Christus Nurses Vote for 40th Percentile, Enforcement

Union vote Saturday late into night on contract with management where both sides make concessions

Christus St. Vincent Regional Medical Center union members overwhelmingly voted to ratify a three-year contract with the hospital's management late Saturday night.

The vote was all but certain following a late-night agreement by top union delegates Wednesday night to recommend approval to its members of management's offer.

Christus St. Vincent CEO Bruce Tassin issued a memo Thursday to employees saying he "strongly" recommends the adoption of the contract by the District 1199 of the National Union of Hospital and Health Care Employees, whose negotiating committee also urged members to adopt to agreement after they spent two months picketing outside the hospital for more robust staffing levels.

Tassin says in a statement released last night that management is "pleased" membership voted to ratify the contract.

"We will now focus on moving forward and, as always, continue working together to provide high-quality care to our patients and their families," he says.  "Our ultimate goal was always based on a win-win philosophy that would result in accountability from the Union with respect to patient satisfaction."

Part of the agreement ties 1.5 percent pay raises in 2015 and 2016 for nurses to patient satisfaction scores, which the hospital says have improved over the years with current staffing levels but which have been below average, leading to a $2 million cut in Medicare funding from the federal government.

In the agreement, the hospital "committed" to staffing targets no lower than the 40th percentile for nursing units and no lower than the 33rd percentile for tech units over the next three years, according to Tassin's memo to employees.

That means Christus St. Vincent's nursing units will be staffed below that of 60 percent of peer hospitals. For technical employee units, 67 percent of similarly sized hospitals will have more robust staffing.

Departing local 1199 President Fonda Osborn says that while the union didn't get everything it wanted, the staffing floor gives it a "foundation" to ensure better staffing levels. For instance, one the of the early demands of the union, she says, was that hospital management look at staffing on a shift-by-shift basis instead of in the aggregate. Tracking staffing levels in the aggregate, she says, led hospital management to leave "holes" in staffing schedules on units, like only scheduling 4 nurses on the medical-surgical unit when it called for seven nurses.

The 40th percentile is around the same target staffing number the union had been protesting for the past three years, but the union got a concession out of management by getting the hospital to self-monitor daily for compliance checks with staffing needs. The hospital "will pay up to $900 per day into a nurse and tech education fund if staffing is not on target," says Tassin's memo, "except for attendance issues and other exceptions" out of the hospital's control.

The agreement comes after union picketed the hospital for over 60 days and more than a half year of protracted talks.

"So while it took seven months to reach an agreement," Tassin says in his statement, "it was because of our unwavering stance that the patient experience must always be our first priority. 

Still, union members indicate they'll push the staffing issue in other venues.

Osborn says staffing levels should not be an issue in contract negotiations and that she hopes the legislature will pass "safe staffing" legislation next year.

"We really had to move a mountain to get here," she says. "We're the only nurses in the state that had that ability here because we fought for it."

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