Waterfall no prescription for health care dilemma 
Thursday, March 30, 2000

By Dianne Williamson
Telegram & Gazette Columnist 

Anyone who has spent even one night in a hospital knows that it's the nurses -- not the doctors -- who are entrusted with the care and well-being of patients.

Doctors, of course, are indispensable in curing what ails us. But the doctors aren't usually around when you need help to get to the bathroom, or your prescribed medication is making you sick, or you're frightened of impending surgery and need a soothing voice to calm your fears.

Which is not to say nurses aren't highly skilled professionals in their own right. Many a busy doctor's hide has been saved by a good nurse, and the honest doctors know it.

For more than two years, the 535 nurses at St. Vincent's Hospital have been negotiating a first contract with Tenet Healthcare Corp. of Santa Barbara, Calif. Tenet owns St. Vincent's and the sparkling new Worcester Medical Center, which features a preposterous 28,000-square-foot Atrium complete with weeping fig trees and a waterfall.

An exceedingly practical bunch, the nurses are not impressed by the Atrium. Mere mention of the word typically provokes derisive laughter, which is grounded in more serious concerns about the priorities of their new megaboss.

"The patients aren't going to enjoy it," said Marlene Hassett, a member of the nurses' bargaining team. "As soon as they're better, they'll be rushed out the back door."

Such sentiments are at the heart of tomorrow's nurses' strike, if you believe that nurses are on the side of the angels in their battle with the nation's second-largest health-care chain. While specific issues such as mandatory overtime are at the crux of the impasse, there also exists a strong undercurrent of doubt among the nurses that Tenet will do right by the patients or the staff.

The nurses' frustration is palpable. They are quick to bemoan the intolerable increase in patient-nurse ratios and their helplessness in the face of a bottom-line mentality. In the negotiations, for example, they wanted the number of patients assigned to each nurse cut from eight to five or six; they say they settled for language ensuring that "safe staffing levels" will be maintained.

Nurses preparing to strike have also felt emboldened and empowered by their aggressive union stance. For too long, they say, they have been overworked and ignored by a cost-cutting hospital administration.

But they deny the contention of some -- most notably Robert E. Maher Jr., hospital CEO -- that they have been "hellbent" on striking, regardless of concessions made by management.

"Anyone who believes that should have witnessed the agony that went on in the negotiating room for 13 hours last Friday, and the tears, and all the effort we made to avert a strike," said Sandy A. Ellis, a member of the bargaining team.

Asked if the nurses are abandoning their patients, Marlena Pellegrino offered a quick answer: "I feel I've been abandoning the patients all along by not doing anything. We can't meet the standard of care, and we haven't been able to make the administration listen until now."

Ironically, nursing is the chosen profession of both the wife and mother of CEO Maher, who has incurred the nurses' wrath by saying they should be ashamed of themselves for striking.

In an interview moments before yesterday's failed bargaining session, he praised the nurses as a whole but said the negotiating team must bow to the realities of today's health-care system. He said the hospital must require its nurses to work overtime, or be allowed to send them home on less busy days. The nurses have balked at both measures.

"I understand people have families and lives and I respect that," Mr. Maher said. "I also know they work twice as hard as they used to. None of us would have gone into this profession if we knew what it would be like today. But what am I supposed to do? Am I going to take care of the patients myself? I don't see how they can say they care about the patients by doing what they're doing ... I think some of these people feel they're going to teach us a lesson."

He also denied the bargaining team's contention that gender issues have played a role in management's approach to the nurses. Nurses maintain that Mr. Maher never would have chastised a group of men in such patronizing ways; they say the management's lawyer has scolded and lectured them.

"It's like we're bad little girls," Ms. Pellegrino said. "The lack of respect given to our profession is astounding to me. I think they're surprised that women would have the stamina to do this." Only a handful of union members are male.

While not all of the rank-and-file nurses at St. Vincent support the strike, members of the negotiating team are fueled with the zeal of those convinced they're doing the right thing. They understand that unions don't attract the automatic support they once did; they know that skeptics say it's easy to make demands by citing concern for patients rather than convenience of the staff.

But when they speak in wistful tones about the days they had time to give an elderly patient a back rub or wash a woman's hair, when their eyes fill with tears as they remember the things they didn't have time to do -- you find yourself thinking that these are the sort of women who would never waste health-care dollars on a waterfall.

"Never in any of this have we felt like we were wrong," Mrs. Ellis said. "Never in my life have I had the privilege to unite with such smart, powerful women and men. Nothing in my life has made me prouder, other than my children."

Colleague Debra Rigiero agreed.

"No matter what happens, we will never be the same," she said. "The hospital will never be the same, and it will never have the power it once had over us."

Dianne Williamson can be reached via e-mail at diannew@telegram.com

© 2000 Worcester Telegram & Gazette

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