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In late September, I joined the nurses attending our annual education conference to help gather signatures for our Put Patients First petition. The reaction from the people we encountered along the way was overwhelmingly positive.
I’ve been a nurse for more than 30 years and I have to say that I am still amazed at the public’s reaction when we identify as being nurses. They say things like thank you for helping my son. They tell us how grateful they were to have us at their side, while they underwent their treatment. They mention the little things we did, which we assumed just went unnoticed. No, they noticed, and they remembered because it made a difference.
And then they tell us how scared they are about what is happening in health care. They’re confused about where to go should they have an emergency.
They’re worried about a loved one who’s access to important health care services is now limited. They have a grand-daughter who just graduated as a nurse; will she have a job?
Then they ask us how they can help. We’ve always had their trust, but now more so than ever. They’re looking to us to lead the way – and we will. Nurses are the strongest patient advocates and they know that we will not let them down. They know that they can always count on us.
What this government is doing to health care is frightening. They are dismantling our public health care system in a manner that makes little sense and poses severe risks to the delivery of safe patient care. Nursing positions are being deleted, and while they keep promising that there will be a job for every nurse, I am skeptical.
Nurses at The Vic and The Grace have already completed the selection process, while others are awaiting their deletion notices. These are challenging times. There is a lot of frustration, a lot of anger, and unfortunately not many answers. I share your frustration. Please know that we are doing our best to ensure your rights under the collective agreement are upheld.
We are fighting for you each and every day. We are speaking out. We are loud, but we need you to stand with each other – stand with us. If there ever was a time to support each other, it’s now.
You are the voice of health care. You are at the frontlines. You are the most trusted spokespersons on all issues relating to health. Your patients are counting on you.
Please join me in answering their call. Twelve thousand plus voices are hard to ignore.
Actionmarguerite recently introduced a mentoring program for nurses new to long term care (five years or less) as well as a senior leadership nursing group to focus on the challenges of being an experienced nurse. While the program was developed for this specific group, it is open to any nurse who feels he/she could benefit from the experience.
“We believe strongly that supporting our nurses with any and all resources is not only a benefit to the nurse and the resident, it aids to build the kind of long term care we all strive for,” said Colleen Reidke, Assistant Director of Care at Actionmarguerite. “The mentoring group came out of the need to support nurses and to help them grow in their field.”
Typical mentoring formats
usually pair the mentor with the mentee
over a period of time.
Since there was such a large group of nurses at this facility with five or less years of experience, it was decided that a group setting would be more beneficial. Furthermore, Reidke said that sometimes one to one mentorship can be difficult to pair and sustain as it is dependent on the work routines, personalities and schedules.
“The group concept is a way to not only help the mentee feel comfortable and grow a relationship with their coworkers, but also to let them know that their challenges and fears are shared by others,” she said. Caroline Ndiaye has been working as a nurse for only five months and said that this program has provided a much needed confidence boost, as well as a strong support system as she finds her way in her chosen profession.
“The mentoring program is providing me support and guidance for best practices in a new working environment,” she said. “It is also allowing me to build self confidence and skills in order to facilitate the transition throughout the nursing stages.”
The mentoring group is divided into two, one for days and one for evenings. This is done to support staff members who are beginning to build relationships with each other, as coworkers. This is also a way to ensure that the groupings would be able to discuss similar experiences.
“A full-time nurse in their first year might have the chance to gain about 2,000 nuggets of knowledge. An expert nurse with 10 plus years might have 20,000 nuggets of knowledge,” said Reidke.
“We want new nurses to gain some of those nuggets now, from the nurses with 10 plus years’ experience, as opposed to 10 years down the road.”
The program was built with a planned agenda to provide some structure, but there has always been the understanding that the actual agenda will ultimately be built by the nurses. In every session, if there are any issues that the group did, or did not want to explore, the discussion would then be changed to accommodate the needs of the group.
