WORCESTER—The St. Vincent Hospital nurses’ strike officially ended on Jan. 3, 2022, but nurses are alleging that patient care conditions are getting worse, not better.
Marlena Pellegrino, a St. Vincent nurse for more than 37 years, maintains that conditions have been acrimonious since their [the striking nurses] return.
“When we came back after our strike, we were told that we could return to work before the 24th but we didn’t have to return until the 24th,” Pellegrino told the Worcester Guardian. “Then, HR and hospital administrators held an orientation to welcome us back and promptly violated our ‘return to work’ agreement. They handed [us] the schedule and told us that we had to be back to work the shifts immediately. If we didn’t show up for these shifts starting tomorrow, we’d be terminated. So that was the start of the new relationship. They obviously didn’t want us back there.”
After the attempted decertification of the Massachusetts Nurses Association (MNA) in February 2022, Pellegrino said communication between hospital administration and the MNA has also decreased.
Dominique Muldoon, a medical-surgical floor nurse currently on suspension, said that collaborative meetings between MNA officers and hospital administrations used to be weekly events, and were a forum at which issues that arose between nurses and administration could be resolved in real-time.
“In the past over 20 years that we’ve been unionized, we [nurses] have always had monthly meetings with the hospital administration, facilitated by a union [MNA] representative,” Muldoon said. “There has been no collaboration between our union committee and the hospital for at least a year. Even though our staffing ratios, which should, per our contracts, be 4:1 or 5:1, are not met. “
Pellegrino asserted that this breakdown in communication between the union representatives and hospital administration is causing an unprecedented number of cases to go to arbitration.
“Every relationship dynamic, our labor management meetings once a month meetings, we will discuss issues that come up,” she said. “This is to avoid grievances and labor problems. We had a delegation of nurses meet with our chief nursing officer (CNO) or head of HR or both. We haven’t had a labor-management meeting in one and a half years. So, for all the little things that come up between nurses and [the] hospital, we now have to go through arbitration.
“We have 70 issues in arbitration, which can take up to 12-18 months. In the 20-plus years we’ve been unionized, we’ve had eight or 10 total cases of arbitration. So what they are doing is they are tying up everything that we do as a union in the arbitration. It’s a lengthy process and buys them time while straining union resources.”
According to the post-strike contract, the staffing ratio must be 4:1 or 5:1, with some minor fluctuation between departments. Now, nurses are saying they are being forced to handle up to six or seven patients at a time.
“It’s not really all about the numbers either,” Muldoon said. “The more patients you have, of course, the harder it is to properly care for them. This makes it much more dangerous; time and time again, research has shown that with every additional patient beyond the 4:1 ratio, there is a 7 percent increase of something going wrong. We are not reaching our standard of care of what we are supposed to be reaching based on our Massachusetts licensing. We are too busy to meet the standards.”
Mary Sue Howlett, associate director for the MNA and a licensed nurse, said that she is doing all she can to bring attention to these unsafe conditions.
“I have personally reviewed more than 500 unsafe staffing forms between July and December 2023,” said Howlett. “I also reviewed about 100 cases in the month of January alone. I filed the report in June and in July with the Joint Commission (JCO), which is an agency that monitors patient care quality. They did a surprise site visit. The results remain confidential.”
The litany of well-documented incidents includes unobserved falls, said Howlett, patients not having access to their medications in a timely manner, a patient waiting five hours for a c-section while in labor, and even a patient’s death. The latter is currently under investigation by the Massachusetts Department of Public Health.
In addition to patient ratio noncompliance, Pellegrino and Muldoon said that there are cuts to nursing support staff, including IV nurses, resource nurses, and respiratory therapy nurses.
“They dismantled our IV nurse team,” Pellegrino said. “The IV nurse team is a group of nurses whose entire role is to insert IV lines into patients. Yes, floor nurses can do that too, but it’s a very specific skill. When patients are old and frail and going through chemo, their veins can be very fragile. We’ve had an IV team the whole time I’ve been here. It was only six nurses total but they were experts; they were doing it 24 hours a day in three shifts. Now they are gone.”
The MNA stresses that its decision to speak to the press was made only after repeated attempts to speak to hospital administration about the issues.
Muldoon said: “We didn’t just decide to go to the press. We have been trying to reach out to management, we have notified our CNO, we’ve notified our direct supervisors for months and months. When nothing improved, we had to escalate. We wrote letters about what was happening with the unsafe staffing forms. We had one of our MNA representatives call. We have notified the JCO and Department of Public Health (DPH).”
As a result, Pellegrino reported an increase in rapid responses and codes.
“Patients here with sepsis with infections; doses are sometimes just missed,” she said. “It’s humanly impossible to maintain that many patients. With one personal care attendant (PCA) and two nurses for 18-20 patients, it’s impossible. We’re supposed to do hourly check-ins on some patients. They are in a closed room with the door closed. You can’t see them just by walking by. You have to have time to go look in on them once every hour.”
Nevertheless, Pellegrino, a graduate of the Saint Vincent School of Nursing (back when it existed), feels loyalty to her workplace and her patients. “I don’t want to leave,” she added. “Everyone has their breaking point, though. Everyone has that point. Nursing jobs are plentiful. Why would I keep allowing myself to be treated this way?”
She continues: “I actually sent several texts to the new CNO. I’ve never met her. She has no interest in meeting me. I’ve sent her at least three lengthy texts, letting her know what the conditions were: what I couldn’t provide to my patients, what was going on, I couldn’t give pain medication on time, there were no sitters to sit with the patients. She’s not responded. Not once.“
The Worcester Guardian reached out to both Tenet Healthcare, Saint Vincent’s Hospital CEO Carolyn Jackson and St. V’s HR office. So far, no one has agreed to comment.
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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
