Action Summary:
1. Extra picketing needed on Wednesday, April 19th, noon to 6:00 PM outside Worcester Medical Center while Tenet conducts a job fair inside.
2. The St. Vincent nurses will rally April 19th (Wednesday evening): as during prior rallies, we need nurses and other volunteers to cover for them on the picket lines outside the Worcester Medical Center while they meet: 5:30 PM until 8:30 or 9:00 PM, or as long as possible.
3. Picketing round-the-clock is ongoing, and extra help is always welcome. The more the merrier! Contributions to the Strike Fund, as well as expressions of solidarity, have been coming in from far and near, but much more needs to be done. Consult the MNA web page (http://www.massnurses.org) for details. Spread the word!
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Message for Somerville Labor Party supporter:
Hi, Sandy!
Uploaded the bulletin to the same URL ...
(http://users.rcn.com/wbumpus/worcester.html)
A passing thought - has anybody raised the possibility of the city taking over the Med Center (or maybe even the old hospital) by eminent domain? Seems to me if Tenet is refusing to provide safe health care for the citizens, the public has an overriding interest in seeing to it that someone does...
Bill B
Letter (so far unpublished) past president, Massachusetts Public Health Association:
Letter to the Editor:
April 10, 2000
It's the Patient Stupid!
Congratulations to the Globe, specifically its April 7th Editorial "Too many Hours." I vehemently contend that "it is the patient, stupid". Patient safety is at the heart and soul of this protracted strike at the Worcester St. Vincent/Tenet Hospital and it is central in this debate. It is very simple. Patients have a right to receive care that is safe from harm. It is management's "right" and job to staff the hospital. With this right comes "obligations" to do the right and the best thing. At a time when we are trying to prevent medical errors and deaths in hospitals, for-profit Tenet cannot say that they do not have the money. Their history of routine and repeated understaffing should be a harbinger of doom for us. The hospital nurse staffing standards at St. Vincent's/Tenet should be built on what patients need when they are sick. When a hospital doesn't have enough permanent nursing staff to meet these patient needs they can do two things ... hire more qualified nursing staff to meet patient needs by using flex-pools of part-time nurses, or use temporary agency nurses. Or they can retrench, close units, divert admissions or transfer patients to facilities where care can safely be provided. It is unconscionable to have nurses work 16 hours straight when it is not an emergency. That is like having a pilot fly a plane from LA to Boston and then being asked to go on to London. That is a recipe for disaster and only increases the potential for profound error and/or death. Who would fly in that plane? Does the public know? Not only is for-profit Tenet digging their heels in and mandating overtime when it is not an emergency, they are attempting to change the paradigm for hospital care in Massachusetts and jeopardize patient's lives. We need system reform to improve patient safety, and protect patients from harm but we do not need for-profit Tenet's self-indulgence. Public beware!
Douglas RN, MPH
Associate Professor of Health Services
Boston University School of Public Health
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Rx for hospital nurses: unions
Long hours, conditions drive care-givers to seek a solution
By Bruce Taylor Seeman, NEWHOUSE NEWS SERVICE
WORCESTER, Mass., April 15 - When more than 500 unionized nurses walked off their jobs last month at St. Vincent Hospital, analysts blamed the complexities of a troubled health care economy. Hospital nurses nationwide, however, might find a simpler truth in one of the hand-lettered signs on the picket line. "This is not about money," it read. "This is about sleep."
ACROSS THE COUNTRY, the drumbeat is growing: Nurses, traditionally uninterested in the distractions of organized labor, are showing new eagerness to embrace unions. But rather than objecting to pay scales or benefits plans, they are aiming more often at working conditions - depleted staffs, reduced time with patients, jobs that increasingly intrude upon their personal lives.
Union membership is rising. The string of strikes last year - 21 - was about five times the number just four years earlier. More than 1,000 nurses are currently off the job. In California, union nurses have pushed lawmakers to guarantee more nurses on hospital floors.
At the Worcester hospital, where the nurses strike interrupted plans to transfer patients to a new medical complex, the most urgent worry is overtime. Tenet Healthcare Corp. wants its nurses to work extra shifts on demand.
"You got a sick kid, you got a dental appointment, it doesn't matter," Candi Warila, 47, said as she picketed near the hospital's main entrance. "No other industry does this to the employees. They don't care if you have a life."
TOUGH NUT TO CRACK
Hospital officials and insurers characterized the grievances as understandable but difficult to assuage. Current health care dynamics, they said, are testing the limits of all segments of the industry.
What's unknown is whether nurses' relationship with labor will gain more momentum and what long-term effects that might have on the nation's medical network.
