Save the date: Next Local Unit meeting will be October 6 at Donni Heidenson’s beautiful home. Thank you Donni for your generosity in hosting our next Local Unit Meeting!

In this issue:

• Conference Committee Report
• Nurse Practice Committee Report
• WSNA-PAC
• Grievance Update
• Treasurer’s Report

Conference Committee Report

Kathleen Thompson, RN, BSN, CDCES, Local Unit Chair

January 2022

We shared your quality of patient care concerns, which nurses believe stem from too many patients for the number of nurses working. We shared that many nurses are reporting feeling overworked due to long hours and extra shifts. We have heard from you that nurses feel their work never truly ends due to the expectation of keeping up with emails or completing other tasks after hours. Many of our colleagues, are complaining of symptoms of moral distress. We believe as professional Registered Nurses, we know what’s best for the patients.

We recommended shared governance to improve nurse job satisfaction.

We communicated with management that shared governance is a process that promotes shared-decision making, collaboration, and accountability through workforce recognition and empowerment. Shared governance is described by nurses as a feeling of fairness, support and a sense of control. Studies have reported that shared governance is related to empowerment. Research done in 2005 showed that nurses in an organization with few opportunities for professional autonomy, lack of shared governance, felt disempowered by the lack of influence over practice (Attree M. Nursing agency and governance: registered nurses' perceptions. J Nurs Manag. 2005 Sep;13(5):387-96. doi: 10.1111/j.1365-2834.2005.00553.x. PMID: 16108776.) A study done in 2007 discovered that shared governance was the only retention intervention employed by home health care agencies that made a statistically significant difference in job satisfaction The authors found that job dissatisfaction occurs as a result of the lack of shared governance, and that organizations can promote shared governance by encouraging nurses to participate in the development of organizational culture, policies and procedures, and the decision-making process. (Ellenbecker CH, Samia L, Cushman MJ, Porell FW. Employer retention strategies and their effect on nurses’ job satisfaction and intent to stay. Home Health Care Serv Q. 2007;26(1):43-58. Doi: 10.1300/J027v26n01_04. PMID: 17387051)

At the end of the January meeting, we made 5 recommendations to provide immediate relief to the nurses:

1. Immediate relief from documentation. The highest burden is the Care Plan and the Wound Form. Allow for a simplified Care Plan (the only CMS requirement is “discharge planning” and to document wound status in narrative form outside of the wound form.

2. Seek formal nurse input into criteria used in deciding which referrals to accept-not on an individual referral basis but in general. What should be considered when making the decision

3. Temporarily reassess case management model—get nurse input

4. Consider recognizing quality of care, improved clinical outcomes

5. Temporarily stop on-call

Following that meeting, management announced that Care Plans could be simplified. We consider this a win! In addition, Liz Harrison and Amy Collins voluntarily stepped up to take the bulk of on-call, which greatly alleviated the burden on everyone else, and we are so grateful to Liz and Amy for doing this.

March 2022

The March Conference Committee was canceled. By the May meeting, we had no further response from management regarding our recommendations around shared governance and reiterated the importance of involving nurses in the decision-making process. The Officers decided to utilize the Nurse Practice Committee to address this head-on and not wait for Management. See Amanda Crawford’s article below.

July 2022

At the July meeting we expressed our displeasure over having to discover for ourselves the fact that we were not given our raise in June as negotiated. In addition, we addressed the issue over having a nurse wait months to receive her rightfully entitled referral bonus, as well as the issue of new hire nurses NOT being given the WSNA application upon hire. All of this undermines our trust in Providence. The WSNA application process for new hires has been successfully reworked and is now electronically included on the same web page in which new hires access other required documents. We are hopeful this issue will be resolved with the implementation of this new process.

Nurse Practice Committee Report

Amanda Crawford, RN, WTA, Local Unit Vice Chair

May 2022

We are back on track with the Nurse Practice Committee meeting via Teams! We put out the request and had some new volunteers and returning faces as well, trying to represent each of the geographic teams! This meeting of the committee was tasked with brainstorming ideas to present to management to help alleviate the current RN staffing crisis we are facing now. With more than one geographic area having only one full time Case Manager, this is a crucial topic, and we need to hear what the nurses in our organization think will help.

Some of the top contenders to provide immediate help:

1) Evaluation of chronic wound care patients in hopes of finding safe and appropriate discharge as we need to focus on our mission as a short-term solution.

2) Discharge long term catheter patients when able to set up urology referral and routine care.

3) Case Managers meet with co-case managers or care partners weekly via teams or phone call to discuss patient load and how best to get the patients seen or who to prepare for discharge.

4) Utilize “notes” in scheduled visit to state patient ready for discharge. Don’t be afraid to discharge other people’s patients, and if unsure call CM to clarify.

5) Be more discerning about SOC intake of patients that do not fit criteria or should not be admitted.

These are just a few of the amazing ideas brought up during our breakout session!

All total there were over 40 ideas to start working on or refine and submit to management for discussion.

Second topic of our discussion was identifying the aspects of a referral that make it a difficult patient case for our teams.

For example: working with certain medical groups, dealing with absent caregivers, information not screened by CSL or not included in documentation for us to see in advance, unsafe home environments that make care nearly impossible…etc.

