Union says nurses can’t do everything

Bonnie Belec
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President hopes members won’t be expected to serve evening snacks

The Newfoundland and Labrador Nurses’ Union (NLNU) is digesting news that its members working with Eastern Health may be directed to prepare and serve snacks for hospital patients in between carrying out their regular duties.

NLNU President Debbie Forward

Union president Debbie Forward told The Telegram Thursday she hasn’t been told by nurses that this is happening, but if it does it will be an ill-advised idea and a waste of nursing resources.

“I would be very discouraged if this employer is taking the position that because we don’t have staff to do this, that the default is now registered nurses have to prepare snacks for patients and give them out,” she said.

Related story:

Cutting bedside snacks panned by critics

Foward said the NLNU has done significant work in the last couple of years with employers and the government around the whole issue of non-nursing duties, and taking nurses away from patient care to prepare food would set the whole process back.

“We can’t look at registered nurses as being the catchall to do everything. Is it sound financial practice to have a registered nurse, who’s making $25-$30 an hour, to make snacks for people on a regular basis as part of their nursing care? I think that’s a very poor use of not only their time, but I would argue their knowledge, expertise and what they can provide to the health-care system from a registered nurse perspective,” she said.

It hasn’t been that long since the profession moved away from nurses handing out meal trays, said Forward, and to take them away from providing patient care would be a step backward.

As reported in The Telegram Wednesday, Eastern Health decided to stop providing bedside evening snacks to patients at St. Clare’s Mercy Hospital and the Health Sciences Centre in October 2013, saying it was “identified as an operational improvement initiative to save $97,000 and reduce 1.8 full-time equivalent employees through attrition,” according to an emailed statement from Eastern Health.

That move also brings the hospitals in line with other facilities under its authority.

Evening snacks will continue to be provided for patients on special or therapeutic diets who have been prescribed evening snacks by their clinical dietitians, and to those who ask.

“We also recognize that some patients may be hungry outside of regular meal hours. As such, we will continue to stock snacks, including juice, milk, tea, coffee, bread and crackers on the units for patients who request it,” said the statement.

Is it sound financial practice to have a registered nurse, who’s making $25-$30 an hour, to make snacks for people on a regular basis as part of their nursing care? NLNU President Debbie Forward

Eastern Health said it will remind staff that snacks can be made available when people ask.

When Forward was asked what other staff are on duty with nurses in the evening, she said there weren’t any, and if the authority says it will remind staff, it probably means nurses.

 “For the most part it will be registered nurses. If that happened, the nurse would have to prioritize in terms of snacks and what other care they are required to provide to the patients they’re caring for,” Forward said.

“My members are struggling right now to provide nursing care and that would have to be their priority.”

She acknowledged that when a patient is admitted, often nurses will ask when the patient last ate, and if it has been a while, nurses will get them something.

But as for providing snacks on a regular basis, Forward said the union will have to wait and see if it becomes a concern.

“The employer is using all types of mechanisms to become more efficient — using the right person and making sure that person is doing the right job at the right time,” she said.

“But I would not see telling a registered nurse they are now responsible for snacks as being a very efficient use of the nursing resource. If that is happening we will work through it at the employer level and hopefully come to some form of resolution.”

In an emailed statement from Eastern Health Thursday, it said snacks are provided on the units by nurses and support staff prepare snacks and that practice will not change.

 “There is ample supply of snacks on our hospital units, and nursing staff best determine how that is made available to patients who request snacks. How, and the frequency of when snacks are offered to patients by nursing staff can vary from unit to unit. Most of the snacks that are stocked do not require much preparation,” it said.

 During a news conference on May 29, 2012, Eastern Health announced initiatives to improve its operations in order to balance the budget. Part of that is the elimination of 550 full-time equivalent positions to save about $43 million. The elimination of evening snacks is one of those initiatives.

