STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

FLORIDA NURSES ASSOCIATION, )

)

Petitioner, )

)

vs. ) CASE NO. 75-109

) PERC NO. 8H-RC-751-0012

WEST PASCO HOSPITAL, )

)

Respondent. )

)

RECOMMENDED ORDER

A representation hearing, as provided by Chapter 447, Florida Statutes, was held, pursuant to proper notice, in this cause on May 14, 1975, and June 5, 1975, before the undersigned hearing officer. Ben R. Patterson, Esquire, appeared on behalf of the Petitioner, and Michael Malfitano, Esquire, appeared on behalf of the Respondent. The following witnesses were presented:

Mary Finnan - Executive Director

Florida Nurses Association.

George Billings - Acting Administrator of

West Pasco Hospital.

Bessie Snell - Staff Nurse at West Pasco Hospital.

Ruth Talttenberg - Shift Coordinator at West Pasco Hospital. Barbara Lumpkin - Economic and General Welfare Staff

Assistant, Florida Nurses Association.

The following exhibits were marked and/or received into evidence during the hearing.

Exhibit 1 - Affidavit of compliance for registration of employee organization.

Exhibit 2 - Affidavit of compliance for required showing of interest.

Exhibit 3 - Notice and Order of Continuance. Exhibit 4 - Petition.

Exhibit 5 - Xerox copy of a subpoena, purchaser's receipt and receipt for certified mail directed to Mrs. Maurine C. Finney.

Exhibit 6 - Xerox copy of subpoena, purchaser's receipt and receipt for certified mail directed to Barbara L. Lumpkin.

Exhibit 7 - Letter from Florida Nurses Association and financial statements of Florida Nurses Association for year ended December 31, 1973.

Exhibit 8 - Copy of letter to Ms. Mary J. Finnan from Mr. Carl Lange.

Exhibit 9 - Letter to Mr. Carl Lange from Mrs. Charlotte Anzalone.

Exhibit 10 - Xerox copy of labor organization annual report. Exhibit 11 - Labor organization annual report.

Exhibit 12 - A composite exhibit consisting of the Public Employees Relations Commission file.

Exhibit 13 - A letter to Ms. Mary J. Finnan from Mr.

Carl Lange dated November 18, 1974.

Exhibit 14 - Notice and Order of Continuation of hearing dated May 29, 1995.

Exhibit 15 - Pasco County Ordinance No. 75-11. Exhibit 16 - Letter to Mr. John Rauch from Ms. Barbara

L. Lumpkin dated January 2, 1975.

Exhibit 17 - Letter to Mr. John Rauch from Ms. Barbara

L. Lumpkin dated January 20, 1975.

Exhibit 18 - Xerox copy of subpoena and receipt for certified mail to Patricia Hill.

Exhibit 19 - Copy of Order to Revoke Subpoena signed by Curtis L. Mack, Chairman, PERC, dated June 2, 1975.

Exhibit 20 - Xerox copy of subpoena to Mr. George Billings. Exhibit 21 - Salary schedule.

Exhibit 22 - Table of organization of West Pasco Hospital. Exhibit 23 - Job descriptions.

Exhibit 24 - Personnel policies, West Pasco Hospital. Exhibit 26 - Copy of Chapter 465, Florida Statutes.

Exhibit 27 - Return receipt, registered, insured and certified mail, certified no. 158846.

Exhibit 28 - A list of items contained in Composite Exhibit 12.1 and Composite Exhibit 12.2.

Prior to the beginning of this hearing on May 14, 1975, the Pasco County Board of County Commissioners passed Ordinance No. 75-11, which purports to replace the West Pasco County Hospital Board of Trustees as the governing body of the West Pasco Hospital and place in their stead the Board of County Commissioners of Pasco County. It is argued by the Respondent, that because of this Ordinance, the Petition is deficient as it is directed to the West Pasco County Hospital Board of Trustees as the Respondent, when, in fact, it is argued, the correct Respondent is Pasco County.