“I feel like it’s a safe environment to ask questions without being judged,” said John Rasay, a nurse of two years. “The open discussions and case scenarios are very helpful. I’m very thankful for this program. It’s a great help for nurses.” The meetings are planned to take place one hour, once a month, for up to 12 months if the group desires. If the group decides not to continue after a few months, the program will be adapted, based on their need. “The nurses are in control of the learning plan. This is their group. We are only here to help facilitate the process,” said Reidke.
The program includes a participant handbook and three modules. The handbook includes self-evaluation checklists, action plans, and hand-outs with information from the College of Registered Nurses of Manitoba and others things to direct their own knowledge plan.
There are no tests, or mandatory assignments. The groups are encouraged to use the handbook as a tool to help them determine what they want out of the program.
“I am more comfortable and confident in doing my role as a nurse,” said Alfred Ilagan. “Knowing that the support I need is available and that our senior nurses are more than willing to mentor us gives me confidence to come in to work and provide care for our residents.”
The three modules are designed with mostly open discussion topics and accompanying information. For example, the group is told on day one, that they must ask or answer at least one question during each meeting to help them find their voice and learn to be in the situation of discomfort. The rational behind this exercise is a good one — nursing regularly puts us in uncomfortable situations and we need to embrace that feeling and overcome, so we can act and advocate for our residents and ourselves.
“We gain nothing by not supporting our staff in every way we can,” said Reidke. “As an organization, we are very proud to offer this new style of mentoring, and hope to see it as an ongoing program for many years to come.”
At this time of cutbacks and increasing demands and workloads, WSRs give nurses an ability to voice their concerns and influence change. In fact, it’s not a stretch to say that based on the current state of our health care system, Workload Staffing Reports are more important now than they have ever been.
The right to complete a WSR is enshrined in the MNU Collective Agreement, Article 1103 (3) (a), and speaks to the mutual obligation of both parties (the nurse and the employer) to provide the best possible quality of health care. The form itself is a joint document utilized by the union and the employer to identify issues, facilitate discussion and a problem-solving approach.
Currently, there are two versions of the WSR form — a regular form and a community form. The community form is used by home care, public health, and individual nurses that work in the community or clinic environments.
The other form is used in acute and long term care facilities. In the future, there will be a separate form for long term Care. We are also working towards an on-line version but that is not yet available.
A nurse can complete a WSR when there is an unsafe or potentially unsafe condition, which can result in safe patient care being compromised. The nurse must have already identified the issue to an out of scope manager, nevertheless the situation remains unresolved to the satisfaction of the nurse. This means either that no steps have been taken to create an environment where safe, quality care can be delivered, or any steps that have been taken are ineffective to resolve the situation.
WSR forms should be available in an accessible location in your facility or place of work. Ask your MNU president/representative where they are kept. If there are no forms at your facility, please contact the MNU provincial office at 204-942-1320 or email the office.
The WSR serves as documentation of a nurse’s workload/staffing concerns and the attempts to resolve a situation that he/she feels may compromise his/her nursing standards.
This is part of a nurses’ professional responsibility.
Most nurses are familiar with the phrase – “not charted” means, “not done”. It is similar here in that if nurses do not document their concerns, it is interpreted as satisfaction with that current or ongoing situation.
For example, if a sick call is not replaced for one shift and there are impacts to patient care – that is a reason to complete a WSR. If additional responsibilities are added to the nurse’s workload or the number of nurses on a unit is decreased, that also impacts the care the nurse is able to provide.
Just speaking out is not sufficient. There must be documentation of your concerns. A verbal exchange with your manager is not a permanent communication.
Imagine the power
of many forms and many nurses
documenting the same concern.
When you identify a situation, you must speak with an out of scope manager to make them aware of the situation. They should problem solve with you and/or offer solutions to mitigate the risk. If the situation is not resolved to your satisfaction a WSR can be completed. In some cases, additional resources might be provided as a result of your conversation with your manager, however, if the situation is not fully resolved or is an ongoing concern, the form can and still should be completed.
