UMass Memorial and Nurses Union Clash Over “Dangerous Mismangement”

Thursday, November 15, 2012

Ashley Klann, GoLocalWorcester Contributor

Local nurses protested last week against what they called "dangerous mismanagement" at UMass Memorial Medical Center, but the hospital denies that any of its changing policies will threaten the hospital’s quality or their employees’ jobs.

The Massachusetts Nursing Association (MNA) says that the hospital is guilty of falling from the top spot in the city to the worst staffed hospital in Worcester after six staff cuts in two years. The most recent cut came in September when 140 nurses were laid off.

UMass Memorial nurse, Margaret McLoughlin, said that there is a “disconnect and disrespect” at the hospital right now.

“With a hospital continuing to make drastic cuts, it’s going to affect the patients. I’m not sure the hospital understands the magnitude of the impact. With the hospital being run like it is, it’s making it nearly impossible to put patients first.”

The MNA is claiming that the hospital has maintained a posted $88 million surplus, yet continues to cut jobs.

“It’s like they don’t care about the patient anymore," said ICU nurse Ellen Smith. "That’s the bottom line: how quick they can speed things up and how much money they can make. That doesn’t work in healthcare. These aren’t vehicles, they’re human beings."

Area politicians spoke out at the protest held last week. City Councilors Sarai Rivera, George Russell, and Philip Palmieri were in attendance, as well as State Senator Michael Moore, State Representative Jim O’Day, and Representative-elect Mary Keefe.

Clashing Claims

Despite support from area politicians, UMass Memorial Medical Center has posted several releases on their website stating that the claims made by the union are false.

“We are proud of our nurses and the great care they provide. We are committed to continuing discussions with the MNA, and finalizing a contract that is fair and equitable to all,” said Rob Brogna, Media and Public Relations Manager at UMass Memorial Medical Center.

He said that despite the MNA’s words, quality care at UMass Memorial Medical Center is not under threat after staff cuts. Brogna also said that their operating costs have dropped in recent years.

"We have made the MNA leadership aware that, since 2008, our operating margin has fallen at the Medical Center. Our operating margin was $68 million in 2009; $49 million in 2010; $46 million in 2011. We anticipate that when our financials are complete for fiscal year 2012, we will end the year with a breakeven operating margin or slightly better."

He added that despite "economic headwinds and a new financial reality in health care," UMass Memorial Medical Center remains committed to its patients' care.

McLoughlin said that the statements UMass Memorial Medical Center is putting out aren’t shocking, given their attitude.

“I’m not surprised at their response, but what the union is saying is in fact right. They’re trying to make cuts. They’re trying to make themselves look better than us.”

On their newly acquired website, umassmemorialchange.org, UMass said that although they are nationally known for their quality care, they disagree with the MNA’s request for a mandatory staffing ratio. They said studies have shown that mandated ratios do not improve the quality of care.

McLoughlin said that the management staff at UMass Memorial is severely disconnected with how the cuts affecting the hospital.

“I’d like to see management come down and put on their scrubs and do what we do – not one has ever volunteered,” she said. “I wish they would look at what they’re doing and look at the ratios. They need to work with us to get a good contract and protect our pension, and look at benefits that they’re trying to take away.”

According to information provided by UMass Memorial, mandatory staffing ratios did not improve the quality of care, decrease patient mortality, patient safety events, or patient outcomes. On top of this, they said that the staffing demands that MNA is requesting would cost $50 million and eliminate flexibility.

Understaffed?

While the hospital said the staffing levels are adequate, the MNA’s primary concern, McLoughlin said, is that with the recent cuts, their ratio of nurses to patients is getting worse.

ICU nurse, Ellen Smith came to UMass in 2002 from St. Vincent’s due to the staffing.

“UMass had some of the best staffing where I went to work. Now they have the worst. It’s all about taking care of patients,” she said. “In ICU where we work, they’re trying to double these patients. You can’t do that.”

McLoughlin added that patients on average have been arriving in worse condition than she witnessed when she started

“It’s a personal level to us, and on a business level for them,” she said.

According to her, the hospital’s resource nurses are taking on five or six patients, “Which doesn’t sound like a lot, but when you’re thinking about how much you’re doing for them – helping them to bathroom talking to family, explaining the procedure... It’s not just a hit and run.”

McLoughlin said that one of her major concerns is not allowing nurses adequate time to educate and explain procedures to patients.

“When you keep pushing back and loading more and more on the nurse and taking us away from the bedside, it’s putting a bad weight on nurses,” she said.

Brogna remains confident, however, that UMass maintains appropriate staffing levels.

"There are many variables and differences - not only between units within one hospital, but also between hospitals - when it comes to appropriate staffing levels," he said.

"These differences range from patient acuity, patient census and the experience and skill of the staff. Hospitals across Massachusetts and the country have consistently rejected efforts to put mandatory staffing ratios into collective bargaining agreements. One size does not fit all patient needs."

Hand Over Fist

Smith is asking the hospital to reinstate the jobs that were previously cut.

“If they’re making all this money… The stuff they send out is very inaccurate. Umass Memorial is making money hand over fist,” she said. “They’re trying to get the public against the nurses.”

Smith repeated some of the same issues McLoughlin stated, including the relationship between management and nurses. She says there are things you don’t see on paper.

“The managers run the rounds, never putting on a pair of scrubs. They probably couldn’t do our job now. It all looks good on paper, but if look at it, the patients aren’t getting the right care,” she said.

Still, the two remain hopeful that the MNA will be able to work out a fair contract.

“We’re always hopeful to work out a good contract. We’re still trying to put our best foot forward,” McLoughlin said.

Smith said she was unsure of when they may meet a resolution.