Message from MNA Director of Public Communication:

In the interest of keeping the many supporters and interested parties to the
St. Vincent Nurses' strike informed on recent developments, below is a
summary of events from last week. Please cross post to your email lists, and
visit the St. Vincent Nurses Strike Page on the MNA Web site for new
developments: <http://www.massnurses.org> www.massnurses.org.

(Ed.'s Note: During a break in this evening's meeting of the Massachusetts
delegation to the ANA House of Delegates, someone noted how widely these
daily strike bulletins were being spread, coining the term 'word of mouse.'
-- SE)

FOR IMMEDIATE RELEASE
May 9, 2000
Contact: David Schildmeier (781) 821-4625 x717 or (508) 426-1655 (Pager) or
781-249-0430

St. Vincent Hospital Nurses Strike Update

Talks Break Down After on May 4th As Tenet Refused to Budge on Demand for 16
Hours of MOT

Senator Kennedy Visits Nurses on the Picket Line, Calls Mandatory 16 Hour
Shifts Unacceptable
Entire Mass. Congressional Delegation Sends Letter to Tenet Urging CEO to
Come To Worcester

Fallon Pulls Day Surgery Patients From Worcester Medical Center, Calls Upon
Tenet to Reach Settlement With the Nurses

DPH Reports that Three Replacement Nurses Were Fired for Substandard Care,
DPH and HCFA Conduct Survey of Facility in Response to Patient Care Concerns

WORCESTER, Mass. - The past week has seen the pressure on Tenet continue to
build as patient complaints and stories of deteriorating care made headlines,
and political pressure intensified in favor of a fair settlement with the
nurses on strike. Still, at the last round of negotiations on May 4, Tenet
once again refused to budge from its demand to have the right to mandate up
to eight hours of overtime, once again causing the talks to break down after
nine hours of negotiations.

For their part, the nurses worked hard to reach an agreement, making a major
concession in this round of talks. Initially, the nurses were opposing any
language in their contract allowing mandatory overtime. On April 7, they
modified their position, allowing up to two hours of overtime each shift, and
an additional two hours of overtime per shift in emergencies. At the May 4th
session, the nurses compromised further with a proposal that would give the
hospital the right to require each nurse to work up to for hours overtime at t
he hospital's discretion, provided the number of mandatory shifts was held to
eight per year and to no more than two per quarter. A nurse would still
retain the right to refuse mandatory overtime if she felt too fatigued to do
so and provide safe patient care.

The hospital would not relinquish its demand for the right to require eight
hours of overtime per shift, or 16 hour shifts in total, with the last eight
paid at double time.

"In essence, we gave this hospital an additional 20,000 hours of mandatory
overtime per year, on top of the voluntary overtime we already give them,"
said Sandy Ellis, RN, spokesperson for the nurses' bargaining unit. "Given
that this hospital has never had to use mandatory overtime in the past, we
believed this would provide more than enough of the flexibility they say they
need. Their refusal to accept this compromise once again confirms our worst
fear, which is that they really intend to use mandatory overtime on a regular
basis to staff this hospital."

At the end of the negotiations, the hospital made a final proposal to have
the nurses end the strike and come back to work, while both sides submitted
their last best offer on the issues of mandatory overtime, as well as the
issue of flex time to an independent arbitrator. The type of arbitration
proposed by the hospital is sometimes referred to as "baseball arbitration,"
where the arbitrator can only choose one of the proposals presented.

The nurses refused the offer to go to arbitration. In rejecting the offer,
the nurses pointed out that the issue of flex time had already been agreed
upon by both parties. Flex time is a policy where nurses are sent home on
days the hospital feels census is low, forcing the nurse to compensate for
their time lost with vacation time. At a previous negotiating session, both
parties had agreed to phase out this policy over a three-year period.

"The most important reason for rejecting this proposal is that we cannot and
will not place the future of our practice, the integrity of our nursing
license, or the safety of our patients into the hands of a third party,"
Ellis explained. "We have made a commitment to ourselves, our patients and
this community that we will not accept a contract that places nurses in
jeopardy of working forced 16-hour shifts. The entire community has rallied
behind this position, our nurses have put their very livelihoods on the line
for this position, we can't afford to roll the dice and hand over this
decision to someone with no vested interest in its outcome," Ellis added.
"Tenet has once again attempted to use a public relations ploy to avoid doing
what is best for its patients and this community. We will not allow them to
escape their responsibility to us or their patients."

