09:0709(85)NG - AFGE Local l822 and VA Medical Center, Waco, TX -- 1982 FLRAdec NG



[ v09 p709 ]
09:0709(85)NG
The decision of the Authority follows:


 9 FLRA No. 85
 
 AMERICAN FEDERATION OF GOVERNMENT
 EMPLOYEES, LOCAL 1822, AFL-CIO
 Union
 
 and
 
 VETERANS ADMINISTRATION MEDICAL
 CENTER, WACO, TEXAS
 Agency
 
                                            Case No. O-NG-362
 
                 DECISION AND ORDER ON NEGOTIABILITY ISSUE
 
    THE PETITION FOR REVIEW IN THIS CASE COMES BEFORE THE FEDERAL LABOR
 RELATIONS AUTHORITY (THE AUTHORITY) PURSUANT TO SECTION 7105(A)(2)(E) OF
 THE FEDERAL SERVICE LABOR-MANAGEMENT RELATIONS STATUTE (THE STATUTE),
 AND RAISES THE QUESTION OF THE NEGOTIABILITY OF THE UNION'S PROPOSED
 CHANGES TO A REVISED NURSING SERVICE BULLETIN NO. 80-05 (NSB NO. 80-05)
 ISSUED BY THE AGENCY, CONCERNING THE REPORTING OF MEDICATION "INCIDENTS"
 AND "ERRORS" FOR NURSING SERVICE PERSONNEL.  (SEE APPENDIX.)
 
                              UNION PROPOSAL
 
    PURPOSE
 
    TO DEFINE ACTIONS TO BE TAKEN IN REPORTING INCIDENTS/ERRORS IN
 ADMINISTRATION OF
 
    MEDICATION.
 
    POLICY:
 
    INCIDENTS/ERRORS IN ADMINISTERING MEDICATION MUST BE REPORTED
 IMMEDIATELY AND IMMEDIATE
 
    ACTION TAKEN FOR PATIENT'S SAFETY AND WELFARE, AS APPROPRIATE.
 
    PROCEDURE:
 
    REPORT, IMMEDIATELY, ALL MEDICATION INCIDENTS/ERRORS TO THE NURSE
 COORDINATOR, TO THE
 
    NURSING SUPERVISOR, AND TO THE WARD PHYSICIAN AND/OR MEDICAL O.D., AS
 APPROPRIATE.
 
    THE NURSE COORDINATOR ON EACH NURSING UNIT IS RESPONSIBLE FOR
 INITIATION OF VA FORM
 
    10-2633, AFTER HER INVESTIGATION OF THE INCIDENT.
 
    MEDICATION ERROR:  (DEFINITION)
 
    WHEN A PATIENT RECEIVES MEDICATION NOT PRESCRIBED BY A PHYSICIAN OR
 DENTIST.
 
    CLASSIFICATIONS:
 
    PRIMARY:  1.  MEDICATION ERROR CAUSED BY FAILURE TO FOLLOW PROPER
 PROCEDURE.
 
    2.  A PROCEDURE CARRIED OUT INCORRECTLY CAUSING ANOTHER PERSON TO
 MAKE AN ERROR.
 
    SECONDARY:  AN INCIDENT RESULTING IN ERROR THAT IS THE DIRECT RESULT
 OF THE INCORRECT
 
    ACTION OF ANOTHER PERSON.  THIS CLASSIFICATION DOES NOT RESULT IN ANY
 FORM OF DISCIPLINARY
 
    ACTION.
 
