MultiCare is putting profits before patients at TG

In these days of ever shorter stays, you have to be pretty sick to be in the hospital. Nurses, who provide the front line of hospital care, are not only taking on sicker patients, they’re getting more of them as hospitals try to cut costs by cutting staff.

At MultiCare Tacoma General, nurse staffing is so strained that in some departments it is nearly impossible for nurses to take the breaks they need – and are entitled to under state law and their contract. This is an issue that should concern everyone who could ever be a patient at Tacoma General.

The simple truth is when there aren’t enough nurses on the floor and nurses are working 8, 10 or even 12 hours without a break, patients are at risk. When you or a loved one are in the hospital, you don’t want your nurses – the ones responsible for making critical decisions that can mean life or death – to be overworked and fatigued because they can’t get a break.

The problem at Tacoma General has been so bad for so long the Washington State Nurses Association filed a lawsuit in 2010. Registered nurses at MultiCare’s hospitals were not able to take their rest breaks in alarming numbers – thousands of missed breaks per quarter at Tacoma General alone.

By the time WSNA and MultiCare entered into a settlement agreement in 2013, missed breaks had nearly tripled, to almost 6,000 per quarter, according to the hospital’s own timekeeping system. Last year, missed breaks reached 14,000 per quarter.

MultiCare has utterly failed to address the problem and, in fact, continues its years-long fight against their nurses. This despite the fact that Tacoma General’s annual profits are more than enough to give its patients the safe nurse staffing levels they deserve. It pulled in $65 million in profits in 2014 alone.

Nursing is a profession that requires you to be “on” every minute. In addition to the myriad nursing tasks, nurses are responsible for constantly monitoring patients. At any moment, a patient’s blood pressure can suddenly drop, a baby’s heartbeat can become erratic necessitating an emergency C-section or a patient can have an unexpected response to a medication. Nurses need their breaks to briefly step away from these constant responsibilities.

The settlement agreement was supposed to ensure that each nurse was completely “relieved of patient care duties for a 15-minute rest period every four hours” without violating hospital staffing plans, which include nurse-to-patient ratios deemed a baseline for providing safe patient care for each unit.

MultiCare’s solution: Continue using the “break buddy system.”

Here’s how it works: Say you’re a nurse in the Intensive Care Unit, caring for patients in such critical condition they require one-on-one or one-on-two attention. When the unit is short-staffed you might have three patients. To go on break, you would need to get a colleague to cover all of your patients as well as their own – a completely unsafe number that violates the hospital’s staffing plans.

When MultiCare refused to honor the settlement agreement, WSNA submitted the issue to final and binding arbitration, as agreed in the settlement. On Dec. 28, the arbitrator ruled that the “break buddy system” did not give nurses a real break and ordered Tacoma General to cease using it.

MultiCare’s response? Ask a federal court to nullify the arbitrator’s decision, demand that WSNA agree to cancel the arbitrator’s decision in its next contract and threaten to discipline nurses who report missed rest breaks.

The registered nurses of Tacoma General are fighting to make sure you – their patients and community – get safe, high quality care.

Nurses always put patients before profits. We expect MultiCare Tacoma General to do the same.

This story was originally published March 3, 2016 at 5:47 AM with the headline "MultiCare is putting profits before patients at TG."