St. Vincent's Strike

St. Vincent's Hospital RNs And Tenet To Talk Tomorrow As Strike Deadline Looms 

• Nurses Will Begin Strike on March 31st Unless Tenet Resolves Outstanding Issues
• Pre-Strike Rally Planned for March 30th at Vernon Hill Post from 6 – 9 p.m

WORCESTER, Mass.—Registered nurses represented by the Massachusetts Nurses Association (MNA) at St. Vincent's Hospital in Worcester go back to the negotiating table with Tenet Health Care management tomorrow, March 29, 2000, in a last ditch effort to settle remaining issues in dispute and avert a strike scheduled to begin at 6 a.m. on March 31, 2000.  The session, which was requested by Tenet and will be held with a federal mediator, will begin at 10 a.m.  The MNA will contact the media when the talks are completed, and nurses will be available for comment.  For information, call the MNA Communications Department at 781.830.5717 or 781.249.0430, or call the St. Vincent's Nurses' Strike Office at 508.792.2181.

Barring a settlement at tomorrow's talks, the nurses are proceeding with their plan to strike, which includes assisting nurses in finding work assignments at area hospitals and mobilizing committees to manage strike-related activities. This includes plans for running 24-hour picket lines at both St. Vincent's Hospital and the new Worcester Medical Center, working with other labor unions, political and community leaders to build support for the nurses' cause, fundraising to support the striking nurses, and educating citizens about the issues behind the strike.   Last week the nurses opened a strike office at the Carpenters Union Building at 29 Endicott Street.  This week, Richard Rafferty, managing partner for the Worcester-based law firm of Eden, Tollins and Rafferty donated space in the firm's offices for a satellite strike office at 19 Norwich Street, which is less than a block away from the new Worcester Medical Center.

"We sincerely hope that Tenet management will come to the table prepared to resolve the remaining issues that are holding up the settlement of this contract," said Sandy Ellis, a nurse at the facility and spokesperson for the bargaining unit.  "After two years and 45 negotiating sessions, we are close to a settlement, and it would be a shame if Tenet wanted to force a strike, particularly over their unreasonable demand to use mandatory overtime as an alternative to providing safe staffing at this new facility. Throughout this process, and especially in our last negotiating session, the nurses have made substantial concessions to settle this contract. Enough is enough, it's time for Tenet to do what is necessary to reach an agreement and prevent a strike. "

The two parties last met on March 24, when talks broke down over a number of issues, with the most significant  being the issues of mandatory overtime and the hospital's refusal to allow the nurses to engage in protected negotiations over issues related to the move to Worcester Medical Center. 

The issue of mandatory overtime is the single most important issue of concern to the nurses. Currently, the hospital does not use mandatory overtime.  Under the new contract, the hospital is demanding the right to mandate double shifts for nurses, forcing nurses against their will to work up to 16 hours straight, something nurses believe is dangerous to patient care. 

The nurses want to place strict limits on forced overtime to prevent the practice from being used as a means of compensating for a lack of safe staffing at the facility. The nurses also want the right to refuse overtime if they feel fatigued or incapable of providing safe care.  The hospital would only agree to allow a nurse to refuse mandatory overtime once every quarter. 

"Tenet's stance on this issues says everything there is to say about this corporation's lack of commitment to quality patient care," said Ellis. "If we concede this issue, we concede everything we stand for as nurses, and as legally-mandated advocates for our patients' safety. We cannot allow this hospital to staff this hospital by doubling the workload of its nurses, thereby placing patients in the hands of exhausted practitioners.  Nurses have a hard enough time making it through there regularly assigned shifts under current staffing conditions, there is no way we should be forced to make it through an unplanned double shift.  It's a recipe for tragedy, and we cannot and will not abide a contract that sanctions this practice." 

The second unresolved issue concerns the nurses' legal right to negotiate over the impact of the move into the Worcester Medical Center.  The union has already filed a charge against the hospital with the National Labor Relations Board for its refusal to provide information the nurses need to bargain effectively.  The hospital has also flatly refused to allow the nurses' union representative to enter the building and tour the facility.

