SHC/LPCH and CRONA Negotiations SHC s & LPCH s Proposals on PNDP Proposals March 17, 2016



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SHC/LPCH and CRONA Negotiations SHC s & LPCH s Proposals on PNDP Proposals March 17, 2016 Stanford Hospital & Clinics and Lucile Packard Children s Hospital hereby propose a package proposal to resolve all PNDP issues in these negotiations: 1. Section LPCH 32.5/SHC 35.5: Maintain Hospitals proposal of 3/2/16, except revise BSN waiver subsection to allow Nurses currently eligible for BSN waiver to use it multiple times, as shown in attached; and 2. PNDP Packet: See attached.

Section 35.5(h): BSN Waiver A nurse with five (5) or more years of service as a registered nurse, two (2) or more continuous years of service with Stanford Hospital & Clinics and/or Lucile Packard Children s Hospital, and who was a Staff Nurse III or Staff Nurse IV as of March 31, 2016, but does not possess a BSN or MSN degree or a Doctorate of Nursing and does not desire to enroll in classes to obtain such a degree, will be considered to meet the educational requirement for becoming a Clinical Nurse III or Clinical Nurse IV if the nurse has or obtains a nationally recognized certification, as specified in subsection (iii) below. Notwithstanding the foregoing, a nurse who was a Staff Nurse III or Staff Nurse IV as of March 31, 2016 with at least twenty (20) years of service with Stanford Hospital & Clinics and/or Lucile Packard Children s Hospital, shall be eligible for this waiver of a BSN or higher degree, regardless whether that nurse has or obtains a nationally recognized certification. i. To be eligible for a waiver of a BSN or higher degree, the nurse must have obtained a Clinical Nurse III or Clinical Nurse IV position no later than [END OF CONTRACT] and thereafter may use the BSN waiver to maintain such a position. The nurse may use the BSN waiver to apply multiple times for Clinical Nurse III and/or Clinical Nurse IV level, but may use the BSN waiver to obtain only one promotion, either to a Clinical Nurse III or Clinical Nurse IV level. ii.a nurse who obtains a Clinical Nurse III or Clinical Nurse IV position pursuant to this BSN waiver provision and thereafter maintains a nationally recognized certification specified in subsection (iii) below (if required under this provision) will be deemed during future review periods to meet the requirement for purposes of retaining the Clinical Nurse III or Clinical Nurse IV status that the nurse obtained prior to [END OF CONTRACT]. iii. A certification that qualifies for the BSN waiver is either the most applicable certification in the nurse s area of specialty or a certification that supports the basic clinical practice in the nurse s area of work, e.g., pediatric certification for pediatric units and clinics at LPCH; O.B. certification for O.B. clinics and Labor & Delivery and Postpartum units at LPCH; medical/surgical certification for acute care pediatric units and clinics at LPCH, acute care units and clinics at SHC, and the cancer centers at LPCH and SHC; critical care certification for critical care units at SHC or LPCH; or ambulatory care certification for outpatient clinics at LPCH and SHC (other than the cancer centers). iv. The seniority and experience requirements provided for in this section shall be determined as of April 7, 2011.

f. Nurses who apply for and are accepted for Clinical Nurse III or Clinical Nurse IV status under the Professional Nurse Development Program will be placed on the step on the appropriate Clinical Nurse III or Clinical Nurse IV scale commensurate with their service or prior experience credit (e.g., if they are on Step 5 of the Staff II wage scale and are accepted as a Clinical Nurse III or IV, they will be placed at the Step 5 of the applicable wage scale). g. The Hospital agrees that, during the life of the 2016 20 Agreement, it will maintain records of all applicants for Clinical Nurse III or Clinical Nurse IV who go before the Clinical Nurse Selection Panel, whether they are accepted or rejected by the Panel, the reason given for rejecting each nurse, who among those rejected utilized the appeal process, and the result of the appeal process in each case. At the completion of each application period, the information concerning nurses who are rejected (identified by Employee ID Number) will be compiled and shared with CRONA in Joint Conference. h. Role of Panel during term of 2016 20 Agreement: Notwithstanding Section XI (7) of the PNDP, no changes shall be made to the negotiated terms of the PNDP during the term of the 2016 20 Agreement. As provided by Section XI(6) of the PNDP, the PNDP panel may continue to exercise its authority to interpret the terms of the PNDP. In addition, the PNDP Panel may make recommendations as provided by Section XI(7) on procedural and other issues that are not addressed by the terms of the PNDP.

