Front Lines. PTSD and Nursing. President s Tour The Magazine for Nurses by the Manitoba Nurses Union / Issue 5 / 2014

Transcription

1 Front Lines The Magazine for Nurses by the Manitoba Nurses Union / Issue 5 / 2014 PTSD and Nursing President s Tour 2014 Violence is not in our job description Courage in Canada s Capital PLUS Improvements to Health and Safety in the Collective Agreement

2 Message from the President Sandi Mowat, MNU President As you are no doubt aware, the subject of Ebola preparedness has been the focus of much of our work lately. Initially, we were very concerned regarding the apparent lack of preparedness and especially, the lack of communication to our members regarding any plans. Boundary Trails Health Centre donning and doffing Ebola training Last month I met with the WRHA representatives who assured me that the equipment is in place and training has taken place for many of the nurses. I made the point to the WRHA representatives that all nurses should be made aware of our readiness. I also expressed concern that rural facilities did not appear to have been given the proper equipment or training to deal with Ebola. I have since seen firsthand that the equipment is flowing to the rural facilities and training is ongoing. It also appears that Regional and Local leaders, as well as the LROs have been involved in regular teleconferences around Ebola preparedness. At the same time, the CFNU, with input from our respective WS&H officers across Canada, developed a Policy Directive around Emergency Preparedness for the Ebola Virus. This document is available on the MNU website for all members to review. I am pleased to report that our employers have agreed (and implemented) almost all of the recommended protocols and procedures. I will continue to make the point to all stakeholders that emergency preparedness and pandemic planning should be ongoing, and that in the future we must be proactive instead of reactive. 2 MNU Front Lines Magazine Issue

3 Front Lines In this Issue 7 Violence is not in our job description Fourth International Conference on Violence in the Health Sector 8 President s Tour 2014 #MNUtour2014 FEATURE PTSD and Nursing The experience of wounded healers 4 13 Courage in Canada s Capital DEPARTMENTS Pension & Benefits Corner 18 Double Dues 19 Board of Directors 20 Front Lines is published by the Manitoba Nurses Union (MNU). Founded in 1975, MNU continues to be an active member driven organization dedicated to meeting the needs of its members. Approximately 12,000 nurses province-wide belong to MNU. That s 97% of unionized nurses in Manitoba. Editors Emily Doer Contributors Bob Romphf, Kirsten Andersson and Debbie Winterton CONTACT US MNU Communications Department Broadway Winnipeg, Manitoba R3C 4M6 (Tel.) (Fax) (Toll free) Website: info@manitobanurses.ca MNU is affiliated with the Canadian Federation of Nurses Unions and the Canadian Labour Congress. MNU is a member of the Canadian Association of Labour Media. MNU adheres to all Privacy Legislation requirements. Publication Agreement # RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: Manitoba Nurses Union Broadway Winnipeg, MB R3C 4M6 info@manitobanurses.ca MNU Front Lines Magazine Issue

4 PTSDAND NURSING THE EXPERIENCE OF WOUNDED HEALERS The Manitoba Nurses Union is in the midst of a research project on the prevalence of Post-Traumatic Stress Disorder (PTSD) among nurses. This project has involved extensive reviews of existing research and literature on PTSD and nursing, surveys and focus groups with members, and speaking with our members about very difficult firsthand traumatic experiences. We will be releasing the full report with our findings in Spring Here is a preview of what we have learned so far, including defining PTSD and facts and figures related to nurses and the nursing profession. Defining Post-Traumatic Stress Disorder Post-Traumatic Stress Disorder (PTSD) is a result of experiencing events that are outside of the range of human experience. During the course of their working lives, nurses are witnesses to and experience various critical incidents that accumulate and manifest as burnout, depression, anxiety and stress. The development of PTSD is a, normal reaction to an extraordinary event, and is typically associated with war veterans, war survivors, prison guards, police officers, firefighters and paramedics. A developing field of research focuses on the nursing profession and trauma nurses are exposed to as part of their duties. Some research reveals that nurses may be more prone to PTSD than war veterans, though the condition has rarely been associated with the nursing profession. Clinically, trauma, which can stem from a variety of critical incidents, is generally defined as an event that involves actual or threat of death or serious injury, or another type of threat to one s physical integrity. Even witnessing an event that involves death, injury or a threat to the physical integrity of another person will often be considered trauma. When it s one of those nights when you can t sleep or whatever it is, that s when the images come to you. You always think, why can t I forget those things? You wonder. You don t know why. Are they there so you can help someone else? I don t know. All I know is that they re stuck in my head and I wish I could get rid of them, but I don t know how to do that or if I even could if I tried. MNU Member 4 MNU Front Lines Magazine Issue

