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Nursing strike cost Allina Health $149 million

Last year was a tumultuous one for Allina Health in Minneapolis and its nursing staff. After a week-long walkout in June, Allina nurses went on strike in the fall as part of ongoing contract negotiations centered around the elimination of union-backed health plans. After a six-week strike, both sides finally reached an agreement that ended the strike and sent the nurses back to work.

As part of its 2016 earnings report, Allina Health reported that while revenue increased over the year, operating income dropped, thanks in part to expenses related to the nursing strike. Allina recorded a $30 million operating loss, a significant $179-million-dollar swing from the $149 million operating gain Allina posted in 2015. As part of its report, Allina cites a $149.3 million of strike expenses, which included hiring 1,400 replacement nurses to cover for the striking staff.

For more information on nursing strikes, check out the Strategies for Nurse Managers Reading Room.

Trump: for every new healthcare regulation, two must be removed

On January 30, President Trump signed a new executive order declaring a “one-in, two-out” rule for healthcare regulations. Under the executive order, for a new healthcare regulation to be implemented two older regulations will have to be eliminated.

http://www.modernhealthcare.com/article/20170130/NEWS/170139994

“If you have a regulation you want, number one, we’re not going to approve it because it’s already been approved probably in 17 different forms,” Trump said during the signing. “But if we do, the only way you have a chance is we have to knock out two regulations for every new regulation. So if there’s a new regulation, they have to knock out two.”

http://www.nbcnews.com/politics/politics-news/trump-signs-executive-order-reduce-regulations-n714151

The order also sets an annual cap on the cost of new regulations and cuts the regulatory budget for fiscal year 2017 to zero. This means the only way to afford new regulations issued between now and September 30, 2017 is by repealing existing regulations.

While each agency will decide which regulations they think can be cut, the White House will ultimately decide which ones to gut. Regulations dealing with national security, foreign affairs, and the organization, management, or personnel of federal agencies are exempt.

Hospitals trying out Pokemon Go in a clinical setting

Check out this article from Health Leaders Media:

A trial at the University of Washington Medicine Burn Center aims to find out if the game is more stimulating and engaging than the pain patients are experiencing.

Hospitals and health systems have been grappling with how to deal with Pokémon Go since the mobile gaming phenomenon hit earlier this summer.

Massachusetts General Hospital banned staff from playing the game on its campus, warning of possible privacy violations, and Allegheny Health Network asked the game’s maker to remove all of its locations from the app.

But some hospitals are finding that there are upside to patients using Pokémon Go.

Getting Patients Out of Bed

C.S. Mott Children’s Hospital in Ann Arbor, MI, has been urging its young patients to play the game in an effort to get them out of bed and socialize with other kids.

“It’s a fun way to encourage patients to be mobile,” J.J Bouchard, the hospital’s digital media manager and certified child life specialist, told USA Today. “This app is getting patients out of beds and moving around.”

A trial that University of Washington Medicine Burn Center researchers are conducting at Harborview Medical Center in Seattle, WA, is looking at how playing Pokémon Go may help keep patients moving while also taking their minds off the pain.

“Our challenge is to find something that’s more stimulating and engaging than pain they’re experiencing, so something like virtual reality that’s new or Pokémon Go that’s new, it’s more exciting and takes attention away from the pain,” Shelley Wiechman, attending psychologist in the Burn and Pediatric Trauma Service and Pediatric Primary Care Clinic at Harborview, told the local media.

The Pokémon Go trial isn’t the first time the hospital has tested augmented and virtual reality games for pain management, but it’s the first that allows patients to use their legs and keep their infected areas mobile.

Weichman said if patients using the game continue to show progress, the staff may begin using Fitbits to track patients’ steps.

So what do you think? Can mobile games help patients in your hospitals? Let us know what you think in the comments below!

Editor’s Pick: Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other, 2e

The American Nurses Association (ANA) has recommended the second edition of Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young and Each Other, by Kathleen Bartholomew, RN, MN, in its official position statement on Incivility, Bullying, and Workplace Violence as a resource for nurses. Now in its second edition, the cornerstone work has just been released as an eBook and offers 4 continuing education credits (CEU).

Ending Nurse-to-Nurse Hostility, Second Edition

The first and most respected book showing new and experienced nurses how to build a better workplace by facing and overcoming horizontal hostility is now updated.

Find out why this book is a best-seller and how it’s empowered thousands of nurses to create positive change for themselves and their peers!

Revised to reflect current research on horizontal hostility in the nursing field (also known as lateral violence), Ending Nurse-to-Nurse Hostility, Second Edition, provides staff nurses and their managers with techniques to create a workplace that promotes team relationships and career development while preventing burnout.

Ending Nurse-to-Nurse Hostility provides staff nurses and their managers with the knowledge they need to:

  • Identify verbal abuse, bullying, and other detrimental behaviors
  • Develop responses to defuse or head off such behaviors
  • Create positive alternatives to hostility

These skills support the success of the individual nurse, the unit, and patient care quality at a time when healthcare systems are publicly ranked on patient experience and outcomes.

