Valley Hospital Spokane Valley

Photo credit to Harvey Brown

(By Kevin Graman) Nurses and other medical workers await a bargaining date for long-awaited contracts with the Deaconess Hospital, Spokane, Wa. and Valley Hospital, Spokane Valley, Wa. Their key demand for more staffing to improve patient health and safety goes unanswered by the hospitals’ for-profit owner Community Health Systems Inc.

Meanwhile, Service Employees International Union 1199NW, the union that represents nurses at Valley Hospital and technical and service employees at both Valley and Deaconess Hospitals, presses its efforts to convince the state Legislature to follow California’s lead and impose mandatory nurse-patient ratios in Washington hospitals.

Labor Dispute at Deaconess Hospital and Valley Hospital

“It’s about good quality patient care,” said Mary Robinson, a service technician at Deaconess Hospital Spokane and a member of the SEIU bargaining team. “It’s about having enough staff to do our job correctly.”

The union said the Tennessee-based company is cutting back on staff at its Spokane hospitals for the sake of larger profits. The SEIU local said administration has not responded to requests for statistical information that would back up workers’ case for more staffing at the Deaconess Medical Center, Spokane, Wa., and Valley Hospital in Spokane Valley, Wa.

“Patient falls, failure to rescue, infection all increase as patient-to-nurse ratios increase,” said Teri Nicholson, an outpatient nurse at Valley Hospital who is on the bargaining team.

Patient Falls at Valley and Deaconess Hospitals

By way of example, Nicholson cited an increase in patient falls following administration-ordered staffing changes at Valley Hospital in 2012. Several studies have associated patient falls with nurse-patient staffing ratios.

Deaconess Hospital Spokane, Wa

Photo Credit to Bryan Burke

In August 2012, the medical-surgical department celebrated going 13 months without a patient fall, Nicholson said. Later that month, the administration changed the patient-nurse ratio from four or five patients per nurse to six per nurse, she said. By October, the department experienced 13 falls, including two that resulted in severe injury to patients.

Patient falls resulting in injury or death must be reported quarterly to the state Department of Health. State records confirm that there were two such falls at Valley Hospital in the third quarter of 2012.  There are similar problems at the Deaconess Hospital.

In fact, DOH records available at http://www.doh.wa.gov/Portals/1/Documents/2900/689013.pdf show that since 2010 there has been a higher rate of patient falls resulting in injury or death at Valley and Deaconess Hospitals than at either Spokane’s Providence Sacred Heart Medical Center or Providence Holy Family Hospital, which are owned by Washington-based Providence Health and Services, a non-profit Catholic organization.

Sasha Weiler, a spokeswoman for Valley and Deaconess Hospital Spokane, said the for-profit hospitals take patient falls “very seriously,” and have put many initiatives in place to prevent them. However, she disputed a relationship between staffing decisions and patient falls.

“There are so many reasons for things like that to happen,” Weiler said. “I don’t think you can point to staffing ratios for an increase in falls.”

Contract Dispute Over Hospital Jobs

According to SEIU, Spokane Valley Hospital employees have worked without a contract since December 2012.  Spokane Deaconess Hospital service employees’ contract expired last May and its technical employees’ contract expired in August.

In November, after the union filed an unfair labor practices complaint against Community Health Systems Inc.-Rockwood Health Systems for not coming to the bargaining table, a mediator was called in, Nicholson said.

In December, Spokane Valley Hospital locked out about 80 nurses for 72 hours and brought in replacement workers after the nurses and other employees held a one-day strike at Spokane Valley and Deaconess Hospital Spokane. Reviews from the community have mostly been in favor of the striking workers.

The Spokane Area Community

The hospital employees and their demands have won the support of other labor and community groups.

SEIU Health Care Workers Strike against Valley and Deaconess Hospital Spokane

Photo Credit to Bryan Burke

SEIU has won the support of other labor and community groups in the Spokane area for the demands of the hospital employees at Valley Hospital and Deaconess Hospital.  Spokane City Council President Ben Stuckart and City Council members Jon Snyder and Amber Waldref wrote a letter to Deaconess and Valley hospital officials raising concerns about medical staffing levels.

In response, the Community Health Systems lobbyist representing the owners of Deaconess Hospital Spokane and Valley Hospital requested that Spokane City Attorney Nancy Isserlis issue an advisory ethics opinion about the council members’ use of city letterhead.

The request by hospital lobbyist Tom Parker was later dropped, The Spokesman-Review reported.

Eliminating Jobs and Hours

SEIU spokeswoman Nicholson said the union has proposed nurse-patient ratios similar to those in California, which became the first state to mandate ratios 14 years ago.

The Washington State Hospital Association opposes any new state law mandating clinical staff levels for hospitals. This includes House Bill 1095, establishing staffing ratios, and HB1153, regulating meal and rest breaks for hospital nurses as well as limiting overtime and on-call staffing. For further detail on WSHA policy visit http://www.wsha.org/policyadvocacy.cfm

Association spokeswoman Mary Kay Clunies-Ross said such rules “make it impossible to make adjustments in staffing based on acuity of patients and undermines effectiveness of nurse staffing committees.”

However, the union said that Spokane Deaconess Hospitals and Spokane Valley hospitals routinely ignore the direction of their nurse staffing committees, which are created by state law to set appropriate staffing levels.

Nicholson said the number of patients per nurse – individualized for each department — is not the only issue the union has with staffing by administrators at Spokane Valley and Spokane Deaconess Hospitals.

“They have also cut back on aides and secretaries and cut back on techs’ time by 20 percent,” Nicholson said. “Routinely at end of quarters they cut back to increase revenue.”

She said secretaries in intensive care have been reduced “so there’s no one to watch the monitors or take phone calls.” Transport staff has been cut, “so nurses have to leave their units to transport patients.”

“In my department, which is outpatient, when people leave they don’t replace them, resulting in forced overtime,” Nicholson said. “There are jobs open, and they tell us everything has to go through Tennessee. Ultimately we just don’t get them replaced. Everywhere they can they drag their feet.”

Robinson said it’s much the same at Deaconess Hospital in Spokane.

“In every bargaining unit, staff is shrinking through attrition or through the company cutting hours” and effectively eliminating Deaconess jobs, Robinson said.

For example, housekeepers at Deaconess Hospital are being sent home early every day, she said. So housekeepers have to ask, “OK, what don’t we clean today?” Robinson said her department, which is in charge of sterilizing surgical instruments, often gets backed up and workers face excessive overtime.

At Deaconess Hospital, “Sometimes we have had to cancel or postpone surgery because we didn’t have an instrument pan ready,” Robinson said.

Weiler, spokesman for Valley Hospital and Deaconess Hospital, said staffing changes at Valley Hospital were the result of organizational changes in which post-operative patients were separated from medical and oncology patients and that the staffing levels at Deaconess and Valley hospitals are “consistent and appropriate” based on patient need.”

“Compared to like-sized and acuity hospitals across the country, our (staffing levels) are very much in line with nursing standards,” the hospitals’ spokeswoman said. “There have not been any across-the-board staffing changes or layoffs at any of our hospitals.”

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