Nurses from UMass Memorial Medical Center campuses in Worcester, Marlborough Hospital and Leominster Hospital Detailed Concerns Prior to Delivering Joint Letter to UMass Memorial Health Care CEO Eric Dickson Calling for Immediate Action to Protect Patients and Improve Care
(The full text of the letter may be viewed at the end of this story)
WORCESTER, Mass. — The Registered Nurses who work at a number of UMass Memorial Health Care facilities represented by the Massachusetts Nurses Association/National Nurses United held a press conference today to voice their concerns about a growing system-wide patient safety crisis and to call for the system’s CEO to take immediate action to rescind and/or reverse plans to cut staff, eliminate and/or consolidate services in nearly every UMass/Health Alliance owned facility – plans the nurses believe are degrading the quality and safety of care for every patient entering the UMass Memorial/Health Alliance system.
“We are here today, with other members of this embattled system, to appeal to our CEO to heed our warnings and to work with us, not against us, as we all strive to fulfill our ultimate mission, which is to protect and provide healing to the patients of Central Massachusetts,” said Ellen Smith, RN, a critical care nurse at UMass Memorial Medical Center’s University campus who was one of four nurses from different UMass Memorial-owned facilities who spoke at the press conference.
Despite posting profits of more than $80 million in 2013 and more than $300 million over the last five years, UMass CEO Eric Dickson has endorsed cost cutting measures and the reorganization of patient care services based on a manufacturing model borrowed from the auto industry. There have been countless rounds of layoffs and service closures at the UMass Memorial facilities in Worcester; cuts to the urgent care and cancer centers on the Burbank campus in Fitchburg; layoffs of staff and poor patient care conditions at the Marlborough Hospital campus, and at Leominster Hospital plans have been introduced that would downsize staff and increase patient assignments in nearly every department.
“As registered nurses, we provide 90 percent of the clinical care our patients receive in our hospitals. We are the nurses who bear witness to the suffering of our patients, needless suffering caused by administrative neglect and the callous focus on the bottom line over patient care,” said Lynne Starbard, RN, a maternity nurse at the UMass Memorial Medical Center’s Memorial campus.
Jayne Biddy, a nurse at Marlborough Hospital for more than 40 years, took pains to describe the impact of what she characterized as the hospital’s “slash and burn management tactics,” which has resulted in cuts to staffing in the hospital’s emergency department and unsafe patient assignments for nurses working on the hospital’s medical-surgical and telemetry floors.
“What does such a slash-and-burn tactic look like inside of a hospital,” Biddy asked rhetorically. “It looks like one RN caring for three patients at a time in the ICU, or one RN simultaneously caring for six, seven, or even eight patients on a medical/surgical floor. It looks like a patient being 14 to 31 percent more likely to suffer an injury or die as a result. It looks like an emergency department where cuts to RN staffing result in longer waits for care and an increased chance that patients will be “boarded” in the ED rather than moving to a medically appropriate floor. And it looks like a management team that is willing to implement all of these misguided plans, even at a time when their hospital has the second worst record in the state for preventable readmissions.”
Smith described the impact of cuts on the UMass University campus nurses and patients. “Morale has never been lower. Nurses feel disrespected on every level, and recent staffing and service cuts impact our ability to provide the care our patients deserve. We have seen round after round of staffing cuts, both for nurses and valuable support staff, increases to patient assignments on many floors, the elimination of one-to-one sitters for confused patients at high risk for falls or other injuries, and the elimination of the expert IV Therapy Team,” Smith explained.
Colleen Wolfe, who works on the UMass Memorial Medical Center’s campus followed with her own reports of compromised patient care following cuts there.
