St. Vincent's Strike

Letters to Editors...

Time to Support the Nurses of Worcester

How long is Tenet's prepared to wait for the striking nurses of Worcester to cave in? "Forever," the Worcester Medical Center CEO told the T&G April 21, "And I'm not kidding."

How important is this battle between our nurses and Tenet? It could affect the healthcare industry nationwide, according to hospital spokesman Paula Green, Maher's longtime tag-team buddy. "It is much bigger than St. Vincent," Green told the T&G April 22. "But the bottom line is that we need to have flextime, or mandatory overtime."

The bottom line is that mandatory eight-hour overtime for nurses is a barbaric way to protect Tenet's bottom line.

The bottom line is that it's way past time for Maher and Green to catch the next golden parachute out of town. And it's the perfect time for the good people of Worcester to rally around the striking nurses, to support them in all ways possible - physically, morally, and financially - in their battle to take one, small, significant step toward healthcare sanity.

In this age, when most mothers, many of them single parents, must work to survive; when everyone agrees that the cultural fabric has been torn asunder and family values are hanging by a thread; when everyone agrees that children more than ever need consistent, dependable, loving care - what kind of company would require mothers to remain at work for an extra shift on short notice?

Tenet, for one, and any other hospital corporation that can get away with it.

In this age, when severe understaffing is the dirty little secret of every hospital in Massachusetts; when any doctor will tell you privately that things are out of control, when any nurse will tell you publicly that under-trained aides are mucking up procedures that should be left to nurses; when hospitals and HMOs are mismanaged by CEOs, good and bad, whose mandatory obsession on bottom lines can only pervert the medical system - what kind of company could maintain with a straight face that making stressed-out nurses work an extra shift at the drop of a hat could possibly make things better?

Tenet, for one, and any other hospital corporation that can get away with it.

And just because they do get away with it at most hospitals around the state, how can you suggest, as State Rep. Harriette Chandler did on the Jordan Levy Show, that Worcester nurses shouldn't be able to expect anything better than the industry standard? Reminds me of the favorite saw of mediocre junior high school teachers worldwide: "If I let you do it, everyone will want to do it."

That's the point. If the Worcester nurses can make a dent, even a dent, in this mandatory overtime plague, nurses everywhere else will want to do it too.

That's an argument to stand fast, to unite in common cause. Right here in Worcester nurses have the chance to fire a shot that will be heard around the world.

And if they have the guts to fire it, the least we can do is stand with them all the way.

The good news is that the people of Worcester are as solidly behind the striking nurses as we were behind the firefighters. Now it's time for us to come through for them in any way we can - be it money, temporary employment, moral support, continued letters to the editor, daycare ... you name it. Some one should get a community coalition going. If the nurses have to settle in for the long haul on the picket lines, at least they'll have the ways and means.

It's not like the nurses jumped at the first chance to strike. Nurses are not radicals. It took years of declining conditions before the St. Vincent's nurses were willing to unionize. It took months more of declining conditions before they went out on strike.

This country's medical system is in disarray, and it's nobody's fault - not the hospitals, not the HMOs, not the doctors, not the nurses. But right here in Worcester nurses are taking one small step to make things better. Let's take that step with them.

Congratulations to the Globe, specifically its April 7th Editorial "Too Many Hours". I vehemently contend that "it is the patient, stupid". Patient safety is at the heart and soul of this protracted strike at the Worcester St. Vincent/Tenet Hospital and it is central in this debate. It is very simple. Patients have a right to receive care that is safe from harm. It is management's "right" and job to staff the hospital. With this right comes "obligations" to do the right and the best thing. At a time when we are trying to prevent medical errors and deaths in hospitals, for-profit Tenet cannot say that they do not have the money. Their history of routine and repeated understaffing should be a harbinger of doom for us. The hospital nurse staffing standards at St. Vincent's/Tenet should be built on what patients need when they are sick. When a hospital doesn't have enough permanent nursing staff to meet these patients needs they can do two things—hire more qualified nursing staff to meet patient needs by using flex-pools of part-time nurses, or use temporary agency nurses. Or they can retrench, close units, divert admissions or transfer patients to facilities where care can safely be provided. It is unconscionable to have nurses work 16 hours straight when it is not an emergency. That is like having a pilot fly a plan from LA to Boston and then being asked to go on to London. That is a recipe for disaster and only increases the potential for profound error and/or death. Who would fly that plane? Does the public know? Not only is for-profit Tenet digging their heels in and mandating overtime when it is not an emergency, they are attempting to change the paradigm for hospital care in Massachusetts and jeopardize patient's lives. We need system reform to improve patient safety, and protect patients from harm but we do not need for-profit Tenet's self-indulgence. Public beware!