 

bbelec@thetelegram.com

Organizations: Mercy Hospital, Health Sciences Centre

Geographic location: Eastern Health.That

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  • MCRNENCC
    February 21, 2014 - 18:09

    As an RN of 32 yrs who works in ER - our ER does not have LPN'S or PCA'S as part of our REGULAR staff. Note - I said REGULAR. If the workload is increased - and by that I mean lots of admitted people on stretchers in ER waiting for a bed - or any other unusually busy circumstance, we at times have an LPN or PCA on as extra staff. GOD LOVE EM'! Their help and enthusiasm and expertise is very much appreciated. So, when one of them is on duty - yes - they will give out a night lunch or change sheets - while I give life saving cardiac drugs or triage patients. But - when we have no help - I or one of my co-workers, will do the night lunch, will do a bed bath - or stretcher bath - will shave a patient, will change over stuffed laundry bags, we will toilet a patient etc etc. It all depends on what area you work in, and what your regular compliment of staff with their respective skills is. With all that said - I have always respected all my co- workers - and - always felt that LPN's and maybe PCA's too - now that I think about it - need a change- And maybe the change they need is a different union. NAPE is such a large union, and from what I have seen and heard in my many yrs of nursing - have not given the LPN's the best representation. Not downing the union as a whole - I'm not. And - as an RN of 32yrs - no BN here - some may say - what does she care - she's out in a few yrs. Yes - that's true - I am out in a few yrs - and glad to be out. But anyone who knows me knows that I have always respected all my fellow health care workers. From the top of the pack - to the bottom. "A" 's comment was right on the mark. As a front line - hands on health care worker - I feel that NONE of us on the front lines have an easy or enviable job.

  • Hungry
    February 02, 2014 - 16:24

    Snacks are awesome. They are fully stocked as aforementioned. Whom knows better what a patient can or not have to eat better than his or her Nurse, respectively. Respectfully, Hungry

  • Michelle Hynes R.N.
    February 02, 2014 - 12:21

    hmmmm evening snack or evening meds...let me choose or better yet why don't you.

    • Hungry
      February 02, 2014 - 16:39

      So you have an uncontrolled diabetic and a pt. NPO. Who delivers the snacks then? Hungry, Hypoglycemic

  • Anonymous
    February 01, 2014 - 20:51

    I would love to know where they are getting $53.77 an hour max refers to. I'm top of the pay scale and I get nowhere near that! I'd like to apply for the job he referred to. I beg all the people that are on here crapping on nurses to do one shift as a nurse. Maybe then they'll have half an idea what they are talking about. I do things in one shift that would make the strongest man vomit his last three meals. It would be a break to prepare meals. The publics perception of nurses is so sickening and uneducated that it has become a job that, though you give it everything you have, leaves you feeling unworthy. I've seen and done things that have almost broken me and these are the comments you get. It is the most thankless job that i find it hard to, in good consciousness recommend it to anyone. I love the job and helping people when they need it. But it has become so mentally and emotionally draining from so many levels. Only thing these days that makes it worthwhile is when a patient or family member thanks you and you know at least one person is happy you are there. I know as a registered nurse I have given out my fair share of lunches. For our hero the pca that is here, I also do my fair share of baths and changes, even when I did work in long term care! So I don't know what the nurses where you work do, but don't judge us all by them!

  • Studentnurse
    February 01, 2014 - 11:54

    Definitely agree with what Debbie is saying.. Being around the hospital, it is very easy to see how busy nurses are. Having this extra task is going to make things that much harder. However, I am somewhat confused and a little disappointed in Debbie's comment stating "registered nurses who are making $25-30 an hour...". No RN is making $25. It's clear to see this in the NLNU collective agreement. A brand new nurse on the bottom of the pay scale starts at nearly $31. And that goes up to $38+ To the top of the scale. It's a little strange to see the collective bargaining union president falsely stating the wages of her members. This should probably be addressed, especially if it was a typo.

  • Erin
    January 31, 2014 - 19:43

    PCA's & LPN's clean patients, feed patients, shave patients, take blood pressure,take temperture, do dressings & from what I understand are now capable to distribute meds in nurseing homes. If you want to know what a nurse does in a nurseing home just ask an LPN or PCA and they will tell you"nothing"

    • Francine
      April 08, 2014 - 08:02

      Erin that is soooooo correct. And people do only have to attend a hospital (visiting) and do only have to look around to see what nurses do. Nurses sit at the desk/office, they obstruct the ward clerk from doing her job, they go to meal breaks enmasse and leave people on the ward watch that they consider unprofessional (but good enough to cover whilst they all go on am, lunch and pm tea breaks). In fact nurses do a stack of things during a shift ----other than any nursing duties.

  • dougie
    January 31, 2014 - 17:35

    This is for irritated So I guess when our soldiers were in Afghanistan and were told they would be on point they could just refuse?, or when a firefighter has to run into a burning building to rescue someone, he can refuse as well?, or how about a police officer who is on a call that could become a firefight, he/she can refuse?. You chose this career so you should suck it up and do your job.