“In what was our seventh round of layoffs in three years, our entire IV team was abolished. Our IV team was made up of long term expert RN’s dedicated to the specialty of IV placement and care across all clinical settings. They set the standard for excellence in IV care. Citing safety and quality concerns, hundreds of nurses signed a letter pleading to maintain this critical service for our patients and yet the plan moved ahead. Our patients are now enduring multiple sticks and many are harmed by complications such as phlebitis and serious tissue injury requiring a Plastic Surgeon,” Wolfe explained. “Unfortunately, it does not end there. Patients at a high risk for injury no longer have the safety net of one to one sitters, our high risk Labor and Delivery unit continues to be chronically understaffed and the Emergency Department nurses are burned out and fed up with the lack of staffing needed to care for their patients.”
For Linda Grossi, an emergency department nurse at UMass/Health Alliance Leominster Hospital, the main goal for those nurses is to prevent proposed cuts from being made, thus undermining the one facility in the UMass system that is actually providing good care to its patients. At Leominster, management is seeking to cut staff in the emergency department, pediatric and maternity units, and to increase patient assignments on the medical surgical floors.
“Ironically, up until now Leominster Hospital has been the hospital within the UMass system with the best rate of positive patient outcomes, as well as the lowest rate of preventable readmissions,” Grossi explained. “Does management really believe that these achievements will be sustainable if it implements those short-sighted proposals? After all, the same number of patients will keep coming through our doors  be it by foot, car, or ambulance. Except now the wait times for assessments and care will become longer; RNs will be carrying dangerously high patient assignments; and poorer patient outcomes will be the end result.”
Following the press conference, a delegation of nurses marched to the offices of UMass Memorial Health Care CEO Eric Dickson to deliver a letter detailing their concerns and demanding that he take immediate action to end this system-wide patient safety crisis.
In recognition of Dickson’s history as a physician who practiced alongside many of the nurses, the nurses’ letter goes on to appeal to Dickson in light of his own professional ethics, stating, “As a physician …we are appealing to you personally and professionally to work with us to uphold your own sworn oath to “first, do no harm,” or in this case, to stop the incredible harm your policies are causing our patients, your employees and the communities we serve.”
In addition to holding the press conference and appealing to Dickson for a meeting to begin discussions of how to improve patient care, the nurses plan to take out ads in local papers, to continue to meet with and engage local and state public officials about their concerns, and to engage in other community-based efforts to educate the public about the dangers these changes pose to the health of patients seeking care at these facilities.
Joint Letter to UMass Memorial Health Care CEO Eric Dickson Calling for Immediate Action to Protect Patients and Improve Care
July 31, 2014
Dr. Eric Dickson, CEO
UMass Memorial Health Care Group
55 Lake Avenue
Worcester, MA 01655
Dear Dr. Dickson:
The Registered Nurses who work at all the UMass Memorial Health Care facilities represented by the Massachusetts Nurses Association/National Nurses United are taking this opportunity to appeal for immediate action by your administration to rescind and/or reverse plans to cut staff, eliminate and/or consolidate services in nearly every UMass/Health Alliance owned facility – plans we nurses believe are degrading the quality and safety of care for every patient entering the UMass Memorial/Health Alliance system.
- At the UMass Memorial Medical Center Campuses in Worcester, we have seen round after round of staffing cuts, both for nurses and valuable support staff, the closure of a medical floor, increases to patient assignments on many floors, the elimination of one-to-one sitters for high risk patients and the elimination of the valuable IV Therapy Team, and this was after more than 2000 nurses were ready to strike over the already dangerous conditions in 2013. The response to the latest round of cuts was universal and resounding, with the Memorial campus signing petitions opposing the cuts to the IV Therapy Team and an unprecedented vote of no confidence by the University campus nurses in your handpicked director of nursing, who was the architect for many of these unseemly changes.
