A group of VA nurses sounds the alarm on a new patient practice

Registered nurses at the VA’s Cincinnati Medical Center recently staged a public protest — an “informational picket” — over what they say is a new and unsafe practice. They say veterans will become collateral damage and they put their own nurses licenses at risk. For details, Federal Drive with Tom Temin spoke with Eric Cromer, a nurse and member of National Nurses United.

Interview Transcript: 

Tom Temin Tell us, what is the practice that the VA Medical Center in Cincinnati wants to institute that you feel would be harmful?

Eric Cromer Well, the practice that you’re speaking of and that we had the informational picket about was changing the way that medications are administered by the staff. So the sickest patients go to the ICU because they need the most critical oversight the most constant assessments, things of that nature. And therefore, the medications that are given in those ICUs require a special level of training. They require a lot of oversight and a lot of special labs and things that have to be looked at. Those medications should only and those patients should only be in ICU. The Cincinnati VA wants to change the policy where certain medications that pertain to, as I just mentioned, would be on a med surge floor with a nurse that’s got five patients and may be off the floor for a certain amount of time. And it’s just an unsafe practice. And that was what that informational picket was about, along with so many other issues that are everything so heavy handed here.

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Tom Temin And we’ll get to some of those issues. But just to clarify, these would take the patients out of the ICU that would otherwise have been receiving their medications in the ICU and having them receive those medications in a situation where there would be many more patients per nurse to supervise.

Eric Cromer Correct. Absolutely.

Tom Temin And why do they say they’re doing that?

Eric Cromer Well, they don’t see an issue in it. We actually sit down initially with them, myself and one of the other union members here. And we voiced concern, along with the pharmacist and the doctors who have told us privately, the pharmacist publicly, that those medications do not belong on a med surge floor why they’re doing it. We don’t know. We’ve pointed out that it’s unsafe, that it takes more oversight. It seems like they just hear that it takes more nurses and that we’re just looking to have more staff. But we’re trying to fight for the veterans so they get the highest and best quality care and they trust us. The veterans trust us with their care, and we want to be good stewards of that trust. And it’s a violation of their own policy. Their own national policy is what is so puzzling about this. You can actually look in their database, but here in Cincinnati, they believe that they can just do it their own way.

Tom Temin And you said there’s some other issues between the management of that center and the registered nurses that’s underlying all this also.

Eric Cromer Oh, absolutely. Back in May, we had a very peaceful meeting. There was a group of us, about 12 of us, that went to the director’s office or conference room, knocked on the door. We were invited in by her and we were asking about a flexible schedule that we had been promised well over a year ago. We had about a ten minute meeting. We thought that was productive. All the nurses went back to work after that. Two days after that, we all got subpoenas from the federal police that we were being investigated, not only being investigated, but we were read our Miranda rights. The police, we went ahead and cooperated with the federal police. They did the investigation and sent it to the US attorney. And the attorney didn’t see anything that was the grounds for any legal action because it was of course, protected concerted union activity. And the local administration here still is calling upon different nurses to investigate them and just attempts to silence us and this intimidate any advocacy at all that we’re trying to do for our veterans. I mean, we’re just here for the veterans. And it’s our job to advocate for us. And they get the best care here, the veterans do. And it’s like we want the same thing. We should want the same things. But it just doesn’t seem like the management here at Cincinnati VA wants that.

Tom Temin We’re speaking with Eric Cromer. He’s a registered nurse at the Cincinnati VA Medical Center and a representative to the National Nurses United. And when you went to the office, I mean, did you come with noises and placards or something, or was it a scheduled meeting?

Eric Cromer It was a we call it an action, which it’s called a march on the boss. And it’s just a way to get the attention of the boss, which in this case was a director, Jane Johnson. She was there with her co-director, Chris Schweighardt. We just wanted to make them aware that our nurses were very concerned because they had been promised this flexible schedule for well over a year and it had been put off and put off, and it just had gotten to the point where it was apparent that they were just not going to do it. And so when you do something of this nature you just do it so they can see that this is what’s causing your nurses to be upset. We want to attract the best nurses and we want to keep the best nurses because registered nursing, there is a shortage around this country. So we do need to do everything we can to keep the highest and best talent that these veterans deserve.

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Tom Temin And with respect to that flexible schedule, what would change in your work life relative to how it is now?

Eric Cromer It would make it better. In the private sector, most nurses, they prefer 12 hour shifts. They do what’s called a compressed schedule, so they work 72 hours. In the federal sector, they do 80 hours. Now about half of VAs across the country, they already do this and it works out great. The actual productivity goes up, the absenteeism goes down, the overtime goes down. It basically lets the nurse have the same schedule as in the private sector where they work 72 hours and they get paid for 80. So it’s a great retention tool. We’ve had many people that stayed just because they were promised this a year ago. We’ve had people that were promised this and they took a job here and they haven’t been given it yet. So that extra day would mean a lot to so many. I mean, with child care and with job burnout, retention. And it helps you care for the veteran better because a happy nurse is going to provide better quality care as well.

Tom Temin And that’s 72 hours in a two week federal pay period, in other words. Well, I guess to the uninitiated, it sounds like if you have 80 hours of pay, why should you work 72 hours? How does that work in the private sector?

Eric Cromer Yeah, in the private sector, there’s all sorts of different scenarios. I mean, I know there’s like they have a weekend option where some nurses will only work weekends and they’ll get paid for the same amount of hours because the weekends are undesirable. So, I mean, there’s all sorts of flexible options in the private sector that they use to recruit and retain nurses. This 72 for 80, what we’re talking about was something that was actually passed in Congress to retain RNs. And I think it goes back to like 2012 or something, the actual statute that was passed. But it is one of the tools that the VA has given to retain and keep the nurses.

Tom Temin Right. So it’s optional for a given center to do the 72 or for 80?

Eric Cromer That’s correct. That’s correct. And right now I think we have about over half of the VA’s around the country do it. And there’s all sorts of studies that come out as far as like the benefits of it and what created this concern as far as this meeting was, it was actually promised to the nurses here at the Cincinnati VA via a town hall meeting chris Schweighardt gave well over a year ago. So once he said, hey, look, we’re looking at getting the 72 for 80 out for you guys. And this was in the midst of when so many nurses were leaving and they were going to travel agencies and things like that. This was something that was stated in a town hall meeting to try to keep nurses from leaving and to bring new nurses on. So it was promised and a lot of people got very excited about it. And here we are so many months later and we’re still waiting.

Tom Temin Right. And getting back to the policy with respect to the patients moving out of the ICU, what is the status of that and are they moving ahead with it or is it in limbo at this point?

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Eric Cromer As far as I know, they have not changed their mind on it. I just spoke with my director. She said as far as she knows, she didn’t get any information. In the beginning, they were actually doing the right thing because any time you have a change in work, you’re supposed to sit down with the union. And they actually did sit down with us. But when they saw that the Union was not going to be on board with putting our veterans at risk, they decided not to talk to us and use a clause, a very cowardly clause called 7422, which basically says that they don’t have to negotiate with us because it’s outside of the negotiating parameters.

Tom Temin Right. So it’s a potential at this point, but they haven’t actually pulled the trigger on it.

Eric Cromer Correct. We’re hoping that by bringing the concerns to the public and by letting people know that if they bring their loved ones here, that they could be at risk, that maybe they’ll rethink it because it’s something that I would not want to put anyone I love on a floor with not the proper trained RNs and staff to care for someone being on one of these drugs that regulate your heartbeat, essentially or life saving temporary medications.

 

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