United Nurses of News

Bulletin VOLUME 28, NUMBER 2 MAY 2004

PROTECTING SAFE NURSING and the Decision time coming in Provincial Negotiations Reporting Meeting TIME called for May 31 TO CARE

RN Linda Jones shares a light moment with four-year old Carson. SAFE NURSING, SAFE NURSING CARE

n April 28 I attended the memo- Published by six times a year for our members rial ceremonies for the Day of Mourning forO Dead and Injured Workers and it was Editor: Keith Wiley • Production: Kelly de Jong very moving. There was a choral group that Provincial Office sang a powerful song. Called “More than a 900, 10611-98 Avenue paycheck” the song talks about industrial Edmonton, AB T5K 2P7 PH: (780) 425-1025 • 1-800-252-9394 work hazards and how they can affect a FX: (780) 426-2093 family. The chorus is heart-rending: Southern Alberta Regional Office 300, 1422 Kensington Road N.W. “We bring more than a paycheck , AB T2N 3P9 to our loved ones and families

Contact Us PH: (403) 237-2377 • 1-800-661-1802 FX: (403) 263-2908 We bring asbestosis, silicosis, E-mail: [email protected] brown lung, black lung disease Web Site: www.una.ab.ca Radiation hits the children before Heather Smith, President theyʼve even been conceived.” HM: 437-2477 • WK: 425-1025 st Bev Dick, 1 Vice-President When I heard the song I couldnʼt help thinking of the nurses who battled HM: 430-7093 • WK: 425-1025 SARS in Toronto. Some of them brought the disease home to their families. nd Jane Sustrik, 2 Vice-President All of them brought home an incredible strain, whether it was the isola- HM: 461-3847 • WK: 425-1025 tion of being quarantined or the stigma that nursesʼ families experienced Karen Craik, Secretary/Treasurer in their communities. Every health care worker in Ontario was touched by HM: 720-6690 • WK: 425-1025 the terror of SARS. or 237-2377 Every day nurses invest their personal health and the health of their fami- North Roxann Dreger Kelly Thorburn lies in their jobs. North Central Thatʼs why it is important we keep nursing work as safe as possible, for Alan Besecker Judith Moar nurses and for our patients. Teresa Caldwell Beryl Scott Chandra Clarke Cari Smith If we donʼt, we run the risk that we wonʼt have the nurses our system and

Executive Board Executive Tim Grahn Heather Wayling our fellow citizens need. Central Marilyn Coady Kim Ruzicka Of course this is central to our current provincial negotiations. Itʼs a lot Joan Davis about respecting nurses and respecting the nature and value of our contribu- South Central tion. The heroic efforts of the Health Employees Union in British Columbia Jacki Capper Denise Palmer to defend their collective agreement and maintain publicly delivered health Blanche Hitchcow Robert Reich-Sander services speaks volumes about the insensitivity and disregard employers Donnie Lacey Daphne Wallace and governments have for the contributions made by public sector workers South Barbara Charles John Terry across this nation. As I write this we are coming to decision time for nurses. At the Reporting David Harrigan Director of Labour Relations Meeting on May 31 we will need to make very important decisions. I ask Darlene Rathgeber you to keep yourself well informed of negotiations as we approach the end Director of Finance & Administrative Services of mediation. Your Negotiating Committee sent out a package of detailed Florence Ross information of the concepts for change discussed thus far. But negotiations

Senior Staff Director of Information Systems are on going and we donʼt know yet what the outcome will be. So keep in

PUBLICATIONS MAIL AGREEMENT #40064422 touch with your colleagues, with your local UNA executive members and RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: watch for more UNA information. CIRCULATION DEPT. 330-123 MAIN ST TORONTO ON M5W 1A1 2 PROVINCIAL NEGOTIATIONS DECISION TIME IS COMING NegCom taking details to UNA members

