War Memorial Nurses Association

below you will find both local meeting minutes and labor /management meeting minutes for your review,

we have removed the last names to protect the inosent  =-)

Local meetings minutes

LABOR/MANAGEMENT MINUTES

MNA/WAR MEMORIAL MANAGEMENT MEETING

Present:    Deb Colbert, MNA President, Joe Cohee, MNA Representative, Sue Tetzlaff, VP of Nursing, and Susan Sliger, Director of Human Resources
Guests:    James Vollick, Staffing Coordinator

Date:        September 12, 2011, 8-10 a.m.

Subj:        DISCUSSION ITEM MINUTES

The above meeting was held to discuss the following items:

Service Pillar:
First Come First Serve Policy.  Susan has finalized the policy and posted it in the Meditech library on 8/18/11.  She sent Meditech notice to all employees to review the new policy.  Susan will send an electronic copy to Shela and Debbie.
MNA Pre-grievance Folder.  All MNA pre-grievances upon discussion with the Nurses leader either resolved or not, shall be turned into the Human Resources.  A folder is maintained in Human Resources; the pre-grievances will be brought to the monthly MNA labor/management meeting for review.     
Press Ganey Update.  Currently we are at 65% of our patients rating us a 9/10, goal is 75% and the national average is 68%.  We will be changing our impatient survey source to Arbor Associates effective October 1, 2011.  On January 1, 2012, Ambulatory Services and ER will change over.  The BHC has to stay with Press Ganey.  Arbor has proven that it gets more timely and better results by using a telephone service.  They will still select a valid, random sampling of our patients.  Arbor Associates is a Certified Medicare Vendor. 
Nursing Priorities List 2011.  Sue will provide an update of form usage at the next meeting. 
November 2 and 3, 2011, EDIs.  MNA and management want to encourage the attendance of all nurses to the November EDI.  MNA has asked about the attendance being scheduled on final schedules.  If you are scheduled on the day of an EDI management can assign your work station to attend the EDI.  The hospital encourages staff to attend on their days off; as we do pay for attendance.  Debbie and Shela will review some mandatory meeting language that Sue proposed at the meeting.
Pre-grievance Outcome Form Revision.  Susan will amend the pre-grievance form to add language regarding the rights of MNA to advance pre-grievances.

Growth Pillar:
GN/Interns.  Sue researched the Public Health Code and believes that we are complying with the guidelines.  Nothing has changed since the last formal review.  It is in the nurse’s scope of practice to provide direction and supervision of less skilled personnel and the performance of delegated duties.  The intent of the law is to encourage the learning process.  We currently assign nurses to preceptors that are comfortable in this role.  The nurse should access the level of the “less licensed” personnel’s abilities and only delegate duties that they are comfortable delegating.  Sue, will the hospital offer preceptor training again, as that seemed to help prepare RNs for this role?
OB Crosstraining.  Susan provided the date of October 30, 2011 that Deb S will start her crosstraining to OB.

Financial Pillar:
Update Financials.  WMH has had a profit for the first 7 months.  We have had a couple months of loss.  Patient admits are up.  Cash on hand should increase once our USDA loan and Meaningful Use areas have been finalized.  Susan will discuss with David to clarify in his monthly update the area showing physician practices with losses. 

People Pillar:
Article 27.2 Draft Pre-Schedule/Approval of PTO Time.  James’ sends out in his notice about the pre-schedule a reminder in that notice that vacation approved on the pre-schedule is not final.  Final approval of PTO time is on the final schedule only.  Nurses should read through his full email – so they receive important reminders regarding schedules.
Grievance #011311, C1, C2, C3.   To clarify who will monitor level updates and changes, nursing leaders meet one-on-one with nurses – during those meetings the nurse’s levels will be discussed and determined or updated.  The Kronos system is only able to designate those levels of C1 RN.  A separate spreadsheet or system will have to be maintained.  Sue recommended adding the level to the evaluation form.  Shela will highlight concerns of MNA regarding new contract language.  The intent is to have “general” language in the contract that applies to all areas and then department staffing plans for “specific” language for departments.  MNA will review the general language first. 
BCBS Insurance Plan.  Susan proposed to MNA to consider moving its members to the new 3-tier plan.  Non-union and AFSCME are moving to this new plan on 1/1/12.   A copy of the plan will be emailed to Shela for review, as contract language gives the hospital the right to amend the plan as long as notice is provided to the union in 30 days.  This plan has some benefits that Nurses will miss out on, if they do not switch.  We will have further discussion at the next meeting. 
#0131909 Grievance/Arbitration Settlement.  The hospital is moving forward with complying with the arbitrator’s orders.

Quality Pillar:
Missed Break Form.  Susan will delete this form off the Meditech library.  The original intent of the form was to provide data for management to use so that proper coverage could be obtained for meal breaks.  To date, there is very little reported data, so management is willing to eliminate the use of the form.  There is accountability on both parts to ensure proper breaks on the units.  Leaders and RNs need to communicate.
LTC RE:  Travel Nurses.  Sue responded to this concern and this resulted from changes on the unit, summer schedules.  MNA wants more cross training opportunities to LTC.  Sue will determine if there is a need for cross training.

Other:
Contingent RNs.   The hospital has posted 8 full-time positions; most likely our current contingent employees will bid on these positions. 
Schedules.  The team discussed pre and final scheduling concerns.  Sue will meet with Jenny and Dennis to clarify the contract language regarding master, pre and final schedules.   The contract language in Article 12.7 addresses the requirement to develop master schedules.  James Vollick from staffing will work with the Surgical Services leadership to complete this requirement in Kronos.  In conflicts, the highest seniority Nurses will be given preference.  On the preschedule any changes require a conversation first regarding a change of master schedules.  Concerns of final schedule changes are change of start time for next day cases; mandatory meetings; and movement of staff.   Susan will follow up with James in Staffing assisting with schedules in Surgical Services.

Pre-Grievance:
#09011 ER/Use of Holding.  Susan will respond to the pre-grievance as a 3rd step grievance. 
#091211 Med/Surg.  Two nurses have pre-grievances.  Joe will go to Lacy.  The concern is nurse aide carry over time.  The AFSCME contract, Article 9.3, addresses reporting time and shift carry over.  May need to change the model of care to a triad.

Grievances:
#081011 Salomon.  Susan responded.  MNA is reviewing and will get back to management.
#090711 Class Action Pharmacy.  Susan will respond as a 3rd step grievance and present to MNA.
#011311 Payment of Overtime.  Debbie will complete a LOA.

