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Some Nurses Blue Over Color-Coded Uniform Policy

 |  By John Commins  
   April 23, 2012

The Minnesota Nurses Association has filed a grievance against Allina Hospitals & Clinics, claiming that the Minneapolis-based health system violated its labor contract when it unilaterally instituted a color-coded uniform requirement that will go into effect on May 1.

"We didn't get the opportunity to negotiate this issue and it does fall under the terms and conditions of employment," says Bernadine Engeldorf, RN, first vice president of the 20,000-member MNA. "The union contract states that the expectation is that this will be negotiated.

"We didn't see evidence of a need to change what we're doing, and there wasn't an ability to sit down and have that dialogue," she says.

Allina spokesman David Kanihan says the 11-hospital health system has been talking about the switch to mandatory color-coded uniforms for "quite some time," and has "made a very dedicated effort to involve" staff.

"The reason we are doing it is because patients have told us they have a hard time telling who's who and what's what," Kanihan says. "A lot of people come into their rooms for various reasons during the course of a day and one of the things we are trying to get after is making sure that the patients understand what is going on and who they can ask for certain things. It just makes the hospital stay that much easier for the patient."

After months of discussions and feedback, he says, about 5,500 of the 8,500 staff who would be affected by the mandate voted to pick their colors in a December ballot. "We had good turnout, about 60%. Not everybody who was eligible to vote did, but a pretty large percentage did," he says. "We kept the union informed as we went through the process. We provided a lot of input opportunities from the nurses themselves. I would say we did not negotiate this with the union in any formal sense." 

Nurses chose navy blue. "Nurses being by far the largest group under this program, they were able to choose the color they wanted," Kanihan says. "They are a much bigger voting block than, say, housekeepers."

Kanihan says the grievance filing will not delay the May 1 launch of the color-coded uniform requirement. "We announced the results earlier this year and a lot of nurses and other staff have already started this," he says. "We made the requisite color choices available to all of our people at a discount through a Website we set up. We're providing some level of subsidy to help employees buy their first few uniforms. Many have already done it. On May 1 we require it."

Jaci Krech, RN, administrative director of orthopedics and surgical services at Woodwind Health Campus, in Woodbury, Minn., says the 86-bed acute care hospital has used color-coded uniforms for the past five years. She believes staff at the nonunion hospital—part of the HealthEast Care System—have embraced color-coded uniforms because staff were involved in the process from the onset, and because they believe it improves patients' experiences.

"It is about really understanding the 'why' behind it—of knowing what is the purpose you are looking for and seeking feedback from the community," Krech says. "It's important that the key stakeholders are involved in the dialogue to identify 'is this the right path we want to go down and how do we want to engage the rest of the stakeholders in the decision making?'"

At Allina, Kanihan says employees support the new uniforms policy.

"They understand why we are doing it and they support the idea that it makes the hospital stay easier for patients and they want and support that," he says.

Engeldorf says dissent has been muzzled. "Are most nurses in favor of this? I think most nurse believe they have to do it because the employer is saying you will do this," she says. "Some nurses say it's a good idea but most nurses believe we should have had the right to negotiate the issue."

Kanihan says nurses and other staff may face disciplinary action if they show up for work on May 1 not wearing their appropriate colors. "They will be asked to change if they have the ability to go home and change or potentially they could be provided a set of scrubs of the appropriate color at the hospital," he says. "Repeated violations would kick off a disciplinary process but it is not going to be a heavy-handed thing. We will work with people to try to remove any barriers that might be in the way of them complying."

Engeldorf says many nurses are resigned to the mandate. "Are we going to have an action and people will show up to work and refuse to wear their uniforms? I doubt that will happen," she says. "But I've had nurses tell me 'I am doing this because I have to but I am waiting until the last day to do it.'" 

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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