Tenet Breaks Off Talks With St. Vincent Nurses After Only 20 Minutes,
Refuses to Budge on 16 hour Demand, Refuses To Divulge Staffing Patterns

Below is our press release detailing the terrible result of today's
negotiation. Tenet came in for all of 20 minutes to tell the nurses they
would accept nothing less than mandatory 16 hour shifts. It is clear that
Tenet is taking a hard line in these talks. Now more than ever, these nurses
need and deserve our support.

FOR IMMEDIATE RELEASE
April 21, 2000
Contact: David Schildmeier - (781) 821-4625 x717 or (508) 426-1655 (Pager) or
781-249-0430

Friday's Talks Break Down Again With No Resolution
St. Vincent RNs' Strike Continues
Tenet Continues to Demand Mandatory 16 Hour Shifts

WORCESTER, Mass. -- After a negotiating session today that lasted less than
an hour, talks between the St. Vincent Hospital nurses and Tenet Health Care
broke down after the hospital refused to withdraw its demand for mandatory
16-hour shifts as a means of staffing the hospital in non-emergency
situations. The impasse will keep the nurses on the picket line as the strike
enters its fourth week.

"We are deeply disappointed that Tenet refuses to negotiate over the issue of
mandatory 16-hour shifts, and in so doing, is forcing this strike to
continue," said Sandy Ellis, spokesperson for the nurses bargaining unit. "We
have already made a concession granting up to four hours of mandatory
overtime and were hopeful that today's negotiations would result in talks
leading to a compromised settlement. Tenet has said it will not change its
position, and will not come back to the table unless we accept 16-hour shifts
as a means of staffing this hospital. We have already made an enormous
concession in meeting them half way, we cannot ever accept 16-hour shifts. It
is unsafe for nurses, and more importantly, it is dangerous for our patients.
"

The hospital also refused to stay and bargain over other remaining issues,
including the move the Worcester Medical Center, and most importantly, issues
related to staffing levels in the new facility. The issue of staffing levels
is inextricably linked to the issue of mandatory overtime because the only
reason mandatory overtime becomes a problem in hospitals is when there is a
shortage of nurses on staff. The hospital has come to the table demanding
mandatory overtime, stating that they need this provision to staff the
hospital in the future.

According to Debra Rigiero, co-chair of the nurses bargaining unit, "The fact
that they will not even discuss staffing issues at the new hospital makes the
nurses even more fearful and distrustful of Tenet's intentions regarding
mandatory overtime. We have a legal right to this information, and it is an
appropriate subject of bargaining, and we are left asking ourselves, why are
they so afraid to provide us with this information? A nurse who interviewed
with the hospital on Wednesday was told by a Tenet manager that
nurse-to-patient ratio in the new facility would be 12 patients per nurse. If
this is the case, there is not doubt that they are intending to use mandatory
overtime to staff this hospital, and of greater concern to patients, the
staffing levels in the new facility will be patently unsafe."

The nurses have called for an emergency meeting for its rank and file
membership tomorrow, April 22, 2000 from 2 - 4 p.m. to update them on what
happened in the brief negotiations today.

At the last negotiating session on April 7, the nurses made a significant
concession to resolve the dispute by agreeing to work up to four hours of
mandatory overtime. The nurses' proposal would allow management to mandate a
nurse to work two hours of overtime plus two additional hours in the event of
unforeseen circumstances. This would allow the hospital to fill its periodic
staffing shortages. Additionally, a nurse would have the right to refuse
mandatory overtime if and when she feels too fatigued or impaired to provide
safe patient care, and the mandated hours would move to the next nurse in the
rotation.

The proposal to place limits on mandatory overtime mirrors a number of
contract agreements MNA-represented nurses have negotiated at facilities
where poor staffing conditions exist and mandatory overtime is used to
compensate for lack of adequate staffing. The proposal also responds to CEO
Bob Maher's public statements that, in most cases, nurses would not be
expected to work more than two to three hours of mandatory overtime.

For its part, Tenet continues to demand the right to mandate 16-hour shifts.
Under their proposal, a nurse working an eight-hour shift would be provided
only one hour's notice that he or she would have stay an additional eight
hours. Those who are mandated would be paid double time.

The nurses have been attempting to negotiate their first contract with Tenet,
the nation's second largest for-profit hospital chain, for more than two
years. The 615 nurses have organized a union and been using the collective
bargaining process to address their primary concerns about inadequate
staffing levels and deplorable working conditions under Tenet management.
Tenet's staffing levels are the worst of the 85 facilities where the
Massachusetts Nurses Association represents nurses in the state. St. Vincent
nurses on the day shift are regularly assigned between 8 - 10 patients on
days, and between 12 - 14 patients on nights. A safe assignment is no more
than six patients on days, and 8 patients on nights. The nurses have filed
more than 450 official reports of unsafe staffing assignments that
"jeopardize patient care."

