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Publiahed byTuH CALIPONiA STATs Nue ' AUOCIATION

111 O'Fsrfl StreetSoa Francisco 2, Californis

October 1947

It's about YOU . . . about your future . . .your chosen profession ... and the most realisticway to improve it.

It's about professional nursing standards,economic security for the nurse, legislative pro-tection for nursing, counseling and placementservice, and lots more ...

It's about problems of long hours and lowsalaries, the exodus of exploited nurses into otherfields of employment, the alarming lag in studentnurse recruitment ...

It's about YOU and an organization that isUP and DOING something about your problems-an organization that formerly needed to con-cern itself only with traditional professionalproblems but recently has been forced into theeconomic arena by mounting economic problemsthat threaten the nurse and her professionalfuture.

A newspaper editor wrote: "The NursingProfession has been sold to the public historicallyas consisting of a group of self-sacrificing youngwomen, who want to help suffering humanity asa religious duty.

"The public doesn't regard it as a professionso much as a sisterhood. The idea that nursesmust eat has never penetrated the public mind!"

A 1947 federal survey said it with statistics.Uncle Sam surveyed a cross-section of 22,000nurses. His study announced that a 44-hour $40work week was "typical" among nurses, coast tocoast. He found that "dissatisfaction" with work-ing conditions in general created a "serious prob-lem" contributing heavily to the critical nurseshortage.

Moreover, the nurse cannot give the bestprofessional service to the patient if she mustwork excessively long hours, has too heavy apatient load, is distraught by anxiety about payingthe butcher and the baker, and is haunted byfears of unprotected old age and illness. Propercare of the sick is conditioned by the economicsecurity of the nurse.

WHAT YOU NEEDYou desire for yourself a normal personal

and professional life, like that of other profes-sional women.

You want desperately to practice the "art" ofnursing as you know it should be practiced andnot in the mechanical manner of a speeded-upautomaton.

You will therefore need reasonable hours in2

order to give your patients good care and to pro-tect your own health.

You require a salary in line with the respon-sibilities you shoulder, the mounting cost of liv-ing, the needs of future security.

You know that enlightened employment poli-cies promote personal satisfaction and profes-sional efficiency.

A NURSE'S LIFECAN BE A SATISFYING ONE

There are no problems facing the nurse thatcannot be solved. On the professional, social andeconomic fronts, there is an answer to each prob-lem.

You cannot accomplish this alone. No profes-sion or group of people with mutual interestshas ever solved such problems as individuals.But most professions have successfully attackedtheir common problems as a profession.

You must work with others to do this.

EVERYBODY IS "ORGANIZED"We live in a complex social age, when vir.

tually everybody, to win an effective voice inhis destiny, has become "organized." Doctors,lawyers, dentists, beauticians, businessmen, la-bor, the butcher, the baker, the candlestick maker-yes, and hospital management-all are organ-ized for effective planning and action.

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For that matter, the United States is an or-ganization of once individual colonies or states;the United Nations are organized nations; allsections of the population are mobilized accord-ing to mutual interests and in order to voicecommon aspirations coherently.

A complete absence of organization-at na-tional, state and professional levels-would, ofcourse, open the way to chaos and anarchy in ourhighly complicated age.

During the recent war, when wages andprices had to be stabilized to avert inflation, thegovernment set up the War Labor Board to de-termine which groups deserved slight increasesin salary. This Board recognized the right of anorganized group in any occupation or professionto petition for relief. Because CSNA was so or-ganized, it was possible for its leaders to appealon behalf of professional nursing in Californiafor an increase to meet the high cost of living.The appeal was heard and granted. An individualcould hardly have accomplished this. An organi-zation-CSNA-could, and did.

"CSNA" MEANS WORKING TOGETHER

The California State Nurses' Associationwas founded in 1903 to advance the profession ofnursing and to safeguard the mutual interests ofnurses. It is an affiliate of the American Nurses'

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Association, with other active state nurses' asso-ciations all over the nation.

Such improvements as have been effected inprofessional status, nursing legislation, personnelpractices and economic conditions of nurses maybe attributed to organized nursing.

However, much remains to be done. Theplight of the nurse and her profession is acute.It is vital that every nurse, who wishes to see herprofession continue to improve its status, allyherself with her professional association to getresults.

HIGHER SALARY SCHEDULESA federal survey has disclosed that nurses as

a group are earning little more than clerks, book-keepers and seamstresses. Most hospital nursesthroughout the country are still working a 44 to48 hour week under exacting and exhausting con-ditions, aggravated by personnel shortages.