Horizontal hostility, also known as bullying or lateral violence, is a major factor in nursing attrition rates. Healthcare organizations that don’t proactively create a healthy workplace face the expense of finding, hiring, and training new nurses to replace burned-out staff.

This book provides the following benefits:

  • Skills: Nurses will learn skills for identifying and responding to verbal abuse, bullying, and other detrimental behaviors that undermine individual nurses, the unit, and the quality of patient care.
  • Real-world examples: Gain insightful reflections from individual nurses who have experienced horizontal hostility, presented in their own voices.
  • Author voice: Kathleen Bartholomew is a beloved nursing author who is authoritative yet approachable and always respectful.
  • Scholarship: Extensive references draw on the latest empirical and theoretical literature concerning horizontal hostility.
  • Culture change: Improve nurse retention, nurse productivity, and hospital rankings with an improved environment for patient care.

For more information or to order, visit the HCPro Marketplace.

Featured webcast: Drug Diversion in Healthcare: Improve Security and Avoid Fines

Phcpro_live_webcast-iconreventing the theft of controlled substances at hospitals continues to be an tremendous issue even with increased security measures. Failed drug diversion programs in hospitals have led to record fines and in the midst of heightened scrutiny over drug security, hospitals must improve their processes to avoid litigation.

On Thursday, April 26 from 1–2:30 p.m. Eastern Time, join us for a live webinar with expert speaker Kimberly New, JD, a nurse, attorney, and consultant who specializes in helping hospitals prevent, detect, and respond to drug diversion.

During this program, New will discuss drug diversion by healthcare personnel and present specific steps facilities can take to minimize the risk of patient harm. She will discuss fundamental components of a diversion prevention, detection, and response program through an overview of the scope of the problem, including case studies. New will also review regulatory standards and best practices relating to controlled substance security and diversion responses. She will additionally provide tips on how to promote a culture in which all employees play a significant role in the deterrence effort.

At the conclusion of this program, participants will be able to:

  • Identify risk factors and signs of employee drug diversion
  • Fully comply with regulatory requirements of the DEA and other accrediting organizations
  • Train staff on how to report suspected abuse and who to report it to
  • Create a culture of accountability and develop an effective drug diversion prevention plan

Don’t miss this opportunity to hear practical advice and have complex regulations simplified in this program suitable for your whole organization. For more information or to order the webcast on demand, call HCPro customer service at 800-650-6787 or visit the HCPro Marketplace.

California nurses seven-day strike ends in stalemate

On March 15, the newly unionized nurses of Kaiser Permanente Los Angeles Medical Center arranged a seven-day strike in hopes of getting their first collectively-bargained contract.

Last summer, 1,200 nurses voted to join the California Nurses Association (CNA), and the walkout was their first major action since joining the union. Negotiations for a new contract have been taking place since September, and this timed strike is part of the negotiation process. The union hopes to improve the conditions both for the RNs and their patients; the nurses report being understaffed, often having to cover units outside of their specialties, and seek economic improvements to attract and retain qualified nurses. Another concern brought up by the union is the hospital’s plans to open a medical school in the next few years, which will put additional strain on the hospital and its staff. The combination of factors led to the strike.

Kaiser Permanente expressed disappointment at the nurse’s tactic, and claims that they made a fair offer last month that went without a response. Additionally, Kaiser notes that their nurses are among the highest paid in the region, and their new offer would keep them there.

All of this is happening among growing concerns about healthcare coverage, as demand has spiked over the past few years.

The striking RNs have gone back to work after seven days of picketing, and negotiations between the two sides are still ongoing.

Winter Nursing Roundup: The best and worst of nursing

As the winter winds down, I thought I’d round up some of the best and worst stories from the world of nursing to celebrate the arrival of spring.

Braving the cold

During a winter storm that called for a state of emergency, one brave nurse made the trek to get to her overnight shift at Hebrew Home. Chantelle Diabate, a licensed practical nurse, waked an hour and a half in blizzard conditions to make her shift; she was the only nurse that made it in that night. “As long as my daughter was safe [with a baby-sitter], I knew I had to come back and take care of my second family,” she said. “I knew they needed people and it was an emergency.” (via: The Source)

When winter weather hit the National Institutes of Health (NIH) in Maryland, the nurses there were faced with a different problem. The children of the hospital were eager to get out and build an Olaf of their own, but unable to leave due to their health conditions. One nurse took it upon herself to fill up tubs with fresh snow so the kids could play. The kids were able to build and color their own snowmen, and enjoy the benefits of snow without leaving the comfort of the hospital. (via CBS News)

Feeling the heat

The director of nursing services at Kindred Transitional Care and Rehabilitation Center in Columbus, Indiana was arrested last month. It turns out, she had allegedly been posing as a registered nurse after stealing the identity of another nurse. She oversaw nurses at the center for over a year before being caught, fired and arrested. (via Becker’s Hospital Review)

Meanwhile, a Pennsylvania nurse was arrested for reckless endangerment after showing up to work intoxicated. The nurse spent the afternoon drinking at the casino, forgetting he was on call later that night. He was called for an emergency surgery after 10 p.m. and went to work intoxicated. He was seen on security footage stumbling, and staff members reported that he was having trouble punching in and had slurred speech. He has also been charged with DUI and public drunkenness. (via Outpatient Surgery Magazine)

Do you have a great nursing story that you’re dying to tell? Feel free to send them in to kmichek@hcpro.com, and we might report on it here!