5 I think in some ways we are trying to preserve our humanity, but assault after assault changes our ability to do that changes our ability to find the humanity and be human. It s almost like you take a little piece away you don t want them to see that you re cold, because you re not cold but you almost have to protect that little piece of yourself. MNU Member Primary vs. Secondary Trauma Primary trauma and secondary trauma, also known as vicarious trauma, are defined differently. Primary trauma is an event experienced directly, such as being physically assaulted at work Secondary trauma is categorized as witnessing a traumatic event Nurses may experience primary and secondary trauma simultaneously on a regular basis. These are daily elements of the nursing profession that inevitably and adversely impact the well-being of nurses and their patients. The nursing profession is one where on an ongoing basis nurses are witnesses to trauma and an inordinate amount of pain, suffering and death. Not only is the experience of trauma a trigger for PTSD, but the threat of violence or the perception of some type of personal trauma may actually induce higher levels of stress than when trauma is experienced directly. Common symptoms of PTSD are intense fear, helplessness, flashbacks or horror. Medical literature suggests that between, two days to four weeks after a critical incident, severe post-traumatic stress, which is also known as acute stress disorder, develops. Acute stress disorder is easier to diagnose because the affected individual begins displaying some of the symptoms shortly after the incident takes place. The development of PTSD on the other hand, is a gradual process that can take years to manifest, since it s a condition that is related to an individual s processing of a traumatic event. 1 Jacobowitz, William. PTSD in Psychiatric Nurses and Other Mental Health Providers: A Review of the Literature. Issues in Mental Health Nursing. 34, Pg Jacobowitz, Pg Powell, Patricia. The Prevalence of Post-Traumatic Stress Disorder among Registered Nurses Working Manitoba Emergency and Intensive Care Units. University of Manitoba: Winnipeg, MB. Pg.2 4 Jacobowitz, William. Pg.787. What you need to know about PTSD and Nursing Research shows that % of nurses have PTSD, which may be lower than the actual number, given that nurses are not likely to self-identify and that PTSD in women is misdiagnosed as anxiety, depression, or burnout. Studies of burnout and compassion fatigue show that nurses who experience one or both of these phenomena, also showed symptoms of PTSD. In fact, burnout and compassion fatigue have overlapping symptomology with PTSD, which is often misdiagnosed as burnout and compassion fatigue. MNU s research shows that 62% of nurses in Manitoba are experiencing compassion fatigue, and another 71% have experienced burnout at some point in their careers. 53% have experienced critical incident stress. The scale that measures PTSD is biased in favour of men s PTSD symptoms, and may not capture symptoms women experience. Violence or the threat of violence plays a large role in development of PTSD in nurses. Nursing is one of the most dangerous professions and studies show that nurses are more likely to be attacked at work than prison guards and police officers. In Manitoba, 52% of nurses have been physically assaulted, while 76% have been verbally abused, which highlights the prevalence of violence in our healthcare facilities. A study of nurses in New York concluded that the, stress of exposure to assault and the potential for assault appears to impact nurses emotional states in the form of PTSD. 1 The study also found that nurses who did not sustain any injuries, but anticipated some sort of violence at work, reported higher levels of stress than nurses with minor injuries. 2 Nurses are susceptible to both primary and secondary or vicarious trauma, including cumulative trauma, which is a result of events that are not typically seen as traumatic, but are emotionally and physically taxing. Medical advancements that enable numerous interventions to keep patients alive longer, in turn prolong nurses exposure to suffering and dying. Over the years, research has shown that nurses have a higher prevalence of PTSD than is reported in post-vietnam war veterans. 3 The threat of serious injury or death in the nursing profession is as strongly correlated with PTSD as actual combat exposure in military personnel. 4 A Manitoba study of nurses with PTSD, showed the following as top 5 stressors that lead to PTSD: 1. Death of a child, particularly due to abuse 2. Violence at work 3. Treating patients that resemble family or friends 4. Death of a patient or injury to a patient after undertaking extraordinary efforts to save a life 5. Heavy patient loads MNU Front Lines Magazine Issue