Arbitrations Scheduled:
    Susan will provide final resolutions on all three noted below for consideration:
#101110 ER Betcher – Payment of shift – (Betcher and Pattison will be combined and set for same date.)
#110110 OB Pattison – Shift Change.
Class Action BHC

The team convened with the next meeting scheduled for October 3, 1-4:30 p.m. in the VP of Nursing’s office.  Additional dates:  From October through the next year, we will schedule our meetings on the first Thursday of every month from 1-4:30 p.m.


MNA/WAR MEMORIAL MANAGEMENT MEETING

Present: Deb Colbert, MNA President, Shela Kahn Monroe, MNA Representative, Joe Cohee, MNA Representative, Sue Tetzlaff, VP of Nursing, and Susan Sliger, Director of Human Resources

Guests: James Vollick, Staffing Coordinator

Date: August 10, 2011, 2-5 p.m. and continued on August 16, 2011, 1:30-3:00 p.m.

Subj: DISCUSSION ITEM MINUTES

The above meeting was held to discuss the following items:

Service Pillar:

1. First Come First Serve Policy. Susan has this policy almost completed it is being reviewed by our leaders. Once finalized, Susan will add to the Meditech Library and send out notice to all employees.

2. Pre-grievances. All MNA pre-grievances upon discussion with the Nurses leader either resolved or not, shall be turned into the Human Resources. Susan will provide a folder in Human Resources for MNA pre-grievances to be logged and maintained. The practice is then to bring these grievances to the monthly MNA labor/management meeting.

3. Press Ganey Update. The baseline is set for the hospitals HCAP numbers (July 09-March 10). Patient satisfaction will be measured from July 2011- March 2012. The goal is to be above the baseline or above the national average. Currently from July 1-March 31, 2012, we are below the baseline. Communicating with nurses is up. We believe we are hitting the wall we will be providing more training and resources with our staff. We will be focusing on validation of rounding and key words. OB and Radiology are the pilot groups on validation and then will roll our training in September to all areas during lunch and learns.

4. University of Michigan. This year we were notified by the University of Michigan as one of 5 hospitals in Michigan to take part in a service and quality survey. The areas identified, when you take the employee satisfaction survey, will have an addition 5/10 minute on-line survey to complete as well. The information is confidential and the direct link to the University of Michigan is on the Employee Satisfaction Survey Link. We appreciate all of the feedback, this will help us gain more knowledge to seek improvements and focus on areas of service and quality.

5. November 2 and 3, 2011, EDIs. MNA and management want to encourage the attendance of all nurses to the November EDI. A topic we can all improve at is Crucial Conversations. Tina Aown will be the instructor as she is soon to be a Certified Instructor in this topic.

Growth Pillar:

1. Dialysis Cross training. Currently Dialysis has two interns. In the Fall, we will be posting cross training positions in Dialysis.

2. Surgical Services Jaimee. Jaimee currently holds a contingent RN position in Surgical Services; therefore she is a bargaining unit member. Even though she now has licensed as a NP, her job with WMH is a RN job. She will work in the capacity of RN with WMH. She holds both a RN and NP license.

3. Pharmacy: Safety Concerns. Sue followed up with Michelle and provided a summary of items addressed with Pharmacy. The meetings are held in Room 216, Sue will follow up with Michelle so that we can notify the night shift nurses of these sessions. We encourage attendance of all nurses to these meetings.

4. GN/Interns. Sue researched the Public Health Code and believes that we are complying with the guidelines. Nothing has changed since the last formal review. It is in the nurses scope of practice to provide direction and supervision of less skilled personnel and the performance of delegated duties. The intent of the law is to encourage the learning process. We currently assign nurses to preceptors that are comfortable in this role. The nurse should access the level of the less licensed personnels abilities and only delegate duties that they are comfortable delegating. Sue will look into the hospital offering preceptor training again, as that seemed to help prepare RNs for this role.

5. Cross training. A cross training to OB was awarded. The intern is already cross trained, so another nurse can receive the cross training posted. Deb Schoberg initiated a pre-grievance and Susan will follow up with Kathy Perry on her response to the pre-grievance.

Financial Pillar:

1. #011311 Class Action Overtime. Upon review of Article 22.6, Susan followed up and has updated the overtime rule in Kronos. Nurses shall be paid overtime, moving forward for all hours worked beyond 40 hours in a week, or if applicable SNOT. Issue is resolved.

2. Update Financials. WMH has had a profit for the first 7 months. We have had a couple months of loss. Patient admits are up. Cash on hand should increase once our USDA loan and Meaningful Use areas have been finalized. Susan will discuss with David to clarify in his monthly update the area showing physician practices with losses.

3. GN Wage Scale. The GN job description was amended to add language regarding the NCLEX. A GN must pass the test in two attempts or the following two options are available: terminate employment or be awarded an open position in which they qualify. Shela will write a LOA for us to sign.

People Pillar:

1. Non-Union/Union. Sue will follow up on Adriennes role. Joe Cohee stated she is on the call log.

2. Cell Phone Policy. The policy was updated and sent out to remind clinical areas that cell phones or personal devices should not be in patient care areas. MNA brought this forward, as nurses do have applications that they use to enhance nursing skills. Management has agreed to look into putting these applications on hospital systems to make the devices easy to access for all team members and to prevent nurses of using their own devices. Sue will follow up on the systems for nurses to contact physicians that want to be notified by text. The union has asked management to share with the team that is reviewing options and present the concerns of the nurses.

3. Unscheduled PTO Time. Discussion regarding the requirement to use PTO due to a recent policy reminder that all employees must use PTO if they have it on the books; the only time not required is during ROMs or if on FMLA. In addition a discussion of denial of PTO included James Vollick from the Staffing Office. Articles 12.9, 25.2, and 27.2 address PTO. If two nurses put in for PTO and vacation, the team is discussing whether the person with PTO gets it over the person who does not have any. Shela will review before further discussion, regarding FTE. It is managements intent to not deny PTO, unless there is no other choice. James mentioned that when you look at the whole, only about 2 percent of PTO requests get denied.

4. Article 27.2. The concern of nurses is that during the draft pre-schedule all PTO is being approved. As educated during the Kronos Sceduling implementation and communicated repeatedly, the system only allows for denial or approval. The final schedule dictates the final outcomes. James Vollick will ask Kronos, one more time, if we can add an additional option, tentative. Since James currently sends out notice to request PTO, he will add to that message, That any PTO requested and approved in the draft schedule is not final until the final schedule is posted. The Kronos Scheduling Policy will be updated soon and PTO will be clarified in it as well.

