News & Events

Workload is nurses’ sticking point

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Tufts Medical is the latest to face threat of walkout

By Liz Kowalczyk and Robert Weisman
Globe Staff / April 16, 2011

The nurses threatening to strike at Tufts Medical Center and Saint Vincent Hospital join colleagues at an increasing number of hospitals nationwide — including others in Massachusetts — where disputes have erupted over how many patients are assigned to each nurse.

On Thursday, hundreds of Tufts nurses voted to authorize a one-day strike at the Boston teaching hospital amid a bitter dispute between the union and management over nurses’ workloads. In Worcester, Saint Vincent’s nurses last week OK’d a one-day strike.

Neither vote means strikes are imminent, but they give union negotiators leverage — the right to call a one-day walkout if the talks break down.

Nurses at both hospitals — who are represented by the Massachusetts Nurses Association — and management bargained again yesterday, but Tufts nurses said negotiations stopped mid-afternoon without any progress being made. More sessions are scheduled for Friday and April 25.

Nurses at Tufts say that by forcing them to care for too many patients, the hospital’s quality of care is being diminished. Hospital executives dispute that assertion.

Patient-to-nurse ratios vary depending on the type of unit and time of day. For example, each Tufts nurse in pediatrics cares for at least 1.4 critical care patients, compared with 1.03 patients at

Massachusetts General Hospital, according to the nurses union. Tufts executives have said that in some cases the number of patients assigned to each nurse has been increased to save money, but also to improve nurses’ jobs. And hospital officials said they have brought in dozens of technicians to free up nurses from doing work such as transporting patients to tests.

Tufts chief executive Ellen Zane said she believes that the union’s parent organization, the National Nurses United, is pushing its national agenda of mandatory patient-to-nurse ratios by encouraging 24-hour walkouts that force hospitals to spend millions on replacement workers. That group has filed legislation calling for limits on the number of patients assigned to nurses.

“It’s hypocritical for the MNA/NNU to claim it cares about patient safety while it authorizes a potential walkout that would cause undue stress on patients and their families,’’ Zane said in a statement following Thursday’s vote.

State and national union leaders deny that the national union has had a role in the Massachusetts disputes. “The notion that we are defining the issues for nurses at Tufts is absurd and disrespectful of nurses there,’’ said Chuck Idelson, a spokesman for the national union.

Idelson said nurses’ workloads are a “preeminent issue for nurses throughout the US [as] more and more hospitals are being run by Wall Street-type firms whose focus is on the bottom line rather than the service they are supposed to be providing to patients.’’ Even nonprofit hospitals, he said, are making more cost reductions, which often means cutting back on nurses.

The National Nurses United does not keep statistics on the number of strikes or threatened strikes, Idelson said. But the national union or its affiliates have threatened or led strikes at numerous hospitals in the past year, including some in Minnesota, Eastern Maine Medical Center in Bangor, Wilkes-Barre General Hospital in Pennsylvania, and Washington Hospital Center in Washington, D.C.

Disputes over the number of nurses also have colored nurses’ contract negotiations at other Massachusetts hospitals, including Cooley Dickinson in Northampton and Berkshire Medical Center in Pittsfield.

If Tufts nurses strike, it would be the first nurses strike at a Boston hospital in 25 years — since Carney Hospital nurses walked off the job in 1986.

The union must give management 10 days notice before a one-day strike. But if they take such an action, Zane said, she will not allow them to return to work for five days because it doesn’t not make sense to fly in, train, and hire hundreds of temporary nurses for a single day. Zane said a strike would cost the hospital at least $4.2 million in lost business and the expense of hiring temporary nurses.

Liz Kowalczyk can be reached at, Robert Weisman can be reached at

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