6 Nurses are unique, given their role on the healthcare team, as a predominantly female profession. Their role is to provide care, and to be nurturing and empathetic, which opens another dimension of vulnerability to the development of PTSD. PTSD in nurses also has ramifications for workplaces, as studies have linked PTSD to decreased job satisfaction, increase in sick leave and staff turnover. 5 Given the definition of PTSD and the top five most stressful circumstances, it can be concluded that all nurses, regardless of designation and facility are equally susceptible to PTSD. In the study, Prevalence of PTSD in Nursing Population in Manitoba, researchers found that the death of a child was rated as the most traumatic situation one could experience at work, particularly children s deaths from physical abuse. One particular instance that was mentioned in the study that was especially traumatic for nurses here in Manitoba, was when the nurses at the Children s Hospital alerted management of issues in paediatric heart surgery, given the unusually high rate of post-operative deaths. Nurses found it extremely challenging to orient parents pre-operatively for their child s heart surgery, when they knew the baby would in all probability, die post-operatively. 6 Many nurses faced moral distress and had great difficulties in managing their stress. COLLECTIVE AGREEMENT INFORMATION UPDATE Please note that the updated pay scales as of October 1, 2014 are now up on the Manitoba Nurses Union website. Another important document that has been added to the website is the Contract Interpretation Manual, which can be accessed under the Union Resources menu tab. We are in the process of compiling all of the information for the updated collective agreements and we will post these to the website as soon as they are complete. We will continue to keep you posted through our social media pages and website announcement as this information becomes available. 5 Andriaenssens, Jef. The Impact of Traumatic Events on ER Room Nurses: Findings from a Questionnaire Survey. Interntional Journal of Nursing Studies. 49: pg Ibid, pg. 38. NBNU and NLNU celebrate 40 th Anniversary ACROSS CANADA 6 MNU Front Lines Magazine Issue We would like to congratulate the New Brunswick Nurses Union and the Newfoundland and Labrador Nurses Union, both celebrating their 40th Anniversaries in October. MNU President Sandi Mowat sent congratulatory video messages that were played at each AGM on behalf of our members. Forty years of representing nurses and advocating for patients is a wonderful accomplishment, said MNU president Sandi Mowat. As nurses we are all leaders. When we advocate for those in our care, when we work to improve nursing practice and improve patient care, or to preserve a health care system that provides for all we are demonstrating leadership. It is certainly a time to celebrate. Congratulations to both NBNU and NLNU. The Manitoba Nurses Union celebrates our 40th Anniversary in We look forward to celebrating all of the accomplishments and memories over the last four decades with our members. Please check the MNU website and Facebook page in the coming months as we post more information for the AGM on April 27-29, 2015.

7 Violence is not in our job description Fourth International Conference on Violence in the Health Sector The numbers tell the story In Manitoba, every day a nurse encounters a violent situation. More than 6,000 nurses are physically assaulted 55% of Manitoba nurses reported physical violence and intimidation has gotten worse over the past 5 years 85% experience violence from patients 76% are verbally assaulted 32% experience violence from patients families The Fourth International Conference on Violence in the Health Sector was held on October in Miami, Florida. Health care experts from around the world participated in the largest global conference dedicated to work-related aggression and violence in the health and social services sector. This year the focus of the conference was to target concrete and sustainable initiatives, projects and research aimed at combating violence in the health sector, and participants had access to over 180 keynote speakers, workshops, papers and poster presentations from 30 countries. The aim is to raise awareness and address the global problem of violence in the health sector. The Manitoba Nurses Union s Curbing Workplace Violence in Manitoba: Effective Lobbying for Regulatory Reform was selected as an abstract presentation for the conference, and MNU president Sandi Mowat had the honour of presenting our findings to an international audience. The conference was attended by participants from all continents, from developing countries to highly developed ones, said MNU president Sandi Mowat. It was a powerful forum to exchange knowledge, information and tried and true methods that make healthcare workers safe in their work settings. Countries like Nepal, for instance, don t have any occupational health and safety standards. So, it s important to come together and share information and methods that have proven to be successful in Manitoba, and perhaps serve as a starting point for other countries to frame their OHS standards, said Mowat. Recently a patient threatened to smash a nurse s face in. The threat was disregarded by management. Later that week, the nurse was punched, suffering a dislocated jaw, concussion and whiplash. The punch was witnessed by another employee and was so violent that it was heard by several others in the hallway. Despite the eye-witness account and the doctor s diagnosis, the employer claimed that the nurse was exaggerating her injuries and manipulating the system to augment her holidays. a quote from president Sandi Mowat s presentation on violence. MNU Front Lines Magazine Issue

8 President s Tour 2014 #MNUtour2014 MNU president Sandi Mowat began the 2014 provincial tour this September, and has been traveling across Manitoba speaking to members about their concerns. Touring the province is so important because it gives me the opportunity to meet and speak with our members, said MNU president Sandi Mowat. Each of our members brings a different perspective and voice from the communities and facilities they work in, and all have unique daily challenges and triumphs. I am continually inspired by commitment and courage that I see from our members on a daily basis, and I want to thank each of you for taking time to meet with me on this journey. Join us on tour! Follow the conversation on Twitter and check in to see which facilty MNU president Sandi Mowat will be visiting #MNUtour MNU Front Lines Magazine Issue

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10 Locations Visited Neepawa District Memorial Hospital Country Meadows Personal Care Home McCreary Health Centre Dr. Gendreau Personal Care Home Ste. Rose General Hospital Dauphin Regional Health Centre & Personal Care Home Berens River Renal Health Centre Selkirk & District General Hospital MacGregor Health Centre Third Crossing Manor Lions Prairie Manor Seven Regions Health Centre Portage District Hospital Bethesda Hospital Bethesda Place Personal Care Home Vita and District Health Centre Desalaberry District Health Centre Whispering Pines Personal Care Home Altona Health Centre Boundary Trails Health Centre Pembina Manitou Health Centre Foyer Notre Dame Notre Dame de Lourdes Centre de Sante St. Claude Swan Valley Health Centre Swan Valley Lodge Swan River Valley Personal Care Home Benito Health Centre Thompson Clinic Northern Spirit Lodge Thompson General Hospital 10 MNU Front Lines Magazine Issue