he Negotiating Committee has set agreement. The Negotiating Commit- Clint Dunford asking him to persuade the date for the provincial Report- tee said that artificial deadlines do not the Regions to agree to an extension ingT Meeting on negotiations for May serve the process well. But the Health or to extend the timeframe himself. 31 and held a special Presidentʼs meet- Regions initially refused to respond Finally, after the extension issue was ing on April 19th. to the request. Sims, along with both raised in the Legislature and in news “With the new June 15 absolute dead- the UNA and the Employer nominees, coverage, the Regions agreed to extend line for this mediation process with wrote to Human Resources Minister to the June 15 deadline on March 24. Andrew Sims, the Committee decided the Reporting Meeting should be sched- uled,” President Heather Smith said. The special Presidentʼs Meeting on April 19 included a detailed update Working out a deal on what is being considered in media- tion, especially on the topics of mobil- that protects nurses… ity, seniority, promotions & transfers, layoff & recall, and scheduling. Details of working proposals on mobility, Details on the proposals being consid- and region-wide bargaining units ered have been distributed to all UNA members in a special update document. The progress comes out of the medi- he main provincial round of negotiations with the Health Regions ation efforts of Andrew Sims, UNA started over a year ago with Employer proposals for hundreds of nominee Lyle Kanee and Employer rollbacks,T proposals to worsen conditions in the health system. The first nominee Bill Armstrong who were mediation process with Alan Beattie in 2003 produced recommenda- appointed as an arbitration board last tions that were rejected by 98.8% in the vote by UNA members in December. UNA agreed to work with September. Through all the negotiations since then, little progress was the Board in a mediation process, but made. The Health Regions insisted nurses accept these conditions or also made it clear that actual arbitra- have them imposed either through an arbitration award or by special tion was not an acceptable option. government legislation. The mediated talks began in January, But with the mediation assistance from the appointed panel and chair however early in March, Chair Andrew Andrew Sims, possible terms are coming together to adapt the UNA Sims pointed out that it would be contracts to the Bill 27 reality. The key feature of Bill 27 is that all the impossible to conclude all the details nursing Employees of a Health Region will be in a single bargaining unit. by the original deadline of March 31. (For simplicity this is referred to here as Region-wide bargaining units.) He asked both sides to agree to extend the process to June 15 and expected a This means significant change in many of the terms of the contracts, response to his request by March 15. but throughout the process the UNA Negotiating Committee has made it clear that nurses must be protected from arbitrary juggling around of UNA told the panel that nurses are their jobs. prepared to continue mediation for as long as it takes to reach an acceptable 3 Director of Labour Relations David Harrigan answered many questions on negotiations at the April 19th Presidents meeting.

Presidents and members get inside look at negotiation details Committee optimistic about agreement he provincial Negotiating Committee called a second Delegates at the meeting said they were ready to take Presidentsʼ meeting in Edmonton on Monday, April 19, action if necessary. Daphne Wallace, from Calgary, said 2004T to outline some of the changes under discussion with she always keeps a picket sign in her car, just to be ready. the mediation panel. The Presidents passed a strong motion Itʼs not time to throw the sign away, responded David Harri- of support for the Committee. After the meeting UNA sent gan, the Director of Labour Relations. But, he said, Daphne out a package to every member with more information on can keep the sign in the car. She just shouldnʼt pin it on the adapting UNA contracts to the new Bill 27 Regional bar- front of her hood yet. gaining units. “The June 15, 2004 deadline is truly a deadline,” Heather “These changes would be the greatest fundamental shift Smith told the meeting. “Either the mediation with Andy Sims, in contract provisions in the history of UNA,” President Bill Armstrong and Lyle Kanee will result in an acceptable Heather Smith told the Presidents at the meeting. new contract or efforts will be made to impose a settlement.” “In light of the changed bargaining unit framework across “The efforts we have invested in this process may not lead this province, this Committee believes it is imperative that to an acceptable settlement,” Heather Smith concluded. “But we will take whatever “next steps” may be necessary appropriate provisions are established to protect safe prac- to complete negotiations 2003. Our motto for these talks tice, while advancing the rights of our members to secure has been “Strength in Unity” – If it is possible to achieve and maintain employment opportunities,” she said. a deal which unifies nurses in a profound new way, it will But the delegates were also told that, while the Negotiating be as a direct result of the determination and commitment Committee was optimistic about the possibility of reaching of nurses in this province to stand together in the face of a settlement, it was still very much uncertain whether the adversity. It is our hope that this mediation process will Employers would come to an agreement. do what Alan Beattie and employers did not expect us to accomplish – to move forward not back.”

e must adapt to the new Bill 27 unit and so on. But Bill 27 changes the reality of the Region-wide bar- bargaining unit from just one hospital gainingW units, the Presidents heard at or site to all nurses directly employed the April meeting. At the same time Current by each Health Region. Some Employ- nurses must protect good practice in ers believe that this would mean they nursing care and protect themselves could move Employeesʼ positions to from being moved around like push is NOT an any of their sites, and still be in the bar- pins on a bulletin board. gaining unit. This is, of course, what The big change is this: nurses have option. the Health Regions wanted when they always had protection within their bar- asked the government to pass Bill 27. gaining unit which has usually been CONTRACTS The new structure is precisely why the hospital or work site. A nurse canʼt current contract conditions are NOT be moved outside the bargaining unit HAVE TO CHANGE an option. With the current contract and canʼt be made to work in another Health Region Employer could juggle bargaining unit. A nurse who is laid off nurses anywhere, and almost any time, must be recalled to the same bargaining they like. 4 We’ll be calling you… UNA READY WITH A QUICK PHONE MESSAGING SYSTEM