When completing the form, fill in all sections of the form as best as you can. The recommendations section of the form is an opportunity for you to provide strategies based on your knowledge, skills and judgment. The problem-solving recommendations are not limited to the checkboxes provided on the form. You are certainly allowed to add your own recommendations, based on your professional opinion.
After completion, the form is given to the manager with whom you discussed the situation (or in some situations, a designate manager). It is important to follow the process at your facility to ensure that the employer gets the form and your union representative/president is aware a form was submitted.
Some locals use the vouchers on the inside cover of the form, some make a copy for their local president while some send a text or email to their president. Make sure you follow the process, whatever that process may be.
In accordance with the MNU Collective Agreement, a written response from the manager shall to be provided within 14 days of receiving the WSR. The response is to outline the action taken and any further actions to be implemented. It is the responsibility of your union representative to ensure this happens.
But it does not end there. All WSRs are discussed at Nursing Advisory Committee (NAC) meetings. NAC members must follow up with the nurse who completed the form to advise of the outcome of the discussion at NAC and any further actions to be taken.
If the issue remains unresolved, it can be referred to an Independent Assessment Committee (IAC) and reviewed further.
At their September meeting, MNU’s board of directors approved a significant financial contribution toward the establishment of a Manitoba Health Coalition.
A health coalition is a non-partisan, broad based collection of organizations and individuals, united to advocate for the preservation and improvement of our public health care system.
Typically, many organizations and individuals are represented, including community groups, not-for-profits, charities, seniors’ groups, scholars, labour organizations, professional organizations, religious groups and more.
The goal is to create an avenue for anyone interested in enhancing public health care to join something larger, be heard, and have real influence with decision makers. This is sometimes done through the organization of rallies, town halls, campaigns and other events.
Every province in Canada has a health coalition, except Manitoba. Many of these coalitions have had success influencing public health care policy. Provincial health coalitions are affiliated with a national body, the Canadian Health Coalition (CHC).
With the recent cuts and moves toward privatized health care in Manitoba, the need for a united voice to speak out has never been more important.
The CHC has been working with partners in Manitoba, including MNU, to establish a health coalition in Manitoba. When enough interested parties have agreed to participate and contribute, a board can be established, and the coalition will be launched.
A victory for all patients. Thank you.
Our facility is divided into three separate wings with a central nursing station and activity area. Baseline staffing would normally be one RN and two LPNs for days (one for each wing) working 12-hour shifts. There is one charge nurse to oversee all three wings.
On 12-hour night shifts, one RN and one LPN split the three wings. There is also a Best Practice Educator for an eight-hour day shift. The nurse-to-elder ratio is 1:18-22 on days and 1:30 on nights.
The decision was made to not replace the first sick call of a shift for nurses and health care aides (HCA). The second sick call would be replaced at straight time only, though some exceptions could be made to replace with overtime.
We were led to believe that the sick calls not being replaced would be for unforeseen needs. Soon it was not just unforeseen needs that were not being filled. Shifts left open due to medical leaves following surgery, injuries and illnesses were considered the first sick call and not replaced even though it was known well in advance that these shifts would be open.
We also had two RN rotations vacant at that time. It was decided that if the vacant 12 hour night shift could not be covered at regular time, the first four hours would be covered at overtime. That nurse would then go home, leaving the LPN/RN to work the last eight hours, with three health care aides.
The LPN/RN was then responsible for 60 residents, giving medication, caring for elders who became ill, had a fall, or needed any special care. She/he was also expected to do all the regular night duties which is usually done by two nurses.
On the day shift, the vacancies were filled by the charge nurse. The charge nurse was seconded to do the nursing duties on the ward, which included giving medication, dressings and treatments. She was also expected to do her charge nurse duties throughout the day.
When the charge nurse left at 1600 hours, the two remaining nurses were left to split the three wings between them. This was also done to cover much of the peak vacation time. This soon became an almost daily occurrence.