11 Vacation Scheduling You may have already scheduled an appointment with your employer to talk about your vacation requests. Before you go to your meeting, there are a few important things that you should know. As required by Article 2109 of the MNU Collective Agreement, vacation entitlement lists are to be posted by March 1st of each year and shall reflect each nurse s projected vacation entitlement as at April 30th of that year (dates vary between facilities). The finalized approved vacation schedule must be posted by May 1st (dates vary between facilities). Each year, the employer must schedule an appointment so that you, the nurse may indicate your choice of vacation dates including any unpaid vacation that you may be requesting, in writing. Vacation is approved at your scheduling appointment and is not dependent on whether or not the employer has found relief for the vacation requests. It is not the nurses responsibility to agree to replace one another before the employer approves vacation. Please remember that it is mandatory that you attend your vacation scheduling appointment, because this is the only opportunity you have to request vacation for the upcoming year. If you miss your appointment, you cannot use your seniority to select your vacation and your request for vacation will not be considered until the last person on the seniority list has had her/his vacation requests approved. New practice of granting unpaid vacation A nurse who is on an approved leave of absence is entitled to all of the vacation accrual because employment is considered continuous. The nurse is still considered to be employed, even though she/he is not earning wages. Nurses who return from leave are entitled to their full vacation time, but not full vacation pay. The time they are away on leave does count toward their years of service when determining how many vacation weeks they are entitled to. For example: A nurse who is on unpaid leave for 6 months during the vacation accrual year is entitled to all of the vacation accrual, i.e. if she/he is earning vacation at the 4 week rate, she/he is entitled to 2 weeks of paid vacation and 2 weeks of unpaid vacation. The nurse may choose to take only full paid vacation weeks. The nurse shall not be forced to take any unpaid vacation in order to be off for the entire vacation weeks. MNU Front Lines Magazine Issue

12 Booking unpaid vacation Unpaid vacation is booked at the same time as paid vacation and is granted on the basis of seniority. However, once you have requested unpaid vacation and it is approved there is no ability to cancel it later and work instead. Recognition of length of service Nurses who have completed 20 years of continuous service will now receive an additional five days of paid vacation in recognition of their length of service. Furthermore, an additional five days will be earned on each subsequent fifth anniversary of employment (i.e. 25th, 30th, 35th, 40th, etc). It is important to note that this bonus week of vacation does not have to be earned and even if you were on an unpaid leave of absence during the previous year, when you would have been accruing vacation, you are still entitled to this week of vacation. Article 2104 Booking bonus week vacation This bonus week of vacation can be scheduled any time during the vacation year in which it is earned. It does not have to be specifically following your anniversary date. However, if you are on a leave of absence in the vacation year during which your bonus week occurs, you will not receive it and it is not carried over into the next vacation year. The bonus week of vacation must also be included in your projected vacation entitlement. NOTE: Payment for this bonus week of vacation, for part-time nurses, is based on the greater of your EFT or the amount of vacation pay calculated in accordance with Article Nurses on disability A nurse who is on D&R/WCB/MPI prior to the commencement of her/his vacation shall, upon her/his request, have her/his vacation displaced and re-scheduled at a time mutually agreed between the nurse and the Employer, within the available time periods remaining during that vacation year. Your scheduled vacation is not automatically displaced so you must ensure you request that it be displaced. You can continue to take your vacation as scheduled however it will impact the amount of money you will receive from D&R, WCB or MPI for that period of time. If the nurse s current annual vacation cannot be reasonably scheduled by the end of the current vacation year, the nurse may elect to carry over to the next vacation year up to five (5) days of current annual vacation (pro-rated for part-time). Except for these 5 days, a nurse must use current annual vacation, (which was earned during the previous vacation year), during the current vacation year. If the current annual vacation is not used or scheduled by January 15th, then the Employer has the right to schedule the vacation prior to the end of the current vacation year. Vacation may be paid out only in extenuating circumstances. Booking carry over vacation If a nurse chooses to carry her/his vacation over to the next year, she/he will be allowed to select her/his vacation on the basis of seniority. This provision provides for carry over of one (1) week (38.75 hours) of vacation (prorated for part-time nurses based on their EFT). Mobility and Portability Nurses who use the provisions of Mobility to transfer between Employers can carry their vacation banks with them or receive a payout. If a nurse chooses to have their vacation bank paid out, at the time of transfer, they can still transfer unpaid vacation weeks to their new place of employment. On the other hand, nurses who transfer to another Employer under the provisions of Portability will have their vacation banks paid out, and will only have unpaid vacation weeks to carry over. Questions Article 21, of the collective agreement, covers the topic of vacation scheduling in its entirety. For more information please see the Contract Interpretation Manual or contact your Local/ Worksite President to review the MNU s vacation scheduling procedure. 12 MNU Front Lines Magazine Issue