5. Grievance #011311, C1, C2, C3. To clarify who will monitor level updates and changes, nursing leaders meet one-on-one with nurses during those meetings the nurses levels will be discussed and determined or updated. The Kronos system is only able to designate those levels of C1 RN. A separate spreadsheet or system will have to be maintained. Sue recommended adding the level to the evaluation form. Shela will highlight concerns of MNA regarding new contract language. The intent is to have general language in the contract that applies to all areas and then department staffing plans for specific language for departments.

6. NDNQI. The survey is voluntary, but MNA will promote it to nurses. MNA will send out an email blitz on Meditech to its members. Shela will provide the language to Debbie for sending. The deadline to complete the survey is August 21, 2011.

Quality Pillar:

1. Missed Break Form. The form will be updated by Sherri Pavloski and Sue will provide to MNA. The form will indicate the name of the leader contacted, rather than a signature.

Other:

1. Contingent RNs. MNA is concerned that contingent nurses are getting preference of shifts, as the language indicates four shifts a month in Article 12.7. Shifts shall be offered to non-overtime first, by seniority order. Sue will take to admin team consideration to post 14 new FTEs (12/.9 FTE and 2/.6 FTE), due to a recent FTE analysis she completed of Med/Surg.

2. Schedules. The team discussed pre and final scheduling concerns. Sue will meet with Jenny and Dennis to clarify the contract language regarding master, pre and final schedules. The contract language in Article 12.7 addresses the requirement to develop master schedules. James Vollick from staffing will work with the Surgical Services leadership to complete this requirement in Kronos. In conflicts, the highest seniority Nurses will be given preference. On the preschedule any changes require a conversation first regarding a change of master schedules. Concerns of final schedule changes are change of start time for next day cases; mandatory meetings; and movement of staff.

Pre-Grievance:

1. #080211 GINA. Gina does not want to move forward with her grievance. When the staffing office offers SNOT shifts, they do mention in the call that it is SNOT. Otherwise it may be filling an already open shift.

Grievances:

1. #080211 DIANNA. Susan responded on 8/16/11 to the grievance. Grievance was resolved.

2. #081011 RONDA. Susan will respond.

Arbitrations Scheduled:

1. #101110 ER Michelle B Payment of shift (Michelle B and Kathleen P will be combined and set for same date.)

2. #110110 OB Kathleen P Shift Change

The team convened with the next meeting scheduled for September 15, 2011, 1-4:30 p.m. in the VP of Nursings office. Additional dates: October 6, 2011 from 1-4:30 p.m. From October through the next year, we will schedule our meetings on the first Thursday of every month from 1-4:30 p.m.

MNA/WAR MEMORIAL MANAGEMENT MEETING

Present: Deb Colbert, MNA President, Shela Kahn Monroe, MNA Representative, Joe Cohee, MNA Representative, Sue Tetzlaff, VP of Nursing, and Susan Sliger, Director of Human Resources

Guests: James Vollick and Janet Payment, Staffing Coordinators

Date: July 18, 2011, 8 a.m.-noon

Subj: DISCUSSION ITEM MINUTES

The above meeting was held to discuss the following items:

Service Pillar:

Press Ganey Update

. The baseline is set for the hospitals HCAP numbers (July 09-March 10). Patient satisfaction will be measured from July 2011- March 2012. The goal is to be above the baseline or above the national average. The three year trend from 2008-2010, the hospital went up in every area. 2011 the first six months we are dropping in some areas. Quality Indicators are up and remain up. It is not an option for WMH to be involved in value based purchasing. If we were a CA hospital it could be optional. How do we communicate this information to our nurses? Some ideas include reminder emails, directors communicate at monthly meetings, EDIs, and Restore the Roar. We have to deliver a message to show how it can help them.

Smoking Breaks

. It is difficult to prove that staff is smoking and not just taking breaks, especially during the nightshift. Nurses are advised to say "no", if they know a member of the team has already had their appropriate breaks having face to face conversations with the employee. Nurses should involve the Nursing Supervisors. It needs to be addressed in the moment, get the supervisors attention immediately.

Pre-grievances

. How can we improve this process? The purpose of pre-grievances is to track issues and make sure they are resolved. During the pre-grievance step, a nurse shall have a fact to face conversation with their leader first, the union leader may assist; however the employee must be involved directly. The purpose of this first step is to resolve the concern at the lowest possible level first. Susan will look into having a pre-grievance box near the MNA bulletin board so that pre-grievances can be collected. The current process is to submit the pre-grievance form, once addressed, to Deb Colbert or Susan Sliger so they may bring them to the monthly labor/management meetings.

Overtime Rules

. The Staffing Coordinators were present to discuss the current practice used in overtime situations. The discussion was regarding a partial overtime shift that was awarded to a less senior nurse. In this situation, Nursing Supervision awarded 8 hours of the shift to a high senior nurse and left the remaining 4 hours to be filled by the staffing office. The practice in the past has been to award the entire shift first and if that doesnt happen, then fill partial shifts. The nurse that missed the four hour shift was not awarded the shift as she was already working, and past practice was to award the shift to a nurse not already scheduled due to safety concerns. The hospital has just updated its scheduling policy and states that a nurse cannot work more than 6 shifts in a row or no more than 16 hours in a day. In this case, the nurse would have only been at 16 hours, as she already worked 12 hours that day. In this case, we agree to pay the nurse for four hours. The committee members agree that the nurse has accountability in regards to safe practices. The policy addresses the guidelines, but nurses need to be aware of these guidelines and turn down shifts if safety is compromised. In 2012, management will communicate to the membership regarding the awarding of shifts, due to the elimination of SNOT. The process will be to fill the shift Non-OT full shift first, then partial shift including those working. Overtime will be awarded in seniority order for full shift first and then partial shift including those currently working (not to exceed 16 hours unless Administration approves an exception to the rule).

Contract Language OT and Policy

. Susan will update the staffing policy to address the first come, first serve practice used on the final schedule for open shifts.

Growth Pillar:

Pharmacy: Safety Concerns

. At the last RNPC meeting, Michelle Nogalo discussed processes to improve pharmacy safety concerns. Michelle holds open sessions for Nurses to present concerns and so consideration can be made to improve. Sue will follow up with Michelle so that we can notify the night shift nurses of these sessions. Sue will send Joe Cohee a summary of the ideas that were submitted to address the concerns.

