The Coastal Post - November, 1997

Kaiser Walkout Happening Over Standards Of Care

Registered Nurses will stage a one-day walkout October 29 at 54 Kaiser Permanente hospitals, clinics, administrative offices and regional labs in Northern California. The one-day walkout will begin at 7 a.m. on Wednesday, Oct. 29, and conclude on Thursday, Oct. 30. Some 7,500 RNs are affected by the action. Thousands of other Northern California Kaiser employees have also served notice of their intent to honor the strike.

"Kaiser has turned its back on RNs and patients by refusing our proposals to make sure RNs can practice nursing in an environment where they can protect patients and not compromise care. Instead, Kaiser is seeking 13 massive concessions that would roll back nursing standards 25 years," said Rose Ann DeMoro, executive director of the California Nurses Association.

While announcing the strike date, the RNs also issued a call to Kaiser to return to negotiations in an effort to avert the walkout and end the prolonged dispute. The call came in a letter to Kaiser chief executive David Lawrence. It noted the urgency of resolving the differences in the light of escalating patient care problems most recently evidenced in an announcement last week that continuing patient care deficiencies have prompted federal officials to again threaten to pull Medicare funding for Kaiser's Walnut Creek and Martinez hospitals.

Federal officials documented severe problems with inadequate RN staffing in the intensive care units and quality assurance at the two facilities. An earlier federal investigation, following a series of patient complaints, cited lengthy waits for emergency care and short staffing in labor and delivery that posed "a significant potential danger to mothers and babies." According to one RN, "conditions here are like a M.A.S.H. unit, more appropriate for wartime."

The findings mirrored the results of state and federal investigations earlier this year at two other Kaiser hospitals in Oakland and Richmond.

Those shortcomings, and "in particular an ongoing problem with inadequate registered nurse staffing, highlight the very issue that is at the heart of our dispute," wrote Nancy Casazza, RN, who chairs the nurse negotiating team for Kaiser RNs, in the letter to Lawrence. Casazza asked the CEO to direct his negotiators to return to bargaining "immediately-with the full authorization to achieve an agreement that provides for an effective voice for registered nurses and nurse practitioners in assuring patient safety and to withdraw all of the unnecessary concessions" Kaiser seeks.

Kaiser's staffing shortages coincide with its business decisions to cut RN staffing by 15% in the past three years in Northern California, a period which coincides with rapid membership growth.

While resisting CNA's patient care proposal, Kaiser continues to demand a multi-tiered wage proposal that would mean lower wages for RNs who work in clinics outside the Bay Area, and pay cuts of 19-35% for new hires; reduced health benefits, limits on time off and senior rights, and numerous other contract concessions.

By contrast, CNA's only issue, said DeMoro, is "to achieve enforceable mechanisms to stem the dangerous decline in care standards that has become prevalent throughout Kaiser. The RNs are trying to find a way to work with a system that has become focused on profit and still be able to protect patients.

"Kaiser needs to involve the RNs in problem-solving, and to assure that adequate resources are returned to direct patient care," said DeMoro. "Settling their protracted war on the RNs would be a critical first step."

The October 29 walkout will be the RNs' fourth short-term strike since the prior CNA-Kaiser contract expired last January 30.

While reducing patient services, Kaiser has been shifting its resources for expenditures on expansion, management consultants, marketing, and executive salaries, CNA officials say.

According to news reports, Kaiser has been paying one major firm, McKinsey and Co., $3 million a month for the past five years advising Kaiser how to further slash patient services, shift resources from direct care for Kaiser members in California for national and international expansion, and take a hard line in negotiations with the RNs.

Kaiser has also boosted its advertising budget by 700% the past five years, and handed out large pay hikes to its top executives while demanding belt-tightening for direct care providers and fewer services for patients. In the past five years, Kaiser CEO David Lawrence has received a 78% increase to a current salary of $1,250,000. In the past four years, Kaiser President Richard Barnaby has collected a 293% hike to $827,715, according to IRS filings. Additionally, 42 other top administrators were paid over $200,000 in 1995.

For the past few weeks, CNA has disseminated daily reports of patients who have been experiencing problems with care in Kaiser facilities. Patients will be invited to the picket lines on October 29, where they will be joined by RNs who will describe deteriorating conditions that the RNs see. "We hope that Kaiser will finally pay attention to the voices of its patients and its caregivers," said DeMoro. "Our members will not stand by as increasing numbers of their patients are placed at risk."

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