13 Courage in Canada s Capital On October 22, 2014, Margaret Lerhe who works as a nurse at Elizabeth Bruyere Continuing Care, was walking to work when she saw a man aiming his gun at a soldier guarding the Tomb of the Unknown Soldier War Memorial at Parliament Hill. What she first believed to be a military training exercise, quickly took a turn for the worse when shots were fired at the soldiers guarding the memorial. Tourists and citizens took cover as the gunman opened fire, but Lehre ran towards the scene where fallen soldier Cpl. Nathan Cirillo lay fighting for his life. The other solider told Lehre that Cpl. Cirillo had been shot twice. She began pressing her hands on the wound to his left side to try and stop the bleeding. Barbara Winters, a lawyer at the Canada Revenue Agency and former member of the Canadian Forces Naval Reserve, was also on her way to work when she heard the shots and ran towards the memorial to help. Lehre realized that Cpl. Cirillo was no longer breathing and asked someone to perform CPR. They worked together Winters began compressions, the other soldier started mouth-to-mouth respiration, and Lerhe helped coach Winters on the compressions. The paramedics arrived and took over the chest compressions. As they worked, Lerhe relayed information about his injuries. Cpl. Nathan Cirillo died from his injuries in the arms of the courageous people that worked so hard to keep him alive and reassure him that he wasn t alone and that he was loved. When you ve been trained as a nurse, that s your job is to help and to pitch in in all kinds of circumstances. You step up. The key thing is this is what was so surreal there were four or five people around this fallen soldier all working as a team. I m uncomfortable with the term hero because everybody was just focused on him. I don t consider it heroism; I think it s doing what you should do in the time of crisis. The quote above is transcribed from CBC News on Thursday October 23, 2014 With files from MacLeans Canada. Photo credit - Copyright National Post MNU Front Lines Magazine Issue

14 by Kirsten Andersson, Director of Labour Relations Improvements to Health and Safety in the Collective Agreement Ebola, SARS, PTSD, H1N1 and the seasonal flu are all health issues that have caught the attention of nurses and nurses unions over the last few years. In response, the Manitoba Nurses Union has made health and safety a priority in everything we do including collective bargaining. In the last round of negotiations the PCBC was able to achieve the following improvements in the Collective Agreement: 1. Preamble WHEREAS, the Employer recognizes the responsibility to secure nurses from risks to their safety, health and welfare arising out of or in connection with the activities in their workplaces, the Employer will comply with their responsibilities in accordance with Section 2.2 of The Workplace Safety & Health Act. This amendment solidifies the employer s responsibility to ensure a safe work environment, makes nurses aware of their rights under the Act and ensures compliance with this principle into the future. It is properly placed within the preamble as it is an overarching idea that should inform all decisions and interpretations of the parties. 2. Article 701 The parties agree that there shall be no discrimination, interference, restriction, harassment or coercion based on the applicable characteristics cited in Section 9 of the Human Rights Code of Manitoba. This amendment solidifies the employer s responsibility to ensure a compliance with the Code and makes nurses aware of their rights under the Code. By citing the applicable section rather than listing the protected characteristics, the collective agreement will be updated as the legislation is updated. 14 MNU Front Lines Magazine Issue

