Professional Practice Committee of EMMC
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MARCH 5, 2008
MEETING CALLED BY
NOTE TAKER
ATTENDEES
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MINUTES
Diane Alexander at 1410
Theresa Crossman (Interim Secretary for SNPPC), respectfully.
Diane Alexander (Co-chair), Deb Richards (Co-chair), Theresa Crossman (SN Co-Chair and Interim
Secretary) Pat Martin, Charlotte Nolte, Connie Brown, Dannette McGowan, Tina Gist, Mary Ellen
McKenney, Wayne Marquis, Jaska Black, Barb Letellier
Tom Read, Ken Latarri, Cynthia Simsay, and Stephanie Baillargeon.
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Agenda reviewed and adopted.
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Changes requested by Deb R. as follows: under Lift Team 2nd
"such equipment. "
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paragraph, replace "such a team" with
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Changes made as above. Pat M moved to accept minutes with above change made. All in favor. Motion
carried.
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REPORTS OF COMMITTEES:
LIFT TEAM COMMITTEE
DISCUSSION Survey introduced to entire committee for review by Charlotte.
Distribution of survey discussed. Should be distributed to everyone in hospital as the team shall be accessible to all
patient care areas. Nursing techs should also be included in survey.
Ideas to distribute were via email with attachment, envelopes beside time clock on each unit/area, on intranet page as
online survey, message in Currents, MSNA board as a notice.
Deadline for surveys to be complete will be March 31, 2008
Include in email list Elaine Chambers, Ted Williams.
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ACTION
Send email out
Set up formal meetings for subcommittee lift team
OLD BUSINESS:
EMAIL LIST AND
UTILIZATION
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PERSON RESPONSIBLE
Diane
Charlotte volunteered
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Diane stated the need to have the list adjusted to reflect just nurses
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Cardiac floor is all online now per Deb R.
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Motion by Pat M to have managers check for appropriateness of the API access prior to a decision.
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Diane will work with Deb on lists
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PERSON RESPONSIBLE
Diane/Deb R
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Boxes are available and ready to use. Deb R wanted to know if there were any suggestion forms yet.
Diane states there were none as of today and that once the Currents article is out; hopefully we will
begin to see usage of the boxes.
none
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NEW BUSINESS
TME PAID FOR
COMMITTEE WORK
DISCUSSION
Clarification needs to be made and distributed to all managers with staff nurse PPC members.
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How are we to be paid for subcommittee work? Can it be on our already scheduled hours, as HB versus
EXT.
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All present felt we should be getting paid for any committee/subcommittee work we do.
PERSON RESPONSIBLE
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Clarification of ability to get paid, as HB versus EXT, will it be
department dependent, etc
API CLOCKWORKS
USAGE
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API timeworks- Access to API to view time, EXT, OT other than on the time clock itself. Some areas have
this access and others do not. Some managers present (such as Barb L) were aware of nurses' ability to
view on computer versus just time clock, and that is currently the practice in her areas. Other managers
were unaware and want to check for appropriateness prior to making the decision
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ACTION
API clockworks policy
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PERSON RESPONSIBLE
Deb will talk to Lorraine
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MED SURG STAFFING
MODEL
Per Deb, Stephanie involved in cost/benefit analysis process with Lorraine and others over several
months
Proposed is 4:1 RN, 8:1 for NT for days and "evenings", which is currently 4-5:1 and 10:1. It involves nursing units 3, 4,
5, and 6 in the tower and only covers days and evenings.
Requires additional 27 RN's, 8.6 NT. Cost 3 million dollars per year. Lorraine questions where will money come from as it
can't be from a non-nursing fund. Lorraine wanted to find it in nursing. These positions would be above and beyond what
is posted now on e-hire.
Pat concerned about patient acuity and how this factors in. Also, why is night shift not considered?
Dannette raised concern of the rising ADT rates, can start with 5 and d/c and admit 5 for a nurse. Still very hard for
nurses.
Wayne brought up the removal of the charge nurse involvement of assigning beds as a big concern.
Wayne and Charlotte discussed concerns about language, specifically r/t a higher acuity assignment. Shouldn't it be "up to
4" versus stating "4" to allow for acuity adjustments?
