Reports of Poor Care by St. Vincent Hospital Replacement Nurses Pile Up as MNA Nurses Enter Third Week of Strike for Safer Patient Care

Numerous reports of substandard care and lack of properly trained replacement nurses underscore the need for Tenet to get back to the table to end the strike and finally put a concern for St. Vincent patients ahead of shareholder profits

Tenet has spent more than $16 million to force and prolong a strike over their refusal to negotiate with the nurses to address the patient safety crisis at SVH

News provided by

Massachusetts Nurses Association

Mar 22, 2021, 07:24 ET

WORCESTER, Mass., March 22, 2021 /PRNewswire/ -- As the 800 striking nurses of St. Vincent Hospital move into their third week of an open-ended strike against Dallas-based Tenet Healthcare, local media, and staff working inside the hospital have shared disturbing reports of poor patient care being delivered by hundreds of inadequately trained strike replacement nurses who have been flown in from all over the country to break the nurses strike – a strike solely designed to address a longstanding patient safety crisis caused by poor staffing at the Worcester-based facility.

While nurses are walking outside the hospital carrying signs that read "on strike for safe patient care" Tenet Healthcare is operating the hospital with a cadre of replacement nurses who have never worked in the facility, at times using the physicians and other staff in the hospital to deliver care generally provided by the nurses. According to a number of accounts received by the MNA, the MNA believes that these strike replacements are providing substandard care. The reports show the nurses did not know how to operate key pieces of operating room equipment, have mislabeled labs, failed to respond to patients in a timely way (neglecting the needs of those patients) and failed to follow basic protocols designed to prevent serious errors in care.

In the past week alone, the Worcester Telegram & Gazette featured two separate stories of patients reporting poor care by the replacement nurses. A March 19^th story highlighted a behavioral health patient's report of being injured during an assault by another patient that he attributed to understaffing and the staff's unfamiliarity with the unit. He further reported being verbally accosted in a threatening manner by one of the nurses in his room, simply because he had refused to take the wrong medication that was presented to him in error by the nurse.

As stated by the patient in the article, "I go to St. V's and know a lot of the people there. The people there are really good people and generally give you good care and care about you, but experiencing what I experienced and what I went through seems like a shock and awe effect…The atmosphere was like night and day compared with previous visits to the hospital and that it was "like a complete horror show there."

In an earlier story that week, a Millbury couple has alleged that St. Vincent Hospital is unsafe, after the woman underwent a procedure on the first day of the nurses' strike, and said she found replacement nurses unfamiliar with the hospital and its procedures, who could not operate the equipment that was needed for her care. "My bottom line is the hospital's not safe," the woman stated. "The nurses weren't prepared enough to walk into a hospital. Nursing is nursing, but if you can't find the stuff you're supposed to be nursing with, or you don't know the protocols, how can you nurse appropriately?"

"We are deeply troubled by recent press reports and the stories we are hearing from our non-nurse colleagues about what that they have witnessed inside that building after Tenet made the decision to force this strike and utilize these strike replacement nurses who do not know our hospital, our policies and procedures and are ill prepared to provide quality patient care," said Marlena Pellegrino, RN, a longtime nurse at the facility and co-chair of the nurses local bargaining with the Massachusetts Nurses Association.

In addition to recent press reports, staff who are not on strike, have been reporting a number of other incidents to the striking nurses of replacement nurse incompetence, including:

An operating room nurse who had no idea how to operate a special robot used in a number of surgeries at the hospital, which required an operating room technician to step in and operate the device instead. Over the last two weeks, nurses have heard reports of replacement nurses who failed to operate the robotic device properly. In response to these and other instances where technicians and other staff were expected to perform duties typically performed by nurses, the Teamster Local 170, which represents these caregivers sent a letter to Tenet CEO Carolyn Jackson demanding an end to these practices.
A technician reported that a replacement nurse refused to follow a basic safety protocol, whereby nurses and other staff follow an established procedure to carefully document and physically account for how many sponges and other instruments are used in an operation – a protocol to prevent instruments or other items being left inside a patient exposing that patient to serious injury or harm. After the technician objected to the nurses' refusal, it was the technician who was later disciplined by Tenet, not the offending nurse. The Teamsters Local 170, who represents this technician, has filed a grievance against this callous decision by Tenet.
Staff in the hospital report a replacement nurse was fired after leaving a patient alone on a commode for over an hour while on an IV drip receiving a heavy sedative. As one striking nurse stated, this patient should never be left alone.
Staff report an increase in medication errors and delays in timely administration of medications, including diabetic patients with high blood sugar levels not provided with insulin to manage their condition, and the withholding of blood thinning medications without notifying the physician in violation of hospital policy.
Other staff reported that a nurse failed to respond appropriately once provided with a critical lab value, an indication that showed the patients' condition was deteriorating and would require immediate intervention by the nurse to address the situation.
Other staff report labs being mislabeled, nurses who were unfamiliar with key piece of equipment, including the location of and how to open code carts, which are used to respond to patients experiencing cardiac arrest.

