By Mike LaBellamlabella

The Eagle Tribune

Sat Apr 06, 2013, 12:34 AM EDT

HAVERHILL — Nurses took to the street near Merrimack Valley Hospital in Haverhill yesterday to call attention to what they think is an alarming trend at some local hospitals.

The nurses, all of whom are members of the Massachusetts Nurses Association/National Nurses United, say they are trying to call attention to dangerous staffing levels at local hospitals mandated by their for-profit owners Steward Health Care and Cerebus Capital Management.

“This rally is meant to be a community event, because this hospital and the work we do inside of it is a reflection of the people who live and work here,” said Kathy Renzi, a registered nurse at Merrimack Valley Hospital and co-chair of the hospital’s MNA bargaining unit. “We want the community to know that it deserves better and safer care than we can provide at this time. And, in fact, we can provide the best and safest care available … but only if (owners) Cerberus/Steward will let us do so.”

But Steward spokesman Christopher Murphy disputed those statements, saying the rally was more about paychecks than patient care.

”The quality and safety of Merrimack Valley Hospital are excellent,” Murphy said. “The MNA’s patient safety claims are wrong, their staffing ratio claims are wrong, their claims about wait times are wrong, and all this is an attempt to gain leverage at the bargaining table.”

Spokesman for MNA/NNU David Schildmeier said patients are being placed at greater risk across the entire Cerberus/Steward-owned network of hospitals as management attempts to drive down costs and raise profits at the expense of patients and the nurses needed to adequately care for them.

He said that in response to Steward’s “interested-in-the-bottom-line-only” actions, registered nurses at Merrimack Valley Hospital, Holy Family Hospital, and others have all scheduled job actions and/or community events.

Murphy said the MNA and Merrimack Valley Hospital are currently in negotiations for a new contract. He said the registered nurses at Holy Family Hospital are also in contract negotiations with Steward Health Care.

”This vigil is about nurse paychecks, and not about patients,” he said. “Merrimack Valley Hospital would never risk the health and welfare of patients. It’s disappointing that the Mass Nurses Association raises fictional quality concerns in an attempt to increase their compensation.”

Nurses at Merrimack Valley Hospital say the problem with staffing levels has increased greatly since the hospital’s owner closed a medical/surgical floor several months ago and combined it with its telemetry floor. The pairing has created a dangerous trickle-down effect to patients in the rest of the hospital, they said.

“Fewer beds in med/surg (medical surgical department) means that ER (emergency room) patients have nowhere to move to once stabilized,” said Deirdre Tremblay, a registered nurse at Merrimack Valley Hospital and a bargaining unit representative.

”As a result, patients are sometimes held in the ER for up to two days simply because there’s not a bed to move them to,” Tremblay said. “Adding insult to injury, the same situation is happening to OR (operating room) patients: no beds, no rooms … everyone is waiting and waiting, raising the risk and safety factors while patients are not getting the necessary specialized care they need.”

What happens is that registered nurses end up frantically juggling dangerously high patient case loads that far exceed what current research has proven time and time again to be safe, Tremblay said.

Murphy disputed those claims. He said the hospital combined the medical surgery unit with the telemetry unit about a year ago to provide patients greater access to private rooms. He said there are plenty of open beds and “absolutely no delay” in access to beds from the emergency department or the operating rooms.

”The emergency department length of stay, which is something we measure and report on, has not changed in the past 12 months,” Murphy said. “There is more than enough in-patient capacity at Merrimack Valley Hospital and no patients in the emergency department or operating rooms have to wait for beds.”

”The alleged concerns and fictional quality complaints are all contract negotiating tactics,” he added.

Registered nurses at Merrimack Valley Hospital also say they can safely care for four patients at any one time, but they are being required to care for six or more on a regular basis — risking the health and welfare of patients.

“Studies have shown beyond a reasonable doubt that the best-case standard in safe patient care on a med/surg floor is one RN to four patients,” said Renzi, a nurse in Merrimack Valley Hospital’s ambulatory care department. “And I’m telling you that we’re consistently above that safe level, at one-to five on days during the best of times and as high as one-to-eight on nights during the worst of times.”

Renzi said the research shows that patients who were cared for in hospitals with higher staffing levels were 68 percent less likely to acquire an infection. Other measures such as ventilator-associated pneumonia and skin ulcers were also reduced in units with high staffing levels. Patients were also less likely to die within 30 days in these higher-staffed units, she said.

Murphy said the staffing ratio in the medical/surgical departments at Merrimack Valley Hospital is five patients to one nurse and that any claims otherwise are not correct.

”This is an excellent ratio for staffing for quality care and has not changed since Steward Health Care acquired Merrimack Valley Hospital in early 2011,” Murphy said. “Five to one is considered an excellent ratio in Massachusetts and is an industry standard. And these ratios are publicly available through the state.”

Murphy also contradicted the union’s claims by saying that Merrimack Valley Hospital’s quality performance, including infection rates, patient safety index, length of stay and mortality have all improved in the past 12 months.

“The union said that when we consolidated the units it would have a negative effect on quality, but the opposite has happened,” Murphy said. “Quality has improved in the last 12 months.”

The registered nurses at Holy Family plan to hold their own rally for safe patient care on April 10 from 5 to 7 p.m., Schildmeier said.

“If Cerberus/Steward doesn’t stop over inflating this ‘staffing balloon,’ it is going to burst,” Renzi said. “And I have no idea how we’ll pick up the pieces if that happens.”