DPH Release Report of Poor Care by Nurse Replacements

As the strike continues into its second month, there are signs of continued
problems inside the new Worcester Medical Center. On May 2, the Department of
Public Health reported that three replacement nurses hired by Tenet
Healthcare Corp. had been fired. The report was the first public report by
DPH as part of a disclosure process mandated by Gov. Paul Cellucci the week
before. Two of the nurses - part of a contingent of 125 brought in by Tenant
from Denver-based U.S. Nursing Corps - were terminated after leaving a
surgical patient unattended in a postoperative recovery room. The third nurse
was fired after delivering a newborn to the wrong mother for nursing. The
following day, another patient appeared on television to recount her
experience of being give an overdose of morphine, 10 times the dose ordered
by her physician, by one of the replacement nurses. DPH and the Health Care
Financing Administration have also begun a detailed inspection of the
facility to uncover any deficiencies that might affect patient care.

Secretary of State Calls for Investigation of Nursing Board for Licensing of
Replacements

In response to the problems with replacement nurses, Secretary of State
William Galvin issued a call for an investigation into whether the state
licensing officials at the Board of Registration in Nursing "recklessly"
accelerated their review of the replacement nurses to support Tenet Health
Care in breaking the nurses strike. In a statement to the press, Galvin
stated, "it appears that in their reckless effort to assist Tenet Health Care
Corp. import strikebreaking nurses, the Board of Registration in Nursing has
put at risk the health of our citizens." Oversight hearings on the Board of
Registration in Nursing and the issues outlined by Secretary Galvin will be
held before the Joint Committee on Government Regulations on May 11, 2000.

Fallon Community Health Plan Pulls Day Surgery Patients to Pressure Tenet to
Settle

On May 3, Fallon Community Health Plan, the regions largest insurer, upped
the ante on its efforts to prod Tenet to reach a settlement by announcing its
decision to begin shifting its day surgery patients away from Worcester
Medical Center to another facility. The move is the second Fallon has made to
convince Tenet to negotiate an end to the strike. A week prior, Fallon CEO
Eric Schultz appealed to Tenet CEO Jeffrey Bareback to come to Worcester and
"do whatever it takes to settle this strike quickly." Both moves by Fallon
were based on increasing complaints by patients about the quality of care
being delivered at Worcester Medical Center.

Mass Congressional Delegation Urges Tenet CEO To Come To Worcester to Reach
Settlement

Also on May 3, the entire 12-member Massachusetts congressional delegation
sent a letter to Mr. Bareback of Tenet, urging him to personally participate
in the talks to end the strike. The letter read, "We are seeking a quick,
fair resolution of this dispute because we are concerned about the lasting
impact of this strike on Worcester and Central Massachusetts. The nurses on
strike are trained experts in their field and we believe that patient safety
and quality of care for the patients at St. Vincent's Hospital could be
compromised the longer the strike continues."

While this pressure did not convince Tenet to change its position, it did
strengthen the nurses' resolve to maintain their strike and stand firm in
their fight for safe patient care. They were further strengthened by a
rousing demonstrations of support on Friday, May 5, 2000.

Sen. Kennedy Joins Nurses on Picket Line, Condemns Tenet for Stance in Talks

First, Senior Massachusetts Senator Edward M. Kennedy electrified the nurses
with a rousing speech of support during a rally he joined on the nurses'
picket line. More than 350 nurses, political leaders, labor leaders, and
citizen supporters attended the event, as Sen. Kennedy made clear to the
crowd on which side of the line he stood on this issue. Calling nurses the
backbone of the nation's health care system, Kennedy strongly criticized
Tenet for its stance in this dispute, and called upon them to reach an
equitable settlement with the nurses.

"What's intolerable, what's unacceptable, what's unworthy of any American
company is not to treat those nurses with the dignity and respect that they
deserve," Mr. Kennedy said. "They're part of our hour heart, part of our
community, part of our soul, and we insist that they be treated fairly - no
required, forced overtime."

