The nurses are seeking strict limits on mandatory overtime, similar to provisions negotiated by the Massachusetts Nurses Association-represented nurses at St. Vincent Hospital/Worcester Medical Center last year. The St. Vincent nurses conducted a highly publicized 49-day strike over the issue in 2000, and have won national recognition for their stand over this public health issue. Since that time, other MNA-represented hospitals have negotiated similar provisions.

The nurses are also outraged by the hospital's stance on the salary in the negotiations. While the hospital CEO Norman Goodman has repeated boasted of the hospital's ability to make a profit for the last six consecutive years, as it has dramatically increased its patient volume, Brockton Management is offering the nurses a mere 1% raise each year for a two-year contract. They are offering this while paying Goodman $500,000 per year, and an additional $20,000 in benefits.

The nurses, whose contract expired on Oct. 19, 2000, have been negotiating their new contract since September, 2000. A total of 13 negotiating sessions have been held with the last 3 before a Federal Mediator.

"The nurses at this facility want the public and our patients to know that the hospital has made a calculated decision to put the interest of profits ahead of patients, and they are doing it on the backs of the nurses," said Tina Russell, chair of the MNA Bargaining Unit at Brockton Hospital, which comprises more than 400 registered nurses at the facility. "Instead of investing in their nurses, they are abusing them, forcing us to increase out workloads regardless of the impact on our patients and ourselves. We have asked them for the simple right to refuse mandatory overtime if and when we feel working extra hours and shifts would jeopardize patient care. They have refused to grant us that right. We have asked them to limit the amount of times a nurse can be mandated to work overtime; again, they refuse to place any limits on mandatory overtime."

Mandatory Overtime/Staffing is Top Priority

Nurses at Brockton Hospital have a long history of problems with management over the issue of mandatory overtime, i.e. forcing a nurse against her/his will to work extra hours or shifts to compensate for a lack of appropriate staffing. It was the principle issue of concern in their last contract negotiation of 1998. While the hospital had promised to eliminate the problem, the practice continued at an even higher rate. With the hospital's negotiation of an exclusive contract with the Goddard Park Medical Group in 1999, patient volume has increased dramatically, creating increased workload for the nurses and unrelenting staffing problems and stresses on the nurses.

In 1999, the nurses took the unusual step of sending a letter to the new physician group and the Board of Trustees, sharing with them numerous documented reports of unsafe staffing that threatened patient care and warning them of dire consequences for the facility and their patients if improvements were not made in the nurses staffing conditions.

While the hospital claims mandatory overtime shifts represent only 1 percent of its total nursing hours, they have refused to provide any data or proof of this claim to the nurses' bargaining unit. To the contrary, the nurses report that mandatory overtime on certain units occurs every single week, and during peak periods, such as the winter flu season, it is a daily occurrence. "They won't produce the data because it doesn't exit," Russell stated. "We have documented hundreds of occurrences of mandatory overtime and poor staffing, any instance of which, could have had dire consequences for the patients on that floor. The bottom line is mandatory overtime should never be accepted or condoned."

The nurses are not alone in their concerns about poor staffing/mandatory overtime and the impact on the safety of patients. The Chicago Tribune reported in a three-day series last September that a majority of hospitals nationally have significantly reduced registered nurse staffs. Since 1995, at least 1,720 patients have died and 9,584 others were injured in cases linked to overwhelmed nurses, poor staffing, excessive overtime and inadequate training.

Lucien Leape, MD, MPH, Professor of Health Policy at the Harvard School of Public Health and the nation's leading expert on hospital deaths and adverse drug events caused by medical errors told an audience of nurses at the MNA's Annual Convention last November, "Health care is the only industry in America that doesn't believe fatigue degrades performance." On the specific issue of mandatory overtime, Dr. Leape said, ""It ought to be illegal."

"I have been mandated on a number of occasions and I can tell you it places enormous stress on you both mentally and physically," said Barbara Cook, RN. "Patients on my unit are being carefully monitored for changes in their condition. They are very sick and often on complex medications. When I'm working and exhausted, I have to double and triple check my work to make sure I am doing it correctly. Many times I have caught myself before making an error, but I, along with countless other nurses, live in fear of that one error we don't catch."

"It comes down to this," nurse Linda McMahon explained. "Do you want your mother, brother or daughter being cared for by someone who has been forced to work 16 hours straight. We are not factory workers making widgets here, we're skilled professionals caring for extremely vulnerable patients. This hospital has an obligation to provide enough staff to cover all its shifts."

Salary Is Key To Recruiting Nurses To Ensure Safe Care

The issue of salary is directly linked to the staffing and mandatory overtime issue, because the state, as well as the nation, is in the midst of a major nursing shortage, where the competition for nurses, especially experienced nurses, is tremendous.

According to Russell, "we are losing nurses all the time to surrounding hospitals, and to hospitals in Boston because of our working conditions. The hospital claims to have hired more than 125 nurses recently to improve conditions, but the Brockton nurses claim the new recruits aren't staying, and that the hiring has not had an impact on the amount of mandatory overtime at the facility."

A number of hospitals in the Bay state are offering significant salary increases, bonuses and other incentives to recruit staff, while at the same time negotiating limits on Mandatory Overtime. Just last week, nurses at UMass Medical Center ratified a two-year contract granting their nurses between a raise of between 12 and 25% based on nurses' experience. The UMass nurses also negotiated the St. Vincent Hospital mandatory overtime provisions into their pact.

The Brockton Hospital Nurses are asking for a 7 percent pay hike in each year of a three-year contract. The nurses have not had an increase since October, 1999 and they claim the hospital can well afford to meet their demands given its recent financial performance.

In fact, last week, the hospital's web site featured a story celebrating the hospital's unprecedented growth and financial stability, as announced at its recent annual meeting. Goodman pointed to the hospital's continued investment in growth and development in services, including a $5 million expansion of its radiology department, a $6 million expansion of the emergency department and a $1 million investment in a physician practice facility. He also cited the nurses for having one of the highest patient satisfaction ratings in the country.

"They are investing everywhere—for equipment, buildings and physicians, but they refuse to invest and reward the nursing professionals who spend more time with patients than any one else in this facility and who, according to Mr. Goodman, are having a very positive impact on the satisfaction of our patients," said Linda McMahon, co-chair of the bargaining unit and a nurse in the emergency department. "We are glad this facility is growing and prospering, but we are tired of sacrificing our personal well being, and the well being of our patients to subsidize Mr. Goodman's version of success. Nurses are breaking their backs to make this institution what it is. All we demand is our fair share for the contributions we make."