Nursing a Conundrum
All the big-picture policy talk about controlling the cost of health care runs smack into the real world at the hospital nursing station.
This is true across the country, but especially in Massachusetts, where nurses are pressing several hospitals in contract talks. Two negotiations in particular — at Tufts Medical Center in Boston and St. Vincent Hospital in Worcester — are focused on staffing levels for nurses.
Hospital administrators say they are trying to manage in challenging times, reorganizing work to become more efficient while maintaining the quality of care. Many nurses and their union say the practical result of efficiency plans is a thin staff that put patients at greater risk.
“The hospital has set us up to fail,’’ says Barbara Tiller, a long-time nurse at Tufts and chairman of the union bargaining committee there. “It’s not possible to take care of people like parts on a factory line.’’
Everyone from the governor to executives running the state’s big insurance companies are leaning on health care providers to slow the increase of medical costs. Hospital administrators look at their budgets and see labor as the thickest slice of the pie by far. Inside the payroll numbers, nurses are the biggest expense and a natural target for cost control.