Skagit. Your Skagit Peeps do love and appreciate you, Annie.

Lastly, WSNA is still planning an in-person event in Lake Chelan for our Leadership Conference April 24-26. Our theme this year is RESPECT. The agenda is super, includes highly acclaimed speakers and promises to be extremely informative and educational. As usual, it will be held at the Campbells Resort, and we have rooms set aside at special event rate. Remember, you have education funds you may use for this to offset the cost and we invite you to reach out to an officer to see if there are any local unit funds that may help with the cost to attend. And, we cannot overlook the fact that this is also an extremely fun event and a chance to connect with your nurse siblings from around the state. Further information and registration forms are available on the WSNA website. I truly hope to see you there!

In solidarity,

Liz Rainaud, MSN, RN ~ Local Unit Chair
Jessica Googe, RN ~ Local Unit Co-Chair
Miranda Setty, BSN, RN, ENP-C, CCTN~ Local Unit Secretary/Communications Officer
Rachel Yates, RN ~ Local Unit Treasurer
Abubaker Cameron, RN ~ Local Unit Grievance Officer
Cheryl Pedersen, RN ~ Local Unit Grievance Officer
Hannah Guy, BSN, RN ~ Local Unit Co-Membership Officer

Questions? Contact WSNA Nurse Representative Sue Dunlap at sdunlap@wsna.org.