Long-simmering tensions between Steward Health Care System and the union representing most of its nurses boiled over Tuesday as the union said its members authorized a one-day strike at Quincy Medical Center after the Steward-owned hospital closed a 40-bed medical surgical floor.
Late last month, the Massachusetts Nurses Association was notified that the money-losing Quincy hospital, acquired by Boston-based Steward in 2011, was shutting down the medical surgical floor and laying off 30 nurses who worked there along with 40 technicians, orderlies, and laborers, according to David Schildmeier, spokesman for the nurses association.
“Our concern is not just the layoffs, it’s the closure of the floor,” Schildmeier said. “The deal when they bought the hospital is that there was going to be no reduction of care.”
Staffing has been a sticking point in the ongoing contract negotiations between the nurses union and four Steward hospitals, including Quincy. Nurses filed more than 1,000 “unsafe staffing” complaints against the hospital last year. Steward, owned by private equity firm Cerberus Capital Management, denies there are safety problems and says it is working to stem losses at Quincy in the face of weak patient volume and declining reimbursements for medical care.
Association members at the Quincy hospital, who warned that fewer beds have resulted in patient backups, voted 200-13 Monday night to authorize the union to call a one-day strike if Steward does not negotiate over the floor’s closing. The strike day has not yet been set, but union officials already have filed a charge with the National Labor Relations Board contending that the Quincy hospital’s owners are refusing to bargain over implemented changes.
Steward spokesman Chris Murphy confirmed Tuesday that Quincy Medical Center reduced its number of medical surgical beds last month, but he said they could be added back in the future if warranted by demand. Currently, he said, there is a greater need for outpatient services and Steward can’t afford to allocate staff to beds that aren’t being used. Murphy said the hospital had 54 available beds Tuesday but only 34 patients in medical surgical areas.
“It’s very unfortunate that reducing the number of inpatient beds results in a reduction of staff,” Murphy said. “But when a hospital is losing money the way Quincy is, you have to dedicate your resources to services that the community is utilizing.” He said the hospital has 20 nurses vacancies in outpatient units and that laid-off nurses can apply for those jobs if they have the necessary experience.
Unionized nurses and Steward officials offered starkly different views of conditions at Quincy Medical Center. While Murphy contended the hospital has empty beds and one of the shortest emergency room wait times on the South Shore, nurses said the shuttering of the medical surgical floor has left “boarders” waiting for hours in the emergency department—some of them suffering from cardiac or respiratory problems—with no nurses to care for them.
Closing the surgical unit “significantly negatively impacts the patients and the staff,” said Stacey McEachern, an emergency room nurse at the hospital and a nurses union leader. “Patients are waiting in the emergency department instead of being up in their beds, which increases waiting time in the waiting rooms. It’s stressed the already short staffing and creates a bottleneck and domino effect on the entire hospital.”
Union official Paula Ryan, a recovery room nurse who said she was born at the Quincy hospital and delivered her own children there, disputed Steward’s claims that the Quincy hospital has 20 open nursing positions.
“There seems to be a big disconnect between management and what we do, what our responsibilities are to the public, what our license dictates for us to do,” Ryan said. “They don’t understand what our job function is, and I can only say we will advocate for our patients and our practice. That’s what nursing is about. We’ll continue to speak out about our patients.”
Murphy, however, said the volume of patients using the medical surgical beds has been so low in recent months that nurses are sometimes reading because there is nothing to do.
He noted that Steward saved about 700 jobs in 2011 when it acquired the then-bankrupt hospital and since has absorbed $23 million in losses. The chain also has invested $32 million in new construction, renovations, hiring new doctors, and technology improvements, he said, while committing another $20 million to new operating rooms and labor and delivery units.
“We need to staff the hospital for the volume we currently have,” he said. “No hospital, regardless of tax status, can lose millions or dollars a year and stay open.”
The Massachusetts Nurses Association said a vote turned out 90 percent of members in the union. They voted 200-13 in support of a strike.
The vote gives authority to the nurses’ elected bargaining committee to schedule a strike. The hospital will have 10 days notice before a strike can occur.
“The public needs to know how worried we are, that we’ve been telling management we don’t consider this situation to be safe, and they have been refusing to discuss the issue with us for a month,” said Stacey McEachern, a nurse in the emergency department.
According to the union, the surgical unit closure, which Steward Health Care officials have not confirmed, was initiated on Feb. 17.
Nurses say the change has resulted in patients being boarded in the hospital’s emergency department. Union officials have also said that the elimination of the surgical unit is part of a decision to reduce staff by 30 nurses.
Hospital officials could not be reached immediately to comment on the strike vote. On Monday, Steward officials would not confirm if there is an overall reduction in staffing, but said that Quincy Medical Center currently has 20 open positions for nurses.
Hospital officials also have said there is adequate room for patients, and that the hospital is merely shifting priorities.
Nurses say they are at the end of their patience, and that they were pressing for the hospital to hire more nurses well before the announcement of another reduction.
“At a time when we already lacked the staff needed to provide the care our patients deserve, Steward has inflamed the situation by closing a unit that we desperately need,” said Paula Ryan, a nurse at the hospital and chair of the MNA local bargaining unit. “What is worse, they made this decision without fulfilling their obligation to meet with us and to ensure we had a staffing plan in place to ensure the safety of our patients.”
In response, nurses say they have filed more than 150 written reports of unsafe conditions at the hospital. On March 15, the union filed a report with the Department of Public Health, citing unsafe patient care conditions.
The union says they are additionally filing an unfair labor practice charge against the hospital with the National Labor Relations Board due to management’s decision not to negotiate with the staff over staffing and other issues.
“Our members have had enough,” Ryan said. “We have attempted to negotiate for months with management. We have presented official reports; we have told them we are worried that there are immanent risks of negative patient outcomes. They have refused to respond except to say that this is a financial decision.”