Because salaries of nurses lagged so far be-hind soaring living costs, the CSNA decidedseveral years ago to seek improvement in theeconomic conditions under which its memberswork-improvement in salaries, hours, and work-ing conditions. In this "economic security" pro-gram, substantial results have been achieved andthe program continues to gather momentum.

Statewide salary standards were set up by5

each group of nurses-staff, private duty, indus-trial, public health and administrative-for itsown members through the machinery of theCSNA sections.

Then through a program of implementation,these standards were brought to the attention ofemployers of nurses throughout the State-hos-pitals, public and private health agencies, indus-tries.

As a result, the general salary level of nursesin all fields of activity has been raised in Cali-fornia, until California nurses now receive thehighest salaries in the United States.

Hospital nurses are now receiving a basicmonthly salary of $200 based on a 40-hour week,and many of them are employed under contractsnegotiated by the CSNA as their bargainingagent. Salary differentials for both evening andnight duty and for various types of "special serv-ices" duty, sought by the CSNA, are now stand-ard practice. Compensation for time spent "oncall" and for overtime work is incorporated inall CSNA contracts and is a CSNA goal for allnurses.

Private duty nurses have been enabled toincrease their per diem charges substantially.

Public health nurses in almost all govern-mental jurisdictions have obtained, in many in-stances with the direct assistance of the CSNA,

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higher salaries and larger car allowances. Mostprivate public health nursing agencies have fol-lowed suit.

Industrial nurses have participated in thegeneral lift in the salary level besides sharing inshorter hours and better working conditions wonby their sister nurses.

In short, all registered nurses practicing inthe State have benefited, whether or not they be-longed to the CSNA. Obviously greater gainswould have been assured had all belonged andspoken with one voice their professional andeconomic needs.

CSNA will continue at all times to seek sal-ary standards commensurate with the skills andresponsibilities of nursing.

A STANDARD 40-HOUR WEEKThe standard 40-hour week for nurses, with

two consecutive days off, has become standardpractice in California, precisely because enoughnurses in CSNA urged this working reform or-ganizationally.

Many nurses who now enjoy the five-day,40-hour week, with a consecutive 8-hour workday feel that these are the greatest "improve-ments" effected by CSNA's economic securityprogram.

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BETTER EMPLOYMENT CONDITIONSMany improvements in working conditions

of nurses have been effected by CSNA and arenow accepted practice. Other improvementsCSNA is still working to secure.

Through CSNA efforts, cash salaries havelargely replaced the system of pay which waspartly in the form of perquisites such as room,board and laundry.

The number of holidays has been increased.A longer vacation with pay is a goal which

CSNA is trying to realize for its members.Sick leave with pay is now an accepted stand-

ard practice; longer sick leave and accumulationof sick leave are being sought.

CSNA standards call for the progressive de-velopment of a program which will assure thenurse adequate health protection. The coopera-tive interest of hospitals and health agencies inthis program is demonstrated by the fact that theyare gradually increasing the extent of health pro-tection offered the nurse.

CSNA's goal is to arrange, in every nursingstaff, machinery for channeling to managementany dissatisfactions with working environmentand thus iron out personnel misunderstandingsor injustices. This is known as grievance machin-ery and is incorporated in all CSNA contracts.

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CSNA maintains a dynamic two-point pro-gram of activities, one designed directly to servethe public interests, the other to offer protectiveservices to the individual R. N.

The California State Nurses' Association isan association of professional people. As a pro-fessional organization, it recognizes that its firstresponsibility is the establishment and mainte-nance of standards of professional preparationand competency which will assure the public safeand satisfactory nursing service.

Also, since CSNA believes that the econ-omic and professional welfare of nurses directlyconditions the quality of nursing service offeredthe public, it is the conviction of the CSNA that c,its second major responsibility as a professionalorganization is the securing of satisfactory em-ployment conditions of nurses. It believes thatthe development and maintenance of a high qual-ity of nursing service to the public is directly de-pendent upon economic factors, for only if em-ployment conditions for nurses are satisfactorywill it be possible to:

1) attract promising young women into theprofession;

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2) keep the R. N. within the ranks of theprofession;

3) assure the best possible professional per-formance of each individual nurse.

CSNA is not a labor union; it has no laborunion affiliations. CSNA rejects the strike andother traditional pressure methods used byunions. CSNA forbids dual membership, thatis, simultaneous membership in CSNA and anyother collective bargaining group.