Not only were we working short nurses but the same was happening with the health care aides as well. On many day shifts, we had one nurse and two health care aides per wing. There should have been three. There were days where we had only two nurses working with the health care aides on all three wings. For four evenings we had one HCA to care for 22 elders. There should have been another HCA and a nurse on as well.
The nurses and health care aides from the other wings helped as much as possible, making sure the work was done and the elders were cared for. For three shifts the Best Practice Educator gave medication because there was no other nurse available. These are just some examples of the working conditions.
We did request staff at overtime which was granted for some circumstances but more often it was denied.
We began filling out the WSR forms because we felt that we were unable to provide safe, quality care for our elders. We had many concerns; medications were often late, medication errors were increasing, dressings and treatments were late or occasionally missed.
Some of our elders require three staff members to provide safe care. Their care was often delayed until enough staff was available to help provide that care. Due to the staff shortage ADLs, feedings, turns and repositioning and toileting were also often delayed.
We were unable to perform many of the extra duties we normally do. Our non-elder duties were also suffering. Manitoba Health Standards were not being met. Quarterly assessments were being not completed, family meetings and pharmacy rounds had to be rescheduled.
Filling out the WSR forms began as a slow process. Many of the nurses had never filled them out before and were unsure as to how to complete them. With help from each other, soon all of the nurses were completing the forms on an almost daily basis.
We started to fill the WSRs out in mid-March, 2017. Since then we have submitted well over 100 WSR forms. Health care aides were also completing their forms for their union and they have also accumulated over 100 workloads forms.
Over the last month we have seen changes we feel are at least partly due to the WSR forms we submitted. A full time RN has been hired for St. Paul’s. Three float RNs have been hired to work between St. Paul’s and the hospital (which is attached to St. Paul’s). All nursing shifts at St. Paul’s are now being covered except for the immediate sick calls.
The nurses at St. Paul’s have always been a close group who work well together and help each other out. That has become even more evident now. This whole campaign has been a group effort and each and every nurse at St. Paul’s should be proud of what we have accomplished.
We also received assistance and encouragement from our local union executive and our labor relations officer in Winnipeg. A grievance was submitted over the secondment of the charge nurses which we believe violated our contract.
We are still awaiting results on that grievance.
Thank you to all those involved
for the help and encouragement
you gave us during this journey.
Submitted by the nurses at
St. Paul’s Personal Care Home.
On Wednesday, September 20, nurses attending the 2017 Education Conference took to the streets of downtown Winnipeg to gather signatures for the Put Patients First petition.
Dressed in white scrub tops, the nurses spoke with Manitobans about the cuts to frontline health care services and their concerns that safe patient care will be compromised.
Over the 30-minute period, the nurses had successfully collected more than 1,200 signatures. If you have not signed the petition, you can do so online by visiting www.putpatientsfirst.ca. Please share with family, friends and neighbours.
The 2017 Education Conference was held from Tuesday, September 19, to Thursday 21, at the Radisson Hotel in downtown Winnipeg.
The event kicked off on Tuesday evening with MNU Sandi Mowat bringing the participants up to speed on the cuts to health care, bargaining and more. This was followed by lively discussion during the Q&A portion where members from across the province were given the opportunity to raise concerns and speak about issues specific to their facility and region.
Day one of the conference included a plenary session by Manitoba’s Medical Assistance in Dying Team (MAID), followed by a petition blitz over the lunch hour to gather signatures for the Put Patients First petition.
The three-day education session
was attended by 167 members
from across the province.
Congratulations to Rizal Nues (left) and Brian Goldstein on winning awards for attending this year’s Education Conference.
The following letter was sent to The Honourable Kelvin Goertzen, Minister of Health, in regards to the growing number of for-profit plasma collection operations
in Canada. This letter is part of a Canada-wide effort, spearheaded by the Canadian Federation of Nurses Unions, in an effort to preserve the safety of Canada’s blood supply.
