LEARNING MORE — PEF nurses Vickie Fisher and Donna Cerza talk with Sandra C. Maliszewski, a nurse, attorney and guest speaker at Nurses Conference Day, about patient abandonment. Dozens of nurses attended the May conference held in East Syracuse. — Photo by Nancy Wolff
Unions plan rally to end mandatory overtime
| Sickly base pay underlies wealth of miseries for many state RNs By SHERRY HALBROOK PEF members generally, and PEF nurses in particular should be feeling pretty good about themselves and their work just now. After all, May 9-15 is Public Service Recognition Week and May 6-12 is National Nurses Recognition Week. But truth be told, many PEF nurses are not feeling recognized or appreciated. They love nursing, but they feel overworked, underpaid and disrespected. And they are getting sick of feeling that way. “Why is this group of workers treated so differently from all other state workers? It’s so hard to get anyone to work here, and they’re leaving as fast as they come in the door,” said PEF Division 231 Assistant Council Leader Debbie Mears, a nurse at Capital District Psychiatric Center (CDPC) in Albany. PEF and its Nurses Committee have been working for years to get better pay, staffing and working conditions for nurses, but the results are uneven at best. The law does not require the state to negotiate salary grade allocations for specific job titles with the union. In fact, PEF can only negotiate general pay raises and pay differentials that apply to all PS&T employees living in areas with very high costs of living. The union is left to focus its efforts for nurses on lobbying for laws to require safe staffing and ban mandatory overtime, and on pressuring the state to approve more pay differentials and hire more nurses. Root of the evil “The state is not going to end its nursing shortages, low morale and uneven patient care until it bites the bullet and raises base nursing pay across the board, instead of just layering on pay differentials,” said PEF President Roger Benson. “If the state took all of the money it’s spending now on mandatory overtime, contract per diem nurses, settling negligence lawsuits for inadequate patient care and the patchwork of special pay differentials,” Benson said, “and invested it in major pay upgrades for all of its nurses, the whole system would benefit and it wouldn’t cost taxpayers any more.”  “What are they waiting for?” Mears demanded. Uncompetitive pay The state’s basic pay for direct-care nurses is not competitive with the private sector. For a NYS nurse 1 (pay grade 14) it starts at $34,396 and tops out at $43,923. For a nurse 2 (grade 16) the range is $38,470 to $48,726. “The big issue is the money,” said PEF member Paul Bundrick, a nurse administrator at Great Meadow Correctional Facility in Washington County. “Unless they raise our (nurses’) pay, we won’t be able to hire enough staff.” “We used to be competitive, but now it’s reversed,” he added. “If I had stayed at the Glens Falls Hospital Intensive Care Unit, I would be making as much as I’m earning now, but without having to put in all the overtime. ” Mears said the uncompetitive pay problem is no better in Albany. “This area is rich in hospitals that pay nurses up to $20,000 per year more than the state,” Mears said. “Even Greene County (south of Albany) got the state pay differentials, so our nurses want to transfer there.” “A lot of state nurses are looking to retire early and then work somewhere else,” Bundrick said. On Staten Island, Arthurkill is paying about $55 per hour for per diem nurses to fill its most urgent staffing gaps. That’s more than double the basic hourly starting pay plus benefits for state nurse 1 and 2 employees. It takes a lot of state pay differentials to close the gap, but they are only available in certain areas. Patchwork ‘solutions’ Instead of raising nurses’ pay across the board to fair and competitive levels throughout all state agencies and regions, New York has opted for a Bandaid approach to recruitment and retention emergencies. It temporarily stabilizes staffing when it reaches critically low levels through an ever more confusing patchwork of increased hiring rates, shift pay and geographic pay differentials that are not negotiated with the union and are tied to specific titles at specific worksites. For instance, the state Civil Service Department has authorized an annual pay boost of $12,871 for all state nurses on Staten Island. The basic starting pay for nurse 1s is also boosted by $5,641 there. Nurses can earn another $4,400 to $4,800 there for working the evening or night shift. And, along with all PEF members in the New York City area, they get a negotiated pay boost of $1,230 to offset the higher cost of living. Nurses in some areas also can earn extra inconvenience and hazardous duty pay. But in Albany, the only extra pay available to state nurses is for working evenings or nights and it ranges from a low of $400 for some nurses, to a high of $4,000 for those in nurse 2 psychiatric titles working an 11 p.m. to 7 a.m. shift. At Great Meadow, the only differential available is $400 for nurse 1s and 2s working 6 p.m. to 6 a.m. It’s an insult All these pinpoint financial fixes create a deep division and resentment between the nurses who benefit from them and all the others who don’t. “It’s created an inherently unfair tier system, in which senior nurses — who have worked up through the salary steps over years — end up getting no more or even less than nurses who were just hired,” said Regina Hillier, council leader of PEF Division 181 at Great Meadow. “To have new people come in at a higher rate, right from the start is a real slap in the face to the nurses who take care of the people nobody else wants,” Mears said. “It shows the state has no respect for its nurses or what we do.” PEF nurses who believe their worksite is hiring nurses with equal or lesser qualifications than theirs for higher pay, should notify their PEF field representative. Short staffing Nurse understaffing remains a chronic and devastating problem at many state facilities. At CDPC, for instance, each unit of about 30 patients is supposed to have two registered nurses working the day shift. But nurses there said the facility has been operating with only two nurses per unit to cover seven days a week, which means many days some units have only one nurse working. According to Division 231 Council Leader John Lichak, the short staffing problem is masked by the way CDPC lists and assigns its nurses. “We have 63 nursing items to take care of 163 patients around the clock every day of the year. About five nursing items are vacant, and it’s been hard to fill them,” Lichak said. “It’s difficult to prove we have a staffing problem because CDPC has given ‘in-house promotions’ to five or six nurses who are still listed on the direct-care rosters, although they are actually doing administrative work and are no longer available for direct patient care,” he said. “But on paper, it looks like we are rich in nurses and OMH has told our nursing director not to ask for more staff or pay differentials.” Staffing problems are not unique to CDPC. Great Meadow prison has two full-time doctors, a nurse administrator (Bundrick), 12 registered nurses and 1 licensed practical nurse to provide health care 24-hours a day, every day for 1,675 inmates and any staff who get hurt or have other medical emergencies at work. The Great Meadow infirmary provides inpatient care for 17 acutely ill inmates, and typically 130-140 inmates are seen on sick call every day. “We are chronically understaffed,” Bundrick said.  