- At Marlborough Hospital staffing throughout the facility has been at unsafe levels, with nurses on the medical surgical and telemetry floors forced to care for six, seven and even eight patients at one time placing all these patients at a 14 – 31 percent increased risk of injury or death. The situation was exacerbated by the decision to cut staffing in the hospital’s emergency department, resulting in longer waits for care and an increase in the boarding of patients. All of these changes were made in the wake of Marlborough Hospital having the second worst record in the state for preventable patient readmissions. When nurses voiced concerns about these changes, your managers told them they needed “to do less with less.” Once again, the nurses have responded with alarm to these conditions and in May more than 90 percent of the nurses signed a petition that was delivered to their CEO for immediate action to end this growing patient safety crisis.
- At Health Alliance Burbank Hospital in Fitchburg, your managers made a 30 percent cut to RN staff who work in the Burbank Urgent Care Center and a 25 percent reduction in RN staffing in the Simonds-Sinon Regional Cancer Center. Even more alarming, part of that plan called for the replacement of highly skilled registered nurses with lesser skilled medical assistants who are incapable of providing the assessment, care and treatment the nurses have been providing to patients for years. When nurses raised their concerns about these changes, your managers’ response was “we have become too customer friendly for the business.”
- And most recently, at the Health Alliance Leominster Hospital, sweeping cuts to nursing and support staff have been announced that will impact every area of patient care, including the reduction of staff in the emergency department similar to that carried out at Marlborough Hospital, an increase in patient assignments on the medical surgical floors, and staff reductions and consolidation in the pediatric and maternity units, all of which will dramatically degrade the quality of care at the hospital that currently has the best outcomes in the system and the lowest rate of preventable readmissions. In response, the nurses have signed a petition opposing these dangerous changes and nurses are mobilizing their community to oppose these changes.
In registering our opposition to these policies, nurses want to make clear that there is not a shred of medical or nursing research to support any one of these changes in patient care delivery – none. In fact, all the scientific research makes clear that these changes can only result in an increase in complications, longer hospital stays, poorer patient outcomes and an increase in preventable readmission of patients at a time when our system ranks near the bottom in the state for preventable readmissions.
As registered nurses, we provide 90 percent of the clinical care our patients receive and we are the only provider in the system legally and ethically accountable for the safety of patients every minute they are receiving care at one of our hospitals. In the aftermath of your staffing and services cuts and the implementation of your “lean production methods” we are the caregivers who must deliver and answer for the substandard care provided in this dangerous and under-resourced environment.
We are the emergency room nurses who have to watch our patients languish for hours waiting for beds or treatments due the boarding and backlogs your poor staffing creates; we are the floor nurses who must struggle to respond to alarms, deliver medications and treatments on time with dangerous patient assignments and the lack of one-one sitters or IV therapy specialists. We are the nurses who have to bear witness to the suffering of our patients, needless suffering caused by administrative neglect and the callous focus on the bottom line over patient care. And should something untoward happen to one of our patients as a result of these conditions, we are the professionals who could lose our license to practice our profession.
Through our union we have held dozens of meetings with management to voice our concerns about these dangerous conditions. Our nurses have filed hundreds of official reports of unsafe staffing that jeopardized the safety of our patients. As stated above, nurses have signed petitions, taken votes of no confidence, spoken with the media all in the hopes of convincing your administration that the course we are on is the wrong course with dire consequences not only for our patients, but for the future of our system.
As a physician and caregiver who has worked alongside many of our members, we are appealing to you personally and professionally to work with us to uphold your own sworn oath to “first, do no harm,” or in this case, to stop the incredible harm your policies are causing our patients, your employees and the communities we serve.
We urge you to meet with a delegation of our union leadership as soon as possible to begin a real dialogue on how we can begin the process of reversing the changes you have made to ensure the safety of the patients and communities we are entrusted to serve through our work together.
Sincerely,
The UMMMC University Campus Negotiating Committee & RNs
The UMMMC Memorial /Hahnemann Campus Negotiating Committee & RNs
The UMMMC Marlborough Hospital Negotiating Committee & RNs
The UMass Memorial/Health Alliance Burbank Campus Negotiating Committee & RNs
The UMass Memorial/Health Alliance Leominster Hospital Negotiating Committee & RNs