Dealing with racism in patients

Nurse managers and their staff often face racism in the work place; Minority Nurse reported that almost half of minority nurses said they have experienced barriers in their career because of their race and educational background. In addition to institutional barriers, there is also the problem of patient racism, where patients refuse care based on the race or ethnicity of the provider. As a nurse, you might be put in the unenviable position of deciding how to handle one of these situations. Do you refuse care to the patient? Do you acquiesce to the patient’s unreasonable demand?

The New England Journal of Medicine published an article last week that provides some useful information about how to handle patient racism. The authors point out that there are a number of concerns to take into account, both legally and ethically. The situation pits a number of rights and laws against each other, including the patient’s right to refuse medical care, laws that require hospitals to provide medical care in emergency situations, and employment rights that dictate that hospitals cannot make staff decisions based on race. Nurses that have been reassigned based on a patient’s racial demands have successfully sued their employers, but if a patient doesn’t receive proper medical attention in a timely manner, facilities are equally liable.

The journal lays out five factors to consider when faced with this difficult situation:

  • The patient’s medical condition: If the patient is unstable, treat the patient right away, regardless of the patient’s preference. It is possible that their current condition is impairing their mental faculties.
  • The patient’s decision-making capacity: Try to assess if the patient is capable of making decisions for themselves; psychosis or dementia are important factors to consider. If the patient lacks decision-making capacity, try to persuade the patient to reconsider their request.
  • Reasons for the request: If there are clinical or ethnically appropriate reasons for reassigning staff, that should be taken into consideration. For example, if there are language barriers or religious concerns, it might be reasonable to accommodate the patient.
  • Effect on the provider: Always take into account the effect a decision might have on the employee. “For many minority health care workers, expressions of patients’ racial preferences are painful and degrading indignities, which cumulatively contribute to moral distress and burnout,” according to the article. Always try to support staff when possible, and discuss their preferences when deciding how to respond.
  • Options for responding: In some situations, staffing might dictate your decision. If the department is understaffed and you cannot provide proper coverage by reassigning, try to persuade the patient.

If faced with a non-emergency situation and a patient is deemed capable of making decisions, the article suggests that it may be best to suggest that the patient seek care elsewhere; though that also has its risks depending on the availability of other treatment.

For more information on this difficult issue, including a useful decision-making tool, read the New England Journal of Medicine’s full article.

Free webcast on incident-based nursing peer review

Nursing Peer Review in Action: Experienced Nurses Share Best Practices and Lessons Learned

Thursday, December 3, 2015 at 1:00-2:00 p.m. Eastern

HCPro is hosting a free webcast on December 3 about formal, case-based nursing peer review. Join Sarah Moody, DNP, RN, NEA-BC, and June Marshall, DNP, RN, NEA-BC, for a free 60-minute webcast on how incident-based nursing peer review benefits an organization and elevates nurse practice.

These experienced speakers will clarify the difference between formal, incident-based nursing peer review and the type of review that involves peer evaluation of nurses’ performance. They will demonstrate how incident-based nursing peer review can elevate quality and the professionalism of nursing through sharing case studies and lessons learned.

Moody and Marshall have many years of experience leading nursing peer review committees as incident-based nursing peer review is mandated by the Texas Nursing Practice Act.

For the full agenda and to register for this free webcast, visit http://eventcallregistration.com/reg/index.jsp?cid=58467t11.

Let’s send Kathleen Bartholomew to Oz!

Editor’s note: The below post is authored by Kathleen Bartholomew, RN, MN, who is hoping to represent the profession of nursing as the nurse expert on the Dr. Oz show. Dr. Oz is conducting a nationwide search to find the perfect nurse to join his team and is accepting nominations. Visit the webpage at the bottom of this post to nominate Kathleen.
Kathleen Bartholomew RN
I am on a journey to make healthcare better.

For 15 years I have dedicated my life to empowering nurses and understanding the hidden forces that threaten our identity and potential. What would happen if your patients understood not only their pivotal role in healing, but also the real work of nursing? The trajectory of illness and disease in this country would be radically altered.

As a mother of five children, I have the life experiences that resonate with the general public at a gut level. As an author of five books on the healthcare culture, I have the understanding and expertise to be a voice for this noble profession. And as a seasoned public speaker, I have collected stories from across this nation that poignantly reflect not only nurses’ reality, but the experiences of many of our patients as well.
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