Tenet purchased St. Vincent Hospital in 1997, and has also built the new $215
million Worcester Medical Center in downtown Worcester. Tenet was scheduled
to open the new facility and move the patients into it on April 1, 2000. The
move was postponed for two days because of problems with care being delivered
by more than 120 replacement "scab" nurses provided by U.S. Nursing Corps, a
Denver-based firm that specializes in providing strike breaking nurses to
hospitals involved in labor disputes. The nurses are paid more than $4,000
per week as well as food and lodging. The move to Worcester Medical Center
took place on April 3, 2000. The MNA continues to receive numerous reports
from employees and physicians inside the facility, as well as from patients
leaving the facility that the nursing care being provided is very poor, and
that the hospital is in a state of chaos.

Support for the nurses continues to build within the Greater Worcester
community as well as from throughout the state and nation. On Tuesday, the
Worcester/Framingham Central Labor Council, Community Caring for Nurses (a
newly formed community activist group) and the Massachusetts Interfaith
Committee for Worker Justice held a Candlelight Vigil which was attended by
more than 1,000 citizens, including a number of religious, political and
community leaders.

David Schildmeier
Director of Public Communications
Massachusetts Nurses Association
800-882-2056 x717
508-426-1655 (pager)
dschildmeier@mnarn.org <mailto:dschildmeier@mnarn.org>

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Immediate Need! Coverage for picket lines at Worcester Medical Center while
strikers meet tomorrow (Saturday): 2:00 to 4:00 PM - and ever stronger
support by walking the lines with the valiant strikers round-the-clock!
Financial contributions to the strike fund, plus every manner of material and
moral support, should be at the top of the agenda of every supporter of safe
patient care and the integrity of the nursing profession!

--------------------------------------------------

St.Vincent Strike: Directions:

.Directions to St. Vincent Hospital:

Take the Mass Pike to exit 10B which will say Auburn exit then take 290 to
Worcester. Get off at the Kelly Square Exit 13. Take a right at the lights
and go up the hill. At top of hill bear to the left of fork go through the
light you will see the Hospital on your left.

.To Worcester Medical Center:

From 290 East or West use Kelly Square Vernon Street exit. Go through Kelly
Sq. take Green St.(To the right of Merit gas). Go to end of Green St.- take
right at lights. Follow past Fashion outlets, Medical Center in on your right
across from Worcester Centrum.

.To MNA/St. Vincent Strike Office, 29 Endicott Street . Worcester, MA .
508-792-2181

Directions from Mass Pike--Auburn Exit 10 - After leaving Toll Plaza, take
290 East towards Worcester. Take Exit 12 (Rt. 146 Brosnihan Square/Millbury).
At bottom of ramp, take left under 290. Follow street to end. Take right
-this is Quinsigamond Avenue. Then take 2nd right - this is Endicott
Street. We are at 29 Endicott Street.

Directions from 190 or 495-Take 290 West. Take Exit 12 - before you reach end
of ramp, take a sharp right (Harding Street). Take a left Ashmont Street) at
the Stop sign. Follow this street to the end. Take right onto Quinsigamond,
then take 2nd right which is Endicott Street.

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A Financial Support Fund for the Nurses Has Been Established:

.Make checks payable to: MNA St. Vincent Hospital Bargaining Unit Strike Fund

.Mail payments to: MNA Strike Headquarters, 29 Endicott Street,
Worcester, MA 01610

--------------------------------------------------

Message from Sandy Ellis, spokesperson for striking nurses:

This was forwarded to me after it had made the rounds a few times. Is this
cool or what? Anyone who's been on the picket line sure could appreciate this:

