workplace advocacy nursing

7/28/2019 Workplace Advocacy Nursing

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JOFRED M. MARTINEZ, RN


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At the end of this presentation, we will be able to:

Describe workplace advocacy and nursing shortage.

Analyze your own values and life situation in

relationship to your personal potential for burnout,and adapt personal stress management techniquesto control your work stress.

Discuss ways racial, ethnic, and sex discrimination

has affected nursing. Discuss the various hazards to the health of

employees in the health care workplace and waysthat you can act to protect yourself and others.


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Continued

Analyze the processes through which resolution isachieved in collective bargaining issues.

Compare and contrast the characteristics of agrievance with those of a complaint.

Discuss the concerns nurses have regardingmembership in a collective bargaining group and the

reasons for each of these concerns. Discuss the effects of nursing shortage in the

profession.


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Never give up ideals but see them asgoals toward which you will move.

Orientation programs and provision of anexperienced nurse to work as a preceptor to the

new graduate.

Self-direction in identifying needs and the waysthat those might be met within the constraints of

the system.


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Exhaustion and fatigue, frequent colds,headaches, backaches, and insomnia.

Changes in disposition, such as being quick toanger or exhibiting all feelings excessively.

Decreased ability to solve problems and makedecisions as burnout progresses.

Feelings of guilt, anger, and depression becauseone cannot meet the expectations in doing a job.


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Conflict between ideals and reality.

Feeling of being responsible for all things to allpeople and often take on more and more

responsibility, thus increasing theirown stress level.

Practicing nursing in areas that have highmortality rates.


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Maintaining a balanced program of rest,nutrition, and exercise.

Not subjecting yourself to excessive changesover short periods of time

Focus on those positive aspects of nursing that

drew you to it initially.Institution-wide stress-reduction effort to prevent

burnout involving the health care workers.


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Behavior of a sexual nature that createsa work environment that is perceived

as hostile and unduly stressful.

Sexual harassment may take the form ofcomments about an individuals body, persistent

unwanted attempts to initiate a personalrelationship, the ongoing use of suggestive or

obscene language, unwanted touching,or direct sexual advances.

Both men and women may be the objects of

sexual harassment.


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Giving clear, direct verbal messages indicating thatthe behavior in question is unwanted,

unpleasant, and must stop.

Report the matter in writing to animmediate supervisor.

Keep personal records of the behavior andof all attempts to stop the

behavior in question.


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Collective bargaining consists of a set of

procedures by which employee representativesand employer representatives negotiate to obtain asigned agreement (contract) that spells out wages,

hours, and conditions of employment that are

acceptable to both.


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Refers to a process in which the employer and

employee representatives begin by identifyingthose areas in which they agree and those goalsor values held by both parties. Based on sharedvalues and goals, the two parties then begin to

work out their differences regarding specificpolicies and conditions.


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1. A group of employees in an institution mustsense a difference between employees andmanagers regarding policies, practices, or

personalities;2. The group must have unsatisfied concerns but

retain a sense of commitment to the job and tothe employer; and

3. A supportive legal environment for unionizationmust exist in the organization

Colosi & Berkeley, 1994, p. 11


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A branch or part of a professional associationassumes the role and responsibility of a union,

as often occurs in nursing.

The activity of the group may be referred to asPROFESSIONAL COLLECTIVISM, which

supports the premise that the quality of patientcare is directly tied to working conditions and thatcollective action is a professional responsibility.


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Although each agreement will differ, most

contracts have a fairly general format that

includes:

A preamble stating the objectives of each party

A statement recognizing the official bargaininggroups

A section dealing with financial remuneration,including wages and salaries, overtime rates,holiday pay, and shift differentials


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A section dealing with nonfinancial rewards, thatis, fringe benefits such as retirement programs,types of insurance available, free parking, andother services provided by the employer

A section dealing with seniority in respect topromotions, transfers, work schedules, and

layoffs A section establishing guidelines for disciplinary

problems


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A section describing grievance procedures

A section that may explicitly state codes ofconduct or professional standards


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A mediator is a third person who mayjoin the bargainers to assist the parties in

reconciling differences and arriving at

a peaceful agreement.Due to the cost of mediation, most negotiation

proceeds until things are at an impasse.

Mediation involves finding compromises, and themediator assists with this. He or she must gain

the respect of both parties and must remainneutral to the issues presented.


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An arbitratoris technically defined asa person chosen by agreement of both

parties to decide a dispute between them.The primary difference between a mediatorand an arbitrator is that the mediator assiststhe parties in reaching their own decision,

whereas the arbitrator has the authorityto actually make the decision for the

parties if necessary.


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Occurs when workers refuse to continue to workuntil certain demands are met, thus imposing

economic hardship and pressure on the employer.

When the negotiation process breaks down,employees may use the strike to emphasize the

need to improve their own working conditions,salaries, and benefits.


