The registered nurses and health care professionals of Steward Health Care’s Morton Hospital in Taunton yesterday cast an overwhelming vote (96 percent) in favor of authorizing a one-day strike in an effort to convince Steward to provide improvements in staffing to ensure appropriate patient care. The vote comes after the nurses have filed more than 120 official reports in the last year, documenting staffing conditions that “poses a serious threat to the health and safety of my patients.”
The vote does not mean the staff will strike immediately. It gives the negotiating committee the authorization to call a one-day strike if and when they feel it is necessary. Once the committee issues its official notice to strike, the hospital will then have 10 days before the nurses will go out on strike. If a one-day strike happens, nurses will be prepared to return to work after the 24-hour period.
The key issue in the dispute is the nurses’ call for a number of improvements to the staffing levels on a number of units, including the hospital’s busy emergency department, medical surgical floors, behavioral health unit and intensive care unit. Current staffing levels have left nurses caring for too many patients, and/or providing care without appropriate contractually guaranteed levels of support staff (i.e., nurses’ aides, unit secretaries, etc.) who are crucial members of the health care team. In response Steward has refused to provide any improvements to RN staffing, and have a proposal on the table that would allow them to unilaterally eliminate any and all support staff.
“On a daily basis, on every unit, our staff come to work without the resources we need to provide the care our patients should expect and deserve,” said Selina Foster, RN, a nurse in the facility’s busy emergency department. “The situation is unfair to our patients, and it is demoralizing to our staff who have direct responsibility for the safety of these patients.”
As stated above, the nurses have the ability to document and report, in real time, any instance where they are given a patient assignment that poses a risk to the safety of their patients. More than 120 of these “Objection to Unsafe Staffing” reports have been filed in the last year, and in nearly every instance, the reports document management’s refusal to address the problem. The reports show comments such as “aware of the problem…we have no one to send you… do the best you can.”
On one of those reports filed in 2019, signed by all the nurses on the night shift in the emergency department, described a harrowing situation where the nurses lacked the staff required to meet the “acuity” of patients (i.e. severity of illness and needs of those patients), placing all those patients and the staff in jeopardy. The report stated the emergency department was full, with “two critically ill patients requiring one to one care (these are patients who should be in the intensive care unit, but were being cared for in the emergency department due to lack of staff in the ICU), one patient who arrived in cardiac arrest, a patient with a trach (tracheotomy) in place arrived in respiratory distress, a patient brought in by ambulance with a police escort who was out of control and required to be restrained and provided one on one care, and multiple ambulances arriving at the same time, resulting in delays in patient care.” The contractually guaranteed staffing level for the emergency department at that time was for nurses to have nine nurses on for part of the shift and seven for the remainder; however that night the nurses were down at least two nurses as well as other support staff.
Other reports show similar circumstances, with the addition of 10 to 20 psychiatric patients being held in the emergency department, some of them suicidal, and all of them in a state of crisis.
“These situations are not uncommon, and they are totally unacceptable,” Foster explained.
“With this vote, our membership is sending a clear message to the executives that we are ready to do whatever is necessary to protect our patients and to ensure that nurses are able to provide the care our patients deserve,” said Jacqui Fitts, an RN on the medical surgical floor and chair of the nurses local bargaining unit. “No caregiver wants to strike, but we are prepared to do so if Steward continues to refuse to make improvements in staffing levels – improvements that are needed to prevent a continued deterioration in the quality and safety of care at this hospital.”
The 357 nurses and health care professionals have been in negotiations with management for a new union contract since November 19, 2019, with 10 negotiating sessions held to date and the last five with a Federal mediator present. Throughout the process, Steward has refused to negotiate in good faith to provide information to address union concerns. In fact, recently the National Labor Relations Board issued a complaint against Steward for their failure to provide the union with necessary information. Following the issuing of the complaint Steward reached a settlement last month that obligates them to provide all the information required by the nurses.
In addition to safer staffing levels, the nurses and health care professionals are also seeking a fair wage increase that will allow them to recruit and retain the staff needed to fill staffing needs. The nurses have gone years without significant wage increases. Steward is currently offering a meager wage proposal of 1 percent per year in each year of a four year agreement, which fails to keep to the Morton staff competitive with other RNs and professionals in the region.
“For many of our staff, Morton is where our family members receive medical treatment. We feel strongly about delivering the best care possible,” explained Cheryl Dutra, a pharmacist at Morton and a member of the negotiating committee. When wages and benefits are fair, this hospital can recruit and retain the nurses and health care professionals that our patients need.”
The staff at Morton find it hard to accept Steward’s refusal to invest in its staff or in safe patient care given Steward’s enormous resources. Steward has been involved in a multi-billion-dollar expansion plan.
Steward bought 24 new hospitals in eight U.S. states in the past few years (in addition to the nine in Mass.), and it now owns the three hospitals in the country of Malta. They also closed one hospital in Youngstown Ohio, shortly after buying it, and sold it’s real estate. They are reportedly in talks now to buy hospitals in Montenegro, Macedonia, Croatia, Albania, as well as a number of Persian Gulf states.
“It makes no sense to us that Steward is willing to spend hundreds of millions of dollars to expand their health care empire while neglecting the patients here at Morton and other facilities it has purchased and operates in this state,” Fitts stated.
Steward’s staffing problems in Massachusetts are not limited to Morton Hospital. On the same day as the strike vote, the nurses at St. Elizabeth’s Medical Center in Boston, Steward’s flagship facility in the state, issued the required formal notice to management of their intent to conduct informational picketing outside the facility on March 10 from noon to 1 p.m. to protest Steward’s failure to adequately staff the hospital. Earlier this month, nurses at Steward Holy Family Hospital in Haverhill went public with their concerns about staffing conditions that were resulting in an unprecedented spike in workplace violence incidents at the facility, with nurses and other staff injured from the assaults.
Nurses at Steward Morton Hospital will head back to the table with management on February 28 in the hopes of moving closer to an agreement.
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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public
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