Nurses React to Kaiser Bonus Plan

First, to address your example of inoculation and the nurses rent money (“Kaiser Seeking to Pay Bonuses to Nurses Who Help Cut Costs,” Dec. 22):

Inoculations follow a set protocol and only patient’s allergy, illness or religious objection allow for deviation. Secondly, Kaiser pays its nurses enough to keep a roof over their heads, so that premise is invalid.

Now, as one of those Kaiser nurses, I’m going to tell you what I’m not going to do to help Kaiser meet their target.

I’m not going to let my patients lie in bed uncomfortable, immobile and underventilated so that they get pneumonia, bed sores or blood clots.

I’m not going to delay enacting doctor’s orders or administering needed medicines.

I’m not going to ignore adverse responses to therapy or let abnormal lab results go unreported.

I’m not going to put the patient at risk for infection by my negligence.

I’m not going to withhold information from the patient and the family about preventive care.

By not doing all these things, my patient will get to go home recovered, without complication, on time, or even earlier than expected.

When all is said and not done and Kaiser cuts its costs and wants to reward me--there’s one more thing I’m not going to do. I’m not going to take a share until some of that savings goes back to my patients in the form of lower premiums.

MARGARET C. HENRICH

Northridge

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I have been a nurse at Kaiser Permanente for the last 6 1/2 years.

I am truly appalled that an unreliable source can take out of context and infer that Kaiser nurses would accept bonuses for withholding patient care.

Incentive programs that promote high quality of patient care, personal service guarantees and cost-effective approaches to health-care delivery should be applauded as creative, not criticized as inappropriate. Nurses at Kaiser Permanente truly view the “business side of health-care” as a distinct competency of the professional registered nurse practicing in the 1990s.

Articles such as this only confuse the public and misinform your readership regarding the profession I truly love.

TERRY BREAM

Manager of Clinical Services

Southern California Permanente

Medical Group

Kaiser Permanente

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I was appalled to read that the union that represents Registered Nurses (UNAC) and Kaiser has proposed tying wages to length of stay of hospitalized patients. This is like selling away the birthright of the first-born.

In California, RNs are required as part of our licensure to actively advocate for patients’ safety and quality of care. How will it be possible for RNs to fulfill this requirement of licensure if the leaders of their union propose contract language that contradicts this?

At a time when the health-care industry is trying to replace highly skilled caregivers, the majority of whom are RNs, and place in jeopardy the licenses of RNs by employing fewer and lesser-trained workers providing direct patient care, it is unbelievable that RNs would accept a contract that increases the dangers to patients.

The health-care consumers of California have the protective language of the licensure of RNs and of Title XXII that requires patient care levels for critically ill patients. If the RNs agree to this proposed contract, they will be undermining the safety and quality of patient care.

As an RN of 19 years, I implore all UNAC members to resist this erosion of patient rights and reject any language that includes a “morbidity bonus.”

It is we registered nurses organized collectively in our unions that stand between patient safety and corporate greed. To dredge up a tired but true phrase, “Do the right thing.”

ALAN BARTEL

San Jose

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Pretty soon Kaiser Permanente will be offering bonuses to patients to keep them from seeking care.

A.I. WORTSMAN

Van Nuys