ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, October 29, 1996 TAG: 9610290061
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
Some nurses say the shortage of staffing at Carilion Roanoke Memorial Hospital has become so critical that it threatens patient safety and has driven them to begin talks with three labor unions.
The hospital handles the Roanoke area's most severe trauma cases.
Several doctors also have expressed concern to the hospital administration about the ratio of nursing staff to patients, several sources who asked to not be identified confirmed.
Organizers from the Kentucky Nurses Association arrived in Roanoke on Monday to begin three days of meetings with registered nurses, the only group of health-care employees it represents. Last week, representatives from the Service Employees International Union were at the same motel, Hampton Inn on Franklin Road, meeting with hospital employees from a variety of departments.
The United Mine Workers Association also has been in touch with hospital workers.
While the discontent appears to be centered at Roanoke Memorial, workers at Carilion Roanoke Community Hospital also have attended some union discussions, organizers said.
Carilion President and Chief Executive Officer Tom Robertson had no comment Monday except to say that he needed more time to answer the media questions. A copy of an Oct. 25 memo from senior management to all Carilion managers acknowledged the unionizing activities and called on managers to make communication with employees a "number one priority."
Carilion Health System employs about 7,800 workers throughout a 14-hospital chain that stretches from Farmville to far Southwest Virginia and includes facilities owned or managed by the not-for-profit company. Union activities are focused in the Roanoke Valley, however.
In the past 18 months, Carilion has consolidated labs and hospitals and required staff members to reapply for jobs in a number of departments. It has redesigned itself into a company organized on the basis of services and not facilities. Employment dropped by the equivalent of 350 workers from June 1995 to June 1996. A number of corporate-level jobs were among those cut.
Changes by Carilion included standardizing compensation for on-call status and weekend work for nurses across the system. This resulted in pay increases for some, but decreases for others.
Nurses also are chafing at mandatory overtime, which resulted from the staffing cutback, and they are distressed about the planned closing of employee child-care centers. But they also say they fear for their licenses because they are being forced to work without enough staff to adequately care for patients.
This is especially true in patient units a level below critical care, nurses said.
One group of six professional employees, who had an average length of service of more than 10 years, says staffing is worse at night and on weekends. They also say nurses are so busy that patient monitors at the nurses' stations are not being watched regularly. They worry, too, that Carilion is hiring inexperienced nurses and placing them in roles of responsibility they are not prepared to take.
Patricia Tanner, organizer for the Kentucky Nurses Association, said that based on what she has heard from employees, the level of care at the hospital is "less than acceptable." The most disturbing situation, she said, is the mandated overtime, which has some nurses working 16-hour shifts up to three days a week.
"Articles are being written saying that nurses are being resistant to change. Nurses are accustomed to change. They are extremely efficient in moving through technology, but never have they been asked to do so much with so much less," Tanner said.
In the past few months, a number of employees voiced concerns about the changes, but requested anonymity because they feared that speaking out might damage their employment potential with the company. Many more workers will be required to reapply for redesigned jobs in coming months as Carilion puts in a new patient care system that teams a registered nurse with less-skilled workers who will be given more patient responsibilities. This is a trend in the health care industry.
In July, Carilion's Robertson acknowledged that re-engineering had been difficult for everyone at the time he announced a 2 percent across-the-board bonus as a thank-you to employees.
If hospital employees decide to organize, they will have to choose just one union to represent them, said a spokesman for the National Labor Relations Board. "We would only permit one group to actually end up representing a particular group of employees," said NLRB spokesman Gary Stiffler.
The employees could demand recognition as a bargaining unit, without an election, if 51 percent of them sign cards signifying their desire for a union. An election can be called if 30 percent of the employees request it, Stiffler said.
Estimates are that between 300 and 500 employees have signed union cards.
Dennis O'Connell, organizer with the Service Employees union, said he was confident that his union will be the "union of choice" for Carilion workers.
Staff writer Jeff Sturgeon contributed to this report.
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