    UPON CAREFUL CONSIDERATION OF THE ENTIRE RECORD, INCLUDING THE
 PARTIES' CONTENTIONS, THE AUTHORITY MAKES THE FOLLOWING DETERMINATIONS.
 AS PREVIOUSLY NOTED, NSB NO. 80-05 CONCERNS THE REPORTING OF MEDICATION
 INCIDENTS AND ERRORS FOR NURSING SERVICE PERSONNEL.  SPECIFICALLY, IT
 REQUIRES NURSING SERVICE PERSONNEL TO PROVIDE MANAGEMENT WITH
 INFORMATION IN CONNECTION WITH THE PERFORMANCE OF THEIR WORK.  THIS
 INFORMATION INDICATES WHETHER ASSIGNED WORK HAS BEEN CORRECTLY
 PERFORMED
 AND, THUS, IS ESSENTIAL TO THE CONDUCT OF HEALTH CARE OPERATIONS AS WELL
 AS RELEVANT FOR THE PURPOSE OF TAKING DISCIPLINARY ACTION BASED UPON
 ERRORS IN THE ADMINISTRATION OF MEDICINE.  IN THIS REGARD, THE UNION'S
 PROPOSAL IS INCONSISTENT WITH THE AGENCY'S ASSIGNMENT OF CERTAIN PATIENT
 HEALTH CARE MONITORING DUTIES TO NURSING COORDINATORS OR THEIR
 DESIGNEES, WHICH ASSIGNMENT IS REFLECTED IN NSB NO. 80-05.  THESE DUTIES
 INCLUDE THE CLASSIFICATION OF MEDICATION INCIDENTS AND ERRORS, AND THE
 COMPLETION OR FORWARDING OF QUESTIONNAIRES AND REPORTS INVOLVING SUCH
 MATTERS.  CONSEQUENTLY, THE PROPOSAL WOULD VIOLATE MANAGEMENT'S RIGHT TO
 ASSIGN WORK UNDER SECTION 7106(A)(2)(B) OF THE STATUTE.  /1/ SEE
 AMERICAN FEDERATION OF GOVERNMENT EMPLOYEES, AFL-CIO AND AIR FORCE
 LOGISTICS COMMAND, WRIGHT-PATTERSON AIR FORCE BASE, OHIO, 2 FLRA 603
 (1980) (PROPOSAL XI), ENFORCED AS TO OTHER MATTERS SUB NOM., DEPARTMENT
 OF DEFENSE V.  FEDERAL LABOR RELATIONS AUTHORITY, 659 F.2D 1140 (D.C.
 CIR. 1981), CERT. DENIED SUB NOM., AFGE V. FLRA, .  . . U.S. . . ., 102
 S.CT. 1443 (1982).
 
    FURTHER, INSOFAR AS THE UNION'S PROPOSAL WOULD HAVE THE EFFECT OF
 MODIFYING THE SUBSTANTIVE CRITERIA FOR TAKING DISCIPLINARY ACTION UNDER
 NSB NO. 80-05, IT MUST BE FOUND TO BE VIOLATIVE OF MANAGEMENT'S RIGHT TO
 DISCIPLINE EMPLOYEES PURSUANT TO SECTION 7106(A)(2)(A) OF THE STATUTE.
 /2/ IN THIS REGARD, THE RECORD SHOWS THAT THE UNION'S PROPOSAL WOULD
 DIRECTLY INTERFERE WITH THE AGENCY'S DISCIPLINING NURSING SERVICE
 PERSONNEL FOR CERTAIN TYPES OF INFRACTIONS IN THE ADMINISTRATION OF
 MEDICINE BY NARROWING THE DEFINITION OF, AND THUS THE RESPONSIBILITY
 FOR, MEDICATION ERRORS.  THAT IS, UNDER THE UNION'S PROPOSAL CERTAIN
 ERRORS IN THE ADMINISTRATION OF MEDICINE, SUCH AS INCORRECT FORM OR
 DOSAGE, IMPROPER INTERVALS, AND INCORRECT ROUTE AND DOSE, WOULD BE
 ELIMINATED AS POSSIBLE GROUNDS UPON WHICH THE AGENCY, PURSUANT TO NSB
 NO. 80-05, COULD COUNSEL, ADMONISH, REPRIMAND, SUSPEND, OR TAKE OTHER
 DISCIPLINARY ACTION AGAINST AN EMPLOYEE, BECAUSE SUCH ERRORS WOULD NO
 LONGER CONSTITUTE MEDICATION INFRACTIONS.  SEE DEPARTMENT OF DEFENSE V.
 FLRA, 659 F.2D 1140, 1159-61.
 
    FINALLY, THE UNION'S CLAIM THAT ITS PROPOSAL IS INTENDED SOLELY TO
 CLARIFY REPORTING PROCEDURES OF NURSING SERVICE PERSONNEL CANNOT BE
 VIEWED AS DISPOSITIVE IN LIGHT OF THE LANGUAGE OF THE PROPOSAL AS
 DRAFTED WHICH CLEARLY IS NOT LIMITED TO SUCH CLARIFICATION.  OF COURSE,
 IF THE UNION WERE TO CONFORM ITS PROPOSAL TO ITS STATED INTENT, SUCH
 PROPOSAL WOULD BE WITHIN THE DUTY TO BARGAIN.
 
    ACCORDINGLY, PURSUANT TO SECTION 2424.10 OF THE AUTHORITY'S RULES AND
 REGULATIONS (5 CFR 2424.10 (1981)), IT IS ORDERED THAT THE UNION'S
 PROPOSAL BE, AND IT HEREBY IS, DISMISSED.  ISSUED, WASHINGTON, D.C.,
 AUGUST 3, 1982
 
                       RONALD W. HAUGHTON, CHAIRMAN
 
                       HENRY B. FRAZIER III, MEMBER
 
                        LEON B. APPLEWHAITE, MEM