Brigham and Women’s Hospital Nurses Vote to Ratify Strong MNA Contract and as COVID Surges Call for Immediate Fixes to Emergency Department Problems Impacting Patient Care Quality
MNA Brigham nurses negotiated significant investments in their nursing workforce and remain actively involved in addressing serious ED staffing, equipment, and patient boarding issues amid a COVID-19 surge
BOSTON, Mass. – Nurses from Brigham and Women’s Hospital, represented by the Massachusetts Nurses Association, have voted to ratify a new collective bargaining agreement with the hospital, securing a strong compensation and benefits package aimed at valuing the dedication of nurses who faced enormous challenges through the pandemic and helping recruit and retain the nurses necessary to provide high-quality patient care.
“Brigham nurses fight hard every day for our patients and it’s no different when we’re at the bargaining table,” said Trish Powers, OR nurse and MNA Chair at Brigham and Women’s Hospital. “Our contract is about protecting and investing in Brigham nurses so we can give our patients the very best care they deserve. I am incredibly proud to be a Brigham nurse and to represent the nearly 4,000 nurses who keep our hospital running.”
Brigham nurses voted to ratify their new contract by mail after a tentative agreement was reached on April 18, following nine months of negotiations. The vote was counted on May 24 and was overwhelmingly in favor of ratifying the agreement.
As the nurses’ tentative agreement was being ratified, long simmering problems in the Brigham’s emergency department worsened into a crisis. Nurses are regularly faced with trying to care for 50 or more patients boarding in ED hallways without basic equipment such as monitors and electrical outlets. More than 50 experienced nurses have left the ED in the past nine months. The hospital has not back filled these positions with experienced nurses and there are multiple holes on nurse schedules every day.
“There were 50+ boarders,” Amanda Haimaidi, a Brigham ED nurse wrote to the hospital administration about a May 11 shift. “As you know, we have 65 rooms in the ED, 20 of those for observation. This leaves boarder patients, who belong in rooms, in hallways of the ED. It also leaves no space to care for ED patients. By afternoon we end up with 30-40 patients in the waiting room, sick patients, septic patients, oncology patients, patients with abnormal vital signs, all waiting for hours on end with no end in sight.”
“It is unsafe because there are 50+ boarders EVERY DAY, without any type of emergency plan in place,” ED nurse Kelly Greenwood wrote to the administration about the conditions. “It is unsafe because I have to care for critically ill patients (I.e STEMI, STROKE, patients on PCA pumps) IN THE HALLWAY WITHOUT ANY MONITORS.”
Emergency department boarding of patients in hallways, and in particular long waits for those experiencing mental health issues, is a recognized crisis in Massachusetts. At the Brigham, nurses flagged the ED boarding issue in December 2021 when they called for a Department of Public Health investigation into whether the hospital was violating an emergency pandemic order restricting non-emergent surgeries. Recently, nurses have seen the problem worsen and held a meeting with hospital administrators on May 17 urging them to act quickly.
Brigham Contract Ratification Information
“The dedication of our nurses and the tremendous need to recruit and retain nurses to care for our patients motivated us to stand strong together,” said Kelly Morgan, labor & delivery nurse and MNA Vice Chair at Brigham and Women’s Hospital. “It is important that the hospital recognized that we have gone through some of the most difficult days of our nursing lives. Our contract is an investment in Brigham nurses and our ability to provide quality patient care.”
- Effective 10/3/21 – retroactive pay – add a new Step 20 that is 5% above the current top Step 19.
- Effective 10/3/21 – retroactive pay – increase the salary scale for all nurses by 5%.
- Effective 10/2/22 – increase the salary scale for all nurses by 5%.
- Nurses at the top of the scale receive a total 15% increase or an approximately $12 per hour increase by 10/2/22.
- Over the course of the two-year contract, nurses still advancing on the existing wage step scale receive a 20% overall increase.
- To address PACU staffing issues, the hospital agreed to conduct an HR assessment in the PACU and that PACU nurses will rotate through all five areas (PACU, Pre-Op, Day Surgery, ERU and Boarders) on a fair and equitable basis. Nurses newly hired or transferred into the PACU will be added to the rotation for Pre-Op, Day Surgery, ERU and Boarders no later than six months after orientation is complete.
OR Staffing/AORN Guidelines
- To address OR staffing issues, management agreed to meet with up to four MNA-selected nurses from the Operating Room to address the policies and procedures which guide staffing practices consistent with the AORN guidelines. Meetings will continue regularly until the staffing in all service areas has been addressed. Both sides will upon request meet to discuss on-call as well, but no changes will be made without the agreement of the MNA.
Pandemic Committee Participation
- Pandemic preparedness will be a standing agenda item for the Advisory Committee once per quarter and the hospital will meet weekly in the event of a pandemic or surge event upon request of the MNA.
- Add Juneteenth as an additional holiday without giving up any other holidays.
- $2,000 bonus on ratification to full- and part-time nurses, and per diem nurses who worked at least 1,040 hours.
- Per diem nurses who worked less than 1,040 hours but at least 208 hours receive $1,000.
- Evening rotator increase to $2.50
- Permanent evening to $4.00
- Night rotator to $4.00
- Permanent night to $6.00
- Established a $2.00 differential for time spent precepting for any nurse precepting a newly hired nurse, a nurse transferred to a new unit or an agency nurse during the preceptees’ orientation period.
Shift Incentive Bonus
- To address ongoing staffing shortages, a shift incentive bonus program nurses originally negotiated last fall was extended through 9/17/2022.
- Add great grandparents, stepchildren, stepsiblings, stepparents, and step in laws to the existing bereavement list.
Brigham RN Settlement Highlights Issues to Be Addressed for All Nurses in the Commonwealth
The need for better staffing, wages and benefits for nurses in the wake of the pandemic expressed by the nurses at Brigham and Women’s Hospital is an issue shared by all nurses in the state who are feeling devalued and disrespected by an industry more focused on profit margins and the bottom line as opposed to worker safety and patient care, according to the annual “State of Nurses in Massachusetts” survey conducted by Boston-based Beacon Research and commissioned by the MNA.
More than 8 in 10 registered nurses in Massachusetts say the quality of patient care in hospitals has gotten significantly worse over the last two years as the COVID-19 pandemic careened into a fragile healthcare system already burdened by profit-driven staffing shortages and high-risk conditions for patients and nurses. 55% of nurses said understaffing is the biggest obstacle to providing quality care. The number of RNs who said they do not feel that they have enough time to provide patients with the care and attention each one needs jumped to a record high of 71%, up from 60% last year.
Almost two-thirds (64%) of nurses said inadequate pay or benefits is a major challenge. This response is up from 48% reporting lack of pay or benefits in 2021 and 27% in 2019 – a 37-point increase in nurses having a concern about pay and benefits over just three years. Over the last two-years, most nurses have seen RN positions being left vacant (84%). In 2019, just 50% of RNs saw positions left vacant.
The failure to address nurses’ concerns over these issues have dire consequences for the system, as more nurses consider leaving not only their positions, but the profession altogether. Fully 33% of RNs reported planning to leave nursing sooner than originally planned. Among newer nurses with 0 to 5 years of experience, 37% are planning to leave sooner – the highest percentage of any experience group. Another 25% of nurses said they plan to reduce their hours because of their experience with the COVID pandemic and 25% of nurses think they will leave the field of nursing in two years or less.
Read more about the survey at www.massnurses.org/StateofNursing.
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.