Registered nurses (RNs) represented by the Massachusetts Nurses Association (MNA) at Brockton Hospital will take a strike authorization vote on Monday, April 23, 2001 as contract talks continue to stall over mandatory overtime, salary and staffing conditions. In the last three years, inadequate staffing and mandatory overtime have been a regular occurrence at the facility. Since January, more than 79 nurses have been forced to work extra hours or entire shifts to compensate for a lack of appropriate staff.

The strike authorization vote has been scheduled to take place throughout the day and into the evening on April 23. Nurses will cast their vote by secret ballot at the St. Margaret's Church in the Parish Center Building, 891 Montello St. in Brockton. Voting will take place from 8 – 10:30 am, from 1:30 – 5 pm and from 7 - 9 pm. Media will not be allowed into the polling places, but may talk to nurses entering and leaving the building. All voting will be completed by 9 pm. The nurses will tally the ballots and will announce the result of the vote at 9:30 pm. (Note to editors and reporters: the Brockton Hospital bargaining committee has voted to release the result of the vote only (yes or no). They will not be releasing the counts or the percentages of the vote. Members of the committee will be available for interviews by the media when the results are released.

If the nurses vote for the measure, the strike authorization vote does not mean the nurses would be calling for a strike immediately. The vote authorizes the negotiating committee to call a strike at such time as they feel it is necessary. The nurses are anxious to go back to the negotiating table to settle the contract. Once the vote is completed, the nurses will contact the Federal Mediator to schedule a negotiating session. If and when the nurses issue their notice to strike, the hospital would than have another 10 days' notice to come back to the negotiating table before the nurses walk off the job.

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 repeatedly 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 2% raise each year for a three-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 15 negotiating sessions have been held with the last five 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 our 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 three-year contract with a 6.5% pay hike in the first year, and 7% in the last two years. 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, the hospital's web site recently 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.