In a bold move, five union stewards in Kaiser Permanente led a march on their director, armed with a petition demanding the addition of a charge nurse in the Med Surg Overflow unit, a comprehensive paper citing nine peer-reviewed articles supporting the necessity of a charge nurse to the unit, and several ADOs from exhausted nurses who have faced unsafe staffing levels and missed breaks because of this staffing issue.
The petition, signed by 118 nurses from all of Med Surg, reflects a nearly unanimous call for immediate action to alleviate the strain caused by the lack of safe staffing in the overflow unit. The stewards assert that the lack of a charge nurse has led to overburdened nurses, compromising patient care, and putting the well-being of both patients and staff at risk.
Backing their demand with a meticulously researched paper, the union stewards presented evidence that units with a designated charge nurse have a 30% increase in discharge efficiency, a 2.5-day reduction in the average length of stay for patients, a cost savings of up to 20% due to improved resource management, a staff satisfaction improvement of 35%, and a 25% improvement in bed utilization efficiency. Additionally, the information they researched suggested that appropriate nurse staffing lowered the probability of re-admission and was more cost effective for both the hospital and patients.
Geoffrey Nighswonger, Med Surg RN and OFNHP steward says that running the overflow unit without a charge nurse “comes at the expense of missed breaks, patient falls, staff injuries, rapid responses, and delays in patient care.” Further, he notes that “staff have been voicing their concern and frustration since it opened.”
Nighswonger’s comments are in alignment with the reports of the four ADOs that were also hand delivered by Med Surg RN steward and staffing committee rep Chelsea Bruenn. ADOs (Assignment Despite Objection) are forms that members can fill out if they believe something problematic has occurred with their assignment, such as being assigned to a situation that negatively affected patient care from short staffing. The ADOs, most as recent as December 2023, detail the hardships charge nurses must endure when covering their unit and the overflow unit; or worse, two units as well as overflow; or even more ridiculous, having only one charge nurse for Med Surg 2, 3, 4, and overflow (yes these have all happened).
Understandably, aggravation and frustration ‘overflow’ into these reports as well. They are palpable when reading additions to the ADOs like this: “A note to admin: we are working with the lives of patients and staff, your continued denial to staff MSOF with a charge nurse is putting both the patients and staff at risk. How many more people need to be injured due to your unwillingness to staff MSOF SAFELY before you put people over profits and staff MSOF with a charge nurse?”
When asked about how it felt to take part in this impressive collective action, A.J. McFarland, float pool RN and OFNHP steward replied, “after months of being denied a dedicated charge nurse in Med Surg overflow through planning meetings and the grievance process, it felt amazing to show management that staff is united on safely staffing MSOF. The director seemed stunned when we handed him the petition and even stated “118, that’s a lot of signatures.” He asked to set up a meeting with us in the next week.”
Another Med Surg RN and OFNHP Steward who delivered the petition is Ashley Larson. She noted that “handing it over made me feel proud of our Med Surg steward group. I’ve been feeling so frustrated, and feeling like things keep getting more awful and more unsafe. I think we all felt nervous making a stand, but in the end, we are willing to do that to fight for ourselves and fight for our patients.”
McFarland echoed the sentiments saying, “I am very proud of this group of stewards. We are dedicated to creating a safe environment for both patients and staff, and we con’t compromise our standards.”
Collective actions like this demonstrate the power of solidarity. Five stewards together have quite a voice; 118 nurses is a force to be reckoned with. Nighswonger hit that nail on the head by stating “there is power in numbers and even if our leadership doesn’t want it, we will be heard.”
The MSOF has been a cash-cow for KWMC, meaning it makes a ton of money for the organization. They continually run staff short to ensure its profitability. That deicision has resulted in many workers being unable to take their breaks, increases in patient falls, staff injuries, rapid responses, and delays in patient care. Staff have been voicing their concern and frustration since it opened. The “OH s$&@” look on the face of the director was everything, as we handed him the petition signed by nearly all of his nursing staff in the arena, ADOs from MSOF, and peer reviewed articles supporting appropriate staffing in MSOF. There is power in numbers and even if our leadership doesn’t want it, we will be heard.