GN/Interns

. The discussion was regarding unlicensed staff and who is responsible. RNs delegating to LPNs, CNAs they are responsible for the work. The hospital owns the insurance policy and therefore is ultimately liable. Any concerns of GNs/Interns need to be brought to the leaders attention by the nurse. Under public health code, RNs are responsible for assessment, care plans, and assessment of those plans. Once skill is determined "competent", RN needs to be available to the supervisor (by phone). WMH had reviewed this requirement with the state for paramedics and Sue is confident that we are complying with the code. Sue will follow up on the code for any changes that may have occurred. The code states that if the staff is unlicensed, they can then fall under the RNs license. Sue will follow up for consistency and clarity of training provided to Interns/GNs during orientation. What duties can they do? Push meds, give IVs, etc. The nurses concern is litigation and scope of practice.

Crosstraining

. A crosstraining to OB was awarded. This was a new posting with no "new" training language. Deb Shoberg initiated a pre-grievance. Sue will follow up with Kathy Perry on her response to the pre-grievance.

Financial Pillar:

1. GN Wage Scale. The GN job description was amended to add language regarding the NCLEX. A GN must pass the test in two attempts or the following two options are available: terminate employment or be awarded an open position in which they qualify. Susan will follow up with Jane regarding Lauren.

2. Payroll Withholding. Susan sent out notice to union members and all members of the changes to payroll withholding regarding bonus pay. VALIC must be deducted from any monies earned, unless the employee changes options on the plan. The union will remind nurses in their Quarterly Newsletter too.

3. Update Financials. The first three months, the hospital has a profit. April-June no profit made. Economic times are hard and we are waiting to see how the changes in Washington impact healthcare. Cash on hand reports at 14-20 days; the goal is 34.

People Pillar:

Tracy Cross LOA

. A LOA was signed regarding the payout of terminal benefits for a terminating nurse. The hospital paid Tracy her contingent bonus, as the language was unclear. In the future, if a Nurse does not give and work her 4 week notice; no benefits will be paid including the contingent bonus.

Surgical Services

. In follow up to contingent hours, Mara Mauro resigned her position.

OB-ADA

. Shela followed up with the employee, the grievance was not filed. Matter resolved.

OB Tiah Borth

. Susan followed up that Kathy Perry was able to accommodate one 6-hour shift due to FMLA. After that one shift, she has returned to her normal 12 hour shifts.

Staffing Guidelines, C1, C2, C3. All staffing plans have been re-drafter proposing new levels of C1, C2, C3+, and C3 that will be common to all areas. Each specific unit will address specifics to these levels in their department staffing plans. The competency policy will be updated for communication of the levels. Shela will review prior to our next meeting and provide feedback.

Jen Larson

. Susan provided copies of Jens evaluation and competency checklist. A 90-day plan was not done as the annual performance review was close to the same time. Jen is now off probation.

Cell Phone Policy. The policy was updated and sent out to remind clinical areas that cell phones or personal devices should not be in patient care areas. MNA brought this forward, as nurses do have applications that they use to enhance nursing skills. Management has agreed to look into putting these applications on hospital systems to make the devices easy to access for all team members and to prevent nurses of using their own devices.

Quality Pillar:

Work Schedule, Breaks and Lunches

. The policy was revised on May 18, 2011 notating language for safety purposes. Shela and the union will provide suggested edits to the "missed meal form" at the next meeting for further discussion. The form is intended to track and trend, so we may determine areas where improvements need to be made.

Filling holes after final schedule

. Susan will work on policy to address current practice and application of new Kronos Scheduling system. The policy will address first come, first serve language as currently applied.

Pre-Grievance:

1. #101110 ER Betcher. Please see notes under #4, service pillar. To resolve the grievance, management agreed to pay four hours of OT to Michelle Betcher. Susan responded, grievance resolved.

Carry Over:

NDNQI

. Concerns from nurses in Surgical Services, that feel the information shared from the NDNQI survey was recently used against them. Management disagrees; the information was used to show a consistency of the results that were presented from other surveys and the Surgical Services Investigation. Management hopes nurses will complete the NDNQI survey and employee satisfaction survey, as this is the tool used to make changes and to gauge how we are doing.

Nursing Priorities

. Sue shared the nursing priorities list. MNA will sent that out to the members in a mailing.

Arbitrations Scheduled:

#101110 ER Betcher Payment of shift

#110110 OB Pattison Shift Change

The team convened with the next meeting scheduled for August 10, 2011, from 2-5 p.m. in the VP of Nursings office. Additional dates: September 15, 1-4:30 p.m. and October 6, 2011 from 1-4:30 p.m. From October through the next year, we will schedule our meetings on the first Thursday of every month from 1-4:30 p.m.

MNA/WAR MEMORIAL MANAGEMENT MEETING

Present: Deb Colbert, MNA President, Joe Cohee, Union Representative, Shela Kahn Monroe, MNA Representative, Sue Tetzlaff, VP of Nursing, and Susan Sliger, Director of Human Resources

Guests: Lana Beaulieu, RN

Date: December 6, 2010, 1:00-4:30 p.m.

Subj: DISCUSSION ITEM MINUTES

The above meeting was held to discuss the following items:

Service Pillar:

1. OPS/First Floor Plan. The plan for Sara Hill to move to Dialysis has changed. The nurse that was willing to reduce; has changed her mind. The union requests, that if possible, Sara is allowed to cross train there in the future so that the hospital could eventually eliminate a contractual nurse. Sara will be issued her layoff notice with bumping rights and shell be allowed until December 13 to inform of bumping location.

2. OPS Bumping Rights. Lana Beaulieu attended the meeting to notify all parties of her intent to bump to Holding, Nancy Lightfoots position. Lana will send an email indicating her choice. Lana asked to review the orientation packets for Recovery and Holding by Friday.

3. Chippewa Dialysis. Can we invest money to cross train to Dialysis? The training is about a 6 month period. If Sara moves to Med/Surg she believes the cross training would be better possible, but Sue will follow up with Marla regarding this issue. Due to the unpredictability of available hours (sick calls, vacation relief) the cross training may be difficult.

4. Press Ganey Update. The numbers were reported and do not look good. Ratings are down in OPS, ER has increased to the 90 percentile. Debbie has indicated that attitudes are the same in other areas. OPS believes that Jenny should be more visible on the unit. OPS is looking at instituting patient assignments.

Growth Pillar:

1. New Grad RN Hiring. MNA was concerned about Grad Nurses stating they are promised employment. Sue stated that she will be taking 8 graduate nurse positions to Admin Team for review. If posted, they will be hired as GNs and then are available to bid on open positions upon licensure. They will be scheduled with preceptors on old first floor, not the Fast Track area.

Financial Pillar:

1. SNOT Proposal. Union membership unanimously declined the revision to SNOT language at this time. The union believes the timing is wrong and it should be addressed during wage negotiations.

