D.C. hospital fires 11 nurses, 5 staffers for snowstorm absences

The District's largest private hospital has fired 11 nurses and five support staff members who failed to make it to work during the back-to-back snowstorms that paralyzed the region earlier this month.

Dozens of staff members at Washington Hospital Center face internal investigations, union representatives say, and it is unclear how many employees will lose their jobs. On Friday, the nurses union, Nurses United of the National Capital Region, filed a class-action grievance with the hospital.
"I see it as so unfair and uncaring," said Shirley Ricks, a 57-year-old nurse who has spent her entire career at the hospital. "That's it. You call in one day in the biggest snowstorm in history and you're out. No ifs, ands or buts about it. . . . You go from getting a salary every two weeks to nothing. It's scary."
In a letter sent to the staff on Friday, hospital President Harry J. Rider sought to quell rumors that hundreds of people had been fired. He said he expects fewer than 20 people will be dismissed.
"Sadly, we did experience some issue with associates who did not show the same commitment as most of their co-workers to the community, our patients and their fellow associates. They are the few who turned away from their scheduled shifts and who tried -- and are still trying -- to turn the focus on themselves rather than the thousands of Washington Hospital Center workers who fulfilled their commitment to their patients and colleagues, and made it to work," he wrote.
Hospital spokeswoman So Young Pak said she could not comment on specific cases or personnel issues, but "we do not terminate any associates without a fair process. We always review the entire situation with the final decision based on all facts and circumstances."
Union representatives said about 250 of the hospital's 1,600 nurses did not make their shifts at some point during the storms that pummeled the area between Feb. 5 and Feb 11. Pak could not confirm that number but said on the Monday after the first blizzard, 759 employees who were scheduled to work did not show up. On a typical weekday, the hospital has between 3,100 and 3,350 employees working. The nurses earn an average of $40 an hour.
The hospital continues to examine the circumstances of staffers who did not make it into work, Pak said.
Hoping for sympathy

Officials at other local hospitals and unions that represent critical personnel, such as emergency responders, said they had not heard of staffing problems elsewhere or of disciplinary action against employees who were unable to make their shifts. The Transportation Security Administration last week reversed an initial decision to consider Dulles International Airport security screeners AWOL if they had not made it to work during the snow emergency.
Ricks said she hopes the hospital will show similar sympathy and give her back the job she held for 35 years.
Ricks was scheduled to work Feb. 8, but looked at her unplowed street in Upper Marlboro the previous afternoon and knew she was likely to miss her shift. "My husband had gotten the driveway clear, but that was as far as we could go," she said.
She said she called the hospital to explain her situation and reported to work Feb. 9, as soon as her street was passable. On Feb. 10, she spent the night at the hospital to ensure a second storm wouldn't cause her to miss work the next day.
She was dismissed, effective last Tuesday.
"Now I got to get out there and see who wants to hire an old lady," she said.
Some streets impassable

Washington Hospital Center's "Declared Weather (Or Other) Emergency" policy, does not mention termination as a consequence for failing to get to work. It does state: "Unscheduled absences and late arrivals occurring during a declared weather emergency are not counted when addressing attendance issues, nor are authorized early departures."
Pak said the hospital provided transportation for employees during the storm, but union representatives said it was not available at all times. In any case, they said, the vehicles could not reach every street. Stephen Frum, chief shop steward for Nurses United, said some nurses have photos that show their streets were impassable.
Frum said he has reviewed the records of at least half the fired nurses, and none had prior disciplinary problems. He and others question the timing of the firings. The union is scheduled to begin negotiations with the hospital on a new contract Monday.
Pak said the terminations have "nothing to do with the contract and everything to do with our responsibility and commitment to our patients and their families."
Deepa George, 33, mother of a 5-year-old and an 18-month-old, was not able to make it from her Bowie home to the hospital on Feb. 6, as the first blizzard raged all day. But on Feb. 7, she said she drove the family's sport-utility vehicle down her neighborhood's unplowed roads. She left at 4 p.m. for a shift that started at 7 p.m.
"I just prayed to God to take care of my kids and take care of me as I was driving because I didn't want to leave them orphaned," she said.
She had heard rumblings over the last few weeks that nurses had been fired, but it wasn't until Monday that she received her notice. She had worked at the hospital for eight years. "I hope the hospital realizes no one did this on purpose," she said.
Highs and lows

Geri Lee said she received two pieces of mail this month that represent the highest and lowest moments of her 31-year nursing career. One was a thank-you card from a woman who credits Lee with saving her son's life. The other was a letter of termination from the hospital that informed Lee she was fired for "gross misconduct."
Lee said she showed up at the hospital for her Feb. 11 shift prepared to stay the night. But when her shift ended Friday morning, she said she didn't see a need to stay because the snow hadn't started falling. She went home to Silver Spring.
The next day, Lee, 54, said she tried for an hour and half to get out of her neighborhood before calling the hospital to say she could not make it in. That night, she was placed on indefinite suspension. Six days later, she received a termination letter.
"I was devastated," Lee said.
Lee's last performance review, dated September 2009, says she "volunteers to care for the most challenging patients and is helpful to her peers in sharing her expertise and assisting when needed." Last year, she was recognized as one of the hospital's "Superstars" and her photo was hung on the hospital's "Wall of Fame."
Two days after she was terminated, she said, she opened her mailbox to find a card from Adreion Packer. Twenty-two years earlier, on the day Packer's son, Corey, was born, Lee noticed that his coloring was off and insisted something was not right. The child was found to have a congenital heart defect.
The card was addressed to what Packer has called Lee since that day: "Corey's Guardian Angel."

