Worker rights panel claims EMMC’s nurse staffing level too low

Posted Oct. 10, 2012, at 7:27 p.m.
Last modified Oct. 10, 2012, at 8:20 p.m.

BANGOR, Maine — A report released Wednesday by a labor group contends that nurse understaffing is having a negative effect on patient care at Eastern Maine Medical Center, but EMMC officials question the report’s sourcing, data and timeliness.

The report, presented by the Worker Rights Board of Eastern Maine during a press conference Wednesday morning at the Bangor Public Library, says that:

“Workload and stress caused by understaffing, shift schedules and job requirements have had a critical, negative effect on patient care at EMMC.”

• “At times there is authoritarian and disrespectful supervision of nurses in the hospital and a fear of reprisal toward those who question policies.”

• “Nurses must be viewed with more respect, as professionals with experience and expertise in medical care.”

• “EMMC administration must be more transparent and accountable to the community.”

“We’ve just received a copy of the report,” said Greg Howat, EMMC’s vice president of human resources. “I don’t see any data that specifically refers to EMMC’s staffing levels and it appears to be a lot of narrative, thoughts, and opinions from nurses and patients, but not a lot of scientific data.”

According to the board, the report’s conclusions are based on information gleaned from interviews, meetings and “an extensive investigation of the issues involved” through much of 2011. The board said the report resulted from a request for assistance from the Maine State Nurses Association/National Nurses United union in the fall of 2010 during contentious contract negotiations with EMMC.

Unionized nurses ratified a three-year contract with EMMC in May.

“Frankly, this study has been in the works since last April, and done by an arm of the Eastern Maine Labor Council,” Howat said. “I think a lot of this stuff is from 18 months ago.”

Steve Akerley, a registered nurse for the last 20 of his 30 years at EMMC, attended the news conference to emphasize some of the points of the report.

“There have been many studies that show what all nurses know: that safe nurse-to-patient ratios save lives,” he said.

“Each additional patient added to a nurse’s workload is associated with a 7 percent increase in mortality following common surgeries, a 53 percent increase in respiratory failure, and a 17 percent increase in medical complications,” he added.

Akerley said he was referring to data from the Agency for Healthcare Research and Quality.

“There are some percentages there, but I think those relate to hospitals in general,” said Howat. “Those are not EMMC-specific, and I don’t know where that data comes from. I’m not seeing a lot of information in there that analyzes our staffing levels or rations them by unit or in the aggregate. It’s mainly impressions and reports from nurses on their sense of what it’s like to work.”

EMMC Chief Nursing Officer Jodi Galli said EMMC’s staffing is based on nationally acceptable levels.

“In response to consistent changes in volume in our organization, we’ve actually hired more nurses,” she said. “Since April of 2011, we’ve hired a net of 38 staff nurses, plus 28 nurse techs and unit secretaries as a whole, for a total of 66 new hires.”

Galli also cited EMMC’s high retention rate for staff nurses — 94.9 percent for the recently ended 2012 fiscal year.

The report cites 12-hour shifts as one example of a scheduling practice that isn’t popular with nurses and negatively affects care, something Howat and Galli both vehemently disagree with.

“It’s a surprise to me that 12-hour shifts are listed as a concern and may be too long to work,” Howat said. “Some of our nurses, in fact many of them, prefer the current 12-hour shift system.”

Akerley, a member of the Maine State Nurses Association, admitted that some staffing improvements have been made, but not enough.

The report’s conclusion that more respect for and input from nurses is needed also rankled EMMC officials.

Galli referred to EMMC’s Transforming Care at Bedside program, made up of bedside nursing staff members who are asked to share observations and ideas on how best to improve patients’ experiences.

“We also have a citizen advisory council comprised of people from the community, some of whom have been our patients or had loved ones who were patients,” Galli said.

Galli said another option available three times a year is an anonymous employee engagement survey allowing employees to give input on their managers, working environment and quality of care.

“We’ve received many acknowledgements and recognitions for the quality and services we provide to our patients and we very much respect our nursing staff and their input,” said Galli. “They are the core of our patient care team.”

Members of the the Worker Rights Board of Eastern Maine who spoke at the press conference were state Rep. Adam Goode, D-Bangor, retired teacher Julie Grab, the Rev. Mark Doty, and Bill Murphy, director of the University of Maine’s Bureau of Labor Education.

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