As Talks Continue to Stall Over Staffing and Patient Care Concerns
WORCESTER, MA — The registered nurses of St. Vincent Hospital at Worcester Medical Center voted overwhelmingly tonight to authorize their union leadership to call a strike if necessary in their ongoing negotiations with hospital management. In a unified show of strength, 498 nurses cast ballots, with the nurses voting 433 to 65 (87 %) in favor of the strike authorization.
After more than a year of negotiations, talks continue to stall over hospital management’s refusal to agree to improvements in staffing levels to provide safe patient care, specifically in the emergency department, on the medical/surgical and telemetry floors, where poor staffing levels have led to a number of unsafe situations and a decrease in the quality of patient care.
“With this vote, our membership is sending a clear message to management that we are ready to do whatever is necessary to protect our patients and to ensure that nurses are able to provide the care our patients deserve,” said Carolyn Moore, co-chair of the nurses local bargaining unit. “No nurse wants to strike, but we are prepared to do so if Vanguard continues to refuse to make modest improvements in staffing levels – improvements that are needed to prevent a continued deterioration in the quality and safety of care at this hospital.”
The nurses, who are represented by the Massachusetts Nurses Association (MNA), have been attempting to negotiate their first contract with Vanguard Health Systems, Inc., the newest for-profit owner of the hospital. The nurses, who conducted an historic 49-day strike in 2000 against Tenet Healthcare over the issues of staffing and mandatory overtime, are once again locked in a protracted dispute with the new owners over similar concerns.
The vote does not mean the nurses would strike immediately. It gives the negotiating committee the authorization to call a strike if and when they feel it is necessary. Once the committee issues its official notice to strike, the hospital would then have 10 days before the nurses walk off the job.
Poor Staffing Jeopardizes Patient Safety
Maintaining appropriate staffing levels is a constant struggle at the facility, which is causing nurses on a number of units to take on excessive patient assignments. The nurses point to concrete evidence of a rapid deterioration in staffing conditions that jeopardize the safety of patients.
- In the last year, nurses have filed more than 400 (an average of one per day) official reports of incidents when staffing levels jeopardized the safety of their patients.
- It is not uncommon for nurses on the medical/surgical floors to be assigned as many as 7 or 8 patients which, according to the latest medical research, places patients at a 21-31% increased risk of injury or death.
- Last January, Vanguard significantly increased the capacity of the emergency department and doubled the nurses’ workload, without adding a single nurse. Around the same time, Vanguard laid off 25 nurses and closed a medical/surgical floor specifically designed to accommodate admissions from the emergency department. This has caused longer waits for patients and, in many of these instances, jeopardized the safety of patients seeking emergency care.
- In addition to cutting back on nursing staff, the hospital has also cut back on non-nursing support staff such as unit secretaries, patient transporters, nurses’ aides, etc. Patients have not only lost access to the valuable services this staff provides but, as a result, nurses have been routinely assigned a number of these non-nursing duties, which detracts from the time they have to provide clinical nursing care, such as monitoring a patient’s condition and intervening to address problems and complications.
- While cutting back on patient care resources, the hospital is attempting to reap higher profits by increasing the volume of surgeries. Vanguard has instituted a speed-up of the turnover of patients entering and leaving surgical suites and the recovery room, forcing nurses and support staff to move out one patient and prepare the room for the next patient in just 15 minutes. The process has placed an enormous strain on all staff in these areas and has limited registered nurses’ ability to properly monitor and administer pre and postoperative care.
The nurses have been complaining about the poor staffing and patient care conditions for months and the hospital has taken little or no action.
“We have had monthly meetings with management detailing serious concerns where we have highlighted a number of specific instances when patients were harmed or suffered preventable complications due to these practices. In nearly every case, nothing was done,” said Marie Ritacco, RN, a nurse in the recovery room and a leading patient safety advocate on the nurses’ negotiating team.
According to Ritacco, Vanguard management has refused to restore or add staff to ensure the appropriate expert nursing care patients deserve. For example, Vanguard has increased the practice of closing floors and transferring patients to areas of the hospital where the nurses do not specialize in the care the patients require. They have reduced patients’ access to nurses who are expert in inserting and monitoring intravenous lines. Vanguard’s reduction in staffing has also caused an increase in patient falls because nurses and support staff cannot be on hand to prevent at-risk patients from falling. Management’s only response to the problem was to state they might consider purchasing beds lower to the floor.
To address the staffing crisis, the nurses are asking management to improve staffing guidelines that were negotiated with the nurses following the strike in 2000. The nurses want to improve RN staffing ratios on the medical/surgical and telemetry floors, as well as add addition staff to the emergency department.
The nurses are also seeking contract language that prohibits the hospital from routinely assigning non-nursing duties to nursing staff to ensure nurses can focus on providing the nursing care patients deserve.
The St. Vincent Hospital nurses and management have been negotiating their contract since November 2005. To date, 34 sessions have been held, with the last four sessions involving a federal mediator. The contract expired on December 31, 2005 and has been extended until Feb. 1, 2007.