Over Longstanding Concerns About Poor Patient Care Conditions

After Posting More Than $88 Million in Profits, UMass Memorial Medical Center Has Slashed its Nursing and Support Staff in the Last Two Years and Has Gone From Being the Best Staffed Hospital in the City to the Worst, While Also Posting Among the Lowest Rankings in the State for Quality Patient Care

WORCESTER, MA – In response to deteriorating patient care conditions, the registered nurses who work at the Worcester-based hospital campuses of UMass Memorial Medical Center (UMMMC) cast an overwhelming vote tonight to authorize a one-day strike as management continues to refuse to agree to desperately needed improvements in staffing levels at this major tertiary care provider.

More than 2,000 nurses are represented by the Massachusetts Nurses Association/National Nurses United at UMass Memorial Medical Center. The secret ballot vote was held throughout the day at Coral Seafood Restaurant in Worcester, with 83 percent of the nurses voting in favor of a strike. The vote does not mean the nurses would strike immediately. It gives the negotiating committees 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 would then have 10 days before the nurses would go out on strike.

The strike vote was called after the nurses on the University Hospital and Memorial/Hahnemann campuses of UMMMC have been engaged in over a year of negotiations for a new union contract, with little progress on a number of key issues, including the nurses’ call for safer RN staffing levels. The nurses are outraged about poor patient care conditions, a lack of resources, and untenable patient loads following more than six layoffs involving hundreds of RNs and support staff over the last two years.

“With this vote our nurses are sending a strong message to management that something has to change; our patients are suffering, and nurses are struggling every day under dangerous staffing conditions that prevent us from providing the quality care we want to provide, and that our patients deserve,” said Margaret McLoughlin, RN, a nurse in the intensive care unit and co-chair of the MNA//NNU local bargaining unit on the University campus. “We sincerely hope that management heeds this message and comes to the table ready to work with us to address our concerns for the good of our patients and our community.”

“No nurse wants to strike, but our nurses are committed to do whatever we need to do to protect our patients,” said Lynne Starbard, co-chair of the nurses’ local bargaining unit for the Memorial/Hahnemann campus. “Perhaps now management will do what is necessary to reach a fair settlement with safe staffing for quality patient care.”

According to official staffing plans posted on the Mass. Hospital Association’s “Patient Care Link” web site, UMMMC has gone from having the best RN staffing levels in the city to now having the worst RN staffing for most of their units. These staffing levels have had a demonstrable impact on the systems’ quality of care. Last Fall a report by the federal Medicare program showed that the UMass system was listed among the 10 hospitals in the state receiving the highest penalties by the government for poor patient care, specifically for the rate that UMass patients are readmitted to the hospital post discharge because of preventable complications related to their care. Studies have shown the RN staffing levels are directly related to hospital readmission rates.

“When nurses have too many patients to care for at one time, complications are more likely and at UMass, we have been warning management about these conditions for two years, yet they continue to cut staff,” said Starbard.

In fact, back in May and June at special meetings held with management called by the nurses to discuss the staffing crisis, dozens of nurses from every unit and department at both campuses presented harrowing testimony about how poor staffing conditions on their units are compromising their ability to deliver optimal, and sometimes even safe, patient care. Here are some of the situations presented at those hearings:

An intensive care unit nurse described a horrific night being assigned an unstable patient on an overburdened unit, and the toll it took on her to make it through the shift. "On nights like that you go home crying because you know you didn't do enough, and you know these patients' lives are hanging in the balance of our competence and the staff we have to take care of them."

One nurse spoke questioning the veracity of UMass calling itself a Stroke Center of Excellence, when it won't provide its nurses on its neurological floor with the staffing resources they need to deliver appropriate care. "You need to sit with these patients for a good hour to go over their systems; they are all on telemetry monitors, some are aphasic, which means they can't tell you what they need. If we had the staffing numbers we need, we could have the time to spend with these patients. We could better prevent falls and we would have the time to provide education; teaching them how to recognize or prevent another stroke."

Nurses from the neonatal intensive care unit almost brought the room to tears describing the frustration they feel caring for the sickest babies, with families in the worst crisis in their lives, and not being able to comfort them. They told of babies coming back into the unit post discharge because they didn't receive the care they needed. As one nurse put it, "I love my job, but lately, I feel like a failure every day. You should be ashamed of yourselves,” she told management.

So how did the hospital respond to the nurses’ plea for help? Management cut the staff even further, implementing two more rounds of layoffs on both campuses.

In their call for safer staffing levels, the nurses point to dozens of studies published in the most prestigious medical journals that clearly demonstrate that the RN-to-patient ratios the nurses are seeking not only prevent complications and save lives, but safe staffing can also save millions of dollars. Again, the nurses point to the recently assessed penalties from Medicare for UMMMC due to poor care, which could have been avoided with appropriate staffing in place.

"We are appalled that with all the data supporting our plea for safe staffing, the management team at UMass Memorial has opted to disregard the numerous studies and directed the nurses to 'do more with less.' Just since this most recent round of layoffs, I have received dozens of official reports of unsafe staffing from nurses in the Maternity Center, the NICU, the emergency department and the medical surgical units,” said Colleen Wolfe, co-chair of the MNA local bargaining unit representing 1,000 nurses on the Memorial and Hahnemann hospital campuses. “Patients are at increased risk and are indeed suffering preventable infections such as MRSA, and pneumonia. They are also at increased risk of blood clots, heart attacks and post operative complications. Laboring mothers in our high risk tertiary center are not receiving the focused attention they need from their nurse. This puts mothers and babies in further jeopardy. We are here today to tell you that we are in trouble! There are not enough of us to safely care for our patients! We need safe staffing.”

Adding insult to injury, in addition to forcing nurses to work under increasingly stressful and dangerous conditions, UMMMC management is also seeking to gut the nurse’ benefits package. Once again UMMMC wants to cut the nurses pension benefit, an issue that drove the University-campus nurses to wage a five-hour strike back in 2007. Management also wants to increase nurses’ cost for health insurance and to cut their time off benefits.

The nurses are concerned that these cuts are being made in the wake of the hospital’s posting more than $87 million in profits in the past two years, even after the hospital was fined more than $1 million by the state’s Attorney General for perpetrating a scam of insurance companies for having high priced models dressed in blue wigs parading though shopping malls to lure unsuspecting consumers into undergoing overpriced bone marrow testing.

In response, the nurses are asking the hospital to retract their demands for benefit concessions and to provide contractually guaranteed limits on nurses’ patient assignments. The staffing limits proposed by the nurses are based on the best scientific evidence for quality patient care and, in the case of the maternity and neonatal units, on nationally accepted standards of best practice.

“Nurses at this hospital provide 90 percent of the care our patients receive. Most of us have spent decades in these institutions and want UMass to return to what it once was, which was the flagship system in the region, if not the state,” McLoughlin concluded. “Because of our commitment to our patients, this community and our professional license, we are determined to do whatever is necessary to ensure the safety of our patients and the dignity of our nurses.”

The nurses and management began negotiations for a new union contract in February 2012 for the University campus nurses and in November 2011 for the Memorial/Hahnemann campus nurses. To date more than 20 sessions have been held with each of the two committees. The nurses’ contracts officially expired on December 31, 2011 and April 5, 2012 respectively, and the next negotiating session is scheduled for April 12 with the University campus committee and April 17 with the Memorial/Hahnemann campus committee.

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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 170,000 members from coast to coast.

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