RNs Link Inadequate RN Staffing and Excessive Patient Loads to Longer ED Wait Times (the longest in the state) and Boarding of Patients (10 - 30 a day)
LAWRENCE, Mass., April 2, 2019 /PRNewswire/ --
Thursday, April 11, 2019 from 2 - 4
Outside Main Entrance to Lawrence General Hospital, 1 General St., Lawrence MA
The nurses of Lawrence General Hospital (LGH) have delivered the required 10-day notice to hospital administration of their plan to conduct informational picketing on April 11, in an effort to negotiate a fair contract that will allow the hospital to recruit and retain the staff needed to provide quality patient care. The nurses and management have been negotiating a new union contract for more than eight months, with the last four sessions held with a federal mediator.
The nurses are attempting to reach an agreement that includes much needed staffing improvements to ensure optimum patient care. Other items include: improved time off, increased retirement benefits, and a fair wage increase. On March 27, a delegation of more than 70 nurses marched to the offices of the hospital president and chief nursing officer to deliver petitions calling for these improvements signed by more than 80 percent of the nearly 500 nurses at the hospital.
"I'm proud to work in this hospital and in this community, but there's room for improvement," said Travis Libman, RN, an emergency room nurse at the hospital and chair of the nurses local bargaining unit with the Massachusetts Nurses Association. "Too many patients are left boarding for an extended amount of time in the emergency room while waiting for a bed in the hospital. With the proper amount of staff, we could help alleviate this congestion and get patients where they need to go much quicker. Delivery of quality care is our top priority throughout these contract negotiations and beyond."
According to ProPublica, a service that tracks emergency department (ED) wait times for hospitals across the nation, Lawrence General Hospital patients experience the longest ED wait times in the state (an average of 81 minutes). LGH patients also experience some of the longest wait times in the state to receive needed medication for serious injuries. LGH also ranks near bottom statewide for the time it takes for patients to be admitted to the hospital from the ED (7 hours and 42 minutes). A full breakdown of LGH ED wait times can be found at the bottom of this advisory.
A study published last year in the Western Journal of Emergency Medicine found that excessive patient assignments and lower staffing levels in hospital emergency departments harm patient care, resulting in longer ED wait times, and the likelihood that patients will leave without being seen. Increasing staffing throughout the hospital will benefit the patients and staff alike.
Between January of 2018, through March of this year, LGH nurses have submitted to management more than 140 official reports detailing instances where nurses were forced to take excessive patient assignments that, "poses a serious threat to the safety and well-being of my patients."
As an alternative to having patient care units fully staffed with nurses experienced to care for patients in those areas, LGH has also engaged in the mandatory "floating" of nurses. This is when nurses from one area of the medical center are transferred to another where there is a staffing need. The nurse may be unfamiliar with the specific patient conditions, the equipment or procedures on that unit. Patients, as a result, may not be able to receive appropriate care.
To improve patient care, the nurses are seeking to increase RN staffing in key areas of the hospital to ensure patients receive the care they need when they need it. This will allow for an efficient flow of patients out of the emergency center and onto the inpatient units. The nurses have proposed to ban mandatory floating of nurses, and to prevent the hospital from making any future cuts to nurse staffing levels.
To compensate for the lack of appropriate staff at the facility, the hospital has limited nurse's access to previously agreed upon time off benefits, which is eroding staff morale and preventing nurses from having needed time with their own families.
"Nurses are seeking a competitive salary and benefits, including improved retirement and time off benefits that support the retention of staff and fosters a positive work life balance," said Laurie Spheekas, RN, a nurse on the hospital's telemetry unit and vice chair of the nurses local bargaining unit.
The nurses believe Lawrence General is well positioned to make a greater investment in nurses and the quality of patient care, given that Lawrence General has been included in the merger of Beth Israel Deaconess Medical Center and Lahey Health, which will be the second-largest hospital system in the state, and one of the most profitable. As part of that agreement, BI/Lahey has committed to invest several million dollars in LGH as a safety net provider, and more favorable reimbursement rates.
"The nurses of Lawrence General Hospital, many of whom have worked here for several years, are committed to ensure that this hospital is a first-class provider of quality patient care for the residents of Greater Lawrence," Spheekas concluded. "We provide 90 percent of the clinical care delivered by this hospital. This is not only our place of work, but for most of us, this is our community hospital and we have a professional and personal interest in its continued success."
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.
Background on LGH ED Wait Times
Below is more detailed information about ED wait times for Lawrence General Hospital in comparison with other hospitals in the state, as published on the ProPublica web site, which is derived from data on ED wait times reported by the federal government.
ED Wait Times
- LGH – 81 minutes
- Longest in the state
- Statewide average is 33.4 minutes
- LGH is 142.5% longer than statewide avg
Wait Time Until Sent Home
- LGH – 204 minutes
- 8th highest in the state; 47 hospitals have shorter wait times
- Statewide average is 174 minutes
- LGH is 17% longer than statewide average
Broken bone patients wait until pain meds
- LGH – 61 minutes
- 12th highest in the state; 42 hospitals have shorter wait times
- Statewide average 50.69
- LGH is 20% longer than state average
- LGH – 255 minutes (4 hours 15 minutes)
- 7th highest in the state; 1 hour and 7 minutes longer than the state average
- Statewide average is 3 hours 8 minutes
Time Before Admission (Average time patients spent in the emergency room before being admitted to the hospital)
- LGH is 7 hours 42 minutes
- State average is 6 hours, 32 minutes
- LGH is 1 hour and 10 minutes longer than state average
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SOURCE Massachusetts Nurses Association