The Florida Nurses Association is a professional organization for registered professional nurses which represents nurses in three Veterans Administration hospitals in Florida and has been certified in cases before the National Labor Relations Board. The Florida Nurses Association has been certified as the exclusive bargaining representative for a unit of approximately 700 registered nurses employed by Dade County. The Florida Nurses Association purports to represent 30 percent or more of the registered professional nurses employed by the West Pasco Hospital. No evidence was presented of a contractual bar to bargaining and the Respondent's witnesses testified that they were not presently a party to any bargaining contract.

The Petitioner seeks a unit which would include all registered professional nurses employed by West Pasco Hospital and which would exclude the Director of Nurses and all other professional, non-professional, clerical, managerial and confidential employees as defined by the Public Employees Relations Act. The term "registered professional nurses" as used by Petitioner refers to "registered nurses" as defined by Chapter 464, F.S. According to Chapter 464, F.S., a "registered nurse" is a person who is licensed to practice professional nursing as set forth in that chapter. Similarly, a "licensed practice nurse" is a person licensed to practice practical nursing as set forth in Chapter 464,

F.S. The "practice of professional nursing" and the "practice of practical nursing" are specifically defined by Chapter 464, F.S. One licensed only to practice practical nursing may not engage in any act which constitutes exclusively the practice of professional nursing.

The Respondent argues, in the alternative, that a proper unit should contain all employees of the Nursing Services Department or, that it should contain all professional employees of the hospital. According to the Respondent, the professional employees include the following: Registered Nurses; Licensed Practical Nurses; Pharmacists; Registered X-Ray Technologist; Nuclear Medical Technician; Accountant; and Social Services Director.

Approximately 275 persons are employed by the West Pasco Hospital. Of these, approximately 40 are registered nurses. All registered nurses (with the exception of the Assistant Administrator for Patient Care) are employed in the Nursing Services Department of the hospital. The job classifications which require registered nurses within the Nursing Services Department include the following: Clinical and Staffing Coordinator; Shift Coordinator; Relief Coordinator; Head Nurse; and Staff Nurse. The remaining job classifications within the Nursing Services Department include: Licensed Practical Nurses; Nurses Aides; and Orderlies.

The Assistant Administrator for Patient Care is a Registered Nurse who is in charge of patient care for the hospital and in charge of all nursing personnel. This position is, in practical effect, that of Director of Nursing.

At the time of hearing, there were no other Assistant Administrators. This position is second in the chain of authority to the Hospital Administrator. In the Administrator's absence, the Assistant Administrator for Patient Care performs his duties. The Assistant Administrator for Patient Care is responsible for formulating policy relating to patient care and has the overall responsibility for the scheduling and staffing of personnel in the Nursing Service Department. She conducts personnel evaluations and has the practical authority to hire, discipline and fire employees in the Nursing Services Department. She aids in the preparation of the hospital budget. Her job responsibilities call for the exercise of independent judgment. The Petitioner does not contest the managerial position of the Assistant Administrator for Patient Care and agrees that this position should not be included in the appropriate unit. The Respondent likewise would exclude this position as managerial.

The personnel of the Nursing Services Department work three shifts. They are as follows: 7 a.m. to 3 p.m.; 3 p.m. to 11 p.m.; and 11 p.m. to 7 a.m.

These shifts begin 15 minutes before the hour and conclude 15 minutes after the hour. The members of the Nursing Services Department, including the Registered Nurses, work on weekends and holidays and provide nursing services 24 hours a day, 7 days a week.

The Clinical and Staffing Coordinator is, in actual practice, the assistant to the Assistant Administrator for Patient Care. She is a registered nurse and, in effect, functions as the Assistant Director of Nursing. She is also the person directly in charge of the 7 a.m. to 3 p.m. shift. In the absence of the Assistant Administrator for Patient Care, she performs those responsibilities and duties. She evaluates the Head Nurses. The Clinical and Staffing Coordinator is responsible for maintaining communication with other Shift Coordinators concerning the operational problems and implementation of policies throughout the patient care units. She acts as liaison with other departments within the hospital having patient care functions. The Clinical Staffing Coordinator is reasonable for scheduling of nursing personnel and seeing that the stations are properly staffed with personnel.