2. Notice of available shifts after final schedule. Susan will work on the development of a Kronos Scheduling Policy to address the awarding of open shifts. The timing is good as the implementation of the new scheduling occurs on December 26, 2010.

3. Notice of available shifts based on staffing plans. Susan will verify how the new Kronos will work for the BHC, LTC and ER to allow LPNs to work for RNs, etc.

4. Posting of PTO Declination. A form was created for non-union employees to use to stop PTO accrual to help with a 10% reduction for all non-union employees. Union members were confused of why it was posted on the pillar boards. This form does not apply to MNA.

People Pillar:

1. Surgical Services Intermittent Nurse Request. Susan will follow up with the Director whether a .5 FTE or intermittent nurse option is available to Peggy Willette. Another leader allowed a voluntary reduction. Decision is based on the departmental needs.

2. Surgical Services Crosstraining to Prescreening. Sue will follow up with Jenny regarding Stephanie Burkes crosstraining to prescreening. General membership is not getting the opportunity to crosstrain. Future crosstraining to prescreening will be posted and awarded by crosstraining rules.

3. Surgical Services, Late PTO. The granting of late PTO requests over roming. Late PTO requests do not trump roming; roming should be offered first.

4. Surgical Service ROMing by non-management. The RN running the board, may pass the message regarding ROMs, however management makes the decision. There may be a better way to communicate it so it doesnt sound like they have made that decision; using keywords.

5. Surgical Services Oncall. A member in holding is not required to take call. Jenny will be notifying the nurse of this requirement as it is noted in the job description as required.

Quality Pillar:

1. RN Staffing Plans. The staffing plans are available in the Meditech Library for all to view. There is a separate file titled, Nursing Staffing Plans and Guidelines.

2. LTC- AFSCME grievance. Carrie Horton the new DON on LTC has worked at other facilities that allow the LPNs to complete admissions. We are still deciding if this is something we want to do or not. There is not rule that prohibits it, as the LPN can give IV meds. The RN cannot delegate the care plan.

Pregrievances/Grievances:

1. October 18, 2010, Re: Awarding of Shift (Michelle Betcher). This grievance has progressed to Step 3.

2. October 11, 2010, Awarding of OT. Michelle Betcher was not granted a shift that would have put her at 8-12 hour shifts in a row in the ER. This grievance has progressed to Step 3.

3. October 18, 2010, Awarding of Shift. A grievance filed by Kathleen Pattison will move to Step 2, given to Sue on 12/6/10.

4. ER RN work plan. Will be sent to grievance level.

5. OR RN work plan. RN has progressed and has worked independently.

6. LTC work plan. RN received work plan on 11/22/10; a meeting will be held to discuss.

7. PTO Request McBain. A grievance may be filed.

The team convened with the next meeting scheduled for January 10, 2011 from 1:00-4:30 P.M. in the VP of Nursings office.

MNA/WAR MEMORIAL MANAGEMENT MEETING

Present: Deb C MNA President, Joe C, MNA Representative, Sue T, VP of Nursing and Susan Sl, Director of Human Resources

Date: April 12, 2010, 1:00 4:30 p.m.

Subj: DISCUSSION ITEMS

The above meeting was held to discuss the following items:

Service Pillar:

1. Monthly Press Ganey/Servie Action Update. Sue T reported on current numbers. Med/Surg was down in the personal and nursing areas, ER/Amb Care were up in both areas. OB and ICU are in the 90 plus percentile. The nursing leaders in these departments round on every patient every day. In outpatient, the leaders only round for service recovery. Nurse leaders will be asked when rounding to have the patient rate the care from a 0-10. Sue will discuss with Jenny and Pat regarding implementing a volunteer to help round and call back patients. We are moving in the right direction. The SAT team is also focusing on the service pillar.
2. Grievance #010808 Chemo Training. Susan will follow up with Marla related to the crosstraining to Chemo. The group felt it was important for her to understand where the need came from and it was the result of a resolution to a grievance.
3. LTC Pain Medications. The new leader, Carrie H, believes Specialized is very responsive to this need. The staff was queried and management is committed to make sure the resident gets what is needed. If needed the staff must get it, and if the nursing supervisors must step in the staff should involve them as well. There is a heightened alert and doctors are responding while on call as well as Dr. Bender in the ER to use as needed.
4. Infusion Therapy. The union asked that the hospital reconsider paying $1.00 more per hour for PICC lines. Management stands on its new contract language that only pays $1.00 more for national certifications. There are three certifications for the Infusion area: OCN, COCN, and CRN. The union believes that due to the number of PICC lines and only one person being able to do them it is important to consider training another person. Debbie C volunteers to learn this skill. In addition, the union pointed out that PICC lines are not noted in the job description. Susan will follow up with Marla regarding this concern.
5. OB ROMing- Sydorra R was ROMd by the nursing supervisor early in the day. Sydorra was out of town and ended up being needed, so she came back. To prevent this in the future, no ROMs should occur till after 5:00 p.m., as the staffing logs are not updated until that time each day.
6. OB Master Scheduled Nurse. On April 3, 2010 the staffing office scheduled a total of three nurses and a master scheduled nurse was asked to take a ROM. It was the Easter Holiday weekend and Shannon was master scheduled and called and asked if she would voluntarily take a ROM. Nancy B was put on for the shift. Susan will check with Sault Area Hospital to see how they schedule call (i.e. schedule FT hours first, before seniority)?

Growth Pillar:

1. FTE Evaluations of OB and Surgical Services. Currently Sue T has reviewed outpatient surgery and central sterile. A LEAN process will review the central sterile area during the week of April 19^th. The OB review has not been completed yet. Dianne N still holds a .3 Float to BHC.
2. Follow up LTC RNs. Joe C and Sue T met with three nurses (Kathy, Helen and Rachel) last week. The nurses have concerns of not being able to trade shifts easily. The nurses seem to have concerns since the MNA newsletter went home to them and they wanted to know that there was not active plan to phase the RNs out of the unit. Jason A did tell them that with 8% cuts of Medicaid that leadership would look at every vacancy and consider options. The current staffing plans were discussed with the nurses informing them that we staff above the guidelines. Jason A mentioned to Kathy S that the staffing office goes above to help her get her scheduled covered in the case of a request to be off.
3. Follup LTC ER Letter of Agreement. Currently the staffing office does not automatically put LPNs replacing RNs for open slots on the pre-schedule. These changes will not be moved to the final schedule without director approval. Susan will update the Letter of Agreement for signature at the next meeting.
4. Dialysis Crosstraining. Kelli V, Dialysis, was asking to be able to move to the next person interested for her crosstraining position as the RN selected was off work for an extended period of time. It was determined that the Nurse returned to work the week of April 19-23, so Kelli will move forward with her crosstraining.