onʼt be too surprised if you get a call at home from The broadcast phoning technology is fast. According to Heather Smith in the near future. UNA is preparing to Florence Ross, UNAʼs Director of Information Systems, it Duse a broadcast phone messaging system to get time criti- cannot be beaten for speed. “It gives us a real immediate cal information to each and every member. If urgent news capability to communicate to members,” she says. “Auto- about negotiations, or any other topic, needs to get out right mated phone messaging isnʼt the most personal, of course, away, the new technology can call every UNA member in but we can record a message in the afternoon that goes to the province in just a few hours. The information would every memberʼs home or answering machine that evening. come as a recorded message, most likely from President Itʼs almost instantaneous.” Heather Smith. The system leaves messages on answering machines, can You could get a call that goes: “This is Heather Smith, record feedback about wrong numbers called and provides President of United Nurses of Alberta. Iʼm calling with statistics on all the calls that were placed. urgent information on nursesʼ negotiations that you need to UNA would only be using the phone broadcasting when know about…” there is a real need to get urgent communications out.

NURSES FACE DOWN GUNS IN EDMONTON

urses in Edmonton had to face men with guns in sev- it to the nurses. “Heʼs going to shoot up the place, or heʼs Neral separate incidents over the past month. going to use it was the fear,” said the nurse. Police were The Boyle MacCauley Health Centre was amost com- called and nurses in the lunch room saw them going past pletely evacuated after a man came in with a rifle. One on the street guns drawn and at the ready. The man was nurse got caught in the basement and hid herself behind two “taken down” on the sidewalk outside after heʼd gone for locked doors until police talked the man out of the clinic. a cigarette. Less than a week later another man committed suicide Police later discovered it was a plastic cap gun. with a gun in the drive in bay at the The incident got lots of attention because a CFRN TV Emergency. The threat of gun violence provoked an evacu- crew who must have picked up the call on the police band, ation of parts of the facility and created considerable anxi- got the police takedown on to the supper news. Health ety for everyone there as well. Region managers showed up the next day to discuss safety The Eastwood Health Centre, which runs a harm reduc- with the staff. tion centre and needle exchange for addicts, also had a scare “Now we get the attention,” one nurse noted. “Weʼve had with a man with a gun. The nurse who saw the client in the many other incidents, some worse, and they never came needle exchange program said he appeared too unstable down to find out about it.” She said nurses need clear to be using the program. “Youʼre lucky Iʼm on morphine, guidelines about when to defer service to people. “This guy because generally Iʼm a very angry person,” he had told her. told me heʼd have to rob a pharmacy. It could have been a Later when he was in the waiting room to see the doctor very dangerous situation,” the nurse said. he apparently showed a gun to another client who reported

5 DEATHS IN CALGARY SPARK MEDIA FLURRY ON MEDICAL ERRORS

he Calgary Health Region announcement so-called ʻefficienciesʼ. Bottom-line management just isnʼt Tthat two patients died after a pharmacy mix- acceptable in health care.” up of potassium chloride with sodium chloride The deadly mix-up in dialysis solution may be a direct triggered an outpouring of media coverage on result of staffing short cuts. The Alberta Pharmacists Asso- medical errors. More than one article pointed ciation points out that: “Health regions have been forced to to the provincial survey on satisfaction with work within the realities of their world and develop proce- health care last year. Fourteen percent of the dures that fit their budget and the staffing resources avail- people surveyed reported that they them- able to them.” Under Calgaryʼs Tech Check Tech protocol, selves or a member of their immediate the IV solution had never been checked by a pharmacist but family had experienced a major medical only by technicians. error in the past year. Several Canadian and American studies on errors show “Medical errors can be devastating,” that faulty systems or inadequate conditions are the root says UNA President Heather Smith, cause of most mistakes. The American Institute of Medi- “and so many of them can be prevented cine says, “the majority of medical errors do not result with better practices.” She points to from individual recklessness or the actions of a particular studies that show the cause behind group—this is not a “bad apple” problem.” most errors is inadequate systems, pro- cesses or staffing. “When medical staff The news stories also mention the creation of the new are pushed too hard, mistakes happen,” Canadian Patient Safety Institute being set up in Edmon- she notes. “That tells us that safe health ton by the federal government. The organization will track care isnʼt done by constantly putting on medical errors and work to prevent them from recurring by pressure to cut budgets and increase making changes to the health-care system. The Federal government set aside $50 million in IT’S OBVIOUS SAYS the 2003 budget to create the Safety Institute. FOUNDATION “While the Institute is important to “Considering we live in an era of hospital mergers and share information across the country increasing workload for health-care staff, and considering the on preventing errors, the most effec- sheer numbers of nurses in the health system, it is no surprise tive first step is adequate staffing with that research is pointing to a strong relationship between nurse Registered nurses,” Heather Smith said. “One American study reports that staffing and patient outcomes. Not only is staff mix a factor (the 86% of drug errors from a pharmacy proportion of registered nurses to other caregivers), but nursesʼ or from physicians are caught in time education levels, nurse-to-patient ratios, and the number of care by nurses,” she says. “Enough nurses hours per day that nurses put in also influence patientsʼ level of to monitor each patient and their medi- cations is a crucial step in keeping all pain, rate of infection and death rate.” our patients safe. Exchanging informa- – From Links, The Newsletter of the Canadian Health Services Research Foundation tion on the national level can help, but clearly more nurses at the bedside will improve things immediately.” 6 AMERICAN REPORTS SHOW IMPORTANCE DEATHS IN CALGARY OF NURSES IN PREVENTING ERRORS