Lessons from the picket line

* Picket Line Food can be very fattening.
*Dr. Carroll has a heart of gold.
*Worcester firefighters and police officers are wonderful and very giving
humanitarians who welcome the chance to help those in need.
*Fallon Docs live in fear for their jobs.
*D'erricos makes an awesome vegetable soup.
*You'll never forget the people you picket with.
*True friends and professionals will acknowledge those they know despite
being on the opposite side of an argument.
*Sometimes you need to stand up for what you know is right no matter how hard
it is.
*There are plenty of opportunities to nurse if Money is your driving force
and you don't care about people.
*Nurses who work mainly for financial gains are not good patient advocates.
They are too selfish.
*Dr. Day is the bravest Doctor St. V's/WMC has.
*Dr. Jaffee is a kind and caring human being.
*If you're a nurse at HEART you can't be bought. You remain a patient
advocate despite the financial effect on you.
*There is comfort in solidarity.
*Worcester Police officers have the warmest gloves.
*Worc. Police officers make sure their men all get breaks.
*There's lot's of parking behind the Central St. fire station.
*Nurses and Teamsters have very different ideas about how to picket.
*Donna M is a great T Shirt sales person.
*Marlena's grandmother has a lot of stamina and cold tolerance for an 80 y/o.
*Positive messages like,"I support the nurses" are much more powerful than
negativity and the use of the word "Scab."
*Tenet was Originally a film making company in Hollywood.
*Those who want others to take Ethics classes tend not to be Ethical
themselves.
*The driveway at the Summer St. entrance needs to be fixed because most cars
bottom out and scrape the pavement as the enter.
*The signage at WMC is not adequate. Patients all go to the loading Doc
looking for the ER. There is no Exit sign at the Summer St. exit, so everyone
tries to enter there. The DO NOT ENTER signs cannot be seen until you've
already entered.
*Plastic Ponchos do not make good trash bags. The trash falls out the hood
and arm slits.
*"Sister Mary" is a very charitable woman.
*Firefighters at the Providence St. station don't keep soap in their bathroom.
*The Ambulance (ER) entrance should not be located next to the Centrum.
Traffic gets bottle necked when concerts get out and ambulance entry will be
delayed.
*A school bus with children holding signs to the windows that say "I support
the nurses" can raise the temperature 20 degrees on the coldest of days.
*Tenet's pocket really are lined with gold.
*Elderly Drivers have poor peripheral vision.
*Any weather is possible in April in New England.
*Picket signs should be waterproof.
*If you spend enough time walking around downtown with a picket sign around
your neck it starts to feel natural and you no longer feel silly.
*Worcester Police love VOLUNTARY overtime.
*Worcester really is a union town and the unity carries form one union to
another.
*Breezes are strongest at the "Golden Triangle."
*The bathrooms in the Outlet Mall are at the wrong end on the building.

Thanks for the daily updates - I really appreciate them. I know it's probably
a bit of work for you, but your updates are timely, accurate, and
interesting. Thanks again.

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Letter by veteran staff nurse from Boston's Brigham & Women's Hospital:

Letter to the Editor
Spectrum Magazine

I have been a staff nurse for thirty-three years. During that time, I have
witnessed many changes in technology, in nursing, and in health care.
Fortunately, for the past twenty-nine years, I have worked at an institution
that has a collective bargaining agreement. Through our nursing union, we
have been able to negotiate with our employer to achieve contracts that have
not only improved the salary and benefits for nurses, but have provisions to
protect our professional practice, and safeguard patient care.

During recent years, as the delivery of health care has undergone
reconstruction and revision, there has been a significant impact upon the
delivery of nursing care. Every nurse in practice today knows the scenario
of increased acuity and decreased length of stay. Nurses also know about care
re-design, downsizing, and changes in the bedside staffing mix. Our
institution was, and is, impacted by all of these changes. Nursing care has
changed as well.

Through union negotiations, we have been able to work with hospital
administration to protect our patients and ourselves from some of negative
effects of these changes. When staffing was reduced to levels that we
believed was unsafe for patient care, the strength of our union forced them
to return staffing to prior levels. When mandatory overtime became abusive,
we were able to negotiate language into our contract that has almost
eliminated forced overtime. When the number of nurses available was
insufficient to meet minimum staffing levels, through our union grievance
process, we were able to force hospital management to hire more nurses and
re-construct a float pool. Once, during the past thirty years, our
bargaining unit voted to authorize a strike. It was not over money or
benefits, it was over patient care issues. We refused to compromise patient
care by allowing unlicensed aides to replace nurses at the bedside.

As a union nurse, I am proud of the importance that my union places on
professional practice and the delivery of safe patient care. When hospital
administration focuses too intently on the bottom line, patient care becomes
an after-thought. Nurses are then the only ones able to speak up to protect
patients from sub-standard care. Unfortunately, nurses who lack the strength
of a union are subject to discipline and dismissal when they advocate for
their patients.

The nurses of St.Vincent Hospital and Worcester Medical Center in
Massachusetts are on strike over issues of safe patient care. They placed
their own jobs on the line - giving up paychecks, health insurance, and other
benefits - on behalf of their patients. These dedicated nurses believe that
this sacrifice is necessary to protect patient care from a for-profit health
care corporation that places the well-being of their shareholders above the
welfare of patients.