Financial Pillar:

1. Monthly financials. Sue T reported that we are currently behind last years numbers. We are on target to meet the $1,000,000 goal. The speaker at the LDI will talk about finance and leaders will be expected to develop a contingency plan.

People Pillar:

1. Report from 4/8/10 RNPC. The group met and focused on ideas for celebrating Nurses Week. The nurses had some great ideas. The group agreed with moving forward with the Teddy Bear Clinic, Specialty Coffee, Scrubs for Nursing, Prizes of Nursing Logo wear (scrubs). MNA will send some things for giveaways as well. The RNPC minutes are noted in Meditech for review. The next meeting is July 8, 2010 at 4 p.m.
2. LTC Discontinuation of RN position. WMNA stated they received no notice of this change. Susan had sent email notification to both unions on March 10, 2010. The hospital switched the position over because it was a difficult to fill position when the RN was hired; it had been open for a very long time. Also see above notes under growth pillar #2.
3. Janet L. Management supports that Janet returns to MNA with her seniority being reinstated due to return to the bargaining unit within 6 months. Susan will verify with Mandy in Payroll that she only retained the seniority hours that were frozen before 10/19/09.
4. All Departments Summer PTO. The concern was mentioned regarding vacations for the nurses. There are not a lot of vacancies to cover, so far. Department Directors are asking the nurses not to take too much and Surgical Services stated dont take prime time. Sue believes the requests are due to the number of projects that are taking place this summer. Auto Cabinetry, Online Occurrence Reporting, Nursing Documentation Change, Adding New Surgeons Bariatric, BHC New Documentation system, and Jenny has a huge project list. Debbie will follow up with Jenny F. Debbie has been asked to teach OB/Peds Clinicals by LSSU.

Quality Pillar:

1. OB Crosstrained Nurses. The goal is to teach RNs to put a fetal monitor on (not to read them). They will not be required to do NST and full fetal monitoring until further training is provided. Ronnie H developed a beautiful orientation competency checklist to be used.

1. OB NRP. Kathy P, Director of OB, was verifying nurses certifications. She only notified the nurses that needed updates. Due to not having a trained instructor on staff, she will update the requirement to obtain NRP within 18 months of hire.

Pre-Grievances.

1. #030910 Dianne N On Call. The baby was transferred to OB. The reason Dianne was requested to go to Med/Surg was the baby required a gavage feed. As noted in the OB Agreement and in the management rights clause, the employees work assignment is assigned by the Director. Nurse cannot bump unless approved by the Director and seniority does not apply in this case.
2. #040910 Ronnie H. Ronnie believed she was not called for a shift. Kathy received the pre-grievance form. Debbie Ct worked till 5:30 p.m. (4/1/10) on OB. The on-call person, Adrianna, was able to flex her schedule. Ronnie was already scheduled for the night shift and we needed her. Ronnie wanted to work the 16 hours and believed others were called before her. Past practice has been to flex hours and night shift work 16 hours. Susan will verify on the call log with Janet, Staffing, to see what is on notice for Ronnie H. Ronnie stated she wasnt called.

Parking Lot:

1. Charity Zs ADA. The OB team was very supportive of the short notice change in schedule. A new final schedule was developed by the OB team, so Charity can be scheduled for Sunday, Monday and Tuesday nights. There are three nurses on when she is scheduled. Charity will be required to follow up every two months to HR/OB with a doctors progress note. Susan will remind Charity to update her on May 25, 2010.
2. Mary B. Issue resolved regarding benefits.
3. #011408 Dependent Licenses. Letter ready for signature at 5/3/10 meeting.
4. #111909 Tamara H Grievance. Letter signed, need Shelas signature.
5. #11121010 Cathy S. Letter signed, need Shelas signature.

The team convened with the next meeting will be held on Monday, May 3, 2010 from 1:00-4:30 p.m. in Human Resources.

MNA/WAR MEMORIAL MANAGEMENT MEETING

Present: David P, MNA Representative, Shela K, MNA Representative, Deb C MNA President, Sue T, VP of Nursing and Susan S, Director of Human Resources

Date: March 1, 2010, 1:00 4:30 p.m.

Subj: DISCUSSION ITEMS

The above meeting was held to discuss the following items:

Service Pillar:

1. Nurses Week. Nurses Week will be discussed at the next Nurses Leaders meeting in February. Leaders would love the help from MNA. The leaders will focus on the baskets, if MNA will focus on events. At the end of the next RNPC meeting, the events can be planned. We know that the crepe breakfast is always a hit.
2. Information Request re: Medicare/Medicaid reimbursement. Thank you to David for submitting the article regarding consumerism. It will be published in the monthly WMNA newsletter. MNA found the article to be very informative. On April 30, an open education for all employees by Steven Berger on Whats hot in healthcare finance! will be presented in the Medical Library. As well as he will be speaking at the next LDI on April 29, 2010.
3. 2010 Goals Press Ganey Results. This will become a monthly agenda item at the labor/management meetings. Amb Surgery results were Nursing 24 and Patient Issues 52, ER = Nursing 14 and PI = 42, and Inpatient Nursing 48 and PI 35. Total average = 36 the goal is 90. These results represent any survey received in 2010 (Jan Feb 25).
4. Service Goal Action Plan. This topic will be combined with the RNPC. MNA wants to get more involved. Debbie is asking nurses to attend to help plan steps to move forward.
5. OPS/Chemo-Infusion Training. Debbie will set up a meeting with Marla to set up a cross-training agreement. The original reason that Debbie stepped up to get cross-trained in this area was to resolve Grievance #010808.
6. LTC Pain medications/end of life. There was a concern that pain medications were not available as needed on the unit due to an issue with the use of outside pharmacy. A new Nursing Director started on LTC with a lot of experience in LTC, so she may have a new approach to take regarding this problem. Issue will be addressed at the next RNPC meeting as well. The reason outside pharmacies are used is due to the specialists needed with geriatric patients.

Growth Pillar:

1. Follow-up LTC RNs Posting of Holes. Sue T will get with Jason to set up at next staff meeting to address the staffing plans on LTC. She will educate the staff on the State guidelines regarding staffing a LTC unit.

Financial Pillar:

1. Recent Reports and Information. Sue reviewed staffing plans, FTE, and budgets. She stated the number of dollars spent in overtime, SNOT and callback time is a goal that units are looking at to reduce. Leaders are challenged to reduce these numbers. For example, Med/Surg paid over $200,000 in those areas and OB paid over $116,000. Jane recently reminded her Med/Surg staff that they are variable and that she will staff to meet the needs of the department.