The Worcester strike turned sour quickly. To publicize the names of "scabs" who refused to strike, the Massachusetts Nursing Association posted a list on the Internet. Hospital owners hired replacement workers from across the country, delivering them to work in vans with shaded windows.
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North of New York City, meanwhile, 450 nurses at Nyack Community Hospital have been on strike for more than 100 days, the longest walkout in the history of the New York State Nurses Association.
And at Civista Hospital in La Plata, Md., about 125 striking nurses recently voted to return to work after persuading hospital owners to hire 12 new full-time nurses.
In each case, the issue is time - nurses angry that staffing cuts have left them with less time for patients.
MANAGED CARE
The backdrop is a health care system in tumult.
In the early part of the decade, with the price of health care soaring, managed care gained currency as a strategy to encourage competition and control costs. Insurers notified hospitals that reimbursements for medical treatments would decline. That prompted hospitals to squeeze budgets, including the money spent on nurses, who typically represent about a quarter of a hospital's workforce.
Hospital patients, meanwhile, grew sicker. Diseases that might have been fatal in an earlier age now left patients alive but ailing. Hospitals, under pressure to save money, discharged the less sick patients to focus on the direly ill. Technology made nursing much more complicated.
"The industry keeps telling us we won't need as many registered nurses because technology is coming in," said Kay McVay, president of the California Nurses Association. "So, technology came in. It takes more education and sophistication to operate it. But it takes more to read it. And now, we need more RNs."
The ratio of nurses-to-patients actually climbed for most of the '90s, according to a University of Pennsylvania study, dropping for the first time from 1996 to 1997, the last period measured.
But at the same time, the study concluded, a nationally recognized formula for patient sickness showed that the complexity of care has risen at a sharper rate, more than offsetting any gains for nurses.
In the past three years, about 15,000 nurses have joined the Service Employees International Union, the organization said. About 105,000 nurses now belong.
Another 170,00 belong to the American Nurses Association. Of those, about 60 percent use the organization for collective bargaining, according to the ANA.
The overall numbers remain relatively small. Only about 15 percent of America's 2.6 million nurses are unionized, according to government and industry estimates.
But last year's record-setting number of strikes, followed this year by walkouts in Massachusetts, New York and Maryland, have unfolded in a new context, organizers say.
Particularly objectionable, nurses' advocates said, are attempts by hospitals to save money by manipulating nurses' shifts. Some nurses are simply told to switch floors for a day. Others are called at home and told not to report to work. The worst practice, nurses said, is being ordered to work an overtime shift, even with just a few minutes' notice.
Administrators at St. Vincent defended mandatory overtime as a "patient care safety net" used by many hospitals to cover staffing shortages in emergencies. Union nurses are fighting the provision "as a test case," said Paula Green, the hospital's director of public relations.
Michelle Nawar, a communications specialist for the National Nurses Association, called the practice "disgusting."
"We're seeing employers use it more," she said. "But it's not only totally inhumane. If I were a patient, I wouldn't want a nurse who's been on for 20 hours. It's not safe."
Richard H. Wade, a senior vice president of the American Hospital Association, called nurses' strikes "understandable." But hospitals should not be blamed for shrinking budgets, which are being squeezed by insurance companies offering smaller reimbursements for care and other factors, he said. "The costs of prescription drugs are going up, hospitals are expected to invest in new technology, and many ... need to replace their facilities," Wade said. "The nurses feel no one is concerned with what they're dealing with. But I think everyone understands hospitals no longer have the options. It's playing out with the nurses' turmoil."
Richard Coorsh, a spokesman for the Health Insurance Association of America, acknowledged that the managed care system is often blamed for enduring health care woes. But until managed care was introduced, he said, health care costs were skyrocketing and the roster of uninsured Americans was growing rapidly.
"I can understand the concerns expressed by nurses and other health care professionals," Coorsh said. "But we have to understand that millions of Americans don't even have the luxury of the debate because they don't have insurance at all."
THE NUMBERS
To underscore their worries about staffing, nurses point to a November report from the Institute of Medicine, a federal agency that estimated preventable medical errors are responsible for up to 98,000 hospital deaths each year.
Charles Idelson, communications director for the California Nurses Association, called current hospital dynamics a "lethal mix" - inadequate staffing, fatigued workers, registered nurses being replaced by lesser trained staff.
"Surprise, surprise," said Idelson, editor of Revolution, a new advocacy magazine for nurses. "More patients are dying in hospitals." The nursing walkouts are particularly vexing because the nation's nursing shortage is worsening. About 300,000 new nurses went to work in the early '90s. But nursing school enrollments dropped about 5 percent in both 1997 and 1998, and more nurses are quitting the profession for other jobs, the ANA said.