15 3. Article 7A03 On an annual basis the Workplace Safety and Health Committee will be provided with a copy of the Critical Incident Stress Management or applicable policies for review. Requiring the employer to provide these policies to the Workplace Safety and Health Committee ensures that the policies are reviewed and recommendations can be submitted. 4. Article 7A04 The Employer and the Union agree that no form of abuse of nurses will be condoned in the workplace. Both parties will work together in recognizing, facilitating the reporting of alleged abuse and resolving such problems as they arise. Any nurse who believes a situation may become or has become abusive shall report this to the immediate supervisor. The Employer shall notify the Union ninety-six (96) hours after the receipt of the report. Every reasonable effort will be made to rectify the abusive situation to the mutual satisfaction of the parties. There shall be a policy supporting a Respectful Workplace and zero tolerance of staff abuse which shall be reviewed annually by the Workplace Health & Safety Committee. Such policy shall address the issue of communication strategies, which will include signage. The Employer s Respectful Workplace policy shall include a commitment to conclude the investigation as quickly as is reasonably possible and that the investigation process itself will be conducted in an impartial manner. The amendment of ninety-six (96) hours requires the employer to make the report of an abusive situation within that time thereby allowing the Union to respond to the affected nurse if appropriate. Currently some employers contact the union before ninety-six (96) hours but often the union is not contacted for much longer than ninetysix (96) hours. This language makes the requirement clear and unequivocal. Please note that this language does not prevent employers from making the notification before 96 hours and in fact are encouraged to do so at their soonest opportunity. The amendments regarding the respectful workplace enshrine the employer s obligation to have a respectful workplace policy as well as the employer s commitment to basic principles such as an expeditious and impartial investigation. These amendments were intended to address the concern that investigations are often protracted and that sometimes the employer selects an investigator who is not perceived by members to be impartial. 5. Article 1002 The Workplace Safety and Health Committee will be provided with a copy of the written Disaster Plan annually for their information. The Committee may provide feedback. This amendment allows the workplace safety and health committee to monitor this policy. 6. Article 2410 Legal and Investigative Proceedings a) A nurse required to attend a court proceeding, other than a court proceeding occasioned by the nurse s private affairs where she/he is a party to that proceeding, shall receive leave of absence at her/his regular basic rate of pay, and remit to the employer any jury or witness fees received, only for those days she/ he was normally scheduled to work. The nurse shall not request reimbursement for, or be required to remit any reimbursement of expenses for such duty. If a nurse is subpoenaed as a witness in a work related matter on her/his scheduled day off, the Employer and the nurse will mutually agree on alternate time off in lieu. b) A nurse required to attend a court proceeding/inquest to provide medical/clinical evidence shall receive a leave of absence at her/his regular basic rate of pay, and shall remit to the employer any witness fees received. The nurse shall not be required to remit any reimbursement of expenses for such duty. c) Where a nurse is required to prepare for a court proceeding/inquest where they will provide medical/clinical evidence, during time that the nurse is not scheduled to work, the Employer and the nurse will mutually agree on alternate time off in lieu or compensate for time at regular rates of pay, subject to the Employer s prior approval of the required preparation time. d) Where the Employer requires the nurse to participate in a workplace investigation that is required by legislation or Employer policy, and where such investigation meetings cannot be scheduled on the nurse s regular day of work, the Employer will compensate the nurse for the investigation meeting time at regular rates of pay. e) A nurse required to attend a court proceeding as a party to that proceeding, occasioned by the nurse s private affairs shall receive a leave of absence without pay for the required absence. (Editorial amendments to Article 35 to include This amendment changes the name of the article to reflect the expansion of the application of this provision. The article now ensures that all nurses shall be compensated for time spent at Legal and Investigative proceedings and includes time to prepare for required court proceedings where the nurse will provide evidence. Possible proceedings that would now fall under this provision are: Investigations under the provisions of the Protection for Persons in Care Act Respectful Workplace Investigations Inquiries and inquests Work related court proceedings (eg Sexual Assault Nurse Examiner) Workplace Investigations Please note that this language also applies to casual nurses and this will be reflected with an editorial amendment in Article 35. As always, if you should have any questions or concerns, please contact your local/worksite President or Labour Relations Officer. MNU Front Lines Magazine Issue

16 Safe Staffing Critical for Patient Safety On October 1, 2014 leaders of the Canadian Federation of Nurses Unions (CFNU) and the Canadian Nurses Association (CNA), including MNU president Sandi Mowat, showed provincial and territorial health leaders the inextricable link between safe staffing, patient safety and quality care. The meeting took place at a roundtable briefing held during federal, provincial and territorial health ministers meetings. Nursing leaders presented information from national and international lessons, including examples from England s public inquiry into the relationship between safe staffing, patient safety and quality care. Above all, we need to ensure patients are protected, said CFNU president Linda Silas. We understand it is increasingly challenging for governments and health administrators to balance the needs of patients with the financial realities. Tragic cases such as England s National Health Service are a reminder of what s at stake and why we all must be committed to patient safety. One of our top priorities at MNU has always been advocating for safe workloads and ensuring that patients are receiving the best possible care, said MNU president Sandi Mowat. Heavy workloads compromise our ability to deliver this. As part of our advocacy for our members and patients, our Workload Staffing Initiative was one of our highest priorities in the most recent round of bargaining. Nurses are the largest group of health care providers in Canada and are responsible for providing the majority of health care to Canadians thus making them a key link in the chain of safety. The CFNU and CNA presented the ministers with a joint plan for collaborative action on a sustainable health human resources strategy, and for patient priority care needs to be properly assessed using real time tools, based on factors such as acuity, stability and complexity. The plan is based on four central priorities: Empower patients and the public through education Support nursing students and nurses Promote evidence-based staffing practices Promote strong nursing leadership In recognizing the sheer size of our profession, we realize nurses have to lead patient safety strategies, said CNA CEO Anne Sutherland Boal. One way we can achieve progress is making sure that the staff assignments are based on what is the best match of patient needs with nurse Universal Pharmacare Update At the National health care round table in Banff, MNU president Sandi Mowat, and Canadian Federation of Nurses Unions (CFNU) nursing leaders met with Canada s provincial health ministers urging the government to implement a national pharmacare strategy. Nursing leaders are applauding the Health Ministers stand on the national prescription drug plan as we push the federal government to implement a national pharmacare strategy. It was a very positive meeting overall, and I believe as nursing leaders it s encouraging to see that our health ministers support our research and understand that by lowering the cost of prescription drugs, we are improving the health of patients across Canada, said MNU president Sandi Mowat. This meeting follows the health care round table discussion at the Council of the Federation that was held in Prince Edward Island in August, where health care experts presented their research findings A Roadmap to a Rational Pharmacare Policy in Canada. competencies. Putting the patient at the centre of the system will lead to better health outcomes. The roundtable also featured a presentation from Dr. Maura MacPhee, an Associate Professor at the University of British Columbia s School of Nursing. Dr. MacPhee authored the recent report, Valuing Patient Safety, a wake-up call for health care decision-makers about the importance of transparency and accountability in a safe health care system. For the long term, it s vital that our health care system become more open, transparent and accountable, said Dr. MacPhee. Health care providers, patients, their families, and the public need to have information to influence and engage with health care decision makers, this is the foundation of the quality-safety agenda. The research conducted by CFNU shows that pharmacare could save as much as $11.4 billion per year annually that could be reinvested in health care. Canadians are looking to Ottawa for leadership on pharmacare, said CFNU president Linda Silas. Rising costs have made prescription drugs inaccessible to many of our country s most vulnerable populations, including seniors. 16 MNU Front Lines Magazine Issue