People Pillar:

1. Positivity Training. The union brought forth that staff felt threatened by the emails sent from directors regarding the training. Management explained that the idea came from the Service Action Team (SAT) that has MNA members on it. The intent was to rid WMH of negativity in the workplace. Leaders were to nominate individuals to attend the training and talk to them privately of their selection. Jenny was out sick and sent an email as follow up assuming that her assistant had spoken to her attendees. Jenny spoke directly with Julie V via telephone, as Jenny was on a medical leave. A pre-grievance will be filed. David Ps concern is that bargaining members are reporting other members. MNA does not condone bargaining members forming coalitions with management against its own members. MNA believes perhaps giving this training to all versus singling out would have been better. Susan explained follow up that she had with attendees and it appears that the training helped some see they had a problem. At least, the training started some amazing conversation. Management agreed that the training did not go as planned and in hindsight would have done things differently. Management is looking at providing some lunch-n-learns to teach on topics related to a positive work environment and all employees will be encouraged to attend.
2. Development Behavior Standards. Susan and Debbie believe we need to encourage employees to talk face-to-face when issues arise, as noted in the behavior standards. Possibly a documented form, similar to the pre-grievance form could be used, so a leader knows the employees have taken that step already. Leaders will be encouraged to direct subordinates back to the person before he/she jumps into the problem. Susan will talk with Julie C, Employee Relations Manager, to see if this topic can be addressed at her next employee team meeting for ideas from that group.
3. Awarding Positions (Articles 50.9 and 50.10. Susan and Sue will work on proposing new language to propose a Letter of Agreement regarding this change. This resulted due to FTE analysis that is being completed in surgery.
4. Staffing/Scheduling. Debbie has submitted notification to her membership regarding them providing updated information to staffing.
5. Dianne N. A pre-grievance was filed with Kathy P. Sue will follow up for the next labor management meeting. Dianne was a .6 converted to a .9 for meeting hours per contract. Dianne can work at OB and BHC (2 units), as long as her cross-training is current. Currently Dianne is scheduled 2 days and then her third day she is a float.
6. Charity Z. HR is waiting to receive updated paperwork from charity regarding her FMLA paperwork. Once that is received, it will be reviewed and considered by management. Charity is asking for accommodation of certain work days.
7. Med/Surg Scheduling. Jane has only had two disgruntled employees regarding the schedule changes made on the unit. The union supports that the contract if being followed regarding these changes. Jane did sit down to work with the RNs on days that are more convenient for them.
8. Mary Brown. Susan will follow up with Mary B regarding her benefits. Mary was a CNA, Intern, and then now GN.

Quality Pillar:

1. UR Registered Nurses. Sue T will complete the RN portion of the evaluation that Jane M previously completed or delegate it to an appropriate licensed leader.

1. Letter of Agreement (Grievance #011408). Susan will update the current LOA regarding substitution of shifts of dependent licenses regarding LTC and ER. The union or management has not heard anything from these units regarding this practice; actually the nurses prefer this option.
2. OB Crosstrained Nurses. Sue will follow up with Kathy P on what her intent is regarding the clarification of crosstrained nurses to OB. Are the crosstrained nurses considered to be C2 Mother/baby or do they do NST (basic nursing skills, vitals, strips, etc.)?
3. MichiganCenter for Nursing/Institute of Nursing Excellence. Two nurses are being recognized: Joy C and Rochelle D. The hospital pays $3,000 for them to attend the event in Crystal Mountain on the dates of March 21-24, 2010. Congrats to our nurses!!!

Pre-Grievances.

1. Shannon W. Resolved.
2. Jessica K. Resolved.
3. Negativity Training. Resolved/Discussed.
4. Email regarding Resident Concern. Advanced to the next level of the grievance process.
5. Dianne N. Will follow up with Kathy P to get it.

Parking Lot:

1. Grievance #021210 LTC EMail. Susan has responded to the grievance as a classaction grievance at Step III. She will send out a follow up email to the Nurses on the unit discussing the outcome of their concern.
2. Grievance #111909 Hart-M. Letter of agreement for resolution was discussed. Debbie will follow up with final resolution.
3. Grievance #01112010. Responded on 2/1/10. The group agreed to set it aside to allow time for the new nursing leader to build a relationship on the unit. Management will follow up with Carrie H, DON regarding this concern. As well as the union will touch base with the grievant.
4. Grievance #011810. Referred to arbitration.

Other:

1. Introduction of new MNA Labor Representative. Ms. Shela K will be taking David Ps place representing WMHs MNA.
2. Delinquent Union Dues. The RN on Med/Surg has arranged to payroll deduct and get her dues up to date. The union will follow up on the other members dues. He stated he had taken care of them with MNA headquarters.
3. Jeanne M. In follow up, Jeanne has 12.1 years at WMH, which could qualify her for intermittent nurse status as noted in the MNA contract. Jeanne M. will go contingent and once she is off orientation, must apply for this status with Sue T

The team convened with the next meeting will be held on Monday, April 12, 2010 from 1:00-4:30 p.m. in Human Resources.

MNA/WAR MEMORIAL MANAGEMENT MEETING

Present: David P, MNA Representative, Deb C MNA President, Sue T, VP of Nursing and Susan S, Director of Human Resources

Guests: Marla , VP of Services and Jane , Director of Med/Surg/ICU

Date: February 1, 2010, 1:00 4:30 p.m.

Subj: DISCUSSION ITEMS

The above meeting was held to discuss the following items:

Service Pillar:

1. Information Request re: Medicare/Medicaid reimbursement. MNA is requesting that Sue/David submit an article on consumerism in regards to reimbursement to them for their monthly newsletter. The RNs need to understand consumerism, Studers consultant role to help comply with quality goals and how this impacts reimbursement. Sue mentioned that currently some BCBS payments are related to U/R, medication safety, etc.
2. EDI #1 Update. Currently have 395 employees attending one of the four sessions. There are 2 RNs on the task force (Sue S and Helen C). Joe C and Colleen W have been notified regarding the next planning meetings. There will be evaluations completed after the sessions.
3. 2010 Goals Press Ganey Update. Sue recently sent out an e-mail explaining the hospital goals. Employees will receive more on goals at the EDI. Goals were also discussed at the RNPC meeting. Currently departmental quarterly goals are set. Debbie suggested ideas to Jenny for Surgical Services to help nurses better understand the flywheel. Sue will work to develop a planning session in late February for Nurses to work on 90-day plans.

