This a partial draft of my explanation and to follow will be my final grievance letter tomorrow.
GRIEVANCE LETTER 11 February 2013
FROM: Maria Corazon R. Escobar Job description code: 1105 Clinical Nurse BU
13 June 2012
Failure to reconcile medicine sheet so patient had wrong medicines. Poor charting and lack of clarity with narrative.
18 June 2012
Found taking patient information copy to field assignment.
Rebuttal: Every one takes patient record copies out with them to be use for reference because of the large amount of info that is beyond a normal person's memory.
10 July 2012
First written letter: Unable to follow department system due to poor performance and patient care. Management investigation found failure to comply with hospice guidelines. Rebuttal: My annual job evaluation was always satisfactory or better.
8 August 2012
Failed to do proper teaching after being coached what to say about insurance coverage for an MRI.
11 September 2012
Inappropriate follow through of assigned patient to next shift causing delay of service.
12 December 2012
Arrived late to meeting but already clocked-in 45 minutes before the meeting started and has no patient assignment posted.
Rebuttal: This was my first day of worked after 30 days of vacation overseas thus I needed to check and update all my work official e-mails and reset my synchronization of my laptop account because of accumulated information and be familiar with the policy changes, staffing routine changes and Sharp hospital wide messages. With the large amount of messages and with synchronization this took me at least one hour to read, perform or reply and synchronize physically at work because it is much faster to do this in the office instead of doing it my laptop.
13 September 2012
Incomplete admission documentation and did not synchronize before the end of business day.
Rebuttal: Per memorandum of Ms XXXXX XXXXXson to Ms Kellie White on 29 June 2012, charting of notes can be authorized to be completed by next day shift but must complete all lines marked with asterisked and synchronized before 2230 at the end of each business day.
14 January 2013
Failure to complete a routine visit and to transfer patient to a hospice home.
Rebuttal: I notified Elisa that this patient assignment was cancelled by Memorial and will not be able to transfer until 1300. I told her that I was no longer needed at Memorial because another staff RN was authorized by Elisa to be the coverage at 0800. The time that I spoke with Elisa I was already driving in 5 South Freeway because I was giving myself enough time to get to work because of the heavy traffic starting in Oceanside where I live and that it was raining bad during the morning from Oceanside to San Diego. While still driving Elisa then informed me that I had a patient in Escondido but by this time I was already far from the area and decided that I must as well go the the office at Grossmont in order to complete all my patient chart corrections as mandated by the Utilization Review group for all staff. Before Kellie even contacted me I was already in the process of completing my chart review and corrections.
Kellie as usual again comes to an incomplete picture of the situation and notified me why I was at the office instead of driving first to Escondido, the lack of coordination and non-inquiry from the assigned supervisor which was Ms. Elisa gave her a wrong picture of my plans. She ask why I did not wait and start to drive to Escondido from my house in Oceanside. She always gives me counselling about allegations that where incomplete, misleading and manipulated. She stated that Memorial had no extra coverage for this morning because I did not show up but the fact was the Memorial Hospice Liaison and nursing staff were not aware that another nurse was approved and assigned to be the extra coverage. That is why I decided to continue my drive to the office because I was already in the road at 5 S San Diego FWY and another staff had recently called me that I was no longer needed at Memorial because Ann had arrived as the extra nurse at Memorial. They specified to me not to come to Memorial any more since they no longer needed me.
15 October 2012
Failed to provide a copy of medicine list to patient.
Rebuttal: I informed the patient's case manager to check the list with new orders written and bring it at patient's home with her visit.
16 January 2013
Clocked-in at 0800 but did not attend a meeting, missing on class about hospice insurance coverage and then needed to call the supervisor about admission insurance policy.
Rebuttal: I had a very complicated patient assignment this day and that is why I did not attend the meeting but instead did my patient information research. Then in the afternoon I met with Ms Kellie White, supervisor for admission group leading to my staying over 2.51 hours for this meeting.
Human Resources representative advised Ms Kellie that union representative is not required for this counselling meeting.
I know that Ms Elisa instructed me not to admit the patient without insurance but I was further advised by the supervisor of the Social Worker section than I can admit patients even without insurance coverage and so I admitted this patient using forms given to me by the social works supervisor.