The Shift Coordinators work the 3 p.m. to 11 p.m. and 11 p.m. to 7 a.m. shifts. They are the persons on duty, responsible for the Nursing Services Department personnel during their shift. They are registered nurses who are responsible for maintaining the standard of patient care during their respective shifts. During their shift they are in overall supervision of all activities relating to nursing care of patients. They have final responsibility for the disbursement of personnel during their shift, although the actual assignments in each unit are made by the head nurses, who work under the supervision of the Shift Coordinator. They make recommendations to the Assistant Administrator for Patient Care to remedy long-range problems in areas in need of improvement.

Their duties include coordination with the other departments of the hospital which may provide various medical or other services to the patients under the care of the Nursing Services Department. These include Pharmacy, respiratory Therapy, Physical Therapy, Laboratory Services, Radiology, and Dietary Services. They attend a monthly staff meeting chaired by the Assistant Administrator for Patient Care and attended also by the Clinical and Staffing Coordinator. Their attendance at these meetings is mandatory. The Shift Coordinators punch a time clock but are not paid shift differential or overtime. They Shift Coordinators conduct a periodic evaluation of the performance of all personnel under their supervision during their respective shifts for purposes of merit pay increases.

The Relief Coordinators perform the duties of the Shift Coordinators when those individuals are away from the hospital because of illness, vacation or other reason. The Relief Coordinators are Registered Nurses who are generally not Staff Nurses, but rather, are part-time employees who work on a regular basis several times a week, substituting for those Shift Coordinators who are off-duty. When working, the duties and responsibilities of the Relief Coordinators are identical to that of the Shift Coordinators.

Head Nurses are registered nurses. They only shift they work is the 7 a.m. to 3 p.m. shift. Each nursing unit with the Nursing Services Department, with regard to patient care, has a Head Nurse. Because the bulk of the patient care is carried on during the 7 a.m. to 3 p.m. shift, that shift has many more people working it than do the other two. Consequently, with regard to the unit for which she is responsible, the Hearing Nurse's responsibilities and duties are similar to those of the Shift Coordinators of the other two shifts. The Head Nurses are responsible for insuring that their units are adequately staffed and functioning properly in the exercise of their patient care duties. Head Nurses may exchange personnel between their units are they agree, subject to the authority of the Clinical and Staffing Coordinator. Head Nurses punch a time clock and are paid overtime. They are required to attend the monthly Head Nursing meetings chaired by the Assistant Administrator for Patient Care. They have direct responsibility of the employees in the Nursing Services Department who work under them and they are required to make periodic written evaluations of the personnel under their supervision for the purpose of merit increases.

Staff Nurses in the Nursing Services Department are Registered Nurses who prepare, administer and supervise the care of the patients assigned. The position description of Staff Nurse contained in Composite Exhibit 23 and prepared by the West Pasco Hospital is accurate. Petitioner seeks to include Staff Nurses in the proposed unit and respondent made no presentation nor argument that Staff Nurses should not be included in Petitioner's proposed unit or the unit sought by Respondent.

Licensed Practical Nurses are members of the Nursing Services Department.

As noted above, a Licensed Practical Nurse is one who can engage in the practice of practical nursing as set forth in Chapter 464, F.S., which defines the practice of practical nursing. The job description for Licensed Practical Nurse set forth in Composite Exhibit 23 is accurate in its description of the duties and responsibilities of a License Practical Nurse at the West Pasco Hospital.

Because West Pasco Hospital is a relatively small health care institution with a small staff, the Licensed Practical Nurses are frequently required to perform the duties of a Staff Nurse to the extent that such duties are not required to be performed by a registered nurse.

The duties of a Nurses Aide is to give baths, feed patients, exercise patients, make beds, and perform other tasks of a similar nature. They are not required to be certified. They work all three shifts and receive shift differentials for the two late shifts.

