The Nurses are Trying to Convince the Hospital to Grant Mid-Contract Pay Raises to Alleviate Deplorable Staffing Conditions and Stem the Flow of RNs Being Recruited Away by Other Facilities

The week of May 6 – May 12 is National Nurses Week, but the nurses of St. Elizabeth Medical Center in Brighton will not be attending any of the Nurses Week events sponsored by hospital management this year. Instead, they will be boycotting these events, and appealing to the general public for support for their call for increased salaries to help improve substandard working conditions and unsafe staffing levels at the facility caused by a loss of nurses to better paying, better staffed facilities in the area.

The nurses will be conducting informational picketing outside the main entrance to St. Elizabeth's Medical Center, located on 736 Cambridge St. in Brighton, on May 9, 2001 from 11 a.m. to 6 p.m. and on May 10, 2001 from 3 p.m. – 6 p.m. The nurses are currently working under a 5-year contract. While the contract runs through 2003, the nurses have appealed to the hospital to reopen the contract to negotiate much needed solutions to severe problems with staffing, mandatory overtime and the nurses' salary. The hospital has refused to reopen the contract to address the staffing and mandatory overtime issues, but has agreed to conduct informal discussions over the nurses' pay scale. On April 26, the hospital met with the nurses and offered an additional 2.5 % increase over the next two years. The nurses took the offer back to the rank and file membership on April 30, where the offer was resoundingly rejected.

"Staffing at this hospital is chronically inadequate and, all too often, unsafe," according to Cece Buckley, RN, a critical care nurse and co-chair of the Massachusetts Nurses Association collective bargaining unit at the facility. "We're very disappointed that the management of this hospital refuses to seriously address these concerns, especially while our patients are subjected to inadequate care, and while nurses continue to leave this hospital because of those very conditions. We are also extremely disappointed at their half-hearted attempts to address our salary concerns, as this is the primary reason we are losing nurses to other facilities."

In addition to holding the picketing, the nurses have taken additional steps to protect their patients, including sending a strongly worded letter of appeal to the hospital's board of trustees, which includes a petition signed by more than 400 nurses. The letter to the trustees is both a plea for intervention and a warning about the impact on patient safety if appropriate steps are not taken to address the nurses' concerns. It reads, "The nurses of this hospital want you to know that we are headed towards a crisis at this institution and that steps need to be taken to ensure this facility can live up to its own mission statement, and its commitment to quality patient care. As we continue to suffer the effects of a dramatic nursing shortage, this facility cannot maintain safe standards of care nor improve our dangerous working conditions without first instituting a pay scale that will retain and recruit the highly skilled nursing staff required of this institution."

On both fronts, their concerns about staffing conditions and their pay, the nurses have a very strong case to make. In the past year, nurses at St. Elizabeth's have filed more than 300 official reports of unsafe staffing conditions, where nurses signed a form objecting to their patient assignment because it placed their patients' lives in jeopardy. In addition to being assigned too many patients to care for on a regular basis, mandatory overtime is a regular occurrence at the facility, and the dangerous practice is being used as alternative means of staffing the facility.

Buckley is well aware of the dangers of the practice of mandatory overtime. She tells a story of being forced to work extra hours against her will, and against her doctor's orders when she was pregnant last year.

"I was eight months pregnant, working in a surgical intensive care unit," she explained. "While I usually work 12-hour shifts, my doctor had given me a note for my managers telling them I shouldn't work past 8 hours, given that I was beginning to have Braxton Hicks contractions and I needed to be careful about my work level. I was working eight-hour shifts, when at the end of one shift with a unit filled with very compromised patients, there was no one to replace me. A supervisor asked me to stay. I refused to volunteer, citing my medical condition. The supervisor agreed and called the nurse manager at home who then mandated me to stay and work a 12-hour shift. I got through the shift, and nothing bad happened, but it could have. I had to make a choice between leaving a very ill and vulnerable patient or potentially harming my child or myself. I should have never been placed in that position. No nurse should be forced to make those choices. It's up to a hospital to have staff to operate. But nearly every day they are forcing a nurse in this hospital to make similar choices."

As to the nurses' concerns about their salary level, a comparison of the St. Elizabeth's nurses' pay scale with other comparable hospitals in the region shows them too far below their competitors. The disparity is most acute for the more experienced nurses, where St. Elizabeth's nurses at the top of the salary scale are paid 25% below nurses at Brigham & Women's Hospital, 14 % below nurses at New England Medical Center and 17 % below nurses at Boston Medical Center. St. Elizabeth's salary scale barely exceeds that of many smaller community hospitals.

The disparity in the nurses' pay has great implications for quality and safety of care provided, given that the health care industry is in the midst of a severe and growing shortage of nurses and the area of greatest need is among experienced nurses in specialized areas of practice, such as emergency nursing, critical care and operating room nursing. This is precisely the area where St. Elizabeth's is experiencing a loss of nurses to other better paying facilities.

According to Sheila Ainsworth, an operating room nurse and co-chair of the nurses' bargaining unit, "In a recent two-week period this year, four operating room nurses and technicians left the facility for better pay at another hospital. In one week, three nurses resigned. These were experienced nurses who could no longer take the backbreaking working conditions and lower pay. They had enough and they left for greener pastures," Ainsworth said. "It's devastating for those of us who remain, because now we have less support and we can't recruit replacements because we can't compete with other hospitals vying for these nurses. We need to be able to retain our own nurses."

To add insult to injury, the operating room nurses' resignations came just around the time the hospital was making their 2.5 % per year salary offer to the nurses. That same week, hospital management gave the surgical technicians in the operating room a $5,000 bonus to convince them to stay on.

"If you want to know why nurses are on the street during Nurses Week and not attending hospital-sponsored functions with our managers, there is your answer," Ainsworth said. "They have shown absolutely no respect for their nurses or their patients. They are content to work us beyond our limits, to place us in dangerous situations, and worse than all that, they are doing it at the expense of the safety and well being of those we care for."

The hospital's actions come on the heels of a widely publicized study released in April by the Department of Health and Human Services that clearly demonstrates a strong link between poor staffing and a variety of serious complications for patients, including the deaths of thousands of patients in America's hospitals. Another study of nurses showed that one in five nurses is planning to leave the profession in the next five years because of poor staffing, mandatory overtime and hazardous working conditions.

"We want the community to understand that we are out here as much for them as for ourselves," Buckley said. "In this case, issues of salary and staffing go hand in hand. Since they refuse to talk to us about fixing the staffing problem, the only thing we can fix is the issue related to salary, which can help the staffing at our hospital."