Mass. Teachers March With Nurses

Later that day, the Massachusetts Teachers Association, who were holding
their annual meeting at the Worcester Centrum Center, marched all 1,500 of
their members out of the building and onto the picket line to join the St.
Vincent Hospital nurses. The crowd of picketers and marchers represented the
largest gathering yet on the nurses' picket line.

Nurses From All Over State Celebrate Nurses Week With Day on St. Vincent Line

Finally, on Sunday May 7, the nurses from across the Commonwealth and from
around the nation celebrated National Nurses Week (National Nurses Week) with
a Nurses Day on the St. Vincent Hospital Nurses Picket Line. The event drew
more than 600 nurses from 28 different hospitals and health care facilities
in the Commonwealth, with nurses traveling from California, Michigan, Rhode
Island and New Hampshire to be with the St. Vincent nurses and to show their
support for their cause.

Once again, the nurses were supported by political and community leaders,
with the featured speaker being U.S. Congressman James McGovern, D.
Worcester, who told the nurses, "I come from a family of patients. I am
grateful for all of you and what you have done for us. I am here to help you
make sure that no hospital, whether Tenet or anyone else, forces you to work
double shifts. I stand behind you, and I'll tell you why the whole community
is standing solidly behind you. They understand you want the very best
patient care."

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.

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

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

Two Messages from Boston Public Health Nurse Michael Malone:

Sandy,
A tale of hope and inspiration from today ...
Made my once-a-semester visit to UMass-Boston to spend a couple of hours
talking about tuberculosis and public health nursing to senior nursing
students. Turns out today was the last class meeting before finals and
graduation, so both the morning and evening sections saw me as the last
hurdle to knock down en route to the finish line.
The nursing professor introduces me in the AM session and preps the
students for a 2 hour snooze listening to my drone. Then,taking note of my
red strike button, she tosses the students a juicy carrot. After Michael
finishes his TB lecture, she says, I' m going to ask him to take 15 minutes
to tell us all about the very important nursing efforts occurring in
Worcester. A pleasant surprise of an invitation, I think to myself. I
proceed to anesthetize the class chattering about skin testing, sputum
collection and contact investigations until my time is up. As I'm stepping
away from the lectern and the professor is preparing to distribute the course
evaluations in the precious remaining minutes of this 3 hour class, students
begin to awaken and soon they're calling out to the prof about wanting to
hear about the nurses on strike in Worcester. She recalls her earlier pledge
and brings me back up front. The students, 40% of whom are RN to BSN students
with the remainder preparing to graduate and sit for their boards, are
riveted by my brief description of their courageous sisters and brothers in
Worcester. Questions and commentary flow--all reflecting identification with
the St. Vincent struggle as well as reverence for the moral conviction and
leadership of these nurses.
Regrettably, I wasn't prepared with literature for the morning crew, but
promised them I'd get 'em more info on how to sound the call and participate
in strike support. When I returned to campus 5 hours later for the evening
session, I was armed with copies of Suzanne Gordon's Globe op-ed piece,
Matthew Russell (doc and house officer at BMC)'s eloquent Globe letter to the
editor, the scab ads from the Globe and the MNA list of activities to support
the strikers and win the strike.
Well, the professor saw the literature and promptly had the
strike-related pages stapled to the TB handouts I was distributing to the
evening students prior to the lecture. (And the prof will give these to the
AM students when they gather for their final exam next Monday.) Same sequence
then ensued: the students napped comfortably for 90-120 minutes, then came to
life when I could speak of our Worcester comrades. Nurses in the group told
maddening stories of mandatory overtime in their workplaces and one described
leaving her place of employ because of it. All were glued to the discussion.
The course evaluations then came out and I was packing up to leave when a
not-yet-a-nurse senior student approached me and asked if I could help her
and her classmates get their hands on about 90 or so of the red "I support
the St. Vincent nurses" buttons.
It seems they want to wear the buttons on their gowns at their graduation.
As another student subsequently explained to me, "It's the least we can
do. They're fighting for us, our profession and our patients."
I couldn't say it any better.
Sandy, I just was surprised (thinking TB would be today's exclusive
topic) and overwhelmed by the keenness of the interest in the strike and the
connectedness to the St. Vincent nurses which the students (and the
professor) expressed so resoundingly.
I'd been sad driving away from Worcester yesterday as always--I
invariably feel as though I'm abandoning ship when I return home to Boston
and leave the relentless struggle and picketing behind.
But today raised my spirits immeasurably. These nurses and
nurses-to-be--they understand the safe care issues as their own and are
drawing strength to speak out from their trailblazing colleagues in, as
Jeffrey Bareback would undoubtedly say, Worchester.
These 90 students, all but a few previously unknown to me, showed me
something extraordinary about nursing solidarity.
For now, I'd better get going on my graduation wardrobe consulting
business and find me 100 red buttons for transport to the UMass-Boston
chapter of the strike support network.
We shall overcome, Michael