Deb-what are we doing today r/t higher acuity?
Deb-how can we come up with this money?
Ideas from group were a resultant decrease in EXT and OT hours, staff satisfaction which when over worked with hours
and stress levels higher, may encourage call ins. We could see a decrease in call ins for illness and stress.
Concern reintroduced by Connie, once again r/t night shift elimination. Deb re-iterated that she will bring the concern to
Lorraine.
No one had an idea of how to come up with money from nursing. All feel that we can't take any more from nursing.
Deb asks then where does the money come from if not from nursing? Lorraine had no ideas (per Deb) when asked by
Diane. She was unsure if Stephanie had any.
Deb- we need a "concrete" place to find the money.
Nursing budget includes salaries and fringe benefits per some managers when general question asked.
Jaska feels we need to look at pool and extra time money savings involved. Managers will look at this.
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Dannette discussed concern of managers on even being able to fill these positions.
Charlotte mentioned that nurses would be more apt to stay and or come back if the acuity/staffing were better. This idea
was emphasized by all staff nurses present.
Some of us can recall that nurses are leaving shortly after orientation because of feeling of overwhelmed. Charlotte
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pointed out that often times she hears nurses say that the 5 th
they have been told the same thing.
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patient put the assignment over the edge. Others agree
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Many of us (staff nurses) stated that we have already cut nearly everything possible to save money and that there is no
more to cut.
Mary Ellen pointed out that money savings on units have been utilized to make up for decreased reimbursement.
We agree nursing cannot handle any more "take aways". We are having a hard time to feel we are doing good patient
care in our current status.
Diane feels that if the need for staffing changes has been determined, how come it just doesn't happen and then we will
"reap the benefits".
Nurse educators and clinical supervisors are part of nursing budget on units.
Jaska feels what Lorraine is asking is no matter where it comes from -nursing versus non, the money needs to be found
in the floor budgets.
Tina suggest looking at other departments for contribution of funds and cutting down supplies cost.
Dannette wonders if we can write a proposal of our potential savings, via a pilot project.
Questions resulting from discussion:
What did eliminating the nurse call dept save?
On MED SURG UNITS: (list provided by Deb R at end of meeting)
What is the cost of EXT bonuses?
What is the cost of OT for one year?
What is the cost of pool for one year?
Cost of turnover for 1 year?
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Concerns rose about Med Reconciliation and Cerner System. Deb raised question of whether we need to have a PPC
subcommittee to look at this. Consensus is no, as we have a group here in hospital looking at that already .
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Deb would like to see everyone bring ideas to next meeting on how to fund this change.
PERSON RESPONSIBLE
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Discussion with Lorraine r/t night shift exclusion in model
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Deb states this is what is impacting staffing significantly.
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Concern by SNPPC members were brought that we can't do anything r/t FMLA secondary to federal law. Also, it is not in
the purview of the PPC to discuss these types of issues.
Mary Ellen states she understands contract issues, but why not as a committee be able to come up with a plan together
and utilize a sidebar with MSNA/CAN?
Managers are allowed to request MD notes for illnesses especially with habitual offenders, but some state they usually do
not.
SNPPC members re-iterated the need to be careful of contract issues as the PPC is not where they are to be discussed.
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Deb feels we all need to think about how we can deal with this within the scope of the PPC. Put it on
agenda for next month.
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Topics for Agenda for April 2008 per Deb R:
What can we do for sick calls and FMLA- ? Float nurse pool¼.again.
All should think about suggestions for improving coverage for sick calls, ratios, etc.
Diane asks managers what their suggestions were.
Deb feels we all need time to think about it.
MEETING ADJOURNED 1610
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PROFESSIONAL PRACTICE COMMITTEE
OF
EASTERN MAINE MEDICAL CENTER
MINUTES
Date: Feb 6, 2008
Location: Heart and Vascular Center Conference Room
Members present: Tom Read, Cynthia Simsay, Jaska Black, Charlotte Nolte, Barbara Letellier, Theresa Crossman, Connie Brown, Dannette McGowan, Debbie Richards, Diane Alexander, Pat Martin, Tina Gist, Wayne Marquis, Stephanie Baillargeon, Lisa Jackson, Mary Ellen McKenney
________________________________________________________________________
* Approval of January minutes, Motion to Accept by Jaska, all in favor, motion carried.