SHC/LPCH PROPOSALS RE PNDP PACKET PROPOSED CHANGES TO PNDP PACKET 1) Required Certification for CN IV: Effective January 1, 2018, all candidates for a Clinical Nurse IV position, including renewals, shall possess and maintain a current ANCC certification that is appropriate for the candidate s unit, or an alternative certification with the approval of the candidate s Nursing Director. This requirement should be added to Section V (Eligibility) and the Qualifications section of the PNDP Summary Requirements for CN IV (p. 11). 2) Treat All Unit Transfers as Like Units : Treat all internal transfers within the Hospital similar to transfers between like units. As a result, the lists of like units on page 24 would be deleted; Section XIV would be modified as shown below; and references to like units would be deleted from the packet. XIV. Inter and Intra Department Transfers In the event of a transfer, the nurse will relinquish his/her PDNP status, but may apply for such status in his or her new unit/clinic/department at the next application period. The nurse may utilize any of the items previously used to attain Clinical Nurse status provided they remain timely and are relevant to the current unit/clinic/department, but must meet all necessary requirements, including an appropriate performance evaluation and Assessment of Clinical Expertise from his or her new Nurse Manager. As an exception, if the nurse is transferring to a like unit, as defined on page 24, the nurse will maintain his/her current Clinical Nurse status, if he/she meets the following requirement(s): (1) renews his/her Clinical Nurse status pursuant to Section IX or X (whichever is applicable), by the same date he/she would have been required to do so had no transfer occurred, except that his/her clinical expertise and performance appraisal shall be made by the Nurse Manager in the unit from which he/she transferred based on work performed by the nurse in that unit prior to the transfer, and (2) applies for and obtains Clinical Nurse III or IV status in the new unit, during a designated application period that occurs within nine (9) months from the date of transfer, using any points earned during the preceding twelve (12) months as of the relevant application due date, and demonstrating that he/she meets the required criteria based on the preceding twelve (12) months as of the relevant application due date. Note: If a nurse who transfers to a like unit would not have been required to renew her Clinical Nurse status within nine (9) months of his/her transfer to a like unit, she need only comply with requirement (2) above to maintain his/her Clinical Nurse status in the new unit.

3) Composition of the PNDP Panel (Section VII): Revise Section VII as shown below. VII. Composition of the PNDP Panel The Clinical Nurse Selection Panel ( Panel ) shall be composed of eight (8) members. Four (4) of the members shall be Clinical Nurses selected by CRONA, at least three (3) of whom shall be Clinical Nurse IVs and one of whom may be a Clinical Nurse III. The One members appointed by CRONA shall be from at least three (3)each of the four (4) regions designated in this manual ( Regions ). CRONA shall also select four (4) an alternate Panel members. The alternate Panel members shall be from at least three (3) of the four (4) for each of the Regions. Of CRONA s four (4) designated alternate Panel members, at least three (3) shall be Clinical Nurse IVs and one may be a Clinical Nurse III. If circumstances make an alternate from the same region unavailable for a particular panel interview, the alternate replacing a Clinical Nurse panel member may be from a different region as long as they are the same clinical nurse status or greater than the panel member they replace. The remaining four (4) members of the Panel shall be Clinical Nurse Specialists, Nurse Scientists, or Nurse Managers, including Nursing Directors and Assistant Patient Care Managers, selected by the Hospital. The Hospital shall also designate four (4) alternate members of the Panel from the same categories. Formatted: Font: Bold Formatted: Font: Bold There shall be Chair and a Vice Chair of the Panel. The Vice Chair shall assist the Chair, and shall serve in the role of Chair in the absence of the Chair. The Chair and Vice Chair positions shall each rotate annually between a member appointed by the Hospital and a Clinical Nurse member. For all years after the first year, the Clinical Nurse members of the Panel will select who among them shall serve as Chair or Vice Chair during their rotations, and the Hospitalappointed members of the Panel will select who among them shall serve as Chair or Vice Chair during their rotations. While it is not required, it is the view of the Hospital and CRONA that elevation of the Vice Chair to Chair is desirable to afford some experience to the individual serving in the role of Chair. Appointments to the Panel shall be for a two-year period. Appointees to the Panel are not eligible for successive terms as a Panel member, but Panel members may be appointed to serve a successive term as an Alternate and an Alternate may be appointed to serve a successive term as a Panel member. In no event, however, may an appointee be appointed to serve more than two successive terms, whether as an Panel member or as an alternate. An appointee who has been appointed to serve two successive terms may be reappointed to a Panel or Alternate position after the lapse of an intervening full two-year term.

4) Recusal of Panel Members: Modify the recusal standard for panel members so that it is at the option of the panel member, as provided below. Section VIII(7): The Panel (all eight (8) members, including alternates as appropriate), will determine if the applicant meets the criteria, and can award achievement by an affirmative vote of no less than a majority (5 of the 8) Panel members. Any panel member who is from the same unit as the applicant mayshall be recused himself or herself from the discussion and consideration of that applicant. The Panel will notify the applicant of its decision by letter and e-mail within ten (10) business days. If the nurse is denied, a written explanation will be provided at the same time as the notification. Section IX(7): The Panel (all eight (8) members, including alternates as appropriate), will determine if the applicant meets the criteria, and can award achievement by an affirmative vote of no less than a majority (5 of the 8) Panel members. The Panel will notify the applicant of its decision by letter and e-mail within ten (10) business days of the interview. If the nurse is denied, a written explanation will be provided at the same time as the notification. Any panel member who is from the same unit as the applicant may shall be recused himself or herself. 5) Notice to Manager and Submission of Application Packets: The Hospital seeks to modify the deadlines for notice to and submission of the application packets to the manager, as well as have the applicant be responsible for submission of the application packet to the panel. The last paragraph of Section VIII shall be revised as follows: It is the applicant s responsibility to notify her/his manager in advance of his/her intention to apply for promotion in a timely manner (preferably in writing at least 45 days prior to the deadline for submitting the application packet), so that the manager can provide the appropriate support before the due date. It is the applicant s responsibility to present a complete application package with all required documentation to her/his manager no later than 14 days prior to the deadline for submitting the application packet. on time. After receipt of the Nurse Manager s approval of the packet, the applicant shall submit the application packet to the [CNE at LPCH or Nursing Management at SHC] no later than the specified deadline. Copies of documentation must be retained by applicant for possible future verification of achievement. Corresponding changes are proposed for the similar language in Sections IX and X. 6) Exemplars (Section XVI and Summary Requirements): Delete requirement for Exemplars during non-panel years. 7) Assessment of Clinical Expertise: Add a signature line and date for manager completing the form. 8) Professional Nurse Development Program Points