Spectrum Magazine is seriously jeopardizing this effort by accepting and
displaying advertising from nursing agencies that provide strike-breaking
replacement nurses. It would seem that the owners / management of this
publication have embraced the concept of corporate greed, and turned their
backs on the ideals that should be encouraged - professionalism, integrity,
accountability and respect.

I strongly urge you to reject further advertising for strike-breaking, scab
nurses.

Teana Gilinson, RN
Staff Nurse

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Message from Ann Eldridge-Malone of MNA's Congress on Health Policy &
Legislation:

For those who haven't seen it, I was heartened to see an actual copy of the
4/19/00 Worcester paper with the below article front page above the fold! It
ran next to a powerful picture of the Tuesday night candlelight vigil for the
St V nurses (which Secretary Galvin was asking for directions to -- does
anybody know if he attended/spoke?)

(Ed.'s Note: That great article ran in Wednesday's strike bulletin. The
picture is attached to this bulletin as a file attachment. -- SE)

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Nursing schools see enrollment steadily shrink
Drop especially big in Northeast

Friday, April 21, 2000

By Gerard F. Russell, Telegram & Gazette Staff

The outcome of the battle over mandatory overtime in the St. Vincent Hospital
nurses strike may well have long-term implications as the health care
industry deals with a shortage of registered nurses.
Enrollment in the nation's nursing schools dropped last year, the fifth
year in a row. Some people in health care say the drop does not bode well for
the profession.
The decline was in entry-level, bachelor degree nursing programs. The
drop was 4.6 percent last fall in a sampling of schools surveyed by the
American Association of Colleges of Nursing.
Enrollment in master's degree nursing programs nationwide also dropped
slightly, about 2 percent from the previous year.
The drop was especially steep -- 7.4 percent -- in the Northeast,
according to the association.
It is estimated the supply of registered nurses will not meet the demand
by 2005. By then, a shortage of more than 6,000 registered nurses is
projected for Massachusetts, according to Judy Shindul-Rothschild, an
associate nursing professor at Boston College in the Center For Nursing
Research. She researches trends in nursing.
The nursing shortage has been acute in the past six to nine months at
the UMass Memorial Medical Center-University Campus in Worcester, according
to spokesman Mark L. Shelton. The hospital had openings for 100 nurses this
month.
"That is a little less than it has been. We added about 30 RNs over the
past quarter, some per diem," Mr. Shelton said.
The hospital has held a job fair and continues to recruit, he said.
Some employers are offering hefty bonuses as a lure to fill jobs. The
Visiting Nurse Association of Central Massachusetts entices registered nurses
with bonuses of up to $2,000.
Karen H. Green, president and CEO of the VNA Care Network, said not as
many young people are entering the profession.
"Young women and men are making other choices," Ms. Green said.
In today's robust economy, young people have many more employment
opportunities. Many are more profitable and less demanding than caring for
the sick.
"Nursing is a very difficult, demanding profession. It takes a lot of
time, effort and giving," Ms. Green said.
While enrollment is down nationwide, Worcester State College's nursing
program has had a stable number of graduates over the years, according to
Mary Lou Lovering, chairman of school's Department of Nursing.
The school began its nursing program in 1986 during one of the many
cyclical nursing shortages. It still consistently graduates 40 nurses a year
with bachelor degrees, although the number of applications has dropped.
This school year there were 199 undergraduate applications to Worcester
State's nursing program, compared to 247 last year, according to a school
spokesman.
In the 1980s, Ms. Lovering noted, the college received up to 300
applications.
"I think there is a decrease in applicants who are high school age. A
lot apply, but change their mind," Ms. Lovering said.
Years ago, career tracks for women were limited to being teachers,
nurses or secretaries.
"I just think there are more things open now (to women)," Ms. Lovering
said.
The projected nurses shortage is for those with bachelor of science
degrees in nursing and advanced degrees, Ms. Lovering said.
"There is already a shortage of nursing faculty," she said.
The growing shortage throughout the profession differs from cyclical
shortages of the past, some say.
"It is different from the others because of the aging of the work force.
People will be leaving in droves in 10 to 15 years. There will be a lot of
retirements," Ms. Lovering said.
Karen A. Higgins, a spokesman for the Massachusetts Nurses Association,
said the shortage is worrisome.
"We are putting a task force together to look at the shortage of nurses.
It is only going to get worse," she said.
There was a surplus of nurses nationwide seven to eight years ago. Ms.
Higgins said she was in California at the time and some nursing schools
closed because there were already too many nurses.
"Boy, are we seeing the results of that," she said.
Audrey M. Silveri, director of nursing programs at Anna Maria College in
Paxton, suggested the profession has to reach out to high schools to present
a positive image of nursing.
"We don't even have candy stripers in hospitals anymore. It was a way of
recruitment," Ms. Silveri said of the teen-age volunteers who wore striped
uniforms.
Anna Maria nursing students are already registered nurses who are
seeking advanced degrees and training.
While most in the field are aware of the problem, there does not appear
to be a concerted effort to do anything about it, she said.
Recently, Ms. Silveri said she has been most surprised to get calls from
nurses who have come from South Africa, Zaire and Kenya to the United States
to work.
Nursing shortages are nothing new, according to Ms. Shindul-Rothschild,
the Boston College professor, who has been researching trends in the
profession since the 1980s.
Shortages were a chronic problem because salaries were low, working
conditions were difficult and productivity demands were high.
By 1989, the U.S. nursing shortage was eradicated, and hospitals
concentrated on using a majority of registered nurses for patient care,
instead of less skilled, unlicensed workers, Ms. Shindul-Rothschild said.
Health care trends shifted in the early 1990s in Massachusetts and other
states that cut regulations on health care to create more competition, she
said.
She said she warned at the time that the effect of managed care on
nursing would be costly.
With more competition, coupled with no limits on the discounts that
insurers could negotiate with hospitals, quick fixes led to cutting labor
costs and then to more drastic measures, such as hospital closings.
In Massachusetts, 15 hospitals closed, about one or two a year, with a
slow squeeze on the health care system. In the first 18 months of deregulating
the hospital industry in 1992 and 1993, the number of lost beds equaled what
was lost in the entire decade of the 1980s, Ms. Shindul-Rothschild said.
Labor is a huge chunk of hospital costs, and hospital managers looked
there to cut.
More unlicensed health care workers were used and many registered nurses
were driven out of the work force, she said.
"They went back to the failed models of nursing care," she said.
"We are back to where we were in the mid-'80s, now that nurses are
driven out of the system because they could not, or would not, put themselves
in the position to jeopardize their own license," she said.
As seasoned nurses, some of them in special care units, leave, there are
fewer mentors for new nurses.
From a nursing standpoint, the solution is to go back to the basics.
"You go back to what we know works," Ms. Shindul-Rothschild said. You
treat nurses with dignity and respect. Yes, that might mean you staff more
than you want to, but not more than you need to."

