Brockton, Mass.
–The registered nurses of Brockton Hospital conducted an informational picket today to protest poor working conditions and management practices that the nurses believe threaten the hospital’s ability to recruit and retain the staff needed to keep patients safe.
The nurses, who conducted an historic 103-day strike over the issue of nurse staffing and patient care concerns in 2001, are once again locked in a protracted dispute with hospital management over a new union contract. Talks have dragged on for over a year, with the last five sessions involving a federal mediator. The nurses’ contract has expired and, after the last round of talks on Monday, the hospital has refused to set a date for another negotiating session.
“Once again, deplorable working conditions, low staffing and disrespect of nurses by management have forced us to be out on the street seeking public support as these issues are combining to drive nurses away from this hospital, preventing the recruitment of nurses and causing dangerous understaffing on certain shifts,” said Kathy Metzger, chair of the Brockton nurses’ local bargaining unit of the Massachusetts Nurses Association.
Brockton Hospital has had an alarming rate of turnover for the nursing staff in the last five years, with the loss of 131 nurses (more than 30 percent), with even higher turnover in a number of key areas including: 83 percent on the telemetry floor, 64 percent in the maternity unit, 58 percent on the medical/surgical floors and a 50 percent turnover of staff in the critical care units. Despite having its own nursing school and built in supply of new nursing talent, Brockton Hospital has failed to retain those nurses upon graduation, with most of them leaving within six months to a year.
The key issues in dispute include: the nurses’ desire for specific contract language to protect them against workplace violence (nurses are being assaulted on the job at an alarming rate); a competitive wage with other hospitals in the region; an increase in per diem nurse commitments to improve staffing on the evening, night and weekend shifts; and an effort to prevent dramatic cuts to the nurses’ health insurance benefits.
Health Insurance Cuts
Brockton Hospital management is instituting significant changes to the nurses’ health insurance benefit that will increase their co-pays and require them to pay a financial penalty (of between $250 and $3,000) for seeking care at hospitals other than Brockton Hospital.
According to Metzger, there are many problems with the hospital’s Brockton-only insurance plan: “First, Brockton Hospital does not provide the full range of services that other larger medical centers provide. Nurses have no choice but to use other facilities to receive the care they or their family needs,” she explained. “Second, many people don’t want to receive care where they work for privacy reasons. We had an incident recently where a nurse was tested for cancer and a number of people in the hospital knew about it and were talking to this
nurse about the results before she was even notified about them by her physician. The nurses want to enjoy the same level of choice they currently enjoy; they want the ability to seek the care they need where they need it; and they want to protect their privacy.”
Below Market Wages
While cutting health insurance benefits, the hospital’s pay scale for nurses is as much as 8 – 10 percent ($3 – $7 per hour) below nurses at surrounding hospitals, including cross-town rival Caritas Good Samaritan Hospital. Brockton management has made a salary offer that, while bringing some of the nurses up to parity with other hospitals at the end of the three-year contract, it would still leave a significant number of the most senior nurses’ salary more than $3 per hour behind their counterparts at Good Samaritan.
Low Staffing on Off Shifts
Staffing at the hospital, as it was in 2001, continues to be a problem, particularly on the evening, night and weekend shifts. A recent survey of staffing levels in Massachusetts hospitals found that Brockton Hospital’s RN-to-patient ratios on the evening and night shifts ranked among the worst in the state
“These staffing levels place patients at a dramatically increased risk for complications,” Metzger said.
The staffing crisis and high turnover of staff at Brockton Hospital have been exacerbated by the hospital’s inappropriate use of its per diem staff.
While other hospitals utilize per diem staff to support and augment their regular full-time staff, particularly to cover off shifts and weekends, Brockton Hospital has given preferential treatment to per diems – allowing them to work day shifts and limited weekends – to the disadvantage of the regular staff. This has caused many regular staff to leave the facility, but more importantly, has allowed the off shift staffing at the hospital to become a major safety problem for patients.
The nurses are attempting to correct this problem with contract language that increase per diem nurses’ commitments to include more off shift coverage on evenings, nights and weekends, and to provide a financial incentive for per diems to do so.
“The language is a win/win for everyone,” said Metzger. “The patients will receive better care with more nurses on the off shifts, the per diems will receive more money for working these shifts, and the full time staff will be placed on a fair shift schedule and treated with the respect they deserve.”
Workplace Safety/Protection Against Workplace Violence
The Occupational Health and Safety Administration has identified workplace violence for health care workers as a major problem and has encouraged hospitals to take steps to prevent workplace violence, as well as to provide proper treatment to employees who are victims of violence. Brockton Hospital has done neither, creating an unsafe work environment where violence is a regular occurrence, and where nurses who are victims of violence are not provided with appropriate support.
In the last year alone, there have been more than 800 calls to 911 made from Brockton Hospital for police support. In the last six months, at least eight nurses have suffered vicious assaults from patients. One nurse was punched in the face by a patient; another was dragged by her hair by patient; another was attacked by a patient with a knife, while one nurse had a urinal thrown at her. There have been fights in the emergency department among patients themselves, where in once instance a chair was thrown through a window.
“There is no excuse for such chronic violence, especially when administrative policies are a contributing factor,” Metzger explained. “After the strike in 2001, management made the decision to eliminate a standard police detail to cover the night shift. In addition hospital security services were cutback and security procedures were put in place that prevented security staff from making physical contact with patients. In essence, there is no security for nurses, patients and staff at Brockton Hospital.”
In response to this problem, the nurses have proposed union contract language that would obligate the hospital to institute a "zero tolerance" policy for violence against health care workers. The contract language calls upon the hospital to put in place a system of detecting and removing weapons from patients and visitors entering the hospital, institute policies and procedures for the prevention of violence or potential violence, provide training to staff on how to spot and deescalate potentially violent behavior, and create a special team of staff to respond to and assist staff involved in violent situations.
This contract language has been adopted by a number of hospitals in Massachusetts, but thus far, Brockton Hospital has refused to entertain the language.
Metzger hopes the picket will generate support from the public to help pressure management to get back to the negotiating table to reach a fair settlement.
“There is no reason why this contract should be dragging on this long,” Metzger concluded. “All we are asking for is a fair and competitive contract that will protect our patients and the future viability of this hospital.”
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