WORCESTER—Less than half a year has gone by since the February visits from federal agencies, and Saint Vincent nurses have issued yet another press release and call for oversight from federal agencies.
Mary Sue Howlett, associate director for the Massachusetts Nurses Associations (MNA) and a licensed nurse herself, does not mince words: “Not only have things not improved, they have in fact gotten much worse, hard as that may be to believe. That was the trajectory when we last spoke and Tenet has stayed the course.”
After the last round of talks with their parent company Tenet Healthcare, Tenet agreed to purchase some additional cardiac monitors to help manage what has been described as a ‘severe staffing shortage’ by multiple sources.
“The purchase of more wireless telemetry devices for cardiac patients was prompted by the Joint Commission (JCO)’s last visit here in February,” Howlett continued. “When patients don’t have to be tethered to the wall, it gives them more mobility even when nurses can’t get to them to check on them within a reasonable time.”
The improvements, she argues, are a “drop in the bucket,” and mentions she has documentation that they were identified multiple bedsores or soft tissue injury in the month of April alone 26 such cases.
“That is absolutely related to staffing,” she said. “As a mobile human being, you would move. These patients that are immobile that can’t reposition themselves. They can’t get into the patient and the patient are left lying in urine and feces. The skin breaks down. They can’t move themselves. It is a serious reportable event gets to stage 3 or 4. The department of public health has to investigate those. They have been there three or four days this week.”
Progress regarding oversight from the Department of Public Health (DPH) has been slowed down by the fact that often the DPH requires patient identifiers for specific incidents. This complicates the matter, as most of the time nurses are bound by their adherence to HIPAA nondisclosure guidelines.
Still, Howlett says she’s doing all that she can to alert federal authorities “before something bad happens.”
“I have notified the Joint Commission (JCO) to send for MediCare, MedicAid, CNS and KEPRO of what’s going on,” she said. “I contacted them in the past and implored them to do a report and investigation. I’m hoping that they will do something to protect. As a healthcare company, Tenet would have the obligation to treat patients appropriately.”
Marlene Pellegrino, one of the most veteran nurses still working at Saint Vincent’s, echoes the same urgency. “We’ve lost more nurses on one of our surgical floors within the last several months 10-12 of our nurses have retired, resigned, or quit. On another one of our cardiac telemetry units, the last senior nurse of 45+ years of experience just resigned. Her contract on that floor had a ratio of no more than 4 patients per nurse along with a resource nurse, and they were up to 6 patients per nurse with no resource nurse. Even when you replace nurses, you’re not likely to get someone with that much skill and experience.”
According to Pellegrino, new nurses often leave during orientation or soon thereafter. “Between the culture of retaliation, and the poor working conditions, nurses do not last. They are consistently being forced to take six high level patients at once. This is simply not possible to manage safely. And beyond that, morally it just gets to you. There is pushback from management, and the new CNO tells us they don’t care one bit. Floor supervisors have disclosed that the directions they get from leadership is that regardless of skill levels, regardless of contract, they want to push nurses into 6: 1 ratios. We’ve had more codes and rapid response. Bad outcomes, patient deaths, we have no choice. They won’t engage with us on the labor process.”
On June 17, Tenet will be going to court with the National Labor Relations Board over six sustained cases of unfair labor practices. Pellegrino says that she and other nurses feel their nursing license is in ‘jeopardy’ every day.
Carla LeBlanc has been a Saint Vincent’s nurse for about eight and a half year, with her most recent placement being in the recovery room. “I wish I knew the reason why St.
Vincent’s Hospital is cutting costs and cutting corners and putting people at risk.
“They’ve cut down on nursing staff because the working conditions are such that nurses are leaving in droves,” said LeBlanc. “Tenet has made it very clear that they’re not going follow our contract, but they’re not even going to follow the known best practice recommendations for nursing care.”
LeBlanc speculates that part of the reason for the “complete disregard for patient care” is due to the fact that Tenet is not a local corporation, and has no ties to Worcester County.
“We have a CEO who was working in Texas before she came to us,” she said. “We have a COO before Florida, a CFO from Missouri; they are not invested in this community. They are here to make the most money. The end result is people are going die, and have died. People have suffered long term consequences. The families are going to have the grief of dealing with what’s happening. The nurses and the doctors are going to be facing the consequences whether that’s sitting on the board of nursing and some other lawsuit.”
Pellegrino echoes the same concerns. “There’s something pathological going on with the people that are running. They [Tenet] have disdain for our union, the Massachusetts Nursing Association (MNA). They have a problem with unionized nurses who have a voice to advocate for themselves. I think it’s very cowardly. This isn’t Texas or Florida. It’s Massachusetts. This is a labor state. Their corporate behavior is straight up unethical. You can see they have been brought up to fraud. They are for profit.”
The Guardian reached out to Denise Kvapil, Saint Vincent’s chief nursing officer (CNO) with a detailed shortlist of questions.
In response, Kvapil issued the following: “At Saint Vincent Hospital, we remain focused on providing quality care and serving our community. We respect the contract with the Massachusetts Nurses Association (MNA) and continue to operate in accordance with the provisions that were mutually agreed upon, including all provisions related to compliance with the staffing guidelines in the collective bargaining agreement. We call on the MNA to partner with us on addressing the issues facing all hospitals in Massachusetts, including staffing shortages. “
Pellegrino, and her decades of expertise, continue to sound the alarm bells. “Steward Healthcare, another healthcare corporation with hospitals in the Boston area, has recently filed for bankruptcy and I would say that things here are the same if not worse than Steward. I just think that’s where we’re headed. The entire healthcare infrastructure in Massachusetts could collapse.”
Irena Kaci is a poet and writer living in Worcester, MA with her spouse and two children. She moved to Worcester in 2015, almost a decade after graduating from Clark University. She writes for The Pulse, SevenPonds and the Worcester Guardian. Her creative work has appeared in the Worcester Review, Atticus Review and the 45 Journal. She can be reached at irena.kaci@gmail.com
