June 21, 2018
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National nursing union demands not appropriate for Bangor

By Mike McInnis , Special to the BDN

As a trustee at Eastern Maine Medical Center for several years, I have watched as EMMC has received award after award for quality, patient satisfaction, contribution to national patient safety initiatives and leadership in best practices from primary care to trauma services. I listened at board of trustees’ meetings as proud staff nurses told us about EMMC’s selection (one of only 16 medical centers nationwide) to participate in a Robert Wood Johnson funded, staff nurse-driven project to improve patient care while increasing both nurse and patient satisfaction.

All of this makes me immensely proud of the leadership that EMMC has shown in Maine and beyond, and of the care patients receive from the whole health care team. Clinical outcomes are excellent and overall performance is consistently high.

As a result, I also find myself both mystified and discouraged at the lengths to which the national union representing EMMC’s nurses is willing to go in the current contract negotiations. Emotionally charged claims made by the Maine State Nurses Association/National Nurse Organizing Committee/ National Nurses United about nurse staffing at the hospital are vague and an unsettling tactic. The union has demanded contractual nurse-to-patient staffing ratios to solve alleged staffing problems even though the levels of staffing that the union’s ratios would “enforce” at hospitals across the country are usually exceeded by EMMC’s staffing model. Yet the union insists EMMC nurses are overworked and exhausted.

The trustees have reviewed inpatient nurse staffing information and are convinced that the nursing assignments at EMMC meet and often surpass nationally accepted levels. As community representatives, we ask tough questions about these and other issues on an ongoing basis and are satisfied with the information we receive both from leadership and from the negotiating team.

The truth is that nursing overtime at EMMC is below 2 percent, mandated overtime is less than 1 percent of total nursing hours worked, and 99 percent of EMMC’s full-time nurses average fewer than 40 hours a week. These are facts, gathered from actual payroll and staffing assignment data. EMMC is reassuring the community by releasing actual data that unequivocally refute the union claims of nurse understaffing.

This union’s California-based leadership does not appear to understand that its national agenda is not relevant here in Bangor.

A local minister and a state representative recently wrote a column published in this newspaper accusing the trustees of not listening to the nurses. The information cited was at times incomplete and at others inaccurate.

I welcome the opportunity for this legislator and any legislator to contact us regarding their concerns and look forward to providing accurate information to assist them in representing all members of our community.

The column criticized EMMC for having 100 fewer nursing full-time positions at EMMC than in 2009. In fact, we have had fewer patients, we suspect, in part because of the economy. It is appropriate to adjust nurse staffing to reflect patient volume.

The column also observed that EMMC has eliminated an entire shift. EMMC has followed the national trend and converted three nursing units from eight-hour shifts into two 12-hour shifts per day. It’s a popular option with many nurses because they can maintain full-time status working 12 days a month. In neither instance has the nurse to patient staffing model at EMMC changed.

No hospital can say it is perfectly staffed every shift every day. Inevitably, there will be unanticipated increases or decreases in patient census and unanticipated absences by workers. The challenge for every hospital is to have an appropriate baseline of staffing and the flexibility to adjust to daily and even hourly fluctuations.

Despite these challenges, EMMC’s staffing has passed muster with numerous external quality surveyors in 2010. EMMC’s nursing Professional Practice Committee is tasked to look into any concerns nurses may raise regarding staffing or patient assignments.

The fact is that hospitals across the country are struggling with a new reality in health care, and EMMC is no exception. We are being challenged to provide high-quality care for less payment, and medical center employees will need to be part of the solution.

An example of a change that must be made is the insurance plan in the current nursing contract. It is 36 years old, is very expensive and out of date, and is only affordable to nurses who, as part of the current contract, do not pay any premium as single enrollees. The medical center proposes to eliminate this plan, offer the nurses the same quality coverage other medical center employees have, and require singly enrolled nurses to contribute approximately 20 percent of the premium, as all other employees already do.

The landscape in health care has changed, and the health care community must respond. It’s time to work together for the betterment of health care, not to single out and protect from reality one segment of that community.

EMMC’s board has always been committed to ensuring that the medical center is an employer of choice for all employees, and that providers have the resources they need to give high-quality, safe care to their patients. The EMMC bargaining team is following that same imperative. The board of trustees is fully informed, appropriately monitoring, and supportive of its efforts.

Mike McInnis is chairman of the Eastern Maine Medical Center board of trustees.

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