A federal appeals court has overturned Sacred Heart Medical Center’s button ban that muted nurses’ concerns about the hospital’s commitment to safe staffing levels.
The Washington State Nurses Association said the ruling preserves nurses’ right to speak up about patient care and workplace safety.
“Nurse staffing has an effect on healthy patient outcomes,” said association spokeswoman Anne Tan Piazza. “That’s the bottom line why this issue is so important.”
Sacred Heart declined to comment on the ruling. Patrick Clarry, human resources director for the hospital, said the issue evolved into a dispute between the nurses association and the National Labor Relations Board.
The 9th U.S. Circuit Court of Appeals ruling stems from 2003 contract negotiations between the 1,200 registered nurses and the hospital. To highlight their concerns, some registered nurses began wearing buttons bearing the statement: “RNs Demand Safe Staffing.”
Sacred Heart executives, reacting to worries expressed by nurse managers that the buttons might disturb patients and family members, issued a ban.
The hospital wrote, in part: “This message … disparages Sacred Heart by giving the impression that we do not have safe staffing. We cannot permit the wearing of these buttons, because patients and family members may fear that the Medical Center is not able to provide adequate care.”
Executives also puzzled over the nurses’ decision to wear the buttons even after reaching agreements related to staffing.
Several nurses were told to remove the buttons, though no one was disciplined.
The Washington State Nurses Association, which represents the nurses union, filed an unfair labor practice charge.
An administrative law judge ruled in favor of the nurses.
The hospital appealed to the National Labor Relations Board. In a divided opinion, the board sided with Sacred Heart that the button ban constituted “special circumstances” because of the button’s “inherently disturbing” message.
The issue then landed in front of the 9th Circuit court, which ruled this week that the board erred.
“The board’s determination that special circumstances justified Sacred Heart’s ‘RNs Demand Safe Staffing’ button ban is not supported by substantial evidence in the record,” wrote Judge Richard Paez. “In fact, it is not supported by any evidence.”
The only “offer of proof” of button-related disturbance by Sacred Heart was in the form of concerns by nurse managers, rather than cited examples or testimony of patients and patients’ families saying they were upset.
Paez wrote: “The board’s approach was contrary to its established precedent … and to the basic adjudicatory principle that conjecture is no substitute for evidence.”