Instead of disagreements between employers & employees leading to impasse, under interest arbitration, an neutral arbitrator reviews both parties testimony & proposals.
The arbitrator, not the employer, decides what’s “fair.” 4/
Interest arbitration is usually reserved for collective bargaining groups that can’t strike, such as public safety (police, fire, etc).
HB1764 would expand interest arbitration in WA and expand it to cover residents/fellows too.
As Biden would say, “this is a big… deal”. 5/
BUT it’s not a done deal yet.
#HB1764 made it out of committee. There will be a public hearing tomorrow (Thursday 2/3). This will largely determine the
This is where YOU can help. 6/
3 things YOU can do to support residents bargaining rights:
1️⃣Note your support for HB1764 in the legislative record (takes just 30 seconds) bit.ly/3Ho1e1D
2️⃣Submit written testimony (takes 5 min) bit.ly/3GnM1Ms
Summary:
1️⃣residents/fellows are frontline workers in the pandemic, often asked to work extra shifts w/o extra pay
2️⃣administrators have little incentive to bargain when they can just say “nope”
3️⃣interest arbitration is an key tool to level the playing field #ISupportHB1764
8/8
• • •
Missing some Tweet in this thread? You can try to
force a refresh
Instead of proposals to cap RN pay I’d love to see legislation that:
1️⃣mandates safe RN staffing ratios nationwide
2️⃣enacts a “50 state medical license” w/ straightforward reciprocity
3️⃣imposes limits on executive compensation for any hospital/org that bills CMS
For those doubting these reforms are possible. A couple points:
There already is a federal law calling for “adequate numbers of licensed RNs” 42CFR 482.23(b) The issue is that this is too vague.
15 states have passed laws that go further. CA & MA explicitly stipulate RN ratios
The CA law, enacted in 2004, mandates 1 RN to 5 med/surg patients & 1:2 for ICU patients.
After implementation RNs cared for one fewer patient on average. There was a decrease in hospital mortality & increased RN job satisfaction. ncbi.nlm.nih.gov/pmc/articles/P…
The ivermectin crazies are now recommending hydroxychloroquine too.
Their “protocol” includes a dangerously high dose of diuretics & recommends high dose steroids in people not on supplemental O2.
This has crossed the line from (mostly) harmless nonsense to actual harm.
Supporting Evidence:
A 2021 Cochrane meta-analysis (the 🥇standard) concluded that HCQ “has little or no effect on the risk of death and probably no effect on progression to mechanical ventilation. Adverse events are tripled compared to placebo…”
A more recent meta-analysis in @NatureComms that included unpublished studies went further, concluding “that treatment with hydroxychloroquine is associated with increased mortality in COVID-19 patients”
Just 3️⃣simple acts of compassion can go a long way
Important RCT just published in @TheLancet shows that a family support strategy consisting of 3 extra family meetings can substantially reduce family grief 6mo after the death of a loved one in the ICU thelancet.com/journals/lance…
1/
Pre-pandemic, ICU mortality was often ~20%
In the US, 30-60% of ICU deaths were preceded by a decision to withdraw life support
We are experts at providing comfort focused care for patients but in many cases, families feel grief months afterwards
What can we do about this? 2/
The COSMIC RCT studied this.
The intervention was 3 family meetings held following a decision to withdraw life support:
1️⃣family conference to prepare relatives for the imminent death
2️⃣ICU-room visit to provide support
3️⃣meeting after death to offer condolences & closure
To those who are unvaccinated because of worries about “unproven mRNA technology” you know you can get:
- the J&J vaccine (🇺🇸)
- the Oxford-AZ vaccine (🇬🇧&🇪🇺)
Both can prevent hospitalization or death from COVID. Neither are mRNA vaccines. So why not get vaxxed today?
To those worried about blood clots after J&J, as of April 2021:
-there were 15 cases of TTS
-out of 8 million J&J doses
The vaccine efficacy (VE) of the J&J vaccine *is* slightly less than the mRNA alternatives: 68-71% VE to prevent hospitalization (compared to ~90% for mRNA vaccines). That’s still much much better than being Unvaxxed.
Remdesivir (RDV) is in the “We suggest no remdesivir” category.
At some level, this isn’t too surprising & is old news.
Despite initial hype, RDV never moved the needle much on patient centered outcomes (risk of mortality or requiring IMV) & many of us had stopped using it. 2/
In #ACTT1 RDV did improve outcomes on an ordinal scale, but the effect was modest. It shortened time to clinical improvement but not hospital LOS (patients stayed in the hospital longer to receive it).
RDV did NOT improve mortality or risk of IMV. ncbi.nlm.nih.gov/pubmed/32445440 3/