17 January 2013
Final Written Letter was shown to me and given a copy but I refused to sign because I was not aware of the specifics of this allegations and that a union representative was scheduled by me but my supervisor Ms Kellie cancelled this plan saying that she was advised by HR representative Mr Steve I can be shown this final warning letter without union representation. I am aware that they can show me this letter but I refused to sign it.
I am also aware that this letter indicates that actions being planned by my supervisors was to terminate me as soon as possible.
The allegations about not following through patient assignment, incomplete transfer notes, unauthorized transfer and handover of patient without a written doctor's order. Lisa, RN was in fact the one who was the originating nurse and was the one who started the transfer as she already had contact with the physician for the transfer order and I had nothing to do except that I had to research if all the things needed for the transfer were completed. Consequently I found from Lisa, RN that she needed to continue handling this case because the patient was not transferable until 1300. Since I was assigned to admit a patient in Escondido I needed to leave soon due to lack of time in order to drive to Escondido and finish all admission assessment and carry all the necessary things to admit a patient to our hospice service. Lisa RN agreed to finish the transfer as soon as she gets the MD order and we agreed and therefore I did not need to complete any charting at this time.
This shows a pattern of constant harassment from my supervisors Kellie and Elisa and this started after my co-staff RN and I investigated why we were asked to changed our work hours to start at 1000 AM instead of the regular 0800. We found out that the reason why admission are not being done on time before the end of the day shift because the Memorial Hospice staffs were allowed to start working at 1000 and by this time physicians are harder to contact after they have made their rounds at the hospital and also it takes longer to get orders to make additional orders and carry on changes to patient hospice plans.
We were also being retaliated upon because we were told that I always discuss with this particular co staff RN problems with the service and we were even admonished for always talking in our Filipino language when in the office together.
I was being retaliated also by my supervisors being rude in talking to me and it has been difficult for me to get a reply or when calling them to discuss issues about patient care in the field. I have called and send text messages but there is no reply from Ms Kellie thus delaying my work completion and if really desperate to get authorization or give an official update I have to contact any staff at the office and beg them to have Ms Kellie to reply and call me. This had been how she would reply to my calls or messages since I was asked to move out of Memorial Hospital and be rotated out on the field.
I was not given proper documentation training for field cases since I was removed from my assignment as the Hospice Liaison at Memorial Hospital without valid documentation and explanation for the reason of my transfer. I had a copy of the change in my job description code that my pay rate was raised in order to commensurate with the position versus a regular field hospice staff RN. Ms Kellie consistently denied that it was a not an official assignment and reassignment but as it turned out a newly hired RN was placed to replace me and then eventually she gave preferential assignment to per diem nurses over us who were full time regular nurses. These was connected to again for us regular admission nurses to be working at 1000 AM when these per diem nurses were given preferential schedule and work hours at Memorial instead of them following the old time schedule of starting at 0800 AM. Any hospital hospice nurse knows that nurses need to start early every day in order to verify all needed orders and make necessary changes to plans early before everything gets busy with hospital patients.
The harassment and retaliation did not become too apparent to our co-workers not till around September 2012, as shown by the timeline of an increase in this obvious actions two both of us. We can therefore claim that this occurred to happen after the union was involve with our work issues, continued every month and being fully noticeable by other office staff at the start of this year, January 2013.
The status of both of us being protected from retaliation and harassment were due to the basis that we are being discriminated based on age being older than 55 years old, our female sex and finally for belonging to a minority group as first generation Filipinos in America.
I have requested for a complete copy of my personnel and unit staff records as of 08 February 2013. My union representative had advised us to file for a grievance and I will meet with her Monday, 11 February in order to file my grievance letter this coming week but within four weeks.
Included in this grievance will be a request to give us a written copy that if we are terminated in the future for any reason a severance package will be given:
1. One year of our pay in cash and not to protest and deny our request for EDD unemployment benefits.
2. Lifetime medical, dental, psychological coverage.
3. Lifetime disability and long term care coverage.
4. Purge of our records and not to be used with all work and other request for job history and financial verification.
5. If these entire settlement cannot be authorized in full then we will be guaranteed to be assigned and properly retrained to RN positions we choose and not be subjected to the same retaliation and harassment particularly with out job evaluations.
Finally we will not accept to any of the allegations listed in the letters of warning because of the timing of the complaints to us, the type of adversarial managerial style used, of our protected status of our race, sex and age. Any allegations of poor job performance we strongly object due to all the evaluations given were all satisfactory or better.