For the implementation of its standards, theCSNA relies upon the effective organization ofits members; upon the winning of public under.standing and support through the maintenance ofa dynamic public relations program; through theeffective use of a staff of experts and specialists,such as attorneys specialized in the field of em-ployer-employee relationships, research analysts,statisticians, public relations counselors, and astaff of R. N. specialists; and through the use ofthe techniques of negotiation and of formal ap-peals to public jurisdictions.

TELLING OUR STORYPublic understanding and support are indis.

pensable to winning our goals. The CSNA has,therefore, devoted constant attention to improv-ing the public relations of the nursing professionin California.

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The public's latent sympathy for the aims oforganized nursing, demonstrated repeatedly inpublic opinion polls, has been-converted to activesupport, and this support has materially strength-ened CSNA's position in striving for higher econ-omic standards for nurses. Many persons believethe public's increasing awareness of the nursingprofession and its needs is one of the outstandingrecent accomplishments of the profession.

One of the goals of CSNA is the constantimprovement of relations existing between thenursing profession, the medical profession, andallied professions. The CSNA will continue tomake the public and the other professions part-ners in the common endeavor to provide everbetter nursing care for the sick.

NURSES FIGHT HARMFUL LAWSCSNA can, and does, favor legislation that

helps nursing and nurses, and opposes, success-fully, bills which harm the profession. By so do-ing, and by helping to solve economic problems,CSNA can help to speed the recovery of the pro-fession from the acute shortage that menaces theState and nation.

During the 1947 session of the legislature inthe state capital at Sacramento, the CSNA mobil-ized a statewide campaign in which every com-munity joined to fight several dangerous bills af-

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fecting the standards of nursing in this State.It defeated an attempt to lift the lid off work-

ing hours for student nurses-a bill which wouldhave opened the doors to vicious exploitation ofstudents.

It also headed off a threat to reduce Cali-fornia nursing standards to the lowest in thenation by allowing unlimited registration reci-procity, regardless of requirements in out-of-state nursing schools. The bill which finallypassed was denatured of its elements dangerousto nursing.

OTHER SERVICES, TOOIn addition to its economic security and legis-

lative activities the CSNA offers its membersmany other services. Among them, it:

Maintains a staff of nurses in the field forconsultation and assistance to members and dis-tricts on professional and employment problems.

Maintains a research department and bureauof information to collect and compile up-to-datefacts, available to members, on all matters af-fecting the practice of nursing and the economicsecurity program.

Maintains a full-time staff attorney and otherlegal counsel for expert legal advice on all mat-ters affecting the status of the nursing professionand the economic security program.

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Keeps the public informed through statewidenews channels of the aims and aspirations of thenursing profession and its economic and profes-sional needs.

Gives supportive assistance, particularlythrough the CSNA legislative program, to theBoard of Nurse Examiners and the CaliforniaLeague of Nursing Education relative to theNursing Practice Act and standards of nursingeducation.

Represents the nursing profession in rela-tionships with other professional and citizen or-ganizations.

Publishes a monthly Bulletin, schedules ofemployment standards, and other publications onnursing questions.

Maintains a state placement and counselingservice which is coordinated with the AmericanNurses' Association service and operates locallythrough the 19 district professional registries.

YOUR ASSOCIATION

On state and district levels, the CSNA is avoluntary association of professionals for mutualbenefit and improvement through a twofold pro-gram of advancing professional standards innursing and promoting adequate economic secur-ity as a realistic foundation for personal andprofessional success.

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Most activities take place on the districtlevel, coordinated by the State Office of the CS.NA. Each district works for the best interestsof the nurses of the district and keeps the com-munity informed, through its public relationscommittee, of the objectives and aspirations oforganized nursing.

Officers of the state and the district associa-tions are chosen at all times by elective methods,with complete control always in the hands of themembers.

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C*S*0*4 and YOU

CSNA is composed of the individual mem-bers. You are CSNA and CSNA is you. Theorganization works for you and carries out yourdesires. It is maintained through the dues youpay. These dues make possible the employmentof a large staff of specialists and experts, all ofwhom are employed by you, to work for you, andto serve you and your interests.

The Administrative and Consulting Staff ofCSNA consists of: 7 registered nurses, 3 at-torneys (1 full time), public relations counselors,2 research analysts (1 full time), 1 researchclerk, 2 editorial assistants, 1 bookkeeper, and8 stenographers and clerical workers.

THE CALIFORNIA STATE NuMBs' ASsOCITION111 O'Farrell Street

San Francisco 2, California

C*N*N*A (-if AN0D ''

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