Mandatory OT “When we have nurses out sick or on vacation, we can’t fill all of the shifts at Great Meadow,” Bundrick said. “We have just hired two more nurses. We will have 14 RNs, but we need 16. I have no nurses to work 24 shifts in the next two weeks. That’s why I have been working days as a nurse administrator and evenings as a direct-care nurse.” At CDPC “the pool of nurses working direct care just keeps getting smaller and smaller,” Mears said. “We do mandated (overtime) shifts on schedule here at CDPC, not just for emergencies. On Easter weekend, every day-shift nurse was mandated to work a double shift. “Until a week ago, we were mandated to work double shifts twice a week,” Mears said. “And there’s no such thing as a summer vacation any more.” Although the nurses appointed to do the administrative work at CDPC aren’t complaining, Lichak said, “We may have to file contract grievances protesting the out-of-title work, because we have only a handful of nurses left to do the mandatory overtime.” “We’re working tired and sleep-deprived,” Myers said. “The facility acts like we don’t have lives outside of here. It constantly asks us to put off our own medical appointments or take less time for them.” It was so difficult for CDPC nurses to get permission to use their accrued leave, that many stood to permanently lose a significant number of days off if they didn’t use them before the start of the state’s 2005-06 Fiscal Year on April 1, Lichak said. CDPC’s last-minute rush to accommodate the huge backlog of days off, created a scheduling disaster in late March. “I was mandated to work a double shift Friday, then went home and slept four hours. I had to work Saturday, and then worked another double shift on Sunday,” Myers said. Patient care suffers Not only are the nurses forced to work extra shifts, the work is often on units where they do not know the patients’ individual needs. “I was mandated to work overtime and cover a different unit,” Mears said. “I didn’t know one of the patients on that unit was susceptible to choking until it happened. If we had more staff, some accidents like that could be avoided and the patients would get better care.” Bundrick said while checking the records of an inmate on sick call recently, he discovered no one had reviewed the results of a medical test the inmate had several months earlier. “We work very hard,” he said, “but we are frustrated because we can’t get all of the work done.” Still more challenges ahead The prison and psychiatric patients present many challenges for state nurses they would not face in other settings. And those challenges are becoming more, rather than less, difficult. “We had to deal with three heart attacks last week at Great Meadow,” Bundrick said. “I can remember when we barely saw one a year. It’s a sign our inmate population is aging. Many of them also are suffering from early onset diabetes and HIV.” At CDPC, Myers said she worries about female nurses working alone on a unit of patients with a history of sexual offenses. In the past, male therapy aides helped protect nurses, but are rarely available now. The nurses also must cope with increased demands from management. Beginning June 8, nurses at Great Meadow will face an entirely new challenge as the state Department of Correctional Services launches an experimental new “Behavioral Health Unit (BHU)” program there. A total of 38 inmates will be cared for in the new BHU and Bundrick said that increased need for nurses will absorb the two new nurses and then some. This program will draw the inmates with the worst behavior problems from throughout the state prison system’s special housing units (SHUs) — the modern equivalent of solitary confinement for the most dangerous inmates. “The BHU is for the inmates who failed SHU,” Bundrick said. |
Conference provides new insights to nurses By DEBORAH A. MILES Dozens of nurses who attended the PEF Nurses’ Conference Day in April gave the event five stars. The conference, hosted by the PEF statewide nurses committee, opened with lectures on two critical topics — patient abandonment and professional misconduct. Sandra C. Maliszewski, a nurse and attorney, was the guest speaker. “Sandra is very knowledgeable,” said Donna Cerza, a nurse practitioner from the Dick Van Dyke Addiction Treatment Center in Ovid, which is northwest of Ithaca. “She gave us a lot of useful and insightful information,” Cerza said. “We learned to be aware of the scope of our practice and how to avoid trouble.” Vickie Fisher, a nurse at the Central NY Psychiatric Center in Marcy, agreed. “The presentations were very good. One of the things the speaker reinforced was to document everything. That’s an important point for all nurses to remember.” During the afternoon, the nurses met with PEF health and safety specialist Matt London who spoke on violence in the workplace. “It’s scary how close to home this is,” Cerza said. “We haven’t had violence at my workplace, but we all know it’s just a matter of time before something happens. We’re grateful for the training. If a situation does occur, we are prepared.” “Nurses need continuing education to upgrade their skills and be aware of any changes in the laws,” said June Edwards, co-chair of the Nurses Committee. “PEF provided this conference to help nurses with issues and situations they deal with on a daily basis. It was designed to rejuvenate and expand nursing skills,” she said. “As in many professions, sometimes we fall into a routine. Continuing education provides a new perspective on what we do every day. “Our nurses were receptive to the trainers,” Edwards said. “From the response of those who attended, we accomplished our goal.” |
The
Communicator May 2005
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