BRIGHTON, MA – In the wake of Steward St. Elizabeth Medical Center’s (SEMC) failure and refusal to provide adequate staffing levels at Steward Health Care’s flagship facility, the 600 registered nurses of SEMC have provided management with the required notice of their plan to conduct an informational picket outside the facility on March 10. The protest is designed to alert the public about patient care conditions at the facility, and to seek the public’s support in calling on SEMC to keep its promises to ensure safe patient care.
The issue of patient safety and the need for increased staff support is an ongoing issue for nurses working throughout the health care system at a time when the system faces the prospect of responding to a growing coronavirus pandemic and a potential surge in patients seeking care.
“We will be holding this picket because we are concerned for our patients’ safety.” said Chris Kenney, RN, a nurse at SEMC and co-chair of the nurses’ local bargaining unit with the Massachusetts Nurses Association. “Nurses go to work every day with the fear that an unnecessary patient injury will take place under the current staffing conditions. We raise these issues to management constantly in writing and in endless meetings yet nothing is done.”
The nurses’ concerns for the safety of their patients are well documented. In the last 12 months nurses filed more than 330 official ”Objection to Unsafe Staffing” reports (nearly one a day) detailing instances where nurses were forced to take excessive patient assignments that “poses a serious threat to the safety and well-being of my patients.” Each of these reports was signed by the reporting RN and shared with management representatives in real time, and in nearly every case management refused to alter the nurse’s patient assignment or provide any relief to ensure appropriate care. The typical responses by SEMC management are “we have no one to send you," “there is no one available," “the whole house is short," or, “do the best you can.”
The staff at St. Elizabeth’s 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 its 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.
This issue is especially true at SEMC, the flagship tertiary care facility of the nine hospitals owned by Steward in Massachusetts. At SEMC, Steward has embarked on a $100 million renovation plan, including new medical units, OR suites and a parking garage, yet it refuses to provide the RN staffing it promised to ensure an appropriate level of care to its current patients.
“Our hospital and our nurses are expected to not only care for the patients in our community, but we also are expected to handle some of the most complex patients that are transferred from other Steward community hospitals,” said Kirsten Ransom, RN, a SEMC nurse and co-chair of the nurses local bargaining unit. “In our last contract, we negotiated with management to provide staff needed to ensure we can respond to the needs of this complex patient population, yet Steward has refused to provide those promised resources.”
Specifically, the nurses’ contract called upon Steward to increase staffing for the patients by having “charge nurses” to have no patient assignment. Charge nurses provide a valuable role on all hospital units, overseeing the assignment of patients among other staff on the unit, ensuring an efficient flow of patients in and out of the unit, communicating with physicians and others to ensure patients receive the care they need and most importantly, providing an extra pair of hands when a patient crisis occurs. Unfortunately, much of the time there is not enough staff to provide this level of care.
The lack of these resources also can cause longer wait times and more patients boarding in the hospital’s busy emergency department while waiting to be admitted to a bed on the floors. The situation has been further exacerbated by a number of other factors, including SEMC’s failure to schedule adequate numbers of certified nurse assistants, unit secretaries, and “sitters,” staff to be on hand to monitor patients at high risk for falling, or psychiatric patients at risk for self-harm.
The nurses also point to a chronic lack of basic supplies in the hospital. “It appears that ours is not the only contract that Steward fails to honor. The vendors won’t deliver without being paid,” Kenny explained.
The nurses have filed numerous grievances and have held numerous meetings over a period of years with management to demand immediate action simply to meet their contractual commitments.
Contributing to this problem is the lack of consistent leadership in senior management positions at the hospital. In the last six years, there has been no less than six CEOs and seven chief nursing officers.
“Nurses at St. Elizabeth’s can no longer remain silent while the company that owns the hospital uses their profits to buy more hospitals throughout the U.S. and in other countries at the expense of the care and safety of our patients,” said Kenny. “The public has a right to know about decisions that are being made at these hospitals that jeopardize their safety.”
“Steward needs to make good on its commitment to the community to provide a safe standard of care,” Ransom added. “We and community leaders will be out in front of our hospital on March 10 to help make sure they keep that promise.”
Speakers will include: SEMC RNs, City Councilor Liz Breadon, City Councilor at large Julia Mejia, State AFL-CIO President Steve Tolman, Ben Day national president of Health NOW, MNA president Donna Kelley Williams and other community leaders.