© 2000 Worcester Telegram & Gazette

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St. Vincent works on filling space
Biotech nonprofit is moving out of park

Friday, April 21, 2000

By Emilie Astell, Telegram & Gazette Staff

WORCESTER-- Massachusetts Biomedical Initiatives is expected to move into the
St. Vincent Hospital campus on Vernon Hill as soon as a lease agreement is
finalized, according to Robert E. Maher Jr., chief executive of the St.
Vincent Healthcare System.
Mr. Maher said a lease for 20,000 square feet of space would be
completed "any day now" to allow MBI to move its offices and start-up
business services from the Massachusetts Biotechnology Research Park off
Plantation Street.
MBI would use space on two floors for laboratories and offices.
"We're just waiting for our lawyers to review the draft lease," Mr.
Maher said yesterday.
Mark Roosevelt, MBI president, confirmed that the nonprofit economic
development group is making a transition from its current space.
MBI occupied about 12,000 square feet in Three Biotech, a building in
the biotech park. Besides marketing the Worcester area to life sciences
companies, the organization runs an Innovation Center for start-up companies.
MBI also operates a 20,000-square-foot Innovation Center in Boston.
In addition to MBI, Mr. Maher said, he is negotiating with two medically
related large companies. He declined to identify the companies but said they
may use major portions of the 450,000-square-foot building.
St. Vincent spokeswoman Paula L. Green said administrators are exploring
such uses as congregate housing and assisted living for seniors in parts of
the building.
Administrative offices and some medical services will continue to use
70,000 square feet within the building, Mr. Maher said. Among those services
are a 50-bed inpatient psychiatric unit, an outpatient radiation oncology
unit and an ambulatory care clinic.
Other buildings on the hillside campus are being used for a senior
center and Providence Extended Care Center, a nursing home that is part of
the St. Vincent system.
Most of St. Vincent's medical services and patients were moved from the
hospital to Worcester Medical Center on April 3 in the middle of a strike by
hospital nurses. The nurses went on strike March 31 after failing to reach a
first contract with St. Vincent owner Tenet Healthcare Corp., of Santa
Barbara, Calif.
The two sides are divided over the issue of mandatory overtime. Both
sides return to the bargaining table at 10 a.m. today.

© 2000 Worcester Telegram & Gazette

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