The registered nurses of Leominster Hospital, who are unionized with the Massachusetts Nurses Association and who have been working to negotiate a new contract with UMass Memorial Health Care for more than a year, have scheduled a June 24 vote by members to authorize a one-day strike over the hospital’s refusal to agree to desperately needed improvements in RN-to-patient safety standards.
The nurses have met with management 17 times since last May and, during that time, held two informational pickets and are now utilizing a federal mediator in an effort to come to an agreement on the key outstanding issues. Following their last negotiation session on June 8 however, the RNs agreed it was time to take a strike authorization vote.
The strike authorization vote is scheduled to take place from 7 a.m. to 8 p.m. on Wednesday, June 24. Nurses will cast their vote by secret ballot at the Leominster Veteran’s Center. While the vote does not mean the nurses will strike immediately, it gives the nurses’ negotiating committee authorization to call a one-day strike if and when they feel it is necessary. Should the committee issue an official notice to strike, the hospital will then have 10 days before the nurses go out on strike.
“No nurse inside Leominster Hospital wants to strike,” said Natalie M. Pereira, RN and chairperson of the MNA bargaining unit at the hospital. “But we have spent countless hours with management over the last year and our concerns, our fears, are not being heard.”
Staffing and Safe Patient Care at the Heart of the Matter
“Management refuses to improve its RN staffing levels inside of the hospital, even after years and years of cutting nurse staffing to the bone,” said Pereira. “And although our nurses give quality care to all patients each and every day, it is becoming clear that if management does not improve its nurse staffing it will be very difficult to maintain that level of care.”
Early in their prolonged contract talks, the Leominster nurses offered management a staffing proposal that aims to improve the hospital’s RN staffing situation, making one RN responsible for only four patients at a time rather than the six they can care for now. That proposal was built on more than 15 years’ worth of research that says medical/surgical patients have the best outcomes when RNs are caring for no more than four patients at a time.
Similarly, patients in critical care units are now required by a new state law to have one dedicated RN at all times. Leominster Hospital management, however, is refusing to back off from one of its proposals that would result in the charge nurses on critical care floors having a patient assignment while also overseeing the other RNs and managing the general operations of the unit. As a result, the critical care RN in the charge nurse role would inevitably end up caring for more than one patient at a time.
“We will not allow the hospital to put our critical care patients in that kind of danger,” emphasized Pereira. “We believe, and Massachusetts state law says, that every critical care patient must have one dedicated nurse. If the hospital insists on giving our charge nurses a patient assignment there is no way that our critical care patients will receive continuous one-to-one care.”
In addition, management is also holding to several contract proposals aimed at cutting nurses’ benefits. Management has justified these cuts — cuts that RNs say will lead to a dangerous turnover in staff — by saying that, in terms of finances, they are aligning the hospital for the future.
According to the commonwealth’s Center for Health Information and Analysis (CHIA), during fiscal year 2014 Leominster Hospital was the second most profitable hospital in the UMass system and had more than $153 million in net assets.
“Our hospital is profitable. The UMass system is profitable. Yet, all management wants to do is continuously reduce staffing, eliminate full-time nursing positions, and cut benefits,” added Pereira. “That kind of treatment hurts patients and nurses alike, and ultimately leads to a dangerous turnover in staff. When that happens, everyone loses.”
Other recent reports show that Leominster Hospital is already feeling the effects of its ill-conceived decisions. Leapfrog, a nationwide nonprofit watchdog group that assesses the quality and safety of care in U.S. hospitals, recently gave Leominster Hospital an overall grade of “C.” That score is based on Leapfrog’s review of data that Leominster voluntarily submitted, and it should be noted that it did not submit any data that would have allowed Leapfrog to assess whether or not there were enough nurses working at the hospital to provide safe, quality care.
Meanwhile, CHIA reported last week that Leominster Hospital has seen a 6.4 percent increase in patient readmissions, a rate that is above the state average and indicative of the staffing problems that are plaguing the hospital. Although that 6.4 percent increase was based on 2011 to 2013 data, and the MNA nurses at Leominster say they will not be surprised to see that percentage spike in subsequent reports. “The worst of our staffing problems probably have not even caught up with the reporting yet,” added Pereira.
“Throughout this year of negotiations, management has told us repeatedly that it is all about the patients,” said Pereira. “But if it is all about the patients, why won’t management just agree to the patient safety limits we’ve proposed? Likewise, why won’t they stop cutting staff — RNs, CNAs, dietary staff, physical therapists, and on and on? It needs to stop and now. By taking this step toward a strike, we are appealing directly to the public for their support to ensure that UMass puts patients before profits.”