report published by the U.S. Insti- matter of life or death.” The study was SPARK MEDIA FLURRY tute of Medicine in January 2004 commissioned by the U.S. Depart- Asays adequate nursing care is crucial in ment of Health and Human Services preventing errors. The report, Keeping to discover what improvements in Patients Safe: Transforming the Work working conditions would increase ON MEDICAL ERRORS Environment of Nurses, follows up on patient safety. “These studies… taken the To Err is Human report that esti- together, provide substantial evidence mated as many as 98,000 hospitalized that richer nurse staffing is associ- every 32 patients. And the authors say patients may die of errors in the U.S. ated with better patient outcomes,” that staffing must include “elasticity” each year. “Research is now beginning says the study. The authors concluded or “slack” in each shift to allow for to document what physicians, patients, that maintaining input from front-line changing patient needs. other health care providers, and nurses nurses in health care management themselves have long known: how is crucial. For example, they call for Keeping Patients Safe is available well we are cared for by nurses affects national standards of nurse staffing in from the Institute of Medicine at http:// our health, and sometimes can be a long-term care facilities, one RN for www.iom.edu/report.asp?id=16173

With Bill 27 all the Registered nurses There have been several calls from employed by each Health Region were nurses wondering why they were not in supposed to be included in the UNA bar- UNA yet and it was quickly uncovered gaining unit. That gave UNA membership that because of errors or other reasons, to hundreds of other nurses who had pre- their dues and membership were still viously been in other unions. attributed to another union. The only But many nurses have been missed. way these nurses knew about the error was from talking to other nurses. Many nurses who work in community mental health offices or formerly worked for the Alberta Mental Health Board HELP FIND have not been informed they are now in UNA. And without lists from coopera- THE LOST tive Employers, UNA may have no idea who is being left out. UNA MEMBERS The bargaining unit description clearly The on-the-ground nurse network includes almost all Registered nurses: may be the only way to reach people “all employees when employed in direct who should now be in UNA. If you know nursing care or nursing instruction”. nurses who have not been in a UNA Often job descriptions or competitions bargaining unit before but likely should specifically require RN or RPN registra- be now, encourage them to call a UNA tion and that position should be in the office, or call the office yourself. UNA bargaining unit. For almost any RN or RPN working for a Health Region the case could be made they should be in the UNA bargaining unit. 7 ONTARIO FIGHTS BACK AGAINST LIBERAL P3S

n April 5, thousands of people marched in centres about the possible downfalls of privatization. “Itʼs more across Ontario to protest plans for P3 hospitals. expensive, itʼs less quality, it is less commitment to the OOntario unions and the Ontario Health Coalition kicked off workplace,” said Grinspun. “Thereʼs absolutely no financial the start of what they say will be a lengthy and loud protest or moral sense to this.” against private-public hospital partnerships. The Coalition has also been highly critical of what could “Private medicine means private corporations make money be called the “show” legislation the Liberals introduced, off people getting sick,” said Andrew Hodge, the Toronto Bill 8, the “Commitment to the Future of Medicare Act”. co-ordinator for the Ontario Health Coalition, which orga- The coalition points out that there is no prohibition of fur- nized the march. ther delisting, of the two-tiering that is happening in the Under the previous Tory government, two hospitals -- one MRI/CT clinics, of the service charges that are occurring in Brampton, Ont., and one in Ottawa -- were to be built, throughout the system or of P3s. “It gives the Minister huge run and owned by public consortiums in what is known as powers to restructure the health system without telling the P3 model. After promising voters to stop P3 hospitals in anyone what is his intent,” says the Coalition. the last election, the new Liberal government renegotiated “For-profit health corporations see user fees, service the Brampton and Ottawa deals -- allowing private firms charges and two tier access as potential new revenue streams to cover the cost of building the hospitals with taxpayers and are pursuing these in a much more aggressive way than repaying the money in the same way homeowners pay down their non-profit and public counterparts ever contemplated. a mortgage. In addition, the delisting of services and procedures has Registered Nursesʼ Association chief Doris Grinspun said allowed the growth of two tier access for uninsured ser- nurses represented by her organization need to speak up vices,” the Coalition says.