The nurses have been trying to negotiate over the move for months, but Tenet has stonewalled the process, leaving little time to address the issues as the date of the move fast approaches.  The nurses offered a concession to the hospital whereby they would negotiate all aspects related to the move after it had taken place, thereby allowing the new hospital to open without a strike. However, the nurses wanted to retain their union rights for a process of dispute resolution should issues remain unresolved after the move.  Specifically, the nurses wanted to maintain either their right to strike, or the right to submit unresolved issues to interest arbitration. The hospital refused. 

"We offered to help them get this process done and expedite the move into this new facility," Ellis explained. "But they refused to grant us our most basic union rights to allow that to happen.  What we want to know is why? What are they afraid of?  Why won't they provide us with the information we have every right to receive about staffing levels and work assignments in the new facility? Why won't they let our representative tour the facility?"

At the last session the parties did come to agreement on some other key issues for the nurses, including the issue of nurses' hours of work and shift assignments.  Both sides made concessions on the issue. The hospital originally wanted the unrestricted right to unilaterally change a nurse's hours of work and shift assignments. They also agreed that before any change is made, management would need to negotiate over the change, and if a resolution was not reached, the issue would be subject to expedited arbitration by a neutral third party. The parties also came to an agreement on Tenet's controversial flex-time policy, whereby the hospital has the right to send nurses home when they believe census is low, forcing the nurses to use their vacation time in lieu of lost pay. The compromise limits the amount of flex time assigned and phases out the policy after three years. 

On March 16, the nurses voted by a greater than 2 to 1 margin to authorize the union's negotiating committee to call a strike. The nurses issued their official notice to strike on March 17, after negotiations failed to reach a settlement on a number of issues.

The nurses have planned a pre-strike rally for March 30, 2000, from 6 – 9 p.m. at the Vernon Hill American Legion Post on Providence Street. A number of nursing and labor leaders, as well as political officials have agreed to attend the rally to support the nurses as they prepare to strike on the following day. 

The nurses have been using the collective bargaining process to address their number one concern at the facility, which is to improve staffing levels and working conditions at the hospital. According to the MNA, St. Vincent's Hospital has the worst record of documented unsafe staffing reports of any of the 85 hospitals where the MNA represents registered nurses in the state. In the past 24 months, nurses have filed more than 450 unsafe staffing reports, which are official reports, nurses file whenever they feel "their patients are in jeopardy." 

Recent Research Supports Nurses Concerns for Patient Safety Under Mandatory Overtime 

Nursing and workplace research supports the St. Vincent's nurses' concerns for patient and nurse safety under conditions of excessive, unplanned overtime. 

For example, a study of nurses in Massachusetts conducted by the American Journal of Public Health in 1992 found that nurses who work variable schedules (such as mandated overtime shifts) were twice as likely to report an accident or error, and two-and-one-half times more likely to report near miss accidents.  It concluded that these conditions were associated with "frequent lapses of attention and increased reaction time, leading to increase error rates on performance of tasks."

In a 1989 article published in the Journal of Occupational Health & Safety, the author stated, "Once a shift exceeds 12 consecutive hours, acute fatigue sets in, a worker may still be able to perform routine tasks, but his brain waves exhibit a pattern of stage one alpha sleep. Errors made in this state are frequently major, since the worker tends to perform the opposite of the correct action."

The Institute of Medicine just last Fall published a report on the dramatic rise in medication errors in United States hospitals, which causes the death of between 48,000 and 98,000 patients each year, depending on the study cited. 

Nurses are intimately involved in medication administration in hospitals, as they are the ones who are ultimately responsible for ensuring that patients get their medication, receive the right amount of medication, and receive it at the appropriate time.  Most important of all, nurses are responsible for assessing the patient to make sure the patient is responding appropriately, or to spot any adverse reactions to medications and take immediate steps to address problems that may arise. 

The report clearly states that designing safe medication administration systems for hospitals requires that nurses work with appropriate staffing levels, and that they are well rested. The report states, "Designing jobs with attention to human factors means attending to the effect of work hours, workloads, staff ratios, sources of distraction, and inversion in assigned shifts (which affects worker's circadian rhythms) and their relationship to fatigue, alertness and sleep deprivation…"

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