  • Wondering
    January 31, 2014 - 16:58

    I love how people pick on profession when they would not even choose it for a career themselves. You say we do nothing but stand chatting or sitting behind the desk. Humm I wonder what we are chatting about, does the incision lookworse today. Maybe this will work better. I think she may need a special bed. Sitting behind the desk on a computer, maybe we are looking up test result that family want to know the results. Sending off consults for treatment, or maybe entering new test to be performed. Always on the phone? Calling around other departments looking for medications because my patients meds not in stock in her locker. Calling the lab to see why her blood results are taking so long, checking xray to see if they are ready for my patients procedure? Calling the lab to add on blood work to the morning sample so I won't have to do another vein puncture on the lady who feels like a pin cushion. People talking about a nurse making $70000 over her salary due to overtime. Lol. Wish I were one. I haven't had 5 calls for overtime in the past two years! We are not allowed to replace the first nor second sick call but have to work short staff on an all ready busy unit. I am just wondering, when your love one takes a drastic turn and needs a diagnostic test at 2am butt he tech is not in the building. Would you be willing to wait 51/2 hours until the day staff arrives on straight time? When you love one has emergency surgery in the middle of the night do you care that an entire OR team who just have left just an hour ago and not yet in their bed are being called to return to do surgery on your love one. At that point, do you care if they are getting paid straight time or double time? If passing out evening lunches get passed back to the bedside nurse, well like always we will do it, because that is what we do! I will tell you it will be placed on a priority list like everything we do. I recently stopped my other nursing duties and went in and held the hand of my dying patient so he would not pass by himself. There is nothing worse for a nurse than to have a patient pass by themselves. We do it not because we have nothing to do. We do it because family can not get there in time or they can't handle the situation. I had to stay late to finish my work. Was a nurse holding a dying patients hand as he peacefully passed this cruel judgemental world worth the extra hour of pay if they were your family? BTW, I didn't put in for any overtime! I think the general public often stands in the hallway or doorway and look around but have no idea what they truly are seeing.

  • RANDY from the ROCK
    January 31, 2014 - 16:55

    I remember my first time in hospital, it was at the Grace. The nursing staff would get me a cup of tea twice a day. Back then they wore those beautiful uniforms and it was no trouble to pick them out, unlike today.

  • Eatin Cake
    January 31, 2014 - 14:52

    This union wants its cake and eat it too! Every time negiotations come up, or the suggestion that LPN's or other health professionals do certain tasks, this mofia lashes out and demands that RN's do the work. Now it's "don't ask me to do anything outside of exactly what I have to". What it comes down to is that this one union is sucking the life out of the full system. They're the ones getting disporportinate raises to everyone else and on top of that scheming the system to get thousands of dollars each in overtime each year. And don't tell me this doesn't happen because I see if first hand with a family member... she makes more than most doctors working the system. It's soon coming to the day when the only thing the hospitals will have will be RNs as the health boards won't be able to afford anything after this union gets finished. And what rots me even worst is that the people of this province sides with this union every four years when we're held hostage. Wake up people!!!

  • Irritated
    January 31, 2014 - 12:57

    I am a nurse working on a surgery unit and I can say that we have high turn around in patients and the only time I am found "sitting around" is taking off orders or writing notes in charts at the end of the day. The point is not that we find this task beneath us. I change beds, help with toileting, wash patients, give a snack to a patient that asks, as well as many other tasks! At the end of a shift there are many days we have to stay late to take care of a sick patient or clue up after a busy day with what ever we did not have time to complete. Adding a requirement to hand out snacks to our list will not help. Some nurses are staying late after a busy day, which requires paying overtime and everyone is concerned about the budget as is. I change bed sheets but i am not in housecleaning, I make toast but I am not in dietary and I take care of every patient as I would want my family members cared for so maybe you should not judge if you have not walked in my shoes.

    • nurse
      January 31, 2014 - 15:32

      Irritated, you couldn't have said it better. It's not that these tasks are beneath us, when we have a moment we do all that we can. It's just frustrating how a nurse can do the task of many others but not many others can do a nursing task, such as, insert IV's or prepare meds etc...

  • tammy
    January 31, 2014 - 12:26

    I am a pca worker in long term care and Lpns and pcas are the ones who provide hands on care..support ..and snacks to our residents not the RNs we wash and bath them..feed them provide emotional support for them.