8 alph Klein certainly did boost the health care reform “rhetoric” in recent weeks. Vowing to jump ship from the Canada Health Act – from, in fact, medicareR – promised to bring in big plans for changes, and privati- zation and to make it an issue in the next election. Klein ready for a FIGHT ON HEALTH CARE Thereʼs little doubt that Klein is any more high profile, and controver- in the Globe and Mail noted in a recent serious, dismantling medicare in the sial moves. article: “Premier Klein, whose govern- province has been on his governmentʼs But recently the Premier has been ment has been drifting, is said to have agenda all along. It was put on the publicly musing about dropping out rediscovered the fire in his belly to back burner a bit after the tremendous of medicare and bringing in user fees. tell citizens that something has to be opposition to Bill 11, but it has been “Can we have deductibles? Can we done,? to put options before them and, simmering along back there. In fact have some form of user fee without in due course, to act. If Ottawa objects, it looked as though privatizers were being penalized, some kind of facility throwing up the alleged incompatibil- quite happy to have low-key incremen- fee?” he asked recently. ity of Alberta changes with the Canada tal “reforms” whittling away at the Health Act, the Premier is ready for a public health system, rather than risk Jeffrey Simpson, a national columnist fight.” PUBLIC HEALTH CARE Not only sustainable… it’s a bargain remier Ralph Klein has again been talking loudly in • FACT: The amount of GDP (our total wealth) Alberta the media about health care being too expensive and spends on health care has actually decreased over the Punsustainable. He appears to be setting the stage for the past 10 years from 5.3% in 1993 to 4.9% in 2003. next major step in dismantling Albertaʼs medicare system and promises to make it a major election issue. • FACT: Fifteen years ago Alberta spent about $1914 Even reading her budget speech Finance Minister Pat per person on health care. This year, adjusted for infla- Nelson harped on how much health spending was going tion, we spent $2264. That means the average increase up. It has doubled in the last nine years, she said. That is a reasonable $23 per person a year. may just be a clever use of statistics. Nine years ago, in 1995, the budget cuts hit bottom—with the lowest levels of • FACT: Health care is not crowding out government health spending. Since then the government has recovered funding for other services such as education. Ten spending rapidly. But thereʼs nothing to suggest it is “out years ago the provincial government spent about 30% of control” as the Premier likes to say. In fact, if you use of its revenue on health care and 27% on education. Canadian Institute for Health Information numbers, and Last year it spent 27% of revenue on health care and compare apples to apples – constant dollars and per person 21% on education. spending rates – the results show Alberta is spending just slightly more than in 1989. We are spending less in fact, as a proportion of the overall provincial economy, then we were then. 9 Corporate profits trump safety of Canadians? Critics attack proposed Health Protection Act

here has been a great deal of criticism on the proposed and uncontrollable hazards); Canada Health Protection Act that the federal govern- 5. Avoid liability for regulatory negligence; Tment has been developing. In a pointed critique of the Act 6. Allow direct-to-consumer drug advertising. for the Canadian Health Coalition, Michael McBane notes that, “The government and industry elites have made their Health Canada held a stakeholders meeting in Edmonton choice: economic growth and corporate profits are to trump in March to hear input on various elements of the Health the protection of citizensʼ health. The evidence indicates Protection Act. The ʻlegislative renewalʼ process began that the federal health and safety regulatory agencies have in 1998 with a proposal to consolidate existing legislation been captured by industry.” into a new framework that better addressed new issues in health and safety – genetically modified foods or SARS, for Specifically, the changes proposed so far in the example. The centerpiece of this legislative renewal is the Act include: merging of the Food and Drugs Act, the Hazardous Prod- 1. Shift from health protection (ʻduty ucts Act, the Quarantine Act, and the Radiation Emitting of careʼ) to risk management; Devices Act into a new Canadian Health Protection Act. 2. Prevent the application of the Precaution- It became clear at the stakeholders meeting that despite ary Principle where its needed most; six years of thought and consultation, no consensus had 3. Shift the burden of proof (products are pre- been reached among the interested parties. Indeed, one sumed safe - harm has to be proven); stakeholder group suggested that the government should 4. ʻManageʼ the damage (irreversible harm scrap the entire framework and start from scratch to better