Letter to the Editor, Spectrum Magazine

I have been a staff nurse for thirty-three years. During that time, I have witnessed many changes in technology, in nursing, and in health care. Fortunately, for the past twenty-nine years, I have worked at an institution that has a collective bargaining agreement. Through our nursing union, we have been able to negotiate with our employer to achieve contracts that have not only improved the salary and benefits for nurses, but have provisions to protect our professional practice, and safeguard patient care.

During recent years, as the delivery of health care has undergone reconstruction and revision, there has been a significant impact upon the delivery of nursing care. Every nurse in practice today knows the scenario of increased acuity and decreased length of stay. Nurses also know about care re-design, downsizing, and changes in the bedside staffing mix. Our institution was, and is, impacted by all of these changes. Nursing care has changed as well.

Through union negotiations, we have been able to work with hospital administration to protect our patients and ourselves from some of negative effects of these changes. When staffing was reduced to levels that we believed was unsafe for patient care, the strength of our union forced them to return staffing to prior levels. When mandatory overtime became abusive, we were able to negotiate language into our contract that has almost eliminated forced overtime. When the number of nurses available was insufficient to meet minimum staffing levels, through our union grievance process, we were able to force hospital management to hire more nurses and re-construct a float pool. Once, during the past thirty years, our bargaining unit voted to authorize a strike. It was not over money or benefits, it was over patient care issues. We refused to compromise patient care by allowing unlicensed aides to replace nurses at the bedside.

As a union nurse, I am proud of the importance that my union places on professional practice and the delivery of safe patient care. When hospital administration focuses too intently on the bottom line, patient care becomes an after-thought. Nurses are then the only ones able to speak up to protect patients from sub-standard care. Unfortunately, nurses who lack the strength of a union are subject to discipline and dismissal when they advocate for their patients.

The nurses of St.Vincent Hospital and Worcester Medical Center in Massachusetts are on strike over issues of safe patient care. They placed their own jobs on the line - giving up paychecks, health insurance, and other benefits - on behalf of their patients. These dedicated nurses believe that this sacrifice is necessary to protect patient care from a for-profit healthcare corporation that places the well-being of their shareholders above the welfare of patients.

Spectrum Magazine is seriously jeopardizing this effort by accepting and displaying advertising from nursing agencies that provide strike-breaking replacement nurses. It would seem that the owners / management of this publication have embraced the concept of corporate greed, and turned their backs on the ideals that should be encouraged - professionalism, integrity, accountability and respect.

I strongly urge you to reject further advertising for strike-breaking, scab nurses.

Community Letters to the CEOs of Tenet

I have been alerted to the situation in St. Vincent's Hospital via an international newsgroup for nurses. It appears that the management of the above hospital are intent on mandating nurses to work 16 hour days. Might I urge you to consider that, whilst in the short-term such working practices may bring financial benefits to the organisation, the broader picture that will emerge is of an organisation who places financial expediency over and above the core business of providing safe, effective care. I would have thought that, in simple business terms, the adverse publicity which is now making Tenet health care's name internationally synonymous with compromising patient safety, would be sufficient to warrant a rethink on this employment policy. However, might I put to you the human case for a rethink this policy. If your wife or mother was in your facility would you want her to be nursed by someone who is tired, emotionally and physically from one 8 hour shift and who has just been forced, on one hours notice, to work another 8 hour shift? I would be interested in your response to this last question, but ultimately it is an answer for yourself. If, as I, you would feel uncomfortable with such a situation, I would urge you to change your stance on this matter. Remember also that a change of opinion, in light of considered reflection, is a sign of strength not weakness.