There are 7 or 8 Orderlies employed by West Pasco Hospital whose duties are basically to transport patients to and from the various units in the hospital.

They also take care of certain of the hygienic requirements of the male patients. They work all three shifts.

All employees of the Nursing Services Department receive same fringe benefits. Further, with the exception of the Shirt Coordinators and Relief

Coordinators, all employees of the Nursing Services Department are entitled to overtime payment and shift differential pay for the two late shifts.

There are two full-time and one part-time Pharmacist employed by West Pasco Hospital. They are required to have graduated from a fully accredited school of pharmacy and to be licensed by the Florida Board of Pharmacy. They are responsible for preparing the medications needed and providing adequate patient care to the hospital's patients. These medications are prescribed by the physicians.

The West Pasco Hospital employs a certified Respiratory Therapist who is responsible for breathing treatment for any patient having a respiratory disease for any patient or whom respiratory treatment is ordered by a physician.

Respiratory treatment frequently involves the use of breathing apparatus, which is controlled by the Respiratory Therapist. It requires intelligence and training on the part of the Respiratory Therapist to properly operate the breathing apparatus. West Pasco Hospital employs Respiratory Technicians who work under the Respiratory Therapist and are in the process of in-house training or internship before going to school to be certified as Respiratory Therapists.

West Pasco Hospital employs several Medical Technologists. A Medical Technologist performs various chemical microscopic and bacteriologic tests to obtain data for use and diagnosis in treatment of disease. The position requires three years of college, with courses in biology, chemistry and mathematics, plus one year of training in a school of medical technology approved by the American Society of Clinical Pathologists. The person must be registered as Medical Technologist by the Registry Board of the American Society of Clinical Pathologists.

The Acting Administrator of West Pasco Hospital testified that the hospital employs two X-Ray Technologists. It is noted the Composite Exhibit 23, submitted by the hospital and containing the job descriptions of the various positions in West Pasco Hospital, lists as a position, Chief X-Ray Technologists, Chief X-Ray Technician and X-Ray Technician. It is not clear from the Acting Administrator's testimony (see page 204 of transcript) which of these three positions he is referring to. It appears that he is referring to the Chief X-Ray Technician position. He testifies that two years of formal training in a certified college of radiology are required for the position, along with registry in "their own association" by which he apparently refers to the American Registry of Radiologic Technologists. Further, from his testimony, he appears to be referring to the persons who actually take the x-rays, while the job description of the Chief X-Ray Technologist appears to be primarily an administrative one. In general, the job involves, apparently, the taking of x- rays in a hospital situation.

The hospital employs a Nuclear Medical Technician, which, according to the Acting Administrator, deals with radioactive material and the machine which the technician operates for the purpose of thyroid scans, lung scans, brain scans, and similar type evaluations. The technician must be thoroughly trained and highly skilled. The Acting Assistant Administrator stated that he felt the educational requirements were two years in a "formal school of medicine."

West Pasco Hospital employs an Accountant who must have a Bachelor's degree in accounting and who is responsible for the cash flow of the hospital. He evaluates the hospital's economic situation, prepares the monthly financial statement and performs the duties normally expected of an accountant.

West Pasco Hospital employs a Social Service Director. This position requires a Bachelor's degree in social service. The person who occupies this position does evaluations of patients with reference to making transfers to nursing homes and establishing home health care. She counsels patients with reference to pre-natural matters. She works with patients that have no means of support and who are in need of hospital care or other type of medical care.

Submitted this 24th day of December 1975, in Tallahassee, Florida.

CHRIS H. BENTLEY

Hearing Officer

Division of Administrative Hearings Room 530, Carlton Building Tallahassee, Florida 32304

(904) 488-9675

COPIES FURNISHED:

Ben R. Patterson, Esquire 2007 Apalachee Parkway

Tallahassee, Florida 32301

Michael D. Malfitano, Esquire Alley, Alley and Blue

Post Office Box 1427 Tampa, Florida 33601

Docket for Case No: 75-000109

Orders for Case No: 75-000109