‘Break buddy’ time a major point in contract talks for Tacoma General nurses
Nurses at Tacoma General Hospital are asking their employer to give them a break.
That’s the message their union, the Washington State Nurses Association, sent to MultiCare Health Systems during an informational picket and rally Monday.
About 100 nurses and supporters took part in the gathering outside Tacoma General’s main building on MLK Jr. Way in Tacoma.
On Tuesday, the union returned to the bargaining table with MultiCare as the two parties resumed negotiating a new labor contract.
The nurses have been working without a contract since late 2015.
One issue nurses have raised in negotiations is the so-called “break buddy” system.
At Tacoma General, the arrangement allows a nurse to take two 15-minute breaks per shift while a fellow nurse assumes responsibility for both their patients.
In the intensive care units, each nurse oversees two patients, monitoring the person and responding to emergent needs. In the medical units, each nurse is responsible for five patients.
Critics say doubling up puts an unfair burden on the nurse and puts patients at risk. They point to an alternative: A dedicated break nurse whose only job is to cover other nurses’ breaks.
The break buddy system “makes it difficult for us to do our job without adequate rest and without adequate staff,” said Renata Bowlden, a labor and delivery nurse with 23 years of experience at Tacoma General.
It’s adding to the stress of an overall nursing shortage at Tacoma General, she said.
“We get phone calls in the middle of the night, begging us to come in,” said Bowlden, who was at Monday’s rally. “They are stretching us so thin that it has increased the burnout rate and the turnover rate of our nurses.”
Terry Surratt, another Tacoma General nurse at the rally, said more than 18,000 missed breaks were logged by nurses in the first quarter of 2016.
Said Surratt: “18,000 times we did not rest. If we hire more nurses we get our rest breaks.”
Asked later about buddy breaks, MultiCare CEO Bill Robertson said the system is the most flexible and widely used in health care.
“Break buddy is almost used ubiquitously in the United States,” he said.
The matter was submitted to an arbitrator, who told MultiCare to stop using the system. MultiCare has petitioned in federal court to have the decision overturned.
Robertson did not speak at Monday’s rally but did shoot photos and video of the crowd while Christine Himmelsbach, the assistant executive director of labor at the WSNA, spoke.
“It’s simple math,” Himmelsbach said. “When nurses have double the patient load that they’re accountable for, that they have to take care of, there’s lives that depend on those nurses. It simply isn’t safe to double the number of patients you’re accountable for.”
A few moments later in his office, and with the chants of the nurses outside, Robertson said the dispute is part of the negotiating process.
“This is just part of the process when you have a three- or four-year contract up for renewal,” he said.
Robertson acknowledged nurses sometimes miss their breaks — “there’s no doubt about it” — but said the omissions make up 6 to 7 percent of total breaks and nurses are compensated for them.
He disputed the claims of high nurse turnover.
“Our nurse turnover is consistent with what’s happening in the market,” Robertson said. Still, turnover is higher than normal, the result of a national nursing shortage, MultiCare said in a statement.
One reason for that is the shortage of hospital beds in the Puget Sound area, resulting in priority being given to the sickest patients who stay longer.
“These factors (staff shortages and longer patient stays) meant that it has been more challenging for nurses to get their breaks,” MultiCare said in its statement.
And it’s likely to get worse with a growing and aging population.
“There will be a large gap, and a severe gap, in the next five to 10 years in terms of a nursing shortage,” said Anne Tan Piazza, assistant executive director of the WSNA.
Robertson said not all of MultiCare’s full-time nursing jobs — about 740 positions — are currently filled. Open shifts are filled with agency staff and overtime, he said.
“No shift goes unstaffed appropriately,” he said.
On Monday, he welcomed 140 new employees, about half of whom were nurses, he said.
“We’re hiring all the time and we intend to keep doing that,” he said.
As part of the contract talks, the WSNA is negotiating wages for nurses.
Pay and benefits for nurses at Tacoma General with an associate degree range from $84,000 to $134,000 annually, according to MultiCare. The average nurse at Tacoma General earns $108,000 in salary and benefits combined.
MultiCare has proposed a wage increase of 6 percent over three years. It also has offered up to 6 percent for current longevity increases over three years for a total of 9.5 percent.
The WSNA declined to provide details of its wage request but said nurses “deserve a wage proposal that will attract and retain the quality staff needed to provide quality, safe patient care.”
The next bargaining session is scheduled for Thursday.
Craig Sailor: 253-597-8541, @crsailor
The Washington State Nurses Association union is not targeting MultiCare alone when it comes to rest breaks, said Anne Tan Piazza, the union’s assistant executive director.
“The rest break issue is a consistent problem throughout the state,” she said.
The association is suing St. Joseph Medical Center, a Franciscan Health System hospital in Tacoma, over the matter, and has won arbitration decisions against the University of Washington in Seattle.
A spokeswoman for St. Joseph said managers work directly with its staff members, including nurses, to ensure they take their breaks.
“From time to time a staff person may be enlisted to cover as another staff person takes a break,” Franciscan’s Mary Getchell said.
A spokeswoman for the University of Washington Medical Center and Harborview Medical Center declined to comment on break policy at the two hospitals.
At Olympia’s Providence Saint Peter Hospital, a spokeswoman said nursing breaks are determined by each unit’s leader and nursing staff.
She would not elaborate on what form those breaks were but a nurse at St. Peter said on Tuesday that the hospital uses both break buddy and break nurses.
Craig Sailor, csailor@thenewstribune.com
This story was originally published July 1, 2016 at 12:59 PM with the headline "‘Break buddy’ time a major point in contract talks for Tacoma General nurses."