All of this and more was discussed at the Nurse Practice Committee, and I have to say, it was invigorating to share our concerns, voice what we have been dealing with, and work to present these all to management. The ultimate goal is to relieve the stress of current staffing and scheduling difficulties each team is facing until more RNs can be hired.

Many of you attended our subsequent Discipline Specific RN team meeting where Susan Worster, RN, WOCN did a great job summarizing the points of identifying chronic, non-healing wounds and preparing them for discharge. This is just an example of how our Nurse Practice Committee can help us work towards goals together that benefit us.

The response via email from Mike and including the managers was good:

“We spent two hours as a managers group discussing and clarifying some of the suggestions, as well as categorizing them into groups to make it easier to move forward. Since there were so many suggestions (great work!) to review, leadership will need to meet again to refine the list and discuss which categories and/or specific interventions we can move forward with initially.”

With this we keep moving forward and plan the next Nurse Practice Committee with all your concerns in mind! Please reach out and let us know the future concerns to be brought to the committee!

Next Nurse Practice Committee meeting is set for August 18, 2022.

WSNA-PAC: The Voice of Nurses at the State Legislature

Kathleen Thompson RN, BSN, CDCES, Local Unit Chair

The Washington State Nurses Association Political Action Committee (WSNA-PAC) was established to contribute support to statewide and state legislative candidates who have demonstrated their commitment to the legislative and regulatory agenda of WSNA nurses.

The WSNA-PAC is run by nurses who have been appointed by the WSNA board. I was appointed to the PAC Committee last year.

Prior to deciding which candidates to endorse, the PAC Board reviews candidate questionnaires and provides 30-minute interviews for candidates seeking our endorsement. We ask tough questions of the candidates to gauge their intent to support nursing and the WSNA legislative priorities, such as eliminating mandatory overtime, mandating uninterrupted meal and rest breaks, safe staffing, school nurse funding, SANE funding and nurse educator funding. The PAC is bipartisan, which means we support candidates regardless of political affiliation as long as they show support for nurses and WSNA priorities. Visit https://www.wsna.org/pac#2022-wsna-pac-endorsements to see the current list of candidates endorsed by WSNA-PAC.

The WSNA-PAC elevates the voice of nurses to legislators and gives nursing a seat at the table where important decisions are being made that affect nurse practice and safety.

In addition to endorsements, the PAC Board votes on whether or not to contribute financially to a candidate’s campaign.

It is a potentially very powerful advocacy tool for nurses in Washington state, but we must invest in it if we want to bring about real change for nurses in Washington state. You can make a one-time or monthly donation at: https://www.wsna.org/pac/donate

WSNA dues do NOT go towards political contributions given to candidates.

If every member of WSNA were to contribute just $1 a month ($12 a year), WSNA-PAC would be over $150,000 strong to ensure that we are visible in Olympia.

Grievance Corner from your WSNA Nurse Representative, Jaclyn Smedley BSN, RN

Current Grievances:

Currently, there are 2 grievances in process. Only grievances that are filed on behalf of the whole local unit are disclosed here. Grievances involving discipline, termination or are filed for a personal reason are considered confidential.

Naddy and All Affected Association Group Grievance. #21-09-0239 Issue: COVID vaccine declination form being discriminatory. We found that only those nurses who sought an exemption from the COVID vaccine, were required to fill out the declination form. We believe this to be discrimination. In addition, the nurses were required to attest to certain language prior to submitting their request, and the attestation language, we felt, was not factual as indicated by Providence. This grievance has been advanced to arbitration.

Lovlyn and All Affected Association Group Grievance #21-11-0286. Issue: Flu vaccine declination form being discriminatory. We found that only those nurses who sought an exemption from the flu vaccine, were required to fill out the declination form. We believe this to be discrimination. In addition, the nurses were required to attest to certain language prior to submitting their request, and the attestation language, we felt, was not factual as indicated by Providence. This grievance has been advanced to arbitration.

Treasurers Report

What many WSNA nurses don’t know, or realize, is that 4% of the dues that are paid to WSNA each month, are returned to the local unit in the form of a Local Unit Fund account held by WSNA to support the actives of the local unit. The WSNA Cabinet has indicated the funds can be used by members to promote membership, educational activities, contract administration, internal communications engage in public relations activities, support their officers and negotiating team.

We are happy to report, the WSNA local unit of VNA launched a successful nurses week event this year by providing each nurse a stainless-steel water bottle. In addition, the unit was able to pay for all of the food at the most recent local unit meeting! If you are interested in obtaining reimbursement for a WSNA activity of the local unit, contact a local unit officer, or your Nurse Rep to find if you’re ask will qualify and to find out how.

Funds Status: as of July 2022

• Total Local Unit Funds amount = $8598.38
• Incoming dues each month = $100 on average (Total varies depending on paying members)
• Ongoing Local Unit Expenses =
  • Labor Council Dues = $109.20/year
• Other recent expenses
  • Water bottles for nurses week = $1195.48
  • Officer representational expenses = $ 29.97

A full breakdown of deposits and usage is posted to the local unit web page or can be accessed using the direct links below.