* Approval of February’s agenda, Motion to Accept by Connie, all in favor, motion carried.
* Update on email access
Many departments report 100% of their nurses now have outlook access. Grant 4 Cardiac, one of the larger units report 45% have access to date with more added each day. A contact list unit specific to be emailed to Lisa as current secretary from each manager for global mailings.
* Lift team
Discussion on the need for a subcommittee to focus on subject. Dannette, Stephanie, Connie and Charlotte and Helen Cheney (alt. PPC member) volunteered for subcommittee. Debbie suggested that Cheryl Russell, Robyn Frick and Tom Kohlmeyer be included in the subcommittee.
Chair to be decided at first meeting. Units such as CCU and ICU might offer some suggestions on how a team would benefit them. Debbie mentioned after speaking with Robyn F. earlier that there may be so monies available for such a team.
* Suggestion boxes - Final touches being made to boxes this week. Completion should be very soon. Suggestion forms are being finalized and a copy will be provided for both parties to accept.
* Unresolved business
* New Business
Open discussion - Debbie led discussion on why this forum might be a good one to openly talk about current issues. Issues that ultimately came to light during the past union negotiations.
Connie - “Nurses wanted their voices heard”, “Access to email is a good starting place“.
Pat M. asked, “What do you managers think was the reason why we were so upset?”
Deb - “Staffing concerns?” “Are there other issues?” Deb verbalized her hopes we would be comfortable in talking about those issues here.
Dannette - Offered her ideas, “Frustration with technology and the time needed for charting.”
Theresa - The loss of the charge nurse ability to book beds. The development of the PPC would give nurses a voice, which was what was most important during negotiations.
Stephanie - “I thought I had good communications with my nurses.”
Cynthia - “It takes twice as much time to chart and yet nothing has been taken away. It’s different in the tower. Patients are much sicker. The new people coming in have very poor work ethics.”
Pat M. - “Inconsistent use of policies has come up a lot. At some point this needs to be addressed on it’s own. It creates upset. Holiday scheduling is sometimes different per unit. Inconsistent weekend/holiday scheduling. Some MSNA nurses are getting all their holiday and weekends off.”
Deb - Would like to present a study on how much FMLA is being used. Cynthia states that intermittent use of FMLA strains her scheduling needs.
Connie - “Pool RN’s are rescheduling their hours. Leaving less pool positions available to cover the call-in’s.
Mass discussion on inconsistent use of policies - such as punching late, call-in’s, low morale, low work ethics.
List of Priority topics to focus on in upcoming meetings
1) Staffing
2) Global staffing with pt. thru put
3) Statistic on Tardy and Missed swipes
4) Absentees and FMLA
Pat M. “ What about having an open forum during each monthly staff meetings?” “So that some of these issues could be talked about on each unit”
Theresa - The suggestion boxes should help raise some of the issues without individuals being targeted.
Meeting adjourned at 1600.
Professional Practice Committee
Monthly Meeting
Date: January 9, 2008
Location: Mason Auditorium at EMMC
PPC committee members present:
Diane Alexander, RN - Co-chair
Debbie Richards, RN - Co-Chair
Theresa Crossman , RN
Dannette McGowen, RN
Lisa Jackson, RN
Stephanie Baillargon, RN
Patricia Martin, RN
Mary Ellen McKenney, RN
Connie Brown, RN
Tina Gist, RN
Wayne Marquis, RN
Jaska Black, RN
Tom Read, RN
Barbara L ‘Itallien
________________________________________________________________________
Meeting called to order on Feb. 9, 2008 at 14:00.
*Adoption of the Agenda
Motion to accept agenda as such by Connie Brown, majority vote to accept, motion carried
Language review and clarifications:
Composition of PPC read by Debbie Richards as defined by contract. Covering letter (A). The objective of the PPC shall be… to consider constructively the professional practice of Registered Nurses including improvements related to the utilization of personnel, and to recommend ways and means to improve patient care and the health and safety of Nurses.
All present in agreement that above stated objectives of the PPC is correct.