    • get your facts straight
      January 31, 2014 - 14:41

      Tammy you work in one area, not all over Newfoundland and Labrador. I work in a city hospital in NL. I am a BN RN and I can tell you with most certainty that WE do hands on care. Do NOT speak for us all. At out hospital, we do the washes, the meds, the assessments, the toileting, the feeding, emotional support, iv incursion and countless other duties. We are with our patients all day long, we are the ones who pick up on a patient that is declining and most of the time are able to prevent that patient from getting to that code state. Along with that WE also get our patients snacks when we can. Not because it is our job but because if we don't, who else will, just like many other things that are not our jobs. We take care of the whole patient. Do not insult US by saying that you do the hands on care. That is not the case in most health care areas. You should not make a judgement like that based on your small minded point of view, just because YOU may see it that way in your work environment.

    • A
      February 01, 2014 - 23:12

      I think you are taking the role out of context. I don't think anyone denies that in a nursing home setting, that LPN and PCA worker are hard workers and do the majority of the care for the patients. Due to the acuity of the patients being lower, the care provided can be done by LPN and PCA. I believe that when they discuss this particular role of the Registered Nurse, that the added duties are being given to Nursing staff in the Acute Care setting such Emergency, Surgical/medical floors etc. In this case, your comment about RN's not providing the care is null and void. The RN's in these settings in a lot of cases are focused on providing care to acute patients, and by all means if after the care is said and done, then as a lowest priority providing snacks is acceptable. This is why a Registered Nursing Degree is a university degree and a PCA course is 10 months long. This should not take anything away from the PCA, just that it is a duty suited to the role of the provider and appropriate in a particular settings.

  • anonymous
    January 31, 2014 - 11:27

    As an RN working on a very busy medicine unit in the city, I am very upset, (but not surprised), that this is being pushed on us - on top of everything else we have to do. There are many days that I struggle to provide basic nursing care, such as hygiene and toileting patients as well as medications, dressings, assessments, documentation, collaborating with other health professionals and the list goes on. There are families who need support for their dying wife or husband, blood to be picked up at the blood bank and needs to be given stat to an unstable patient, a confused patient who fell down, another waiting to get their pain medication. We often have to write our notes in charts on our break and maybe get to pee once or twice in a 12 hr shift. Don't get me wrong, I chose nursing because I want to take care of people. But we are being pushed to the limit every day and I can tell you that it is affecting workplace morale everywhere. I don't look forward to work as much anymore, because of the general "the nurse can do that" and coming home exhausted and starving. What about all the other health care workers? We can't do it all. These types of changes are making me seriously reconsider my career. At the end of the day, when patients are sick and need specialized nursing care, the patients won't be getting a snack from me because we need to prioritize our care, just like everyone else in the healthcare field.

  • rotted
    January 31, 2014 - 11:12

    "...a registered nurse, who’s making $25-$30 an hour..." ..... Come on Debbie. RNs right out of school START at over $30/hr! Guess that must have been a "mistake" on your part. Another thing - it's funny that, when you're posturing in negotiations, nurses are apparently the ONLY profession in health care who can do anything for a patient and doom will hit all of us if nurses are cut back. The fact is you obviously feel you're "too good" to do menial duties like snacks, and patient care ultimately has nothing to do with the stand you're taking in this article.

    • W Bagg
      January 31, 2014 - 11:47

      your wage suggestion isn't true.

    • ricki
      February 01, 2014 - 18:03

      So it makes sense to pay someone $30-40 an hour to make sandwiches? Sign me up for that job.

  • concerned citizen
    January 31, 2014 - 10:56

    Its time to brace for more layoffs and cuts by the Cons.

  • M
    January 31, 2014 - 10:51

    Doug nails it!!

  • abby
    January 31, 2014 - 10:03

    Maybe she could call one in on overtime and pay her triple time, the dears.

  • Max Roe
    January 31, 2014 - 08:53

    I was curious about the statement from Ms. Forward that "...a registered nurse, who’s making $25-$30 an hour,...". Appeared very low for these professionals. A quick on-line search and review of the NLNU Collective Agreement salary scales (pgs. 100-101) reveals that Effective Jul 1, 2011 scales run from NS-28: $60,001.50 or $30.77/hr to NS-37: $104,851.50 or $53.77/hr. The only nursing group that makes around $25/hr are LPNs (to the best of my knowledge). If registered nurses are indeed making $25-30/hour, in my opinion they are underpaid.

