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May 23, 2002
ER woesAs face-to-face negotiations between the union representing nurses at St. Joseph Hospital and hospital management got underway Tuesday, one of many unresolved issues was this: should the hospital's emergency room have a lead nurse who coordinates things, or should that responsibility be divided up between several nurses? Last week, a group of nurses at the hospital took it upon themselves to eliminate the "team leader" position. The lack of such a position -- also known as a "charge nurse" -- is a temporary measure until a resolution can be reached on the matter, said California Nurse Association negotiator Pete Castelli. "There will be closure one way or the other," Castelli said. "We're looking at the charge nurse issue and we're still discussing matters. Hopefully within the next few weeks the issue will be settled." In the meantime, however, the emergency room at the hospital will be without what is arguably its most important nursing position. "I look at the charge nurse as the quarterback of the team," said Vicki Gibney, who has held the position. "When I was a charge nurse I was always thinking ahead, always looking at the next patient to come back. I always had to be ready for the next play should the ER overload. A charge nurse always has to have a back-up plan. They are the sole communicator of the department -- the communication goes in and out through the charge nurse." "All the former charge nurse duties have been divided and delineated between all the nurses now," said Roxanne Spencer, another former charge nurse. "It's probably something that won't be at all noticeable to the public." Other nurses differed. "It's definitely more chaotic," said emergency room nurse Pamela Haynes. "There is no one assuming traffic control. Some things have been missed; the fine details are falling to the wayside. This position is very important to the functioning of the department." Added another nurse: "The vital daily functions of the department are not getting done." Hospital management, meantime, refused to discuss the issue -- although it is not clear what, if anything, they had to do with eliminating the position. "This is an operational question, and like any business, we don't want the public to know how we staff," said spokeswoman Laurie Watson Stone. "Do you call every business to see how they staff? This is out of context -- the bigger story should be if other hospital ERs across the nation have or don't have charge nurses, and to see how they operate." A quick survey of area hospitals revealed that Mad River Hospital in Arcata, Sutter Coast Hospital in Crescent City, Santa Rosa Memorial Hospital and Redding Medical Center all have charge nurses or team leaders in their emergency departments. The only area hospital with no charge nurses is Redwood Memorial in Fortuna, which is owned by the same company that owns St. Joseph Hospital. The position of charge nurse has been in the news before. Last December, several charge nurses throughout the hospital took a pay cut and resigned from their positions after management changed the nurses' job descriptions. The change, which came two weeks after the announcement that nurses were going to try and organize, would have prevented the charge nurses from voting for the union by making them part of management. Since then, the C.N.A. has acknowledged no difference between the job descriptions of charge nurse and team leader, except for the fact of the reduced pay. Last week, former emergency room charge nurses received a letter of intent from the hospital promising to pay back the lost 10 percent of wages since December. Other hospital departments, such as the telemetry, critical care and medical/surgical units still have charge nurses. "Some people on other floors waived their right to vote in the union election," explained Gibney. "A 10 percent reduction in pay is just too big of a pay cut for some people." Also, some nurses simply did not agree with joining a union. As for the lack, at least for the time being, of an emergency room charge nurse, Gibney was philosophical: "Of course, it makes sense to have someone as the decision maker there all the time, but we're just trying to go with the flow right now. Our main concern, as always, is primary patient care." -- reported by Meghan Vogel-Fulmer Thompson: Open up CubaEchoing former President Carter, Congressman Mike Thompson called upon the United States to lift a decades-old trade embargo against the communist country. "Many of us have traveled to Cuba and what we've seen and heard firsthand is that Cubans believe it is time for the U.S.-Cuba relationship to change," Thompson said at a Washington, D.C., press conference following Carter's historic speech in Havana last week. Thompson is a member of the Cuba Working Group comprised of 20 Democratic and 20 Republican members of Congress. The group believes that the embargo, imposed to oust Fidel Castro, is outdated, ineffective and has only served to hurt the country's workers. Carter, the most prominent American politician to visit Cuba since Castro took power in 1959, called for an easing of economic sanctions in a speech that was broadcast throughout the island nation. He also called upon Castro to allow greater political freedoms. President Bush on Monday said he would not lift the embargo until Cuba took substantive steps toward democracy. Speaking before Bush's announcement, Thompson aide Mandy Kenney said lifting the embargo would encourage political change. "We are urging this as an opportunity to not only expand trade, but to extend the American ideals of free thought and liberty into Cuba. We hope that by opening up the relationship Cuba will be exposed to Western ideas."
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