Nurses planning the annual Rainbow U of A Hospital nurses to raise support Gala fundraiser are putting out a chal- for the Rainbow Society. The charity lenge for other nurses to take a turn at helps very sick children and their fami- modelling in the fashion show part of lies. On October 14 this year, the Gala the evening. The UNA members who will be held at the Fantasyland Hotel at modelled last year say they want to the West Edmonton Mall and features spread the excitement around. a dinner, the fashion show, entertain- “It’s a lot of fun and we’re challeng- ment and a silent auction. ing other nurses to take it on this year,” “It’s a great party,” says BettyAnn said Alan Besecker, president of the Emery, President of Local #301. “We are Alberta Cancer Board Local, whose giving early notice to UNA members whole family modelled. “I’m going to at other locals who may want model again, if I can,” says provincial to get in early to try President Heather Smith. on some of the The Gala is the annual charity fund- beautiful fash- raiser put on by Local #301, ions.” Nurses interested in helping out with this year’s Gala should contact Local #301 at 407 7453. 10 address the concerns being raised. It was clear that the pro- More information at: McBane, Michael. “Risk First, posals to date benefit industry at the expense of the health Safety Last! A Citizenʼs Guide to Health Canadaʼs Health and safety of Canadians. While Health Canada representa- and Safety First! A Proposal to Renew Federal Health Pro- tives do not expect that draft legislation would be tabled tection Legislation” (http://www.healthcoalition.ca/safety- in Parliament until 2005 or 2006, we will need to be vigi- last.pdf). lant to ensure corporate profits do not override the rights of citizens to enjoy protection from unsafe foods, products or marketing practices. Eminent citizens write the PM: Industry and health a deadly mix This is an excerpt of an open letter signed by 800 people to Prime Minister Paul Martin express- ing concern about the Liberal governmentʼs proposed new Canada Health Protection Act. Shirley Douglas, Jane Jacobs, and David Suzuki, as well as 125 eminent medical professionals from across Canada, are among the signatories — including experts from 30 coun- tries — to the letter.

11 A NEW REPORT OUT OF THE U.S. INSTITUTE OF MEDICINE CALLS FOR UNIVERSAL HEALTH COVERAGE

new American report says that country cannot afford than the additional cost of providing health care, at the level A to not provide universal health care coverage. “The of those currently insured, to those who lack coverage.” economic vitality of the nation is limited by the poorer More information at www.iom.edu/uninsured health, premature death, and long-term disability of unin- sured workers.” says the report from the Institute of Medi- cine from the U.S. National Academy of Sciences. Poorer “It’s true that the U.S. spends far more health due to uninsurance costs the U.S. between $65 and on health care than any other country, $130 billion annually, they estimate. but this wouldn’t be a bad thing if the The number of people in the U.S. without health cover- spending got results. The real question age has risen steadily since 1987 to 2002 when it was 17.2 percent of the population. “Uninsured children and adults is why, despite all that spending, suffer worse health and die sooner than those with insur- many Americans aren’t assured of the ance,” the report notes. It suggests several ways that cover- health care they need, and American age could be made universal by 2010, including moving to life expectancy is near the bottom for a Canadian-style single-payer system. advanced countries.” “The value in healthy years of life gained by providing – Paul Krugman in the New York Times coverage to everyone would almost certainly be greater SWEDEN BANNING PROFIT HOSPITALS

