Staffing Ratios & Safe Staffing — Lucile Packard Children's Hospital RNs

LPCH/CRONA CBA • 4/1/2025 – 3/31/2028 -68- equipment and technology, the complexity of clinical judgment needed to design, implement and evaluate the patient care plan, the ability for self-care, and the licensure of the personnel required for care. If, considering the factors identified in the preceding sentence, staffing is assigned in excess of the state-prescribed ratios, such assigned staffing shall be maintained during meal periods and rest breaks. 32.3 Staffing Plans. 32.3.1 Each unit shall maintain a staffing plan that is compliant with applicable law and based on patient care needs as determined by the patient classification system provided in Section 32.1. The unit or area’s staffing plan shall be available to the Nurses on that unit in electronic form and in hard copy. The staffing plan shall be developed and implemented for each patient care unit or area of practice and shall …

32.1 Patient Classification System and Committee. 32.1.1 As required by law, the Hospital shall maintain a documented and legally compliant patient classification system for determining the nursing care needs of individual patients that reflects the assessment, made by a registered nurse, of patient requirements and provides for shift-by-shift staffing based on those requirements. As provided by law, a patient classification system means a method for establishing staffing requirements by unit or area of practice, patient, and shift that includes: (a) a method to predict nursing care requirements of individual patients, (b) an established method by which the amount of nursing care needed for each category of patient is validated for each unit and for each shift, (c) an established method to discern trends and patterns of nursing care delivery by each unit, each shift, and each level of li …

LPCH/CRONA CBA • 4/1/2025 – 3/31/2028 -69- participants as the Committee determines to be of assistance on particular issues or problems. In the event that either the Employer or CRONA wishes to have additional representatives appointed to the Nurse Practice Committee from departments outside the Department of Nursing who have CRONA R.N. staff, the appointment would be subject to the Committee’s approval. This committee will have a co-chair from the Employer and from CRONA selected by the respective parties from the eight (8) appointed members. 33.2 Purpose. To promote, develop, and continually enhance professional nursing practice, effective utilization of nursing resources, and an organizational climate conducive to professional practice. 33.3 Responsibilities. 33.3.1 To discuss items mutually agreed to be of concern as issues affecting Nursing Practice by both the Employer and CRONA. …

14.1 Summary of Responsibilities. The purpose of Relief Staff is to provide additional staff to supplement regular staff for census and acuity fluctuations, or for regular staffing fluctuations, so that quality patient care can be maintained. The Relief Nurse may be designated to act as Charge Nurse and is responsible for the delivery of coordinated nursing care for a patient or a group of patients within a specified patient care unit. The Relief Nurse is expected to perform according to the assigned unit’s Clinical Performance Criteria for Nurses. 14.2 New Hires. All newly hired Relief Nurses will serve a trial period. After completion of no more than three (3) months of employment, the Employer will give the Relief Nurse an evaluation in writing if they are having difficulty in meeting expectations. This provision does not limit in any way the right of the Employer to terminate a Relie …

LPCH/CRONA CBA • 4/1/2025 – 3/31/2028 -25- d. PTO or an absent day may be offered to and accepted by a Regular Nurse if such Nurse is extra on their respective unit and cannot in the determination of the Employer be utilized elsewhere to meet a staffing need. e. In units where there is prolonged low census, those Regular Nurses who have depleted their PTO will be eligible, depending on operational needs, for up to two weeks of vacation annually without pay. CRONA and Nursing Administration will mutually agree on the definition of a period of prolonged low census. f. PTO shall be granted to Regular Nurses having Herpes who are assigned to specialty units (Delivery Room, Nurseries), and cannot be utilized in other areas of the Employer. g. Nurses not allowed to work because of on-the-job exposure to a communicable disease are entitled to be compensated under the terms of the workers’ compe …

The existing on call shift selection and assignment procedures in effect in the PACU will remain in effect until a new procedure is jointly developed by the parties, and reviewed and approved by the Employer. That on call shift selection and assignment procedure will remain in effect unless and until PACU on call committee recommends a change which is adopted by the vote of 2/3 of the employees performing call in the PACU, and reviewed and approved by the Employer. In the ORs that are expected to be opened during the life of the Master Agreement between the parties, prior to the development of an on call selection and assignment procedure by an on call committee, and adoption by 2/3 of the employees to perform on call in the unit and review and approval by the Employer, the policy for selection of, and assignment of on call shifts shall be that presented to CRONA during the negotiations …

LPCH/CRONA CBA • 4/1/2025 – 3/31/2028 -43- 16.3.2 A Nurse may voluntarily trade weekends with another Nurse with the written consent of the Patient Care Director or Patient Care Manager. A Nurse making such a trade will not be entitled to the premium pay for consecutive weekend shifts for that weekend work. 16.3.3 The Employer will use its best efforts to grant each Regular Nurse with 20 years’ seniority (based on Seniority Date) every weekend off, to the extent operationally feasible to meet minimum staffing needs. To the extent additional weekends off become available, the request shall be granted to Regular Nurses by seniority, on a rotating basis per schedule period. 16.3.4 Regular Nurses who request and receive approval to be scheduled in a manner that would result in premium pay for working weekends under 16.2 above or who request and receive approval to be scheduled weekdays off i …

LPCH/CRONA CBA • 4/1/2025 – 3/31/2028 -39- 14.13.2 The Employer will determine unit scheduling procedures which, in its judgment, best serve this purpose. Shifts may be scheduled in 4, 6, 8, 10 or 12 hour blocks. A Relief Nurse who is scheduled to work is expected to work unless canceled by the Employer. Failure of a prescheduled Relief Nurse to work will be considered a failure to keep commitment under paragraph 14.11 above. 14.13.3 The following process will be used to schedule relief, the goal being to utilize the relief staff to supplement the regular staff. a. The Employer will establish minimum and maximum staffing levels for each nursing unit. b. Prior to the cut-off date for scheduling shifts, the Relief Nurse shall provide to the Nurse manager a written schedule of available shifts at least equivalent to their minimum commitment. Availability does not meet commitment, only worki …