Category D: National Certification/Recertification Add that, to be eligible for points, the certification must be current as of the due date of the application or renewal packet. Category F: Leadership Add Performance Improvement Project team leader (5 points) Remove Member, professional organization from list of activities for which points are awarded For Nurse Liaison/Champions/SuperUser/Warrior, add that Manager approves the designation on an annual basis and move definition of One time activity and On-going activity from footnote to immediately under this item Category I: Professional Publications Add to Acceptable Proof of Points for Evidence based policy writing that Nurse must submit the policy showing supporting evidence and the Nurse s rolereferences for policy writing. Category J: Community Service Under Acceptable Proof of Points, change Sponsor to Sponsor/Organizer 9) Regions: Hospitals designation of Regions due to new hospitals shall be provided to CRONA no later than March 31, 2016. As provided in the PNDP packets, the Hospitals retain the right to modify the designation of regions. 10) Cover Sheets: Have only a single cover sheet. Update and revise single cover sheet as shown in the attached. Delete the Verification of Meetings form due to updated cover sheet. Formatted: Font: Bold Formatted: Font: Bold 11) References: Require that one of the references be from the Nurse s patient care manager to whom the Nurse reports. 112) Committee Evaluation Form: Update form as shown on attached. 123) Checklist: Conform checklist to agreed-upon changes to PNDP. 143) Online Application and Checklist: Replace the application and checklist in the PNDP Packet with an online form. Online application and forms shall be approved by CRONA and each Hospital. 14) Role of Panel (Section XI): Delete the last sentence of paragraph 6 ( The Panel may consult for that unit.). Reject CRONA proposal to allow Nurses with discipline within prior 12 months to apply for Clinical Nurse III or IV positions.

SHC PNDP APPLICATION PROCESS PANEL YEAR COVER SHEET Name: Department: Length of employment in current department: Date: FTE: I AM APPLYING FOR: CN III CN IV Years of employed as a registered professional nurse TO BE FILLED OUT BY Director/Manager: Satisfactory attendance in 12 months preceding application. Yes / No Most recent performance appraisal Overall rating is Acceptable or Fully Competent Corrective action (written warning or greater in the last twelve (12) months. Mandatory training for individual departmet Annual mandatory training/competency demonstration e.g. Healthstream, Skills Day Has attended 75% of Staff Meetings conducted I support this applicant for promotion: Signature of Director/Manager Print Name & Title of Director/Manager NOTE TO APPLICANTS: One week prior to PNDP Panel appointment, call at extension to verify that all requested materials have been submitted. SHC PNDP APPLICATION PROCESS INTERIM YEAR COVER SHEET Name: Department: Length of employment in current department: Date: FTE: I AM APPLYING FOR: CN III CN IV

Years of employed as a registered professional nurse TO BE FILLED OUT BY Director/Manager: Satisfactory attendance in 12 months preceding application. Yes / No Most recent performance appraisal Overall rating is Acceptable or Fully Competent Corrective action (written warning or greater in the last twelve (12) months. I support this applicant for promotion: Signature of Director/Manager Print Name & Title of Director/Manager SHC Hospital or Professional Committee/Council Participation Evaluation Name: Organization: The person named above is seeking advancement or re-credentialing in the SHC Professional Nursing Development Program. Your assistance would be appreciated in evaluating their effectiveness in committee or activity participation. Please furnish the information requested below. Committee: Attendance: # attended out of possible: EVALUATION Meets Expectations Doesn t Meet Expectations Attendance (at least 75%) of scheduled meetings Participation Effectiveness / Contributions Remarks: (Required) Committee Sponsor: Signature: Date: Committee Chair Signature Print Name and Title Date Please fax or mail back to : (Manager) Office: ( ) - Fx: ( ) - Thank you for your prompt attention to this request. The undersigned, as authorized representatives of CRONA and Stanford Health Care, attest the ratification and approval of

this Professional Nurse Development Program. Dated: Committee For Recognition Of Nursing Achievement Colleen Borges Dated: Stanford Health Care Mary Gaines NAI-1500915403v1