September 20, 2002

Cape Cod Hospital RNs to Hold Informational Picket on Monday, Sept. 23rd As Contract Talks Stall Over Salary Issues

Some Progress was made at Thursday, September 19th's Negotiations. As a Result of that, Another Bargaining Session has been Scheduled for the 23rd at 12:00 p.m. Informational Picketing will Proceed at 6:30 a.m. to 5:00 p.m. on Monday.

Nurses' Pay Scale is Inadequate for Recruitment and Retention of Staff to Maintain High Quality Care, Specifically for New Open Heart Surgery Program

HYANNIS, Mass.— Registered nurses at Cape Cod Hospital in Hyannis will hold an informational picket outside the entrance to the facility on Monday, Sept. 23, 2002 beginning at 6:30 a.m., as contract talks continue to stall over differences in salary proposals. With nearly 70 RN vacancies and with fierce competition for experienced nurses, Cape Cod Hospital's pay scale is preventing the recruitment and retention of staff, which the nurses fear will compromise patient care and prevent the successful introduction of its new open heart surgery program.

The Cape Cod Hospital contract dispute comes at time when the health care industry is in the midst of a growing national shortage of nurses, which was driven by a decade where nurses saw a dramatic increase in their patient assignments, a deterioration of their working conditions, and pay rates that have remained virtually flat.

Here in Massachusetts, hospitals are now scrambling to recruit sufficient numbers of registered nurses from a very small pool of nurses still willing to work under current conditions. Nurses, frustrated with their pay and working conditions, are moving from facility to facility in search of the best environment.

"Here at Cape Cod Hospital, for the first time we are seeing a significant vacancy rate. We have as many as 70 vacancies right now, and we are losing nurses every week to other hospitals who are offering significantly higher wages," said Marilyn Rouette, chair of the nurses' bargaining unit. "While we have fought to maintain appropriate staffing levels in comparison with other facilities in the state, we are in serious danger of compromising our quality of care as more nurses leave and our vacancy rate increases."

More than 400 nurses are represented by the Massachusetts Nurses Association at Cape Cod Hospital. They have been negotiating their contract since June 25, with six negotiating sessions held to date. The nurses' contract will expire on Sept. 30, 2002. The nurses submitted the required notice to picket the hospital on Sept. 11, 2002. Nurses at the facility are outraged by the hospital's stance in the negotiations. At an open meeting held on Sept. 4, more than 200 nurses turned out, and there was nearly a unanimous vote to authorize an informational picket.

The timing and distribution of the two side's salary proposals are at the center of the current stalemate. The hospital is offering the nurses what would amount to a 28% pay hike over three years, while the nurses are seeking this increase over two years. The hospital's proposal is structured to offer increases at the top of the pay scale, while the union is looking for more of the increase in the form of across the board raises to help a middle tier of younger nurses, those most likely to leave the facility for facilities in Boston.

"The problem for nurses is that while Cape Cod Hospital now functions and promotes itself as a major regional medical center, it is paying its nurses like a small community hospital," said Rouette.

Rouette points out that the Cape Cod nurses' pay scale is far below that of nearby Martha's Vineyard Hospital, a facility one-quarter of its size, and it is far behind that of the major teaching hospitals in Boston, which are now beginning to recruit away Cape Cod nurses, nurses needed to help establish the hospital's open heart program.

The nurses' proposal would make the Cape Cod scale competitive with in-town hospitals and stop the loss of nurses as well as retain valuable staff. The hospital's proposals would not achieve this parity, and would barely bring it in line with the Martha's Vineyard contract at the end of the three years.

"We've already lost three of our open heart team nurses, and more and more staff are talking about leaving," Rouette said. "We've got nurses talking about carpooling into Boston together to take advantage of the higher wages."

For 30-year nurse Ann Marie Mrozinski, the issue is not just about pay, it is also about fairness and respect.

"Nurses feel overworked and undervalued. Remember, we're the ones who provide 90 percent of care patients receive 24/7. We're the ones who are responsible for monitoring their condition minute by minute and to notify physicians of changes that could lead to complications. We are essential to the success of this hospital, and we deserve to be compensated for the contributions we make."

Mrozinski and other nurses are incensed that the hospital is trumpeting a major capital campaign to build a new 60-bed patient tower at the facility, without first making an appropriate investment in nursing staff to provide the actual care.

"You can build your 60-bed tower, but would good will it do the community if there aren't nurses available to staff those beds and care for those patients," she said.

The nurses hope the picketing will raise awareness among the public of the nurses' concerns and how their concerns and patients' concerns are linked together.

Dispute is Manifestation of Broader Crisis

The contract dispute at Cape Cod Hospital is one being played out at a number of facilities across the state in the wake of a growing nursing shortage in the Commonwealth. Similar job actions have been called for by nurses at MNA local bargaining units at Brigham & Women's Hospital and Carney Hospital.

While Massachusetts has the highest population of nurses in the nation (over 82,000 RNs licensed by the state), we are experiencing a serious shortage of nurses willing to work at the hospital bedside. A recent survey of Massachusetts nurses found that while 81% were working in nursing, only 46% (an estimated 37,000) are working at the hospital bedside, and more than half of those nurses are working part time.

According to Julie Pinkham, executive director of the MNA, "The current shortage of nurses was created by the bad policies of the health care industry and made worse by consistent mistreatment of its nursing staff over the last 15 years. Nurses are just plain tired of being taken advantage of."

Throughout the 1990s, hospitals laid off thousands of nurses and/or replaced them with unlicensed personnel in an attempt to cut costs under managed care. Also, under managed care, only the sickest patients made it into the hospital. Nurses at the bedside saw their patient assignments increase while their patients were sicker, requiring more intensive nursing care. At many hospitals, managers compensated for inadequate staffing levels by using mandatory overtime as a mechanism for staffing their facilities.

Not only did these conditions impact nurses, those who suffer most under current conditions are patients. A number of recent studies, including one published this May in the New England Journal of Medicine and a more recent report by the Joint Commission on the Accreditation of Hospitals, shows that inadequate RN staffing is causing serious harm to patients, including increases in complications, an increase in medical errors and thousands of patient deaths each year.

A recent national survey of nurses by the federal government found that nurses have the lowest job satisfaction of any employee group surveyed by the government. Staff nurses in hospitals and in nursing homes has the lowest job satisfaction of all, which is due to poor working conditions and low pay.

Nursing is also one of the most dangerous professions. Nurses and nurses aides have the highest claims rate for back injuries of any profession. The injury and illness rate for nurses and other health care personnel surpasses that of mining. Nurses and other health care personnel are three times more likely than the general public to contract Hepatitis C, and nurses suffer assaults and workplace violence on a par with police officers and prison guards.

To address the issue of poor working conditions and dangerous staffing levels, nurses are turning to the legislature and fighting for passage of legislation similar to what was recently passed in California, which would regulate RN-to-patient ratios. The regulation of nurse staffing is essential to retaining the current workforce, and to enticing those that have left the bedside to return.

"Unless and until the RN-to-patient ratio legislation is passed and working conditions throughout the state's hospitals are improved, the wages for the nurse willing to work in this environment (which have been stagnant for more than a decade) must be addressed immediately."