While some progress has been made, it’s been six months since nurses at St. John’s hospital won representation, and they and the hospital remain far apart on crucial safety issues.

Bargaining began September 8, and the struggle over patient safety issues has dominated the discussions, delaying talks on other issues, such as pay raises for nurses (many of whom have not had raises in two years).

A new California Nurses Association law to protect RNs from injuring themselves lifting patients will take effect January 1, 2012, but St. John’s management refuses to include the text of the new law in the contract.

The nurses continue to fight for safe RN-to-patient ratios in the contract, but management has proposed language that could allow non-RNs to be used to subvert the spirit of the ratio law. No other hospital in Southern California includes non-RNs in the count for determining nurse to patient ratio.

Such “subcontractors” or “travelers” not only lack nurses’ training, but aren’t familiar with the hospital’s procedures and facilities.

Related to the use of outsiders are limits on when and how RNs can be cancelled or “flexed” – sent home before their shift ends, or told to stay home. Excessive cancellation and flexing frequently results in the hospital being understaffed with RNs, which is unfair to the nurses and unsafe for patients.

Most CNA hospitals have union-negotiated competency “clusters” that ensure that RNs “floating” to a different unit have the necessary capabilities and experience and orientation to work safely in that unit. St. John’s doesn’t.

RNs in some units, particularly OR and perioperative units, currently suffer from lack of sufficient rest time between shifts, as they are frequently required to come back to work four or six hours after the end of a previous twelve-hour shift, because the hospital does not have enough RNs in those units, and because there are no rules on turnaround and rest time. CNA planned to propose such rules on December 15.

“Patient Staffing Systems” includes, but is not limited to, the nurse to patient ratio question. It also includes respecting the RN’s decision at the point of care as to the patient’s acuity level. The RN must be the person who decides what a patient’s ratio should be.

According to CNA spokesman Joe Newlin, the Santa Monica community “has been such an important part of the nurses’ struggle that management has even proposed to shut residents out through a proposed contractual prohibition on informing the community of issues through informational pickets and rallies, print media and websites. Management’s positions on these issues is unacceptable to both nurses and patients.

Residents are invited to join the nurses in Monday’s candlelight vigil at 6 p.m. on Santa Monica Blvd. in front of St John’s the main entrance.