Terry Cowgill
Pittsfield — With its legal appeals apparently exhausted, Berkshire Medical Center will see its approximately 800 nurses go on strike tomorrow barring any last-minute developments.
BMC, the county’s largest hospital, took its nurses’ union to court last week over a one-day strike planned for Tuesday, Oct. 3. The suit questioned the legality of the planned labor stoppage, said it was a violation of the existing labor agreement, and sought an injunction and damages to compensate the hospital for the cost of replacement nurses.
For weeks the union has said the strike is about patient care and nurse staffing concerns. According to the National Labor Relations Board, workers may strike for either economic reasons such as wages benefits and working conditions or because of “unfair labor practices.”
Berkshire Medical Center in Pittsfield. Photo courtesy Berkshire Health Systems
But U.S. District Court Judge Mark G. Mastroianni denied the emergency injunction request in Springfield on Friday, dealing the hospital a setback and allowing the union to go forward with its planned work stoppage.
“We are disappointed that the federal court has denied the request for an injunction to prevent the strike scheduled for tomorrow,” BMC spokesman Michael Leary told the Edge. “This strike does not serve anyone’s best interests — not the nurses, not the hospital’s and not the community’s, and can only serve to harm all three.”
A spokesman for the Massachusetts Nurses Association, which represents the BMC nurses, said its members were pleased at the ruling and that they would be holding a Patient Safety Vigil on Monday from 6 p.m. to 8 p.m. before the 24-hour strike is slated proceed on Tuesday at 7 a.m., “unless BMC bargains in good faith and agrees to a fair contract.”
Represented by the MNA, the nearly 800 nurses at Berkshire Medical Center delivered a 10-day notice to hospital management last month notifying it of their intent to hold a one-day “unfair labor practice strike” beginning at 7 a.m. Tuesday, Oct. 3, and running until 7 a.m. Wednesday, Oct. 4.
That vote came three days after the union staged a forum at which five nurses told troubling stories of understaffed and overwhelmed nurses and certified nursing assistants.
Posters displayed at a Sept. 19 forum held at the First United Methodist Church of Pittsfield supporting the nurses’ contention that patient care was compromised by understaffing. The nurses union has now approved a one-day strike. Photo: Terry Cowgill
Negotiations began for a new contract about a year ago and include a federal mediator. More than 25 bargaining sessions have been held. On May 31, 82 percent of the union nurses rejected the hospital’s “best and final” contract offer.
In July, 83 percent of the nurses voted to authorize a potential one-day strike. The 16-member bargaining committee had the authority to call for such a strike provided it issues a 10-day strike notice, which it did, as required under federal law.
The union says BMC nurses have raised patient safety concerns to hospital management using various means for years including directly to supervisors, at labor-management meetings and during ongoing collective-bargaining negotiations.
But according to officials at Berkshire Health Systems, BMC’s parent organization, the strike will be considerably longer than one day. While BMC says it will bring in “experienced, qualified replacement nurses” to work in place of existing staff, the temporary nursing agency U.S Nursing Corporation requires a minimum five-day contract. Therefore the labor stoppage would result in greater financial losses for the striking nurses.
“We are fully prepared to provide uninterrupted care throughout the five-day period and have been preparing for this eventuality for several months,” Leary said. “The fact that this is the third such strike by the MNA since June makes it evident that this is a tactic the union is using to promote its statewide political agenda.”
The strike includes the following BHS holdings: BMC in Pittsfield, the Hillcrest Cancer Center in Pittsfield and BMC’s facility in North Adams. BHS holdings also include Fairview Hospital in Great Barrington. However, Fairview nurses are represented by a different union, which reached an agreement with BHS on a new contract late last year.
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What are the specific requests of the union to the management?
And what is the management’s response?
They want increased staffing levels and more a more favorable health insurance package. Management says staffing levels adhere to generally accepted norms. This information is in articles that are linked in the above story.
Thank you Terry.
1) Increased staffing levels. The nurses want a guideline for patient to nurse ratio, yes?
2) Health insurance. Can you be more specific? I heard that doctors pay less for insurance than nurses; is that one of the gripes?
10-5-2017
Shawn G.:
In partial answer to your question about nurse staffing levels: I think that what the BMC nurses want is something more sophisticated than a fixed hospital-wide guideline for patient to nurse ratios. Their ideas and concerns on this complex issue cannot be adequately explained in sound-bite form or even in a 25 word sentence. The professional literature on this subject is vast; no one study proves the nurses’ points definitively on the issue, but the sweep of the evidence from many rigorous, peer-reviewed research studies does seem to support their concerns strongly.
Unfortunately, none of our regional media reporters and editors appear to have bothered to read this literature, do in-depth interviews of independent experts on the subject, and summarize their findings in everyday language for readers and listeners. (As a former reporter and medical student, I am now inclined to try to do this work myself, and find a way to publish it widely.)
From what I have heard and read since early May, I strongly suspect that the main administrative issue for BHS management on this subject is not money, but management’s obvious strong desire to maintain complete control over staffing decisions, and not to give nurses any formal power in the making of those decisions. Maybe BHS has some very good clinical and philosophical reasons for this stance, but there needs to be much more public light shed on their thinking and reasoning in support of it, than has occurred so far.
The thinking of the nurses on this issue also may deserve more detailed public scrutiny than it has so far received, but they have already revealed their thinking in a lot more public detail than has BHS. Also, the documentation on their union website, in support of their staffing concerns, is much more extensive, detailed, and evidence-based, than the material on the same issue posted on the BHS websites.
I have begun to think that there is no way this staffing issue will be resolved appropriately without much more detailed public input, and maybe even formal public representation in the making of all BMC nurse staffing decisions.
Here are summaries of two examples of the many nurse staffing studies posted on the MNA website:
Comparison of the Value of Nursing Work Environments
in Hospitals Across Different Levels of Patient Risk
https://massnurses.org/files/file/Legislation-and-Politics/JAMA-Jan-20-2016-Comparison.pdf
“There is a 20% lower risk that a patient will die within 30 days of having general surgery at a hospital with above average nurse staffing levels, defined in this study as facilities that had a mean ratio of about 1.5 nurses per bed vs. those with a mean of less than one nurse per bed. Results were based on outcomes and cost of care of a total of 172,225 patients in 606 hospitals across 3 states (Illinois, New York and Texas) between 2004 and 2006.”
Better Nurse Staffing and Nurse Work Environments
Associated With Increased Survival of In-Hospital Cardiac
Arrest Patients
From: Medical Care (54:1) January 2016
https://massnurses.org/files/file/Legislation-and-Politics/Better-Nurse-Staffing-and-Work-Environments.pdf
“This major study published in the journal Medical Care (January, 2016) shows that patients who suffer a heart attack while in the hospital are more likely to survive in those facilities where nurses have safe patient assignments and higher RN staffing levels. The authors found that for every patient added to a nurse’s workload, the likelihood of a patient surviving cardiac arrest decreases by five percent per patient. Moreover, patients cared for in hospitals with poor work environments (where nurses had less autonomy over their practice and resources and weaker relationships and communication with physicians) had a 16% lower likelihood of survival after a heart attack in the hospital. The study included over 11,000 patients over a two-year period in 75 hospitals in 4 states across the country (Pennsylvania, New Jersey, Florida and California) and focused on only those hospitals with an incidence of more than 10 cardiac arrest events during the time period under study.”