Lars Engqvist he Swedish coalition government has banned However, the government, a coalition of Social Health Minister- Sweden the privatization of hospitals, amid fears that Democrat and centre left parties, said that the Tthe expansion of private health care could destroy privatization of hospitals risked undermining a the principle of a fair and free public health ser- central principle of the countryʼs health care— vice. namely that medical treatment must be given to Health minister Lars Engqvist, a Social Demo- every patient according to their need, not their crat, said that new legislation would end the prac- ability to pay. tise of private patients “buying their way past” Under the terms of the new bill private com- hospital waiting lists. Provincial authorities, panies will not be allowed to run hospitals that which are responsible in Sweden for the local treat state insured patients as well as private healthcare system, will not be allowed in future patients. In addition, provincial authorities will to hand over the running of a hospital to a profit be forbidden from handing over the day to day making company. running of hospitals to profit making companies. The ban comes after two provincial authorities, Also, private companies will not be allowed to both controlled by centre right parties, began to buy regional or university hospitals; only founda- privatize state hospitals that had expanded their tions and non-profit providers are to be allowed private care. to manage hospitals. 12 May 10 to 16 NATIONAL NURSING WEEK Nurses across Alberta will celebrate International Nurses Day Wednesday, May 12 as part of National Nursing Week. UNA Net discussion UNA provincially does not normally organize Nursing Week events, but informally surveys LTC locally nurses certainly do. any Long-Term Care centres in the province have moved to absolutely The NewsBulletin, will publish news minimal RN staffing, and overall limited staffing, particularly for night of some of the innovative and exciting shifts.M Stephanie Velie was concerned about staffing levels in her facility and she put up a question on the UNA Net News conference recently. She wanted to find events nurses hold to celebrate their out what night staffing levels were at other LTC facilities around the province. profession. Please send or email in The emails poured in with reports from all kinds of facilities. news and or photos. (or just send a A sampling of the responses: photo with a phone number to call for One facility has one RN on for 158 beds, along with seven nursing assistants information about the event). who now need no formal training at all. We have an 80 bed dementia unit and an 82 bed unit that has our more medi- cally complex residents as well as a bed for the regional palliative program. Celebrating At night time we have one RN and 4 NAs. We have one RN on nights with two PCAs for 78 residents. the caring We have one RN on each shift for 23 residents. One RN for 25 residents and she is on call for the other 50 if needed. profession I work in a 200 bed LTC facility with a 10 bed trach unit and a 10 bed sub- acute unit and we have one RN to 100 residents on evenings and night shift. Our facility has 90 beds with one RN covering both units on nights. Our LTC facility has 110 beds. It is divided into 2 units but there are actually 3 wings. The north wing has 50 beds and is looked after by one RN & two NAʼs. The South and Central wings have one RN & one NA. The south wing, which is our Alzheimer unit, also has one LPN & one NA. The central RN is in charge of this unit as well as there is not always an LPN to cover on nights. There are about 30 residents on south and 30 on central. We have all levels of care and about 6 tube feeds at present. There is 1 RN for 96 - all shifts. Our facility has 48 patients per floor on the West side and there are 2 PCAs per floor on nights. On the East side there are 52 patients with 2 PCAs on one floor, on the other floor there are 44 patients (3 locked Alzheimer houses of 12 beds plus another with 8) with 3 PCAs. At our Facility, we have 158 beds. There is one RN covering on Nights....2300hrs to 0715 hrs. There are 7 NAs as well. These do not have to have any formal training anymore. Itʼs learning “on the job”. 13 agenda and priorities and to taking a serious look at the increasingly hostile attitude of governments to labour Nursing and workersʼ rights, both in the private sector, and in the public sector where the government is the employer. Bryan Palmer from Trent University will be the key- News note speaker and promises to provide the historical and UNA appeals problem in the Region. The Calgary ready current context for the attack decision on shortage came about in part for pandemic? on labour rights. because of the demolition of LRB bias the Calgary General Hospital The Calgary Health Region UNA will also be sending and the sale of the Grace and has stockpiled about 100,000 2 members to the Canadian UNA has filed an appeal Nurses Association (CNA) of the recent court decision Holy Cross hospitals. N 95 masks, established at least 68 “negative- pres- Convention, June 20-23, that the Labour Relations “Stories of unacceptably long sure rooms” and developed 2004 in St. Johnʼs, New- Board (LRB) was not unduly waits and a lack of resources “assessment centres” in the foundland. influenced by government are not the exception, they event of a potential outbreak involvement in its adminis- are the norm,” Kevin Taft of a severe respiratory illness Full-time RNs tration of Bill 27. UNA and said. the Communications Energy in the city. reduce nursing and Paperworkers had This preparedness plan home admissions. argued that government com- comes as the federal gov- munication to the LRB on ernment and health regions A recent U.S. study found implementing Bill 27 created announce their protocols that Assisted Living Facili- a “reasonable apprehension to respond to pandemic ties (ALF) with full-time RN of bias” on the part of the outbreaks. staffing transferred far fewer Board, which is supposed to residents on to nursing homes be an independent tribunal. The Calgary Health Regions than facilities without RN says it has an Office of Disas- staffing. The study of 1,483 “The case for