Nurses working harder and faster are more vulnerable to job hazards such as back injuries or needle sticks, according to the ANA.
"When I was practicing in the late '80s, I was typically caring for maybe five patients, two or three who were acutely ill," said Cheryl Peterson, a senior policy fellow at ANA. "Now, you have a nurse who has five patients, all of whom are acutely ill. They provide more complex treatment - more complex dressing change, more frequent suctioning, more frequent medications via IV, and more acute psychological care. It's not going in and handing someone a pill."
Some hospitals are trying harder to recruit nurses, either offering preferred shifts or signing bonuses. Sometimes the incentives are effective. But not always.
"The word is out: It ain't worth the money," McVay of the California Nurses Association said of the bonuses. "It's been happening for a year and a half. They can go anywhere from $3,000 to $7,000. It depends on the hospital and how desperate they are."
From 1990 to 1993, nurses struck about 15 times a year, according to the Bureau of National Affairs. Stoppages became less common in the middle of the decade - only four in 1995. But in 1998, the total jumped to 20. Last year, it rose slightly to 21.
The BNA, echoing the nurses unions, said recent walkouts are more likely rooted in complaints about mandatory overtime, inadequate staffing and worries about patient care.
Massachusetts, meanwhile, has become a hotbed of union activity. The Massachusetts Nurses Association persuaded about 1,550 nurses at five hospitals to unionize in a 12-month period in 1997-'98, according to Judith Shindul-Rothschild, an associate professor at the Boston College School of Nursing.
Julie Pinkham, the union's director of labor relations, said it has not been easy organizing nurses to walk picket lines around St. Vincent Hospital. "Sometimes it's like herding squirrels," Pinkham said. "This isn't what they do. They're nurses. And they're going to have to learn it doesn't matter what people think."
On a recent morning, dozens of striking nurses picketed outside the hospital, complaining little about a surprising cold snap and speaking with one voice about the nurses who had not joined them.
Karen Berni-Giarusso, on strike for the first time in her 20-year career, wore a sign that said "Every patient needs a nurse" and expressed little tolerance for her strike-breaking peers.
"How are they going to live with themselves?" she said.
© 2000 Newhouse News Service
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Hospital says nurses' agenda to set state OT precedent
Tuesday, April 18, 2000
by Franci Richardson, Boston Herald
As striking nurses and management for the new Worcester Medical Center prep for a second mediation session, a hospital official accused the union of using the walkout to set a statewide standard ridding all nursing contracts of mandatory overtime.
``It looks like they're going to set a precedent here,'' said Paula Green, hospital spokeswoman. ``They're using us as a jumping off point to negotiate it out of other contracts at a later date.''
While HealthAlliance of Fitchburg recently settled a contract that includes the Worcester sticking point of mandatory overtime, Green is convinced the Massachusetts Nursing Association won't allow that again.
``The nurses they're trying to help are really losing because they're going without pay and benefits over an issue that was resolved elsewhere,'' she said.
The 535-member nurses union - on strike for nearly three weeks - yesterday rejected the notion that it is a pawn in a nursing association campaign.
``Absolutely not,'' said Debra Rigiero, co-chair of the nurses bargaining team. ``Since we have organized, the hospital has tried to make it seem like a third party is going to come in and speak for us and that has never been true. We are the MNA.''
Friday's negotiation session, scheduled for 10 a.m., is a federal mediator's second attempt at resolving the conflict in two weeks. The mediator, Commissioner Jack Healey of Worcester, did not return calls yesterday.
Both sides met for six hours April 7, but neither would budge on the overtime issue.
The nurses' union has maintained that Tenet Health Care, the hospital's management company, is trying to solve its problem of inadequate staffing with forced overtime.
``We're being used to replace a shift and that's not what mandatory overtime is for,'' said Rigiero.
Green said that kind of staffing would be financially irresponsible.
``It doesn't make sense to staff that way,'' Green said. ``It's only used when you have a spike in the census. It's a last resort.''
Meanwhile, the picket line outside Tenet's St. Vincent Hospital, which earlier this month moved its staff and equipment to the newly built Worcester Medical Center, has thinned.
Rigiero has called on union members to donate 12 hours a week to protesting, but at least 100 nurses have found other jobs, she said.
The striking nurses have been replaced by hired nurses at the U.S. Nursing Corps. of Denver, Colo.
The union estimates the ``scab'' nurses are being paid $4,000 a week, including food and lodging, but the hospital refused comment on the cost.
Copyright by the Boston Herald