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“What’s more important to your working conditions than the staff that you have to provide the care?” asks union negotiator Gail Williams, left, pictured with hospital union District President Fonda Osborn.
Wren Abott

Short Sh(r)ift

Nurse’s union, Christus at loggerheads over staffing levels

June 15, 2011, 1:00 am

Inadequate staffing levels at Christus St. Vincent Regional Medical Center were a major factor in the National Union of Hospital and Health Care Employees’ June 13 vote to authorize a strike.

District President Fonda Osborn tells SFR that the vote to authorize the negotiating committee to give notice of intent to strike was “overwhelming.” The negotiators will likely give notice if the hospital doesn’t extend the current contract, allowing more time for negotiation or to make concessions to the negotiators, such as allowing union members more power to set staffing levels. The strike would likely begin July 1, and would be the hospital’s first since 1988.

Nurses at Christus feel so strongly about staffing levels that they’re no longer willing to accept a seemingly sweet trade-off: time and a half pay for working understaffed shifts. That fix was put in place last year after union members prevailed in a mediation session regarding staffing complaints.

“They’re saving money by paying us a little more to put up with being understaffed,” a Christus nurse, who spoke to SFR on the condition her name not be used, says. “It’s like hush money. That’s very dramatic, but it is money that they’re paying us to compensate for not having that extra body when we’d rather have the extra body. I don’t care about time and a half. I want safety for the patients.”

Osborn and union negotiator Gail Williams say that sentiment is widespread among the hospital’s nursing staff. Requiring time and a half pay on “short” shifts was intended to give Christus an incentive to correct the problem. 

“But even with the penalty, we’ve had way too much understaffing,” Williams says.

Christus spokesman Arturo Delgado says the hospital hopes to eliminate that penalty in current negotiations. Delgado says the hospital is being forced to adhere to staffing requirements that are too rigid and is being punished for circumstances outside of its control, like staff calling in sick on short notice. In lieu of the penalty system, Christus hopes to institute a “staffing committee” composed of management and nurses to set staffing levels.

Right now, Christus’ staffing “grids,” or the union-approved staffing levels for different shifts, are actually good, Osborn and Williams say. The problem, they say, is that they’re not followed: Holes are left in the schedule when staff members call in sick, or even when there’s a job vacancy. If negotiations don’t change in their favor, the nurses may lose the ability to decide even staffing grids, which could be turned over to the new committee. Wary of jeopardizing the negotiation process, Osborn and Williams don’t want to reveal the specific sticking points. But Osborn, who says she has a “huge stack” of forms documenting short shifts, says negotiations are “not going the way we would like.”

A study published recently in the New England Journal of Medicine confirms what the nurses already know: Short staffing risks patients’ lives. The research, released in May, shows that patient mortality risk increases 2 percent with every eight hours a shift has fewer than the target number of staff. 

That’s why Williams and other nurses view California legislation passed in 1999, which sets minimum staffing ratios for different types of patients, as a model New Mexico should follow. Instead, Christus measures its practices against industry standards. On the surgical floor, Christus’ staffing grids dictate that there should be five patients per nurse, but often there are seven or eight, Osborn says. According to a University of Pennsylvania study, every surgical patient beyond four under a single nurse’s care increases the patient mortality risk by 7 percent.

“If they want to talk about industry standards, we get very nervous,” Williams says. “They want to save money but, if you can’t take care of your patients, it’s not going to save any money in the long run…Hospital industry standards are just hospitals’ way of trying to control the cost of labor.”

Delgado asserts that Christus is not understaffed, arguing that the hospital “has always provided safe staffing levels to care for the needs present in the hospital,” based on several factors, including industry standards.
“We feel like we have to be able to stand up [and defend safe staffing levels] to take care of our patients,” Williams says. “We’re the front line of surveillance for them. We are the advocates for our patients.”


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