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A lockout occurs when an employer refusesto allow the employees to work.

This is done to force employees to agree tothe terms offered by the employer.

The employer may close a place of business,or the employer may choose to remain open,

discharge the workers, anduse replacement workers.


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A reinstatement privilege is a guarantee offered to

striking employees that they will be rehired afterthe strike as positions become available, provided

that they have not engaged in any unfair laborpractices during the strike, and provided that the

strike itself is lawful.


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AUTHORITATIVE MANDATE, in which a

president, secretary of labor, or otherhigh-ranking or influential person

encourages a peaceful settlement.

This is usually employed when the situationbecomes critical and when continuance

of a strike would cause problemsfor a great number of people.


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INFORMATIONAL PICKETING, which

involves employees carrying informationalsigns outside of the institution.

Informational picketing is not designed to stopwork, but rather to inform the public of the

concerns under dispute and to create publicpressure on behalf of the union and the

employees; it is seen frequently.


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In some instances, an INJUNCTIONmay be requested.

This result in a court order that requiresthe party or parties involved to takea specific action or, more commonly,

to refrain from taking a specific action.Employers may use this measure to

forestall or end a strike.


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A grievance is a circumstance or actionbelieved to be in violation of a contract.

The grievance process represents anestablished and orderly method to be used

in the adjustment of grievances between parties.

In this sense, it represents a problem-solvingmechanism.


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On the overall, shortage of clinical nurses iswell-documented and predicted to worsen in thecoming years

There is a differential shortage:

More developed countries, especially with agingpopulation, have more acute shortage

Some countries like Philippines have surplus ofnurses.


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DEMOGRAPHICS

Nurses are often aged 30 or older when theygraduate and begin their careers

In 2009, the ages 40 to 59 dominated 58% of theworkforce

Average age in Australia is 43

Average age in United States is 46 Nursing continues to be female dominated in

most industrialized countriesSource: World Health Statistics


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CANADA

Shortage estimate of 16,500 nurses

Expected to reach 90,000 nurses by 2022

(CNA, 2009)

AUSTRALIA

In 2008, there were 23,424 registered nurses

and 6,225 enrolled nurses not employed in thenursing profession.

(ANF, 2011)


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UNITED STATES

Despite recent surge in employment, nursingshortage projected to grow to 260,000 registered

nurses by 2025(AACN, 2011)


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NEGATIVE IMPACT ON PATIENTS

Increased wait times

a. Private clinics drain providers from publicsystem

b. Longer wait for tests, discharge and surgeries

Poor patient outcomes

a. Each patient added to nurses workloads

associated with a 7% increase in mortalityfollowing common surgeries (Aiken, 2002)

b. Nurse staffing drops, mortality rates rise(Needleman, 2011)


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POOR WORKING CONDITIONS FOR NURSES

Since 2005, overtime hours increased by 20%:

a. 313,000 hours per week

b. equivalent of 11,900 jobs

c. cost of $18 million per week

69,200 nurses were absent from work eachweek in 2008:

a. 31% were absent due to illness or disability

b. cost of $15.5 million per week

(Informetrica Ltd, 2009)


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POOR WORKING CONDITIONS FOR NURSES

Nurse burnout and job dissatisfaction,precursors of voluntary turnover, also increased

significantly as nurses workloads increased(Aiken, 2002)


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ROLE OVERLOAD

Nurse managers

a. Responsible for >100 staff nurses

b. Impacts job satisfaction and retention

(Laschinger, Finegan & Shamian, 2001)

New graduates

a. 66% report severe levels of emotional

exhaustion (Cho et al, 2006) Overtime

a. Japanese nurse died of cardiac insufficiencyafter being on duty continuously for 34 hours


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The Canadian Nurses Association tested anumber of policy solutions that could eliminatethe nursing shortage within 15 years:

a. Increasing RN productivityb. Reducing annual absenteeism

c. Increasing enrolment in education programs

d. Improving retention of practising RNse. Reducing attrition rates for new RNs

(Tomblin Murphy et al, 2009)


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The Canadian Nurses Association tested anumber of policy solutions that could eliminatethe nursing shortage within 15 years:

a. Increasing RN productivityb. Reducing annual absenteeism

c. Increasing enrolment in education programs

d. Improving retention of practising RNse. Reducing attrition rates for new RNs

(Tomblin Murphy et al, 2009)


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Forum would focus efforts in several strategicareas that include:

Creating new nursing models to address the

shortage, study nursings contribution to healthcare outcomes and create new models of healthcare provision.

Reinventing nursing education and workenvironments to address the needs and valuesof an appeal to a younger generation of nurses.


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Establishing a national nursing workforcemeasurement-and-data collection system.

Creating a clearing house of effective strategies

to facilitate cultural change within the profession(Robert Wood Johnson Foundation, 2002).


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To those who say:

It cant be doneI say:

Dont interrupt the peopledoing it!

workplace advocacy nursing

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