Break Nurse Update

Recently, we have heard a lot of excitement and concerns about the break nurse positions being implemented at St. Joe's, so we would like to take some time to talk to everyone about the program that the hospital is initiating and how it will work with our contract.

Why are they considering break nurses right now?

The new staffing law that went into effect last year calls for hospitals to ensure nurses are able to take their breaks at least 80% of the time, or the hospital will face financial penalties. PeaceHealth has taken some steps to ensure compliance with this law, like the break sheets we talked about in the newsletter last week. Break nurses are an excellent way to ensure the "break buddy" system is avoided and to make sure there is adequate staffing during peak break times. However, the hospital began posting positions without speaking to the union about it first and started planning for four- and six-hour shifts to be part of the program, which are not allowed in our contract. Our contract allows shifts to be 8, 10 or 12 hours. The hospital is required to bargain with the union before they implement alternative shift lengths.

Why would the union be cautious about four and six hour shifts?

If you work five days a week at four hours a day, you end up with a .5 FTE. You need to work at least 40 hours per pay period to be eligible for the employer to pay a portion of your  health care benefits. However, the employer is proposing the creation of FTEs below .5 for this program. This allows them to avoid paying benefits. Per Diem nurses receive a 15% premium in lieu of benefits. The break nurses below a .5 FTE would not be eligible for this premium. We do not want to see nurses losing their benefits without receiving additional compensation in return.

The hospital has also not clarified whether they intend to hire these nurses under the 12/40 hour rule or the 8/80 hour rule, which will affect your ability to earn overtime. If you are hired until the 12/40 hour rule, you must work over 12 hours on a single shift to be paid overtime. If you are hired under the 8/80 hour rule, you earn overtime after working more than 8 hours in one shift. The hospital has been moving towards 12/40 for all their new hires, and we doubt they intend to change that stance for break nurses. That means that break nurses would only acheive OT if they worked for over 12 hours during one shift, or worked more than 40 hours in a week. This sounds like a way for the hospital to avoid paying overtime.

Is this program permanent? What happens if they decide it isn't working?

The hospital is implying that this is currently a pilot program but there are no protections for the nurses who may apply for these positions. They are currently posting the eight- and twelve-hour break nurse positions as "variable" with no mention of the role in the job posting. "Variable" has not been defined in the listings or in job offer letters as referring to your hours, your schedule or your shift (days, nights or evenings) which means the only thing you "own" and control is your FTE. That means that the hospital can decide to take you out of the break nurse role at any time and schedule you for regular shifts on your unit with no protection for which shift you will work and whether you will work on a regular pattern on that shift.

They do not intend to give the nurses hired into these positions the title of "break nurse". They consider being a break nurse an assignment, treated the same as a patient assignment for other nurses. This means that there is no protection for the break nurse from being pulled into the count if the unit is short staffed or floated to another unit that is short staffed. Being hired as a "variable" nurse means that there is no protection to ensure your start and stop times stay the same, or even stay on the same shift. A day shift nurse hired into a "variable" break nurse position can be forced to move to a night shift position at the hospital's whim.

Without the protection of this nurse having a separate title/position from other staff nurses on the unit, there is nothing stopping management from pulling a staff nurse from their patient assignment to be the break nurse, and then sending them home early once the short shift is done. This can lead to patient assignments going through multiple shuffles during a single 12-hour shift, which is dangerous for patient care and a nightmare for the NTL. If the unit is overstaffed and has a break nurse scheduled, who will be called off? Will the break nurses be included in the low census rotation, or will they be considered separately? If a break nurse is on vacation, who will cover their shifts? Will there be float pool break nurses? Do the break nurses count towards the staffing matrix? The hospital has no answers to these questions right now. This will affect all nurses on a unit, not just the break nurse.

What has happened so far and what happens next

The hospital began discussing four- and six-hour positions with the staff nurses before they took the proper steps to notify the union and request that we bargain over the terms. The contract must be amended through a Memorandum of Understanding (MOU) to allow them to proceed with this plan, and they know it will take months and a full member vote to allow for these kinds of changes to happen. They knew that getting nurses excited about these positions without disclosing the negative ramifications would put pressure on the union to give in to their demands without ensuring proper guidelines and guardrails are agreed to prior to implementation. We will not let the hospital post 4- and 6-hour shifts in violation of the contract. We will not be rushed into negotiations over this issue without thoroughly considering the potential negative consequences to our members.

Your local unit officers have met with the hospital to discuss their proposal but have not received a formal request for negotiations at this time. We welcome your feedback on this issue, including your concerns about how these shifts may affect you and your unit. We are truly excited to see an effort to address the need for you to get all your breaks in a timely and safe manner. We want to ensure that the program is given the absolute best chance of success by ensuring you are protected in your role, whether you decide to apply for one of the new positions or want to remain in your current position.

Want to chat with your rep in person? Cafeteria Time Next Week!

We will be hosting our NOC edition of Cafeteria Time on Tuesday, August 20 from 1700 - 2000. Come grab some swag, candy and enter to win a gift card to Fred Meyer! Your WSNA nurse rep will be present along with some of your local unit officers to answer questions and hand out t-shirts to members who have not received theirs yet (smalls and mediums are still out of stock but should arrive in time for our Kickoff Party on September 19).

Contact Grace Chesterman, WSNA Nurse Representative (gchesterman@wsna.org) or your local unit officers if you have questions.