We, the frontline staff of Sunnyside Medical Center's ED need the following from Senior Management and our direct Leadership:
1. Scheduling. Return to the scheduling process that was in place under associate managers Jaci Weems and Marta Michniewicz. The details of this process are outlined by former associate manager Marta Michniewicz:
“It was agreed upon prior to me joining leadership (2018) that staffing would do a 2 week look ahead for ED and attempt to fill shifts after preschedule and redline.
When staffing office was RIF’d it increased communication and became significantly more challenging as their staffing levels were decreased and more responsibility was given to ED leadership.
Preschedule would be done, then redline. We had weekly meetings with staffing to review high needs. Emergent double-time was approved for high needs shifts or hard to fill shifts within those 2-week parameters.
Jaci and I took over most of that process as staffing decreased and started sending out a needs calendar with preapproved emergent double-time for hard to fill shifts (short 2 or more nurses or techs, weekends, nights). This is per a LOU regarding emergent double time booking. We often looked for opportunities to move people to balance the schedule better. This required a great deal of time and attention often requiring us to book shifts outside of our normal working hours (nights, weekends, days off). We would send the approvals to staffing, but rarely did the staffing office attempt to fill, as well as the information rarely was passed on among staffers frequently causing confusion and frustration with staff. It was clearly apparent they did not have the manpower to assist often reporting there was rarely anyone "working our desk".
We rarely waited 72 hours to fill shifts as this was almost never effective, staff rarely picked up shifts less than 72 hours in advance. When days were desperate, we would text, call and beg day of for staff to assist with any available hours. Often, we would attempt to get staff to come in early or stay late day of.”
2. Staff the Department to the agreed upon Matrix created during joint staffing and LMP process with Justin Floyd and Matthew Bennett.
- 0600: CN (Charge Nurse) + 8 + 1 BF (backfill) = 9 floor staff, 1 CN
- 1000: 4
- 1200: 2 RN+1 BF =3
- 1400: 3
- 1800: CN + 8+ 1 BF = 9 floor staff, 1 CN
This number may need to flex up depending on the needs of the department as determined by CN. Autonomy given to CN’s, as agreed through LMP process, to request and book staff for the department as needed per acuity or call outs after broadcast has been sent.
3. Resume weekly ED staff meetings, Wednesday 1500-1600
4. Resume weekly Steward meetings Wednesday 1000-1100
5. Initiate monthly meetings with ED stewards and Jay Robinson and Courtney Caulfield.
6. Creation of a detailed staff retention plan developed in partnership
7. Equitable Charge nurse assignments for relief charges
8. Use correct channels and LMP processes to change/alter previous projects and UBT initiatives. Also use this process with new proposed UBT projects. Ensure transparency of all projects (intent and process). Re-start previous projects that were to immediately benefit the ED that were halted, such as hospital wide announcements and pre/divert.
9. Cooperatively address all changes to RN workflow in accordance with our National Labor Partnership Agreement,
10. Kristin Rachinski is new to the manager role. She needs to be formally oriented, including LMP training. Please provide a detailed orientation schedule.
11. Dan Freeman’s orientation was limited to 2 weeks. We were told at a meeting with Senior Management February 9, 2021 that we would be provided with Dan’s orientation schedule. This was not provided. Many of the acute problems we are dealing with now (botched scheduling and staffing, discontinued projects and misunderstanding of LMP process) can likely be attributed to Dan’s abbreviated orientation. Please provide an explanation of why Dan’s orientation was truncated and plans for remediation.