  • Doug
    January 31, 2014 - 08:23

    It has nothing to do with concern about sound financial practices. Is it really a sound financial practice to be paying a nurse more than $70,000 in overtime or allowing them to collect a salary and pension at the same time? The real issue here is that Forward and company think that preparing snacks for patients is beneath them. One look at the nurses piled around the nursing stations in any hall way of the HSC should tell you that preparing snacks will hardly take them away from nursing duties.

    • William
      January 31, 2014 - 09:13

      So Doug, based on your speculative response, a Doctor should be emptying bed pans. I'm unsure of your profession or if you even have one but if you spend st least 4 years in a university and 60+ thousand to get that degree, why should you be doing the duties of someone who would be better suited for the role?

    • Angus
      January 31, 2014 - 12:55

      I agree with DF on this one. My last job in the private sector we were given an unpaid 1/2 hour for an lunch and location made it impossible to leave the building in this time period. Our manager had a habit of coming in and sitting down at lunch giving instructions and discussing problems from the day. One worker who had enough sent in 20.5 hours of overtime for this and asked the labor board to settle it. The manager went in a tirade but the labor board said "pay it" since this was originally an unpaid lunch the manager deliberately thought he would be able to squeeze an extra 2.5 hours a week by using this time for instructions and discussion about work discussions. This is such that the management goes today in both private and public sectors.

    • Suzy
      February 01, 2014 - 00:39

      As an R.N these comments upset me. Nurses are always judged and ridiculed in the public. I work in Critical Care and I do provide lunches to my patients. I give them there 3 meal trays per day also. In addition to that I hold their hand when they are dying, I provide the most intimate care to them that not one of you who isn't a nurse would be able to begin to mange . The public is ignorant of what a R.N does in the run a 12 hour shift...maybe they should ask someone who was just extubated what that nurse did for them or a patient who was just diagnosed with an inoperable tumor what that nurse did for them. I am so sick of reading about the public talking about how much we get or what we" Don't" do in their eyes. I know I deserve every cent I make and more. Debbie Forward did not say that preparing snacks was beneath a nurse. She said that it takes us away from giving that patient having cheat pain our undivided attention. If preparing snacks was a choice over cleaning a 30yr old after a bowel movement on a bedpan...sure but I am pretty sure that patient would want me to make sure he /she is so they don't get sore in their fragile state first over getting them a slice of toast. Furthermore snacks on units have been almost eliminated because of budget cuts so it isn't as simple as reaching for a cracker if they are not there.

    • Karen
      February 01, 2014 - 08:28

      Just wondering how you know the people standing around, as you put it, are Registered Nurses....they could be housekeeping, LPNs, PCAs, Xray staff, Lab staff, Students of all professions, Pharmacy techs...etc, etc, etc....nothing is beneath the RN, but the duties that can save a persons life or give comfort to them far superceeds passing out a lunch. If I wanted to pass out food, I certainly wouldnt have spent thousands of dollars for education and years of preparation . Perhaps we can ask the physicians to do it...come on people...everyone has a role within health care....we can do many but are expected to do all when the other health care workers currently doing it, are off duty....so much for the health care team....its ok to be part of the team but dont expect me to get your sandwich and fluch your powerport at the same time....unless the kitchen staff can do my duty, i shouldnt be expected to do theirs, otherwise, why do we need kitchen staff at all...

    • anonymous
      February 01, 2014 - 21:14

      Doug, Your comment is so insulting on so many levels I have no idea where to begin. Your very first comment contradicts itself. Don't pay the OT, but don't pay retired staff who can work at straight time? So, no one does the work? Do you think working the OT is like going to the beach? have you ever worked a 24 hour shift? do you WORK? I can tell you, as one of those nurses that you seem to place so high and mighty, I have seen and done things that would make your toes curl. I've also done things that you would consider so BELOW you, no amount of money would you do it for. The nurses you see piled around the nursing stations and halls, are they writing (work), they may have just done something that they are trying to process, may have just watched someone die, May have but hit, bitten, groped or degraded and are trying to get their shit together to go on to the next person. you really have no idea, you are only judging by what you think you see. May be the first time they have stopped that day. Unless you have worked a shift as a nurse, you really have absolutely no idea what you are talking about!!!