*Reading and Approval of minutes from Dec. 20th, 2007 meeting
Motion to accept, all in favor, motion carried.
* Receiving of orientation information as previously requested
Many units have not provided their orientation packages as of yet. Grant 7 just emailed it to Diane, Still waiting on Grant 8, Grant 5, M3S, PO3, ICU, CCU, Walk-in-Care, ED, Grant 6east & Grant 6 west send their packets.
* Receiving staffing plans as previously requested
Staffing plans to come from Barbara Lambarida at MSNA/C.N.A/NNOC
* Review of PPC Bylaws
Discussion - Diane Alexander- Co-chair, reviewed reasons why bylaws are important for this committee to have. They will give clear guidelines for the current and future members. Areas included but not limited to, Elections of members, Ground rules and How business will be conducted to be included.
Diane A.- We WILL be using the basic bylaws structure given to us by the California Nurses Association .
Tom Read - “We have a responsibility to our staff nurses that we represent. The bylaws are like the building blocks we need to fall back on to help guide us forward”.
Debbie Richards - Co-chair - requested the acceptance of the bylaws be tabled per Lorraine Rodgerson’s request. Debbie felt the need for ONE set of bylaws for the PPC. She was not opposed to the staff nurses having bylaws.
Motion to table the acceptance of the Bylaws by Cynthia Simsay, 2nd Mary McKenney, Vote = Favor 9, Abstained 6, vote carried
Diane A.- Lorraine’s early involvement is unwarranted.
Stephanie Baillargon- Asked why there is need for two separate minutes, it was reported that as a courtesy a copy of nurses first meeting was provided to all combined members. Minutes from this date forward will not include the combined meeting minutes as it was found unnecessary to provide minutes from both.
* Unresolved Business
Suggestion Boxes - Tom Read asked where we were at with the construction of the boxes. According to Debbie, they are in the process of being constructed at this time.
Motioned Tom, Connie 2nd , all in favor
Proposed ground rules from EMMC - refer to Proposed Ground Rule sheet
All meetings start and end on time
Adoption of Robert’s Rules
Minutes to be taken by designee on the PPC
Minutes to be approved at the beginning
Unresolved issues and/or recommendations will be brought to the Chief Nursing Officer by the co-chairs. These issues and/or recommendations will be brought forward with possible solutions, cost/benefit analysis, etc.
Agreement reached to not use the pillar format for meetings and minutes.
Move to accept -
Status on all PPC members having email access at EMMC
Discussion on the nurses obtaining in house email access. Diane and Debbie to contact I.S. dept to initiate email access for all RN’s.
In the mean time, posting of the minutes should be on the bulletin boards within each unit for those without email access, all dept with access will begin distribution via intranet.
Feb. meeting progress on where we’re at with the access.
* New Business
Proposal for a lift team at EMMC - Diane lead discussion on the utilization of a lift team. A proposed team of personal that would be trained to provide safe transfers for those patients that require heavy lift and/or safety issues that would require a specialty team.
Deb R. states she spoke with Tom Colemire concerning a trial team. A book entitled Safe Patient Handling and Movement by Audrey Nelson was passed around, Deb R. to make copies of certain pieces of the book that would be relevant to our needs.
Pat M. suggested getting data from Cheryl Russell in Loss Prevention as to the number of injuries and cost analysis regarding back injuries, loss time and /or cost to the medical center.
Theresa - Suggested using charge nurses at bed meeting to begin reporting number of pt‘s that could utilized a lift team.
Pat. M - was identified as an issue 4-5 yrs ago
Research to be gathered between now and the next meeting, who would qualify?,
Robin or Michelle Mayo to be contacted
Deb R. to make copies of materials so that members can review the material and discuss further the use of a team for next meeting
? Of using Transporters as members of a trial group
? Hours of operation
Research weight limits on the current stretchers being used.
In summary
- Next month come with ideas on who would qualify for assistance
- talk with Cheryl on injuries and Tom C.
- Everyone come with ideas on a draft for a lift team.
- Nurse managers to bring up the question at their next meeting on who might be used as a trial.
- Review goals Orientation plans, staffing plans, email list, lift team, bylaws
-Email for all nurses
Closing comments
Motion to Adjourn at 16:00
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