bias is very ter Preparedness in place residents in 278 Assisted strong,” says UNAʼs Director focusing on an “integrated Living Facilities found that of Labour Relations David response” to an outbreak. the staffing characteristics Harrigan, “we need to take it of the facility played an back to the Court of Appeal important role in the likeli- for a further ruling.” UNA sending members to hood of being transferred to a nursing home, according Code Burgundy conferences to the Agency for Health- for CHR bed At the February meeting care Research and Quality. Marion Moodie The vast majority of ALF shortage first nursing grad the UNA executive board decided to sponsor UNA residents (78%) left their Liberal MLA Kevin Taft in Calgary in 1895 members to attend an upcom- facilities because of the need called for a public inquiry for greater health care. “Resi- The Calgary General ing Alberta Federation of into bed shortages and “Code Labour (AFL) forum and to dents of ALFs with a full- Burgundys” in the Calgary Hospitalʼs School of Nursing time registered nurse (RN) was established in the spring attend the Canadian Nursing Health Region in March. Association (CNA Confer- had less than half the odds Taftʼs comments came after of 1895 under the direction of moving to a nursing home of Mary E. Birtles. Marion ence). UNA will be covering reports that the Region had the costs for 12 members to compared with residents in called 14 Burgundy alerts – Moodie was the first student facilities that were staffed to graduate in 1898. After attend the Calgary AFL event absolutely no beds available and two members to the St. differently. For people who to admit patients – during the graduating 2940 registered want to avoid or delay nurs- nurses, the school closed in Johnʼs Newfoundland CNA last six months. Conference. ing home placement, seeking 1974, in keeping with the out an ALF that has full-time In recent months even nation-wide trend to train The AFL meeting is geared RNs on staff may be a good CHR CEO Jack Davis has nurses in an educational, to a discussion of the AFL choice...” commented the lead admitted the bed capacity rather than an institutional, author of the study. setting. 14 Good communication and coordination among team members is as important as technical proficiency for patient safety An Alberta Studies have indicated that company is as many as 80% of medical cashing in errors are related to inter- on sending personal interaction issues. nurses to the In an effort to improve U.S. IPCO, an Alberta teamwork, researchers in Minnesota surveyed 261 OR, based company, has a ER, and ICU nurses at four glossy poster out showing nurses hospitals to identify areas under palm trees in Florida. The posters that needed improvement. could appear anywhere even up on the bulletin Virtually all of the nurses board at your local Safeway. “Our role is to connect you indicated that good com- with the international position that you desire and to help you munication and coordination secure it,” says IPCO. among team members was as important as technical rooms and ICUs. The nursesʼ Great summer kids get to try out a number proficiency for patient safety. association took concerns of outdoor adventures in the But, between one quarter and learning about the practice to the beautiful foothills environ- one third of the nurses rated opportunity stateʼs Board of Registration ment they also participate interactions with primary for UNA kids in an exciting education and consulting physicians, in Nursing, which ruled that “paramedics cannot function program about unions and anesthesiologists, and nurse UNA will be sponsoring two social justice. managers as low or very low. beyond the scope of a typical children of UNA members to Only five percent rated inter- PCA or nursesʼ aide.” The attend the Alberta Federa- The deadline to register for actions with fellow nursing Board said that any nurse tion of Labour Kidsʼ Camp the camp with the AFL is staff as low or very low. or nurse manager who was this summer. The weeklong July 9th. Cost is $275 per delegating nursing tasks to a camp for children of union child for the week including Massachusetts’s paramedic would violate the members will be in its tenth all meals and accommoda- stateʼs Nurse Practice Act. year this summer. Vice-Presi- tion. Buses will be leaving nurses protest “Now it is up to every nurse dent Jane Sustrik who has from Hinton, Edmonton, paramedics in and nurse manager to stand attended the camp for the last Calgary and Red Deer to ERs and ICUs up for quality patient care four seasons says it has been transport children to the and to not allow misguided a great experience for her and camp. For more information According to the Febru- administrators to attempt to for the children. call the AFL at 780 483-3021 ary edition of the American destroy nursing practice by or 1-800-661-3995. The camp location has nursing magazine Revolution handing our practice over to moved this year to the gor- The two UNA sponsored several hospitals in Massa- lesser qualified personnel,” geous Goldeye Centre, near children will be selected in a chusetts are using paramedics said Karen Higgins, President Nordegg. It runs from August draw. Members must enter by in nursing roles in emergency of the Massachusetts Nurses 9 to 13th. Not only do the June 9th. Association.

CHILD’S NAME: ______AGE: _____

MEMBER’S NAME: ______LOCAL #: _____

PH # (HM): ______(WK): ______

Entry must be submitted to: UNA Provincial Office, 900 10611-98 Avenue, Edmonton, AB T5K 2P7 by June 9, 2004 Blaine Snaychuk goes Over 15 Publications Mail Agreement #40064422 U.S. InstituteofMedicineinJanuary2004 * the errorreachedpatient. before patients for medications providing in involved others and pharmacists physicians, by made errors medication all of percent 86 intercepting for were responsible nurses that found 6-month period a over hospitals two in errors medication of study “A Work EnvironmentofNurses,publishedbythe Cited inKeepingPatientsSafe: Transforming t www.una.ab.ca * ” he so eachcarefacilityhasenoughnurses Invest inendingthenursingshortage, signs andtakecorrectivemeasures.” to skillfullymonitorpatientsʼ vital “You wanttosavepatients? 2003 CFNUresponsetoFederalbudget. –KathleenConnorsRN