While the hospital has seen a 20% increase in census following the closing of North Adams Regional Hospital, there has been no increase in staffing to meet the increased demand for care.
Hospital management refuses to comply with a new state law calling for safe patient limits for nurses in the hospital’s intensive care unit.
PITTSFIELD, MA — The registered nurses of Berkshire Medical Center, who are represented by the Massachusetts Nurses Association/National Nurses United, have provided hospital management with official notice of their intent to conduct picketing outside the facility from 2 – 5 p.m. on Wednesday, Dec. 10 to protest what they believe are dangerous staffing levels, excessive patient assignments for nurses and other health care workers and a punitive work environment that is compromising the quality and safety of patient care for patients they serve throughout Berkshire County.
This job action comes as nurses report a marked deterioration in patient care conditions in recent months driven by the hospital’s refusal to increase staffing to account for a dramatic increase in patient census following the sudden and illegal closure of North Adams Regional Hospital. At meetings with the nurses’ union leadership, hospital management has confirmed at least a 20 percent increase in patient census since the closing, with no plan by management to compensate for the predictable increase in census and no increase in staffing.
Nurses in the hospital’s emergency department report being overwhelmed with patients who are waiting longer for needed care and attention, and the inability to move patients through the system due to the lack of adequate staff on other units. Since the closure of North Adams Regional, the hospital has had to call a Code Full on numerous occasions, which means all beds are full and there is no place to put patients, leaving patients being held in hallways waiting for a bed to open.
“We are protesting out of concern for our patient’s safety.” said Gerri Jakacky, co-chair of the nurses’ local bargaining unit. “Nurses are appalled that after the closing of North Adams Regional Hospital, no effort has been made to ensure we are capable of providing appropriate care to what everyone knew would be an increase in patient census at our hospital.”
To compensate for the lack of appropriate RN staffing to meet the increased demand, the hospital is utilizing questionable strategies to deliver care. In many cases, nurses have seen their patient assignments increased, forcing nurses to take on extra patients at a time when the medical research clearly shows that when nurses take on too many patients at one time, the risk of complications and even death increases dramatically. For example, according to one study, each additional patient assigned to a nurse results in a 7 percent increase in the risk of death for all patients under that nurses care.
The practice of assigning too many patients to nurses is not only dangerous, but for patients in the hospital’s intensive care unit which cares for patients who are the most critically ill, the practice is illegal. Berkshire Medical Center hospital is violating a recently implemented state law designed to ensure safer care for these patients. The new law mandates that no ICU nurse can care for more than one patient, or at the most two depending on the stability of the patients as determined by the nurses on that unit. BMC is regularly assigning its ICU nurses up to four patients at a time, double or triple the safe limit dictated by state law.
The hospital is making up for the shortage of staff by the use of widespread “floating” of nurses, a process that involves moving nurses from unit to unit. The practice, as it is being implemented at Berkshire Medical Center is unsafe, because nursing is as specialized as medicine. Again, the medical research bears out the fact that patients are safest and have the best outcomes when they are cared for by nurses who are experienced at caring for the same types of patients on the same unit day in and day out. At BMC, when nurses are shuffled from unit to unit, there is no continuity of care, and no guarantee that the nurse caring for a particular patient is fully competent to provide the level of care the patient requires.
Finally, in addition to the lack of staffing and unsafe working conditions, nurses are protesting an increasingly punitive management culture at the hospital where nurses report widespread bullying of staff to work extra shifts or longer hours, unwarranted discipline of nurses, and intense pressure to speed up care regardless of its impact on the nurses wellbeing and the wellbeing of the patients. A sign has been placed in the OR identifying and shaming nurses who failed to move a patient in and out of a unit fast enough.
“Our hospital is not a factory, we are not workers on an assembly line that is moving faster and faster,” said Gerri Jakacky. “We are not making widgets, we are caring for vulnerable human beings whose very life depends on my having the time and attention to provide the care they need when they need it. It is time for our management to treat us with respect and to provide the resources nurses need to ensure the safety of our patients.”
The degradation of patient care at BMC is coming at a time when the residents of Northern Berkshire County continue to have no access to inpatient care in their community, while the hospital continues to make a healthy profit, posting profits of more than $90 million over the last three years.
According to Donna Kelly-Williams, President of the MNA/NNU, who recently attended a standing room only meeting of the BMC nurses where the decision to conduct the protest was made, “We have a situation in Berkshire County where these nurses are sounding the alarm about a callous disregard for the patients and the communities of this region. Not only do the residents of Northern Berkshire County no longer have a hospital, they, and all the patients of this region, are now coping with the impact of the closure in North Adams and Berkshire Medical Center’s lack of a plan to handle the dramatic increase in patient volume. It’s not right.”
The nurses point out that this job action is not related to an ongoing contract negotiation (the BMC nurses have a contract in place until October 1, 2016) and this protest has nothing to do with the nurses’ wages or benefits. “This is about the safety and well-being of our patients in Berkshire County and about advocating for patients in every way. It is also about the stewardship of health care in all of Berkshire County” said Judith Sharp, a bariatric nurse and a member of the nurses’ negotiating team.