Growth Pillar:

1. Update of MedicalOfficeBuilding. MOB to be completed by June 2010. By July the building will be in use. Ground floor: CCC, SWH, Sault Peds, X-ray and Lab Draw areas. 2^nd Floor: Dialysis (9 chairs instead of 5). 3^rd Floor: Contractor will decide who occupies. 4^thFloor: Dr. Adair and Dr. Rechner (General Surgeons), NP, Bariatric Clinic, Dr. Glay and Dr. Ganzhorn (Orthopedic Surgeons). Updates will be provided at the employee forums or in Davids monthly CEO reports.
2. Moving Chemotherapy to Dr. Bolmers Office. Marla Bunker attended the meeting to clarify for the nurses the expectations of them in Dr. Bolmers office. It is Marlas intent not to have our nurses mixing drugs. Marquette Generals RNS (2 nurses) do mix chemo drugs and are expected to that as part of their job description. At this time, Marla wants the nurses of WMH to get familiar with processes used in the clinic. In the future if WMH desires our nurses to mix drugs, it will not happen until they are fully trained and comfortable with it. WMH is in a joint venture with Marquette General in Chippewa Dialysis and Dr. Bolmer is our employee.
3. Nurses Week 2010. WMNA wants to be involved in Nurses Week. A planning group will be formed at the Nurse Manager meeting in March. WMNA is willing to help plan events or provide gifts.
4. RN Internships 2010. This year the hospital will focus on providing internships to employees already working at WMH, nursing students, or any employees who we have supported through loan programs. There are a total of 14 internships available for 2010, and we are confident we will fill all of them. We are pleased to be able to offer this opportunity to potential employees of WMH as some hospitals are no longer sponsoring this type of program.
5. RN Residency. This program will be more defined and focus on didactic classes and evidence based practice. The hospital will invest in more training in the first year and also allow time together to prep for the NCLEX for our graduate nurses.

Financial Pillar:

1. ROM/On-Call Seniority Hours. Jane wanted to talk about a concern of her nurses not entering the appropriate codes in Meditech to allow credit towards seniority. On call does not count towards seniority hours; only when the Nurse is called back to work does the time count. Debbie mentioned the union will be addressing this in a special newsletter sent out by MNA. In accordance with the contract, a nurse has 30 days to bring forth concerns regarding the draft seniority list. Those issues will be addressed before the final list is posted.
2. Bumping Language Clarification. Union and management agreed to clarify the bumping language in the new contract as both agreed to the intent of the language discussed at the negotiating table. The intent of the language in the new article 12.9 is that the Nurse can only bump within the same week. Article 12.9 will read:

12.9 Shift Bumping

Bumping may occur by seniority when a staff member does not meet their FTE due to ROMing, or being placed on-call without being called back, in the same week. A staff member may bump when an accumulation of no less than four (4) hours of ROMing has occurred. Bumping will occur by seniority, and the following bumping procedure is as follows:

A. The Nurse bumping may be allowed to bump the least senior Nurse, having less seniority, on the same or next shift in any unit in which she is qualified to work.

B. The shift bumped into must be within the same work week.

C. Bumping must not incur overtime.

People Pillar:

1. Nancy L Temporary Positions/Postings. After review of previous labor/management minutes and further discussion with Nancy, when Nancys temporary position ends, she will retain bumping rights. The hospital does not want to lose this valuable nurse. Sue will be meeting with Jenny , OR Director, to analyze the FTE tree in the department. It may be necessary to repost a temp position with an extension time on it.
2. Intermittent Nurse Applicant. The language in article 13.7 will add the words pursuant to the Step Determination Worksheet in Appendix A a nurse will qualify if she has worked 10 years or more at WMH. Jeanne currently will move to a contingent employee and once she has passed her probationary period will be eligible for the intermittent program.
3. Positivity Training. The training will take place on February 17, 2010. The employee will be paid to attend. If the training is during their work day and the leader directs the employee to attend, the training is required as part of the employees work assignment for the day. If leadership juggles the schedules and the employee does not attend, discipline will occur.
4. Awarding Positions (Articles 50.9 and 50.10. Susan and Sue will work on proposing new language to propose a Letter of Agreement regarding this change. This resulted due to FTE analysis that is being completed in surgery.
5. Staffing/Scheduling. The members must notify staffing/scheduling of their availability for shifts/overtime in January and June of each year. The supervisor continues to call down the list in order. Debbie will send out a clarifying e-mail regarding if the office does not hear from the member; that the staffing office will assume nothing changes.
6. Debbie C crosstraining/certification to chemo. As a part of a grievance settlement, Debbie C agreed to crosstrain and attain chemo certification. As of today, she has not done this as it was put on hold due to the needs of the department. Currently Diane and Ruth are chemo certified on Med/Surg and additional staff has been added. Marla still believes it would be helpful to have another dependent upon a shared FTE.
7. Carla W. Carla currently holds a .75 in holding and is accommodated with limited hours.
8. Janet L. Janets position effective 1/14/2010 is a PCC in Surgical Services. This resolves the concern of an extension of charge nurse.
9. Deanna . A physician approached Deanna regarding a statement of recommendation. Nurses were uncomfortable with him approaching them. Management stated that he has a right to approach, based on the Fair Hearing Process. The employee has the right to complete a statement or not; they should not feel forced by the request.

Quality Pillar:

Did not get to these items.

Parking Lot:

1. Grievance #111909 . Jane McLeod followed up with grievant and as a result Debbie will obtain a signed agreement to resolve the grievance. Management agrees to remove the documented verbal within one year, provided there are not additional occurrences.
2. Grievance #123109 . Grievant may be filing a grievance and will present at the next Labor/Mngt meeting regarding not being notified of OB shifts. In fact, James in Staffing, made a round of calls once and then due to low census, the shift was not filled grievant updated the cell phone number on record, as the message was left on another phone. Staffing is required to make only one round of calls, unless the Director requests another. In this case one round of calls was made. In follow up to the February meeting, grievant believed that another member was called on 12/23/09. The call log shows that she was indeed called on the 12/22/09, as well as grievant.
3. Grievance #01182018 . Termination grievance is forwarded to arbitration.
4. Grievance #01112010 . Grievance resolved.
5. Grievance #01112010 . Response provided on 2/1/10 regarding documented verbal corrective action.

Other:

1. OB Shifts Follow up. The concern of shifts being giving away on OB and resulting in overtime was looked into. Kathy reviewed and she is not seeing this occurring that it may have been one isolated incident.

The team convened with the next meeting will be held on Monday, March 1, 2010 from 1:00-4:30 p.m. in Human Resources.