There's a lot of bad blood between docs, nurses

Whether they portray churlish docs like Perry Cox of "Scrubs" and Gregory House of "House M.D," or rule-defying RNs like Showtime's "Nurse Jackie," the actors who play health-care workers on TV reflect a troubling reality: there are some not-always-so-nice people working in hospitals and medical clinics.

A number of surveys and studies in the past decade suggest that bad blood - and bad behavior - between and among doctors and nurses is rampant.

Some behavior is so extreme that it could result in assault charges -- the surgeon who hurls a scalpel across an operating room in a fit of anger, the internist who attempts to stuff a nurse into a trash can or the nurse who squirts a used syringe in a co-worker's face or amends a chart to sabotage a doctor.

But, as one nurse surveyed by the American College of Physician Executives last year put it: "The worst behavior problem is not the most egregious. It's the everyday lack of respect and communication that most adversely affects patient care and staff morale."

That survey of more than 2,100 nurses and doctors - about two-thirds of the respondents were nurses - found that 98 percent of both professions had witnessed behavior problems between physicians and nurses in the past year. Ten percent said they see bad behavior every day.

The most common complaint, cited by 85 percent, was degrading comments. Seventy-three percent said they had heard yelling between colleagues. Other common problems included cursing, inappropriate jokes and refusing to work with one another.

A 2002 survey of nurses at 50 hospitals found that 94 percent had witnessed a physician acting in a disruptive manner.

But a 2004 survey that included hospital pharmacists found that while doctors were most likely to engage in intimidating behaviors such as threatening to complain to a worker's boss, nurses were nearly as likely to make threats or refuse to answer phone messages about pharmacy orders.

Of course there are outbursts and mutterings among and about co-workers on every job. But relatively few workplace dustups endanger lives and long-term health.

The nurses-only survey found that 60 percent were aware of adverse medical events that could have occurred due to disruptive behavior. And the 2004 survey, done by the Institute for Safe Medication Practice, found that 40 percent of clinicians have remained silent or passive rather than question possibly dangerous orders issued by a doctor or nurse who has a reputation for intimidation.

All this plays out in an often-stress-filled setting of odd, long shifts and charged emotions among workers, patients and their families.

One survey of emergency nurses found that half had experienced physical violence on the job that included being hit, kicked, scratched or spit on. Other surveys that have covered more hospital departments report violence rates of more than 13 percent, and 30 percent to 50 percent reporting verbal abuse from patients.
With health-care workers caught in such crossfire, it's hard to focus on quality.

But with mounting evidence that lack of a team approach to medicine is hurting patient care, organizations like the Joint Commission (the nation's main accrediting agency for hospitals and other health facilities) are taking note.

The commission early last year set a new standard that hospitals must have in place - a code of conduct that defines acceptable and inappropriate behavior and sets up a process for dealing with disruptive behavior.
Many hospitals already have codes or policies for staff conduct, but may have left enforcement to supervisors or peer committees. By putting complaints in the framework of patient safety, the commission envisions disruptive behavior being taken more seriously.

At the same time, many medical educators are trying to make doctors, nurses and other professionals better team players by setting up "shadow days" and seminars to help them understand one another's responsibilities and treat each other with greater respect.

Ottawa Hospital to cut nursing jobs

Officials dispute nurse union's numbers as spectre of longer patient wait times loom

The union representing nurses at The Ottawa Hospital says it has been told 190 positions, or about five per cent of the institution's total nursing staff, will be eliminated.

Union officials said the hospital has formally informed them Thursday that 70 nursing jobs will be cut, and another 120 job vacancies will remain unfilled.

The union characterized the cuts as the largest to date by an Ontario hospital.
"This is as big as it gets in Ontario that I've seen in the last six months," said Linda Haslam-Stroud, president of the Ontario Nurses Association, which represents the hospital's 3,900 registered nurses.

Haslam-Stroud said the cuts amount to about 300,000 hours of lost nursing care to patients, who will inevitably face ever longer delays for emergency care and elective surgery.

Hospital officials dispute the union's numbers, saying it has so far only given notice of cuts to 70 nursing positions, including 48 jobs that would be eliminated through early retirement, reassigning nurses to other duties, or layoffs. The remaining 22 positions are vacancies that would remain unfilled.

"We have 48 people who are affected, and that is before we go through all the steps in our redeployment and early retirement process," said Michael Cuddihy, the hospital's vice-president of human resources.

