May 10, 2008 in City
Hospital, union spar over staffing
Union nurses at Deaconess Medical Center contend that layoffs and low morale have eroded patient care and safety and demand management rehire nursing assistants to preserve the core mission of Spokane’s second-largest hospital.
The nurses have taken their concerns public, acknowledging that it could further damage the hospital’s fragile financial condition.
“But at this point, we feel people need to know things are getting worse at their community hospital,” said Chris Barton, secretary of the Service Employees International Union 1199 NW.
The allegations are hotly contested by many at Deaconess, where about 90 employees jammed a hastily arranged press conference Friday afternoon to denounce what they called a union misinformation campaign that smears the hard work of doctors and nurses.
“Their actions and words are deplorable and borders on irresponsibility,” said Ron McKay, board chairman at Empire Health Services, which operates Deaconess and Valley Hospital and Medical Center. He said the union, a local chapter of the Service Employees International Union (SEIU), is using Deaconess as a prop in its campaign to mandate national hospital staffing levels that would increase union membership and dues collections.
Diane Sosne, president of SEIU’s Northwest operations, called the assertions nonsense.
“We’re not running a campaign. We’re advocating for patients and practicing our professional responsibility,” she said.
Thirty-four registered nurses have resigned since Deaconess’ surprise February layoffs of most certified nursing assistants and other aides.
“Most quit in the first 40 days as a protest to what is happening,” Barton said. “It’s very serious when you have a mass resignation of nurses.”
But Deaconess managers said only nine of the departed nurses stated during exit interviews that the financial uncertainty of the hospital was their reason for leaving. None said leaving was related to patient care.
SEIU was poised two months ago to air its members’ grievances. The union held off at the request of hospital managers and finished negotiating a labor pact signed eight days ago. It provides a pay raise but does not restore staffing levels. Rather than jointly announcing the deal, SEIU placed an advertisement in The Spokesman-Review last Sunday questioning patient care and safety.
Nurses also have filed 200 incident reports of patient safety and care lapses with Deaconess managers, hoping that their written worries would spur change.
Now SEIU is ready to submit the reports to the Washington state Department of Health.
Shelley Peterson, chief nursing officer at Deaconess, insisted that patients are safe and cared for by a dedicated, professional staff.
She recounted how nurse managers meet twice daily to review every patient file to ensure proper staffing levels and care.
And Peterson pointed to a March 25-28 inspection by state health officials that found conditions were favorable at Deaconess.
The inspectors were specifically looking for evidence that the layoffs or pending sale of the hospital system was affecting patient safety.
Registered nurse Deb Shafer, who works in the neonatal intensive care nursery, said she would bring her family to Deaconess.
“I would encourage others to do the same,” she said.
But registered nurse Patti Parra, who spoke at a union meeting late Friday afternoon, said nurses at Deaconess are fretting about providing the best care possible.
“I’m concerned that I can’t give the best care I can without safe staffing,” she said.
Nurse’s aides provide critical services to patients. Spreading those jobs to nurses may mean some bedside care will be late or may not get done at all, she said.
Arveta Boone, a licensed practical nurse, said nurses are stressed and overworked, and patients are noticing.
“Patients see how busy we are and say ‘I’m sorry to bother you, but …’ and that shouldn’t ever happen,” Boone said. “Patients shouldn’t feel like they’re a burden to nurses.”
Sosne said if changes aren’t made, SEIU may press its concerns with state officials.
Despite the staffing cutbacks, frequent change among hospital administrators and constant financial pressures, several physicians said Friday they are confident patient safety is intact and refuted claims of declining patient care.
“(Deaconess) does not have unsafe conditions for patients,” said Dr. Greg Jones, who runs the hospital’s wound healing unit and other services. He said he would not entrust his patients to a system he didn’t believe was safe.
Cardiologist Dr. Pierre Leimgruber recounted a busy evening at Deaconess and said not once was he concerned about the ability of the staff to safely care for his patients.
Leimgruber is a member of the Empire board of directors, which has greenlighted the $156 million sale of Deaconess – along with Valley Hospital and Medical Center – to Tennessee-based Community Health Systems Inc., the nation’s largest for-profit hospital owner.
The deal is now being scrutinized by state regulators who are attempting to ensure the sale of the century-old community nonprofit health system is in the best interests of Spokane.
A decision is expected in the fall.
Meanwhile, the financial condition of Empire’s hospitals has deteriorated. McKay and other Empire officials, along with executives of Community Health, said the uncertainty of a sale can leave hospitals in a sort of fiscal limbo. He said recently that the changes – including layoffs, better inventory control and better buying strategies – have helped stabilize the hospitals.