Vote Follows Decision by Cerberus-Steward to Close and Refuse to Negotiate over a 40-Bed Medical/ Surgical Unit, Resulting in Patients Being Boarded in the Hospital Emergency Department For Up to 24 Hours Without Appropriate Care

Nurses file unfair labor practice charge against Steward with the National Labor Relations Board for refusing to negotiate over a staffing plan that would ensure the safety of the patients under the nurses’ care.

QUINCY, MA — Nurses at Quincy Medical Center cast an overwhelming vote last night to authorize a one-day strike over dangerous staffing conditions at their hospital and a recent decision by Cerberus-Steward, the for-profit owner of the hospital, to close a 40-bed medical-surgical unit and layoff 30 nurses and more than 40 other health care staff who provide care to patients admitted to the hospital.

The secret ballot vote was held throughout the day yesterday at Quincy Medical Center. The nurses voted 200 to 13 (94 percent) in favor of a strike, with a 90 percent voter turnout. The vote gives authority to the RNs’ elected bargaining committee to schedule a strike. If and when that decision is made, the hospital will have at least 10 days notice before the strike can occur.

As a result of the closure, which was initiated on February 17, 2013, nurses report that as many as a dozen patients per day are being “boarded” in the hospital’s emergency department (ED), sometimes for as long as 24 hours (or more), waiting for an appropriate inpatient bed like those provided on the unit that was just closed. ED nurses report being put in the position of providing types of care for which they are not equipped to patients who have been “admitted” to the hospital as ICU, Medical Surgical or Telemetry patients, but who, in reality, are physically being housed in the ED. They also report that they are caring for admitted patients without bolstering the number of staff in the ED. When not boarded in the emergency department, patients are being shuffled to other areas of the hospital, such as the intensive care unit, which means that there are now fewer beds available for more critically ill patients. MNA/NNU nurses have been complaining urgently to Steward management for four weeks that patients are not receiving the level of nursing care they should expect and deserve, and that they are greatly concerned about immanent potentially negative outcomes.

“The public needs to know how worried we are, that we’ve been telling management we don’t consider this situation to be safe, and they have been refusing to discuss the issue with us for a month,” said Stacey McEachern, RN, a nurse in the emergency department. “The patients who are being boarded in our ED have been admitted to the hospital, but are not receiving an appropriate level of care because they are being placed on stretchers in an already full emergency room, waiting for a bed on a medical floor that no longer is available to them. The bottom line is patients are being deprived of the services they need. The only explanation that Steward management has given us is that the hospital is trying to cut costs, and that their parent company Cerberus won’t invest more money.”

The nurses have been attempting for months, well before the closing of the unit, to convince the hospital to negotiate with them to improve staffing levels. In the past 12 months, nurses have filed more than 150 written reports of unsafe conditions at the hospital where they felt the safety of their patients was placed in jeopardy. In early January, dozens of nurses from the hospital, including nurses from the unit that was just closed, were out in the community, handing out leaflets at T stations and shopping centers detailing their serious concerns about potentially unsafe staffing conditions at the hospital. Last Friday, nurses filed a report with the Department of Public Health, citing unsafe patient care conditions.

There have been several episodes in the past month in which there have only been two nurses on the schedule in the Emergency Department instead of the five nurses that are supposed to be on duty to care for patients under normal circumstances. McEachern and the MNA/NNU confronted management and asked how they expected the nurses to care for patients in the event of a “code” -- a critical case that demands at least two RNs, leaving no one else to care for other emergencies. Management has been non-responsive, saying they aren’t obligated to have that conversation.

“At a time when we already lacked the staff needed to provide the care our patients deserve, Steward has inflamed the situation by closing a unit that we desperately need ,” said Paula Ryan, RN, a nurse at the hospital and chair of the MNA local bargaining unit. “What is worse, they made this decision without fulfilling their obligation to meet with us and to ensure we had a staffing plan in place to ensure the safety of our patients.” The MNA/NNU is filing an unfair labor practice charge against the hospital with the National Labor Relations Board over management’s refusal to negotiate over these and related issues.

“Our members have had enough,” said Ryan. “We have attempted to negotiate for months with management. We have presented official reports; we have told them we are worried that there are immanent risks of negative patient outcomes. They have refused to respond except to say that this is a financial decision. We feel that we have a duty to our patients and our practice and to each other to take action. The final straw was last Friday: We met with management, they refused to bargain. They told us 10 beds in a small ancillary unit would be open ‘24 hours a day and seven days a week’ from now on to relieve some of the pressure. But they refused to commit to that or anything else in writing. Two hours later they closed that unit and it remained closed all weekend.”

The 236 nurses at Quincy Medical Center have been in negotiations for their first contract with Cerberus Steward, which purchased the hospital in October of 2011. Countless negotiations sessions have been held since December 2011.

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Founded in 1903, the Massachusetts Nurses Association is the largest professional health care organization and 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. The MNA is also a founding member of National Nurses United, the largest national nurses union in the United States with more than 150,000 members from coast to coast.