As nurses have heard these stories, they have also heard that Tenet CEO Carolyn Jackson has taken aggressive steps to prevent leaks of what is happening, including threatening staff inside with termination should they communicate with their striking colleagues.

By its own admission and public statements, the hospital is paying $5.4 million a week for as many as 200 nurses recruited from all over the nation to support the corporation in prolonging the strikes – a strike waged by nurses to improve conditions for patients. In the case of the replacement nurses at St. Vincent, they received minimal orientation to the facility, with much of their orientation conducted via zoom, and then expected to work as much as 60 hours a week, which in and of itself is unsafe.

Keep in mind, during a non-strike situation, any nurse, be it a traveler or a nurse coming from another Massachusetts hospital, would be required to have at least 3 to 5 days of orientation to the hospital and the unit they work on, including the equipment on that unit and the policies related to care on that unit. In addition, they would be paired with a mentor on the unit to become familiar with care on that unit before being allowed to provide total care on their own.

In this case, these nurses are being thrown into the hospital and allowed to function on their own immediately, replacing 800 nurses who have 10, 20, 30 years of experience working on the same unit, with the required equipment and procedures and the same physicians, day in and day out.

"If you are in the hospital in this day and age your condition requires the highest level of nursing care. As a patient you should expect and deserve care that meets your physical and emotional needs with precision and dignity by a beside nurse who is experienced in working on that unit," Pellegrino explained. "There is no way that is possible as Tenet has chosen the dangerous path of continuing this strike. Tenet's attempt to do so is both irresponsible and dangerous."

"It breaks our heart to see that Tenet has chosen to force this strike, and subject our patients to this level of care, rather than work with us to negotiate long sought changes to ensure safer patient care," said Dominique Muldoon, RN, a medical surgical nurse at the hospital and co-chair of the nurses bargaining unit. "But this is their choice, and they must be held accountable for the consequences of this decision. For our part, for more than two years, all we have wanted is to work together for the good of our patients and our community. We remain committed to doing just that whenever Tenet is prepared to put our patients as their priority and not the unwilling tools in their quest for increased profits."

The nurses' strike and their stand for safer patient care has galvanized support from a variety of public officials, labor and community advocates, including the entire Worcester City Council, the Worcester state legislative delegation, Senator Elizabeth Warren, Senator Edward Markey and Congressman Jim McGovern who have all visited the nurses strike line and sent their own letter to Tenet's CEO in Dallas urging Tenet to negotiate with the nurses to address the nurses concerns over needed staffing improvements to ensure safe care.

The 800 SVH nurses, who are represented by the Massachusetts Nurses Association (MNA), voted overwhelmingly on Feb. 10 to authorize the strike, and began their open-ended strike on March 8 at 6 am. The decision to strike followed earnest and painstaking efforts over the last two years by the nurses to convince Tenet to improve the patient care conditions at the facility, poor conditions that have only been exacerbated by the pandemic. Adding insult to injury, the same day nurses voted to authorize the strike, Tenet announced annual profits of more than $400 million.

In the last year alone, nurses have filed more than 600 official "unsafe staffing" reports (more than 110 such reports have been filed since Jan. 1, 2021) in which nurses informed management in real time that patient care conditions jeopardized the safety of their patients. The nurses also report their patients in Worcester are experiencing an increase in patient falls, an increase in patients suffering from preventable bed sores, potentially dangerous delays in patients receiving needed medications and other treatments – all due to lack of appropriate staffing, excessive patient assignments, and cuts to valuable support staff.

For a more detailed review of the staffing crisis, efforts by nurses to convince Tenet to address the crisis, as well as proposals nurses are seeking to improve patient care, click here to view a previous press release on the matter.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.

SOURCE Massachusetts Nurses Association