Local 97 – Employer’s Response to Proposed Nurse-To-Patient Ratios
Further to the last bargaining update we sent out after your employer presented their “Final Settlement Offer” to the Local 97 bargaining committee on December 13th, 2013, we are now sending along their response to our proposals surrounding minimum mandated nurse-to-patient ratios:
11. Union/Management Quality Care Committee – 27.02(d)
(1) An Employee who believes that adequate and safe care of patients cannot be provided because of that Employee’s workload shall bring the matter to the attention of that Employee’s immediate Supervisor, or where appropriate, the Supervisor’s Designate. If the matter is not satisfactorily resolved, the Nurse may file a written report (Clinical Capacity Report) which is attached at Appendix “4” which shall be submitted to the Employee’s Manager within 72 hours of the Employee identifying the concern.
The Manager will meet with the Employee to discuss the matter within five (5) working days of receiving the Clinical Capacity Report.
The Manager will provide a written response (Clinical Capacity Follow-up Report) to the Employee within ten (10) working days of receiving the Employee’s Clinical Capacity Report.
After full completion, the form shall be distributed to the listed parties on the Clinical Capacity Report.
(2) Failing resolution of the complaint by the Manager, the Employee may then refer the matter to the Union/Management Quality Care Committee as set out in Article 27.02(b).
(3) The Committee shall meet as soon as possible to hear and attempt to resolve the complaint to the satisfaction of both Parties. The Committee shall provide a written response to the Employee within ten (10) working days of the meeting.
(4) Where the matter is not satisfactorily resolved under (3) above, or the Committee has received more than ten (10) Clinical Capacity Reports related to separate incidents from a unit in one month, a report with a recommendation shall be forwarded by the Committee to the Employer’s senior management team. The CEO or designate shall provide a written response as quickly as possible.
(5) If the response of the CEO/Designate is not satisfactory to the Committee, the matter shall be referred to an Independent Assessment Committee (I.A.C.) comprised of equal members from the Employer and the Union.
The I.A.C. will review the matter and make recommendations to the Employer, copied to the Union.
CDHA is essentially proposing a slightly modified version of Article 27.02 within your existing collective agreement, which has been in the agreement for 15 years. This existing article already provides a process for reporting quality care issues due to excessive workload. A specific issue on a shift can be reported to management and considered by a Union – Management Committee.
The process has proven to be completely ineffective in addressing heavy workloads and their impact on patient care. Nurses with an excessive workload do everything they can to ensure patient safety. By focusing on specific incidents after the fact and by requiring management agreement for any resolution, the process fails to provide a practical way for nurses to address workload issues.
The employer’s “new” proposal simply recycles the existing procedures in the collective agreement and permits registered nurses to report that adequate and safe care of patients cannot be provided because of the nurses’ workload and to have this report considered by a joint committee and senior management. The only real change is the addition of the following step:
If the response of the CEO/Designate is not satisfactory to the Committee, the matter shall be referred to an Independent Assessment Committee (I.A.C.) comprised of equal members from the Employer and the Union. The I.A.C. will review the matter and make recommendations to the Employer, copied to the Union.
This response is not acceptable to your bargaining committee. This proposed Independent Assessment Committee is not actually independent. Any recommendation would require agreement of the management representatives on the Committee. It is unlikely that the management members of the Committee will disagree with the CEO. The Committee is limited to making recommendations to management. The whole process is focused on an incident on a particular shift after the fact. It will likely focus on the RN’s conduct in handling the incident as much as on the adequacy of the staffing of the Unit on the date of the incident.
NSGEU has proposed to amend the collective agreement to require CDHA to develop registered nurse staffing plans enforceable under the agreement. A staffing plan would require minimum direct care registered nurse-to-patient ratios plus nurse to patient ratios above the minimum depending on factors such as the number of patients, their acuity level, the need for specialized expertise, staffing levels and services provided by Licensed Practical Nurses and other support staff and other relevant factors.
CDHA has completely rejected the union’s proposal and instead proposes recycling an existing reporting and Joint Committee process which has proven to be very ineffective in addressing excessive workloads.
Your bargaining committee believes that it is essential to establish proactive staffing requirements which are enforceable under the collective agreement, and hopes you will stand united with them on this issue.
We are scheduled to return to the bargaining table on January 29th and 30th and will be sure to send out an update afterwards.
If you have any questions or concerns about the bargaining process, please contact the NSGEU by calling 424-4063 (toll-free 1-877-556-7438) or emailing firstname.lastname@example.org, or contacting a member of your bargaining committee.
Susan Dobbin email@example.com
Karen Ferguson firstname.lastname@example.org
Janice Nicholson email@example.com
Rebecca Norris firstname.lastname@example.org
Karin Harrison email@example.com
Linda Power, Chief Negotiator firstname.lastname@example.org
Tony Bremner, ERO email@example.com
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