Cuddihy said the hospital has notified its three unions of a total of 133 jobs that are to be eliminated.
In a statement posted to its website the hospital said:
"Under the current economic circumstances, hospitals, like every other sector, must provide responsible stewardship of scarce public resources. That is why certain vacancies have been closed.
"As of now, no employee has lost their job," the statement continued. "Most, in fact, will continue working at TOH even after the reorganization. We have simply provided our unions with appropriate notice, at the beginning of the restructuring process, as required by collective bargaining."

The Canadian Union of Public Employees Local 4000, which represents 3,200 hospital support staff and nurses at the hospital, said it has been told of cuts that will affect 58 hospital orderlies, registered practical nurses and the medical transcriptionists who convert doctors' notes into patient records.

CUPE local president Bruce Waller said 27 registered practical nurses have already lost their jobs, the result of 28 hospital beds that are being phased out as some elderly patients are transferred to Valley Stream Manor, a privately run retirement home.

A third union, representing 2,300 paramedical staff, has been told eight therapists, representing the equivalent of four full-time positions, will lose their jobs. Rick Janson, spokesman for the Ontario Public Service Employees Union, said most of the employees affected work in the mental-health program.

Collective agreements require the hospital to give its unions five months of notice ahead of any final decision on staffing cuts. Union officials said cuts would start in July.

Waller said CUPE was told "there may be further staff impact."
The cuts are being made in an effort to balance the hospital's $970-million budget. Heading into the 2010-11 fiscal year, which starts in April, The Ottawa Hospital faces a shortfall of $19 million, and that's based on a best-case scenario of a two-per-cent provincial funding increase, said Cuddihy.

Haslam-Stroud said the nurses who remain after the cuts will inevitably have even more patients added to their workloads, compounding their existing stress levels.
The cuts could also increase a patient's risk of being a victim of a medical error or contracting an infection while in hospital, said Haslam-Stroud.

She pointed to the pressures facing both The Ottawa Hospital and Queensway Carleton Hospital, which announced this week that they were temporarily cancelling a number of elective surgeries and accepting fewer patients from other hospitals because of an overload of patients.

"Those pressures are only going to get worse," said Haslam-Stroud.

UK’s stricter student visa regulations to hit Pinoy student nurses

With the United Kingdom set to implement more stringent student visa guidelines to prevent “abuse by economic migrants,” a recruitment consultant expressed fears that the thousands of Filipino student nurses in the British isles may be negatively affected.

The Department of Foreign Affairs (DFA) said Tuesday the UK will effect the changes to Tier 4 (Student Visa) Regulations in March under its new Points-Based System of Migration, based on earlier announcement by UK Home Affairs Minister Alan Johnson.

“The Philippine Embassy in London reiterates its advice for all prospective applicants under Tier 4 to secure updated information on new regulations, procedures, and requirements from the UK Embassy in Manila,” the DFA said in a release on its website.

The DFA said the initial announcement outlines broad measures resulting from a comprehensive review of the Tier 4 scheme as initially relayed by UK Prime Minister Gordon Brown in November 2009.

In the Ministerial Statement/Notes released by the UK Home Office, the UK Government announced the modifications were aimed at achieving a “a balanced and targeted package of measures to tackle the abuse of Tier 4 by economic migrants whilst at the same time continuing to safeguard the ability of genuine international students to come to the UK to benefit from our world class education system and bring benefit to our economy.”

New setup

Under the new setup, students will only be allowed to work during the school term for 10 hours a week instead of the present 20 hours a week.

Students registered in courses of six months or less can also no longer bring dependents with them to the UK.
Further, dependents will not be permitted to work unless they qualify in their own right under Tier 1 (General) as a highly skilled migrant or as a skilled worker under Tier 2 (General worker, sportsperson or Minister of Religion).

The DFA said the changes will apply to adult students coming to the UK to study below degree level in the further-education and English-language sectors.

But it said these changes will not apply to students coming to the UK for a foundation degree (broadly the equivalent of the first two years of a Bachelor’s degree), courses at degree level or above, and those coming in as children at independent or private schools.

The changes will come into force on March 3 and all Tier 4 applications submitted on or after this date will be subject to the new restrictions.

Uncertainty for Pinoy student nurses

Recruitment consultant Emmanuel Geslani said the changes may place in uncertainty the status of about 10,000 Filipino health workers, most of whom are nurses, who entered UK from 2007 to 2009.
Majority of these health workers availed of the study-and-work plan offered by various consultancies and are presently taking awards, certification and diploma courses, also known as National Vocational Qualifications (NVQ).

Further, more than half enrolled only in certificate courses lasting for six months, while at the same time working in care homes.

“Ten hours per week and the new rule which prohibits their dependents the right to work will make it difficult to cope with the living expenses like food, rent and taxes, with the high standard of living in the UK,” Geslani said.

Geslani further disclosed that the NVQ, which is set to be replaced this year by a yet to be determined program, only allows a stay of one year and will not allow the workers to remain as permanent residents.
“Many of these nurses will be forced to return to the Philippines if they cannot shift to higher education courses like degree programs in universities,” Geslani explained.

Geslani, however, said that despite this, Filipino students from all fields may take advantage of taking a one-year degree in the UK. This will allow the students to stay and do paid work for up to two years without studying further, which will in turn lead to securing a work permit.— via GMANews.TV