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It’s about safe patient care

Worcester Telegram, 4/21/11

By Marlena Pellegrino, RN
Worcester Telegram

The St. Vincent nurses are making a stand for safe limits on nurses’ patient assignments to ensure you receive the care and monitoring that could save your life.

Imagine you are a patient at St. Vincent Hospital. It’s late at night, and you become short of breath, you feel a tightening in your chest, you’re scared, you’re in pain, you press the call button and you wait … and wait, as the pain in your chest increases, and your breathing becomes more rapid. You press the call button again. Where is the nurse? Why isn’t she coming?

The reality is, under the conditions that currently exist at our hospital, your nurse is most likely already responding to the alarms and call buttons of four or five other patients. He or she wants to be there for you, they need to be there for you but all too often they can’t be there for you because they are forced to care for too many patients at one time. Every minute you wait could be the minute that determines whether your condition is addressed and you survive, or whether you go without needed care and you suffer serious harm.

If you want to know why the nurses at St. Vincent Hospital have voted to hold a one-day strike, it is to ensure that we have an appropriate patient assignment so that we can be there when you need us to be there. It’s that simple. Every day our nurses leave the hospital worrying if they might have missed some subtle change in a patient’s condition that could alter the entire course of that patient’s recovery. The St. Vincent nurses are making a stand for safe limits on nurses’ patient assignments to ensure you receive the care and monitoring that could save your life.

The fact is, according the Journal of the American Medical Association, any time a nurse on a medical/surgical floor has more than four patients, the risk of death for all patients under that nurses’ care increases by 7 percent. So that when a St. Vincent Hospital nurse has five, six or seven patients, your risk of death increases by 7 percent to 21 percent.

According to the Massachusetts Hospital Association’s “Patient Care Link” web page, and our hospital’s own published staffing levels on that website, St. Vincent Hospital is the worst-staffed hospital in the city of Worcester, and ranks below the average staffing for many hospitals in Massachusetts.

As a result of these conditions, our nurses have filed more than 1,000 official reports of unsafe staffing conditions that could have compromised the care of our patients, more than two a day in the last 16 months. Given these results, it is no exaggeration to say that every day, on every shift, patients in our hospital are being placed in the type of situation I described at the opening of this column, and this is something the St. Vincent Hospital nurses cannot allow to continue.

To address this crisis, the nurses have been negotiating with Vanguard management for more than 16 months. We have been pleading with management for improved staffing conditions at every venue available to us.

Nothing changed until January, when Vanguard finally responded with a proposal to make “some” improvements in staffing. Unfortunately, while improving staffing on some floors, the hospital is planning to close eight intensive care unit beds, to eliminate the additional nurse staffing on a specialized intermediate floor that provides care to patients leaving the ICU, and is also planning to eliminate a team of specialized nurses who respond to patient emergencies throughout the hospital.

Under their new staffing plan, very critically ill patients may be forced out onto general medical and surgical floors, where nurses will not be able to provide the care these patients need.

While no nurse wants to strike, the overwhelming majority of us have voted to do so, because we believe we have no choice given the inability of Vanguard Healthcare, the Nashville-based for-profit owner of our hospital, to adequately respond to our concerns.

We are appalled that this corporation, which according to state filings has posted profits of more than $55 million in the last two years, is refusing to invest in the nurse staffing our patients deserve.

In this corporate health care environment, patients have become commodities, viewed as products on an assembly line. As nurses, we see you as the complex human beings that you are, and we are compelled by our professional ethics to defend the crucial nurse-patient relationship that is so important to your well being. When you push the call button, we want to be there, and that is what this struggle is all about.

Marlena Pellegrino, RN, BSN, has been a nurse at St. Vincent Hospital for 25 years, and is chairwoman of the Massachusetts Nurses Association Local 740 for registered nurses at the hospital.

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