About two dozen Wexner Medical Center nurses gathered in the lobby of Graves Hall, a College of Medicine building, Wednesday morning to voice their opposition to recent staff cuts they say put patients’ safety at risk.
The medical center’s progressive care unit — one step down from the intensive care units, which treat the most at-risk patients — had five nurses cut from its nursing staff of 31 in August.
The cuts reduced the daytime nursing staff from 16 to 13 and the nighttime staff from 15 to 13 in the unit, nurses said.
No one was fired or laid off, said stat nurse Rick Lucas, who assists in various units as needed, and is a member of the nurses’ organization board. Instead, travel nurses who move from location to location nationwide had contracts expire and not be renewed while other nurses on the unit were called off of shifts or asked to move around between units, he said.
The staff reduction was announced at a meeting in mid-August and increased the maximum ratio of patients to nurses in the unit from 3-to-1 to 3.5-to-1. About half the staff now takes on four patients, a responsibility many of the nurses said spreads staff too thin.
The timing of the nursing-staff cuts rubbed some the wrong way, given the medical center announced the same month it had set a new revenue record for the 2017 fiscal year, said Jessie Frymyer, president of The Ohio State University Nurses Organization, the local branch of the Ohio Nurses Association.
We have to be able to change [how many patients a nurse is caring for] when it’s necessary to what the patient needs. And we’re dealing with the human condition. It’s a variable thing. It changes. It would be nice if it fit in a little box. It doesn’t. — Suzy Linville, Wexner Medical Center nurse.
Citing a clause in the collective-bargaining agreement the nurses have with the medical center, the unit — called 8 Rhodes PCU — filed a grievance against the medical center on Aug. 27, Frymyer said.
Several nurses made clear their objections to human-resource managers from both the university and the medical center in a closed-to-the-public grievance hearing as part of the weekly meetings between the two parties. Members of 8 Rhodes PCU, as well as nurses from other units, planned the Wednesday gathering as a show of support for the grievance.
“We really want this process to work,” Frymyer said. “This is how this is supposed to be. We bring an issue forward, HR, nursing leadership looks into it, and then adjusts, hopefully.”
The purpose of the PCU unit is to prevent a need for escalation to an intensive care unit, said Helen Barbis, a registered nurse on the unit.
“I feel like we’re pulled in so many directions,” Barbis said. “Now we’re not adequately able to have that closer eye that we’re supposed to have when we’re PCU.”
A lower patient-nurse ratio allows for nurses to give closer care, something that could prevent sudden emergency situations, said Tina Bezouska, another nurse in the unit.
She recalled a recent event involving two patients “coding” — having a sudden emergency such as stopped breathing or heart failure — within one shift. Bezouska said the incident might have been prevented with a lower patient-to-nurse ratio.
She said the patients had to get intubated, meaning a breathing tube was inserted in their throats, and go to the ICU.
“No extra help,” said Lucas, finishing her sentence.
Suzy Linville, a nurse in the surgical ICU, one of three ICUs at the medical center, said her unit sometimes takes on patients who should be in the less-intensive PCU when the latter is overbooked.
She said her own unit often has to decline overflow patients because they themselves are understaffed, causing the unit to lose the flexibility necessary to meet patient needs.
“We have to be able to change that when it’s necessary to what the patient needs,” she said. “And we’re dealing with the human condition. It’s a variable thing. It changes. It would be nice if it fit in a little box. It doesn’t.”
The medical center said it does not sacrifice quality care in favor of meeting a budget, according to a statement made in response to the nurses’ grievance.
“Patient safety is always our No.1 priority,” the statement said. “The Wexner Medical Center is widely recognized as one of the best health systems in the nation for quality of care. Our operational models are under continuous review, and we staff to the type of patient being treated, not to budget.
“We value and take seriously the feedback from our bedside staff on how we can best meet the needs of our patients. We are dedicated to transparency in working with our nursing staff and organizational leadership to resolve all issues, and will remain actively engaged.”
For some nurses, the change affected them in a personal way.
“To have something like this prevent us from being the nurses that we want to be and provide the care that we want to provide, it’s just really frustrating,” said Barbis. “I strive to provide the level of care that I would want my grandmother to receive or my parents or myself to receive and it’s becoming increasingly more challenging to meet my own standards.”