17 MNU Education Conference 2014 By Debbie Winterton, Professional Practice and Education Officer The 2014 Manitoba Nurses Union Education Conference was held September 22 24, 2014 at the Lakeview Hecla Resort. We had 139 members who attended, representing our 63 Locals/Worksites, all joining together to learn, and to share ideas and experiences. There were six courses offered this year. The returning two-day courses, The Unionized Nurse and the Law, and, Grievance and Arbitration, provided valuable and timely information and examples to members. The one-day course, You ve Got the Power Now Use It, was engaging and well-received. Our Collective Bargaining course, which had not been offered for a few years, was brought back this year and was rated as excellent. Participants who wanted more information focused on local, worksite and employer meetings were offered the course, Money, Meetings and Minutes, which provided information on financial budgeting and minute taking. The one-day course, New to MNU, introduced 30 new MNU members to our union, and the benefits of a collective voice. After classes, attendees could unwind by enjoying the amenities of the resort, group activities, entertainment or metime. Attendees loved the facility and the beautiful weather. We received feedback from participants indicating that members want information on professional challenges, dealing with management and practical examples from their workplaces. We appreciate this feedback as we make course plans for the next year. We hope to introduce new courses for the 2015 MNU Education Conference. Dates and location are being finalized. Look for more information very soon. MNU Front Lines Magazine Issue

18 BENEFITS COVERAGE Pension & Benefits Corner Mental health issues are the most rapidly growing area in our Disability and Rehab Plan and other healthcare plans across Canada. This is especially true in the areas of Depression and Anxiety disorders. In many cases we see this as a result of prolonged, excessive and unreasonable stress and burnout in the workplace. We have had critical incidents that in some cases are recognized by WCB as being work related. However, cumulative and chronic stress builds up and manifests itself in mental illness, which is work related, but is not always recognized as a workplace injury. When these mental health issues are recognized it is often because members are accessing resources like EAP. These health concerns are the second leading cause of disability, and the secondary diagnosis in the case of the Disability and Rehab Plan. It is MNU s understanding the cost may be up to $20,000 per year. Healthcare workers are reporting high degrees of stress, burnout, insomnia, anxiety, and depression which presents itself in the workplace through higher incidents of absenteeism, addictions and counterproductive coping behaviors. It can be a challenge for employers to recognize that short staffing, excessive workload, poor communication and lack of support may be linked to workplace acute and chronic mental illness issues of their staff. The WCB will rarely recognize Critical Incident Stress, which encompasses a broad range of mental health issues, such as acute stress disorder, burnout, compassion fatigue and in some cases PTSD. Nurses who are experiencing a mental health condition may turn to income protection, EAP, or D+R which are often more easily accessible than workplace resources. In some cases our own members need more education on Critical Incident Stress in order to be aware and supportive of members trying to heal and return back to the workplace in a healthy manner. Our Union is working to get workplace psychological and mental health issues recognized and to look at some comprehensive solutions to help all nurses across Canada. Bob Romphf, Labour Relations Officer Benefits Unpaid Leaves of Absence and Access to Benefits There have been a number of communique s from HEB and articles in Front Lines concerning nurses paying their benefit premiums when they go on an unpaid LOA. It is critical that nurses pay their benefit premiums before they start their LOA ie. Maternity, Education, Unpaid Medical LOA and General LOAs. Members often indicated that, they thought someone was taking care of this or they didn t know. No matter what the reason is, when the premium isn t paid it can often mean no benefit. There have been cases where nurses who have gone on a LOA and have not paid their benefit premium before they leave, and are not covered when subsequently diagnosed with cancer and other serious illnesses, or were injured while on leave. BE SAFE PAY THE PREMIUM GET THE BENEFIT! NOTICE-RETIREMENT IN A NUTSHELL 6 THE ADVENTURE BEGINS The newest version of our popular Retirement in a Nutshell is hot off the press. If a Region, Local or Worksite is interested contact Bob Romphf at the MNU office or Ext. 205 to book a workshop in The workshop is about two and one half hours long and summarizes such topics as: Demographics, Pre-Retirement LOA, HEPP pension, HEB Post Retirement Benefits, CPP/OAS, Wills and Estate Planning, Taxes, Travel, Post Retirement Work and Realistic Expectations in Retirement. Note: This workshop is not intended to replace individual financial and retirement counselling for individual members. Hope to See You There. 18 MNU Front Lines Magazine Issue