Dear Minister,
As President of the Manitoba Nurses Union, I write to express our concern regarding the commercialization of the Canadian blood supply system.
Over the past 18 months, a private, for-profit company, Canadian Plasma Resources (CPR), has established plasma collection operations in Saskatchewan and New Brunswick. This company is paying donors for blood product, and has indicated their desire to expand into Manitoba. At the same time, Prometic Plasma Resources here in Winnipeg appears to be expanding paid plasma collection beyond the original limits of their exemption granted following the Krever Inquiry. According to Prometic’s website, they now pay for normal source plasma from almost any donor, not just those with Rh-negative blood.
Nurses in our province are concerned that the spread of for-profit blood collection clinics will undermine the safety of the Canadian blood supply system and risk repeating the tragic errors of the past.
During the 1970s and 1980s, nearly 30,000 Canadians received tainted blood transfusions, often from paid donors or prisoners, and were infected with the human immunodeficiency virus (HIV) and the hepatitis C virus.
At the height of this tragedy, the federal government appointed Justice Krever to lead the Commission of Inquiry on the Blood System in Canada, which led to the establishment of the Canadian Blood Services (CBS), a national and arm’s length public organization responsible and accountable for the blood supply. At the time, the company that would become Prometic was granted an exemption to remunerate donors with rare Rh-negative blood to create a lifesaving medication that mitigates risks of blood type incompatibility between mothers and fetuses. The Krever Commission report noted this exemption as a “rare circumstance.”
Today, CBS is seen as the most trusted entity when it comes to ensuring proper screening and the safety of the blood system. Conversely, the introduction of the profit motive into Canada’s blood system puts the safety of the blood products collected and the security of the supply to Canada’s trusted, public blood agency
at risk.
CBS wrote to the Federal Health Minister in January 2017 to request an end of the licensing of for-profit blood clinics. To date, this request has been ignored.
Ontario, Alberta and Quebec have been proactive in passing laws banning payment for all blood product donations. On behalf of the 12,000 nurses in Manitoba, I urge you to follow their lead and introduce legislation that will protect the integrity of Manitoba’s blood supply by banning payment for all blood products.
Nurses believe deeply in the preservation of a safe, public blood system. We would welcome and publicly support your efforts to introduce legislation in Manitoba to ban payment for plasma. Thank you for your attention on this matter and I look forward to your timely response.
Sincerely,
Sandi Mowat
President, Manitoba Nurses Union
relationships e.g. you work on different units but you play on the same softball team. Each person will be given a list.
Once the session is completed, the workplace leaders are deployed to recruit workplace canvassers from the list they have been given. They will make face to face contact with nurses, listen to concerns, answer questions where necessary and then ask the member to take a specific action, such a signing the Put Patients First petition.
In larger facilities, workplace canvassers can also be recruited as helpers to increase the efficiency of the flow of information.
Over the past months, we have been rolling out our one to one campaignthroughout the province. The campaign, Put Patients First, is based on the simple concept that face to face contact is by far the most effective way to communicate.
This strategy is used to open the lines of communication by bringing members up to speed about government cuts to frontline health care and the impact on the delivery of safe patient care, letting nurses know the different channels through which they can access support and raise concerns and to mobilize the membership into advocating for change.
We are hoping to facilitate 12,000 plus face to face conversations, between members, over the course of this campaign.
Workplace leaders are identified by the local/worksite executive. These are typically individuals who are already somewhat active in the union, they are informed about what is happening in health care and want to advocate for change. Many times, these people are in fact the local/worksite executive, especially in smaller facilities.
Once a group is in place, the MNU campaign trainers will then come to the facility and provide an overview of the Put Patients First campaign. At this time, those attending the meeting will also be given a membership list for the facility. This list will then be divided up based on criteria such as units and
The first action of campaign involves a province wide petition (online and paper) which calls on the provincial government to put patients first by stopping cuts to vital health care services. The petition challenges the government to make real investments in the public health care system to provide a direct benefit to patients. Signatures will be gathered until November 22, 2017, following which the petition will be presented in the Manitoba Legislature.
