Placing Vulnerable Patients on Cape in Jeopardy

Misguided Plan Will Result in Layoff of 18 of the Most Experienced Nurses

MNA Sees Move as Shortsighted and as an Attack on the Nurses’ Union Leadership

HYANNIS, MA — Nurses at Cape Cod Hospital are outraged by CCH, CEO Mike Lauf’s Plan to close the Endoscopy Center at Cape Cod Hospital, an essential program for the diagnosis and treatment of colorectal cancer and other serious gastro-intestinal conditions that serves more than 5,300 Cape and Island patients each year. In closing the program, Lauf will lay off more than 18 of the hospital’s most experienced nurses along with other staff; a move that nurses believe will place patients, particularly frail elderly and disabled patients who require endoscopy services in an acute care setting, in jeopardy.

“The loss of this program is a disservice to our community and to the patients we care for every day,” said Dianne R Desruisseaux, a nurse at the edoscopy center for more than 25 years, and chair of the nurses’ local bargaining unit of the Massachusetts Nurses Association/National Nurses United. “While there are other centers that provide routine endoscopy services, there are a significant number of patients we see who need to receive this care in a hospital setting. We have had many instances where frail patients who had complications were able to be treated and saved because of the full range of services and the experienced staff we have here at Cape Cod Hospital.”

Of the 5,000 plus patients seen at CCH, the nurses estimate more than 20 percent, 1,000 each year, have conditions that require the sophisticated level of care provided by the staff at the CCH center.

“Often, we have complicated patients who, due to certain health issues, can only have this procedure done safely in a hospital setting. Now they will have to go off Cape,” said Beth Piknick, RN, a nurse at the center for more than 12 years. “We see a large number of patients who are severely mentally challenged, many who are non-verbal and are very difficult to assess and prepare for the procedure, often requiring several RNs to manage their care. Also, we care for many patients with a psychological and drug abuse history who take multiple medications and require care from a hospital based program. And in our program, as a true community hospital, we take care of everyone, from all backgrounds and conditions. Unlike a private, stand alone program, we cannot turn anyone away who needs our care.”

The exact date of the closing has yet to be announced, but the latest information provided by management is for the program to be eliminated by the fall of 2013. The rationale for the closing provided by management is that the space occupied by the Endoscopy Center will be needed for the planned expansion of the emergency department. The nurses have advocated for the relocation of the service to another part of the hospital, but management has refused.

Instead, Lauf entered into negotiations with the Cape & Islands Endoscopy Center, an off-site endoscopy service. The plan was to sell the service to the physicians who owned that center, and then to buy the service back. At a recent meeting with CCH management, the nurses were informed that this approach wasn’t coming to fruition, so Lauf decided to close the program outright. The problem for the nurses is that the offsite endoscopy center that would absorb the hospital’s patient population is incapable of treating many of the patients now served by CCH. In fact, on a regular basis, CCH sees patients the off site program refuses to treat because of the complexity of the care required.

In addition, the nurses became even more concerned after meeting with management and discovering that no effort had been made by management to plan for this change and to put in place contingencies to ensure the safety of the patient populations.

“The hospital’s plan is to simply take care of complex endoscopy patients in our already busy general operating suites,” said Desruisseaux. “We cannot see how that will work, and there are a host of problems that will arise with that approach, yet we were astounded that no one in nursing or hospital management had any answers to many of the simple and serious patient safety questions we raised about this issue.”

Aside from the impact on patients, nurses are equally concerned about the hospital’s motivation for closing this service and laying off this staff. The average length of service for the nurses in the unit is 30 years plus. Two of the nurses, Desruisseaux and Piknick are prominent leaders in the nurses’ union. Desruisseaux is the elected leader of the nurses’ local and Piknick is a past President of the Massachusetts Nurses Association\National Nurses United and a current member of the MNA board of directors. Because of the nurses’ level of seniority and bumping rights under the nurses’ contract, the impact of this layoff will have far-reaching implications for many nurses who will be impacted by the extensive bumping that will occur.

“A big part of this is pure union busting on the part of hospital management, and an effort to cut costs by getting rid of more senior nurses,” said Piknick. “We cannot believe they want to jeopardize the safety of patients, and cause such a disruption among the dedicated nurses at this hospital.”

In response to these plans, the nurses are exploring whether unfair labor practice charges are in order, while also reaching out to the public to alert them to how this closing may impact the care they receive at the hospital.

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