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

Sandy,
Rode home from Canton this evening with Inge Corliss from our Congress
(MNA's Congress on Nursing Practice) meeting. She was all ears about the St.
V situation and accepted my invite to have her added to your mailing list. ...
She also voiced a desire to hit the lines next time I go to Worcester. Is
the bargaining unit membership meeting again this Wednesday evening? That
could guide the timing of my next westward drive.
Thanks again and again and again for all your efforts on the strike
bulletins, Sandy. They are invaluable ... .
Michael

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

Message from Quincy ED Nurse Jim Moura to Tenet:

Dear Sirs,

Paula Green's latest comments on Mandatory Overtime in MNA contracts across
Massachusetts to the Telegram border on the ludicrous. UMASS RNs are
struggling to eliminate onerous Mandatory Overtime requirements within their
contract. The nurses at Leonard Morse have chosen not to eliminate it because
they perceive that staffing there would not require it outside of unforeseen
circumstances not associated with normal hospital operations. That is not the
case at Worcester Medical Center.

I suggest a compromise position. Mandatory Overtime will only be used in
unforeseen circumstances not associated with normal hospital operations. Your
position is being perceived across Massachusetts and the nation as abusive
and unwarrented to meet the needs of patients. It is being perceived as a
measure to hold down staffing to reduce costs and increase investor return.
That is not acceptable here in Massachusetts. Our communities demand that
those caring for them be valued and not abused by onerous OT requirements
which violate the Institute Of Medicine recommendations to reduce provider
fatigue and patient injury.

Worcester Medical Center is killing itself in its own community by embracing
the current positions described by Paula Green. Not one working person who
lives in Worcester and who is a potential customer does not understand and
support the nurses in their strike against you. I work in a small community
hospital 40 miles east of Worcester. We have contributed money and time on
the line. We are very aware how we had to struggle to change the language in
our contract to end unreasonable mandatory overtime. It took years but we did
it. The hospital still exists without mandatory OT. Could it be that because
we are non-profit it is less of an issue! One cannot escape the perception of
Tenet avarice in the current atmosphere.

Please compromise. Arbitration would not have been acceptable to us here
either until we achieved language limiting mandatory OT. You have
underestimated the nursing community's resolve on this issue. Please get back
to caring for the community with the spirit of St. Vincent Hospital and not
displaying the avarice of your current positions.

In Solidarity

Jim Moura RN
Co-Chair QMC MNA

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

Message from North Shore Public Health Nurse:

Hi Sandy, Thanks for all the updates. I get them first from you and then from
Peggy (O'Malley). Wanted to let you know that the Massachusetts Association
of Public Health Nurses held their fourth annual conference in Worcester at
the Holiday Inn on this past Friday. Petitions of support were circulated
among the group for signatures with multiple pages collected. These along
with monetary donations were delivered to the strike line late Friday
afternoon by the President of our association, Sandy Collins (another Sandy),
Andrea Penney, Norma Ouellette, and myself. We were all impressed with their
determination and resolve during our conversations with the handful of hardy
souls that were present at that time. We all fight the same battles but on
different battlefields. Charlotte Stepanian