At the time of writing, more than 5,000 signatures have been collected. If you have not signed the petition, please visit www.putpatientsfirst.ca to add your name to the thousands of Manitobans who are concerned about the state of health care in this province.
In July, the second action of the campaign, Wear White Wednesday, was launched. Nurses are encouraged to wear white on Wednesdays as a symbol of their commitment to safe patient care and to raise awareness about the ongoing cuts.
Since the launch, hundreds of nurses from Winnipeg to Norway House have worn white and submitted their pictures to be shared on our various social media networks.
In fact, participation and feedback has been so positive, that we recently added a new component to further recognize nurses for their unwavering commitment to the delivery of safe patient care.
Every week, a winner is chosen from all the pictures that have been submitted and is awarded a prize. If there are several people in the winning photo, all members will receive a prize.
The contest rules are simple. While we welcome all photos, to be eligible for a prize all nurses in the photo must be wearing solid white tops. To enter, please email photos to sturenne@manitobanurses. ca before noon on the following day (Thursday). The Wear White Wednesday campaign will continue every Wednesday, until the government decides to put patients first and stop the cuts to front line health services.
The third action of the campaign is all about giving nurses a voice. Nurses from across Manitoba will be invited to tell their stories as it relates to their profession, their facility, their communities and their patients by writing a postcard to the Minister of Health.
Stories can range from the effects of health care cuts on their ability to deliver safe patient care to their hopes for health care in the province.
Once the postcard portion of the campaign has been wrapped up, the postcards will be delivered to the Minister of Health.
We will also be updating your contact information during this campaign. You will be asked to confirm your phone number and mailing address, as well as your email. This information must be current to ensure that we can communicate with you throughout these challenging times. We want to ensure that you are receiving accurate information in a timely manner.
For this campaign to be successful, your help is crucial. In fact, you are the most important part of this campaign. We encourage you to consider becoming workplace canvasser because your ability to communicate, on a one-to-one basis, with your colleagues is the most effective means we have of mobilizing our members.
Our membership has always been our strongest asset and we need your support now more than ever. We need you to stand with us as we face some of the toughest challenges the health care system has seen in almost two decades.
Your activism and commitment to caring is our most powerful weapon as we fight to ensure that nurses and patients have access to the best possible care, when they need it most. n
A strong union activist, she was one of the founding members of Misericordia Local 2. She went on to work as the treasurer for The Provincial Staff Nurses Council, an organization established to act as the collective bargaining agent under the Registered Nurses Act.
Her role with the Council quickly expanded and she soon was tasked with organizing nurses all across the province. The position suited her very well, and she worked tirelessly to ensure that nurses were afforded the protection of a union.
Doreen participated in a very difficult round of negotiations for a new collective agreement for nurses. Narrowly avoiding a strike, a settlement was finally reached at the eleventh hour on March 17, 1975.
As a result of a Supreme Court decision, in October 1975 the Provincial Staff Nurses Council separated from the, then named, Manitoba Organization of Nurses Associations (MONA). This effort was to ensure that the rights of nurses were protected separately from those of management. In the early years of organizing, nurses felt more comfortable with the word “Association” rather than “Union”, but as time went on that changed.
At the April 1990 annual general meeting, delegates approved the name change to Manitoba Nurses Union, a symbol of the nurses’ determination to achieve a collective agreement that acknowledged the value of nurses’ work.
Doreen was elected to the board of MONA in 1978, but soon gave up her seat to accept a labour relations officer position with the organization.
On January 1, 1990 Doreen was appointed to the Manitoba Labour Board as an employee representative. For 12 years she served in this position, providing a strong voice for both nurses and the labour movement.
Doreen received an Honorary Life Membership from MNU in recognition of the outstanding contributions and achievements she had made for nurses across the province. n