There are no winners in a strike. Please use your negotiation time productively and settle this work stoppage. Many lives are affected by this situation and it is possible to achieve agreement.
Resist the temptation to think of the union as a faceless entity that is fighting for control of your hospital and remember that you are dealing with real people. Your efforts will be reciprocated.
Healthcare is an extremely high cost business, and profits should not be placed ahead of the needs of patients and employees. You must staff your facility adequately to give you the ability to recover from normal absences, scheduled or unscheduled. Mandatory double shifting of employees is a sweatshop tactic that simply cannot exist in a civilized society.
By now you realize that I support the nurses of St. Vincent's Hospital and all other nurses and healthcare providers that reject mandatory overtime.

Nurses are the people who do the heavy lifting in any hospital. Your treatment of them is shameful. As the husband of a nurse, I know the strain they are subjected to on a daily basis.

Ask yourself these questions, Mr. Maher:
Would a patient know (or care) if you were sent home early?
Would day-to-day care at your hospital suffer if you took a two month vacation?
Who is more valuable to a health facility, you or the nursing staff?

Maybe YOU should take a paycut and make the money available for more important matters, like nursing.

The salaries being paid to replacement nurses during this strike tells me you wish to break the union. Fewer people are entering nursing. It's a seller's (employees) market, not a buyer's (employers) market.

This letter is to indicate my support for the nurses at St. Vincent's Hospital in Worcester. As a professional RN, with an MBA for many years and currently an MSN candidate at Yale University I feel compelled to indicate my support for the nurses and suggest that you and others as administrators and managers take heed with their request to eliminate the mandatory overtime. In addition, the ability of the Hospital to request a nurse to cancel her/his shift with no notice is an unrealistic expectation. Management wants cake and to eat it too.

It is as simple as "management 101" to understand that mandatory overtime is not the only alternative to adequately covering changes in patient volumes and acuity. Furthermore, to expect to be able to send professional staff (not hamburger flipping temporary workers in a McDonald's or like place) home without pay is degrading and counterproductive. True professionals cannot and will not continue to work under those conditions. Nurses are professionals with, many years of formal education. It is disgraceful to think that they could be expected to allow themselves to be treated as less than professionals by hospital administrators. What motivation and incentive would management have to staff adequately if they can request and demand overtime at any time? Please explain to me how a staffing policy like that could satisfy a policy in a management 101 class.

Understanding that patient safety and positive outcomes are important components of a reputable hospital as well as a sound financial status is, I suggest that the administration and Tenet Healthcare re examine their goals and the means to meet those goals. Because without a respected staff and without adequately staffed units patient safety and positive outcomes will not be attained.

I am a former St. Vincent's employee, it saddens me greatly to see the nursing staff have to resort to a strike. Having worked with many of these nurses I can tell you that the majority of them are compassionate, dedicated, and professional. They have my full support. I only hope that this can be resolved fairly and quickly. I must admit that I am puzzled by the issue of mandatory overtime. For years I witnessed inadequate staffing, whether it be from high census or staff out due to illness, never have I seen the ward go without proper nursing staff - someone always (voluntarily) would remain past their designated shift or come in early. Many times I would bring up from the cafeteria additional meals shrink wrapped & saved for later for nurses who would not leave the floor for even a quick dinner break.

But, I really don't think I need to continue to tell you of the virtues of a St V's nurse. You should know. If you ever truly were aware of what was happening at St Vincent's you would know.

There's a saying "if you take care of the workers, the workers will take care of the work". I have been a registered nurse for over 25 years in Western Massachusetts and I have been following with much sadness your organization's failure to "take care" of the nurses. Evidently a commitment to safe healthcare is not one of the elements of your organization's mission statement. If it was, you would not be allowing your negotiators to force contract demands for 16 hours of mandatory overtime. I'm sure your lifestyles allow you to strike a healthy work/family balance, allow that for the St.Vincent's nurses. Please consider having your organization join in the Nurse's Week Celebration by negotiating a safe contract for the nurses and allowing them to continue as "Nurses: Keeping the Care in Healthcare". Avoid making your organization's name "Tenet Healthcare" an oxymoron!

Another emailer wrote:...
Take a stand. Prioritize care over the bottom-line. Do the right thing. BARGAIN WITH THE NURSES AT ST. VINCENT'S, AND SETTLE THIS CONTRACT. Let the healing begin.

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