19 Double Dues REFUND REMINDER You may qualify for a refund of the Provincial Portion of your MNU dues deducted by your employer, if you paid MNU dues to two or more facilities/employers. Union dues consist of two components, the Provincial and Local. Only the provincial portion is refundable. PROVINCIAL DUES $26 per pay period x 26 pay periods = $676 Local Dues (varies from local to local range is from $1 $8) $X x 26 pay periods = $XX this amount in NOT refundable EXAMPLE You have been deducted $31 in union dues in one pay period. $26 is the provincial portion while the remaining $5 (31 26) is the local portion. You would have to have 26 pay periods with dues deductions totaling $676 (26 pay periods x $26) before qualifying for a refund. If your total exceeds $676 (without the local portion) then you are eligible for a refund. APPLYING ONLINE IS AS EASY AS 1-2-3! Using the mymnu member portal is quick, easy, reliable 1 Log into the mymnu Member Portal Home page, and click on the Forms tab. 2 On the Forms page, in the left column click the Double Dues Request Form link. 3 On the Double Dues Request page, simply provide the necessary information in the fields. Upon completion, check for accuracy then click Submit. You will receive an instant, confirmation form MNU that we received your Double Dues Refund Application. December 1, 2014 Forms will be available in the mymnu Members Portal January 31, 2015 Deadline for forms submission mid-april 2015 Cheques will be issued In 2016 You will receive a T4A for the 2013 refund MANITOBA NURSES UNION DUES REFUND APPLICATION FORM Mail: Broadway, Winnipeg Manitoba R3C 4M6 Fax: (204) info@manitobanurses.ca Name/or Name Change: Current Address: (Street) (City/Town) (Postal Code) (Phone Number) Nursing Registration/Licence Number Social Insurance Number MNU Places of Employment MNU Worksite/Local # Full Time/Part Time Casual Total Dues Deducted MNU Front Lines Magazine Issue

20 Help us keep you updated If your contact information has changed please contact Veronica Jones at or You can also visit our website at and change your contact information by logging into the Members Portal and updating your account information. If you are no longer a MNU member or are receiving this newsletter in error please contact the MNU office at so that we can update our records. Frontlines is available electronically! Visit manitobanurses.ca to subscribe MNU Board of Directors Sandi Mowat...President Donna McKenzie...Vice President Holly Cadieux...Secretary Treasurer Karen Taylor...Assiniboine Region Marguerite Smith...Assiniboine Region Cathy Jensen...Brandon Region Trudie Empey...Brandon Region Cindy Hunter...Central Region Dorothy Pasowisty...Central Region Carrie Holland...Churchill/Burntwood Region Tracy Bassa...Eastman Region (North & South) Kathy Nicholson...Interlake Region Darlene Jackson...NorMan Region Sharon Zeiler...Parkland Region Charlotte Adolphe...Winnipeg Long Term Care Region Bluma Levine...Winnipeg Community & Health Care Region Winnipeg Hospital Region Amanda Bouchard...Concordia Nurses Local 27 Karen Cannell-Jamieson...Grace Nurses Local 41 Kim Fraser...Health Sciences Centre Nurses Local 10 Anne Boyd...Health Sciences Centre Nurses Local 10 Sandy Forrest...Misericordia Nurses Local 2 Dana Orr...Riverview Nurses Local 1a Sheila Holden...St. Boniface Nurses Local 5 Diana Martinson...St. Boniface Nurses Local 5 Colleen Johanson...Seven Oaks Nurses Local 72 Sonyia Mayo...Victoria Nurses Local 3 Follow MNU president Sandi Mowat on Like us on Facebook