Many months of hard-line negotiations and hard feelings between MultiCare Health System and the state nurses union have brought the participants to a difficult crossroads, and Tacomans have a right to feel anxious.
Registered nurses at Tacoma General Hospital are planning an advisory vote Friday on whether to strike for the first time in TG’s 135-year history. A mediation session between Tacoma-based MultiCare and the Washington State Nurses Association is scheduled Wednesday, so a breakthrough is still possible in this troubling contest of health care brinkmanship.
It will be interesting to see whether a settlement announced last week between CHI Franciscan and nurses at St. Joseph Medical Center is a precursor to labor peace for both large hospitals on the Hilltop. The agreement addresses many of the same grievances still unresolved at TG.
At the core of the Tacoma General dispute are longstanding staffing issues raised by RNs, which have morphed into allegations about overwork, burnout and patient safety.
The hospital’s “break buddy” system requires nurses to cover for each other— and monitor as many as 16 patients at a time— when a colleague goes on break. The result is that nurses often work a full 12-hour shift without taking their three allowed 15-minute breaks. (They also get a 30-minute meal break.)
MultiCare officials don’t question that nurses are missing some breaks, but they say the buddy system is a flexible, industry-wide practice necessary at a time of large patient loads, nurse shortages and high turnover. Chief Executive Officer Bill Robertson has noted that nurses are compensated for working through breaks. TG nurses, whose contract expired a year ago, will receive pay increases once a new labor pact is signed.
RNs at Tacoma General already earn a good living; the average salary and benefits are valued at $108,000. But the steady hands and compassionate caregivers at the end of a hospital bed call light need more than fair wages; they must be energetic, rested and reasonably undistracted.
An arbitrator declared a year ago that the “break buddy” practice should stop, but MultiCare petitioned for a reversal in federal court. Meanwhile, union leaders describe contract negotiations as unusually confrontational.
On the other side, MultiCare says round-the-clock teams of health care professionals ensure safe patient care and that any claim to the contrary is false-alarm rhetoric. MultiCare also says the union has resisted meeting at the bargaining table.
The nonprofit turned heads last month when it announced its $425 million purchase of two hospitals and several clinics in the Spokane area. TG nurse representatives call that acquisition a misplaced priority in light of the $13 million concession they want from MultiCare to hire 120 relief nurses here at home.
We’d caution against comparing short-term operating revenues to long-term investments. An expanded balance sheet could strengthen the viability of a local employer. Health care consolidation is inevitable, and Tacoma is better served when MultiCare acts as a whale, not a minnow.
When this standoff finally ends, don’t expect a quick cure for the wounds that have been opened — certainly not if the worst-case scenario, a nurse walkout, takes place.
Consider the fallout from a monthlong work stoppage at five hospitals in Minnesota this fall. Hundreds of nurses risked the disdain of their peers by crossing the picket line, and dozens of patients logged complaints of substandard care by replacement nurses. Gov. Mark Dayton ultimately had to intervene to forge an agreement.
“This never should have happened — the hard feelings, the strike, none of it,” one Twin Cities nurse on the bargaining team said when it was over.
What’s needed now in Tacoma is a sense of urgency. CHI Franciscan, MultiCare’s local health care rival, might have added some last week; it agreed to hire 26 relief nurses at St. Joseph and install a “block break relief” system in which RNs are guaranteed uninterrupted downtime.
This might not be a perfect blueprint for Tacoma General, but if it serves as an impetus to get a deal done and avert a public health misadventure, it could be just what the doctor ordered.
When the new year arrives, our community needs experienced nurses walking critical care units and emergency rooms, not picket lines.