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

Tenet may skip hearings on TIF

Mariano joins call for Tenet to bring in chief

Tuesday, May 9, 2000

By Jim Bodor, Telegram & Gazette Staff

WORCESTER-- Joining a growing chorus of local politicians, Mayor Raymond V.
Mariano yesterday called on the Tenet Healthcare Corp. chairman to get
directly involved in the contract talks with the Worcester Medical Center
nurses.
At a late afternoon press conference, the mayor said he believed Robert
E. Maher Jr., chief executive officer of the medical center, lacks the
authority to negotiate a contract with the hospital's nurses, who have been
on strike since March 31. Tenet, of Santa Barbara, Calif., owns the medical
center.
Mr. Maher "doesn't have the authority to settle the contract," Mr.
Mariano said. "If he was able to settle the contract, it'd be settled."
Jeffrey Bareback, chairman of the corporation, might be more eager to
see a contract if he came to Worcester to see the effect the strike has had
on residents, the mayor said.
"We need him to spend time here and to understand what's happening," Mr.
Mariano said.
Mr. Maher laughed at the suggestion that he lacks authority over the
contract talks. "I didn't know that he was researching my authority level,"
he said.
It is unlikely Tenet's chairman will come to Worcester to get directly
involved in the contract talks, Mr. Maher said.
"Mr. Bareback has a job to do within Tenet, and he relies on many
divisional, regional and local people to implement the policies and practices
of the company," he said. "I don't think he'd see fit to come here."
Tenet's divisional and regional managers confer with Mr. Maher regularly
about the negotiations, Mr. Maher said. Mr. Bareback is aware of all that is
happening with the talks, he said.
The striking nurses believe Mr. Barbakow's presence in Worcester could
help move the talks forward.
"They've admitted that they are in constant communication with
California, so it's obvious to us anyway that Bob is not in total control,"
said David J. Schildmeier, spokesman for the Massachusetts Nurses
Association, which represents the roughly 500 striking nurses. "We think they
should come here and face the people they're dealing with."
The mayor is not the first politician to appeal to Mr. Bareback. Last
week, the Massachusetts delegation to Congress and the Senate, including Sen.
Edward M. Kennedy and Sen. John F. Kerry, sent him a letter asking he conduct
face-to-face negotiations.
Also yesterday, the mayor announced hearings on the medical center's tax
increment financing agreement will begin the week of May 22 before the City
Council's Commerce and Development Committee.
Under the TIF, the hospital is paying $40.6 million to the city in taxes
over 18 years, $40.5 million less than it would have paid without the
agreement. City councilors have raised questions about whether the hospital
is meeting the terms of the agreement.
Among the issues to be considered are the inclusion of laid off and
outsourced employees in total employment counts, and the total number of jobs
created by the hospital. Mr. Maher insists the hospital is in compliance with
the tax deal.
"We welcome the city administration to come in and look at all of the
books, and to look at the data before you have your public hearings," he said.
Mr. Maher said he would not attend the hearings unless the city makes
some effort to obtain accurate information before the hearings begin.
"I don't have any interest in attending a bunch of public hearings until
they come and look at the books," he said. "If this is just an attempt to
drag us in and say bad things about Tenet and myself, I won't attend the
hearings."
The mayor's press conference yesterday also was attended by several of
Worcester state legislators, who announced that today at 11 a.m. they will
file two bills related to the strike.
One would require that the state Board of Registration in Nursing
perform work history and criminal history checks on all replacement nurses
coming into the state. The board does check the work backgrounds of
replacement nurses, but the legislators say this bill would expand those
checks. The board's executive director was not immediately available for
comment yesterday.
The second bill would allow patients who do not wish to cross a picket
line at a hospital to use their medical insurance coverage at another
hospital nearby.
"We need legislation that makes it easier for consumers to survive
during this kind of crisis," said Rep. Harriette L. Chandler, D-Worcester.
"Both of these items of legislation do that."
The primary contract issue is mandatory overtime. The hospital wants the
right to require nurses to work up to eight hours of overtime, paid at
double-time. During talks last week, the nurses offered to work up to four
hours of overtime, a move from their previous offer of two hours of overtime,
plus two more hours under certain circumstances.
The hospital declined that offer, and asked instead to go to binding
arbitration over the issues of mandatory overtime and flex time, in which the
hospital can send nurses home on less busy days. The nurses refused, saying
they cannot place the outcome of the strike in the hands of a third party.

© 2000 Worcester Telegram & Gazette

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