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星期一, 7月 17, 2017

罷工一天 被拒門外四天後 塔醫護士回去上班了

            (Boston Orange) 在罷工一天,被醫院管理層拒於門外四天之後,塔芙茨醫療中心的麻州護士協會護士們今天(17)回醫院上班了。
            早上7點左右,就有一些麻州護士協會的護士們離開抗議繞行隊伍,從波士頓華埠的華盛頓街走進了塔醫的主要入口。
            這些數以打計的護士們,聚集在橘線地鐵站附近,等到早上7點時,就在支持者的鼓勵喊聲中,跨越那暫時封閉了的華盛頓街。
            許多護士互相擁抱,有些眼中含淚。旁邊的支持者喊著MNA, MNA這麻州護士協會的簡稱。還有些人喊著我們愛你
            除了這些喊聲之外,護士們進入醫院時,和平常沒甚麼不一樣,但上週四,醫院管理層不讓他們進醫院時,那情景可完全不一樣。
            醫院管理層為了讓醫院正常運作,簽了5天合約,請來320名替代護士,才造成直到星期一才結束的拒之門外。
            塔醫及麻州護士協會的管理層,都預期著會重回談判桌,繼續討論沒解決的問題,包括護士們的薪水,退休金計畫,以及員工層級。
            過去這五天,護士們得到許多公職人員的支持,包括曾是麻州行業工會領袖的波士頓市長馬丁華殊(Martin Walsh)。上週六時,他向500多名護士喊話,希望護士和醫院繼續談判。
週日時,工會支持者聲稱,在離醫院數里之外的酒店,他們和替代護士起了衝突。靠近羅根機場那兒的酒店,有大約20人在州警出現時才因為沒有抗議許可散去,
塔醫和護士們都認為,在護士們回去工作時,可能會遭遇醫些緊張狀況。


華人前進會等支持塔醫護士機構早前發表如下聲明,為護士撐腰。

Tufts Medical Center Nurses Will Wage One-Day Strike on July 12 As Last-Ditch Talks Fail to Reach Agreement

塔夫茨醫院的護士會在712日進行一天罷工,最後談判未能達成協

注冊護士正計劃在712日發動24小時的罷工,護士們憂慮醫院病人安全,資源短缺,和減掉退休計劃的問題仍未得到解決;塔夫醫院威脅4天把護士關在外面

波士頓– 1,200名塔夫醫院注冊護士選出的護士代表在712日星期二在波士頓聯邦調解員辦公室返回談判,希望與塔夫醫院達成共識,設法在預定計劃進行歷史性的24小時罷工前,解決有關病人護理安全,退休保障和其他的問題。

“塔夫茨的護士們已經提出解決醫院人手和病人護理問題的方案,並已找出如何支付解決方案”手術室護士兼談判小組共同主席 Mary HavlicekCornacchia提出,“我們希望塔夫茨的管理層會在星期二能坐下來,聆聽護士的聲音和決定會真正的談判。

護士們正在尋求急需改善人手方面的問題,保障護士能有多些時間照顧病人,和增加工資去保持與其他波士頓醫院的競爭力(塔夫茨的護士是全市最低工資的護士),并保留和加强他們的退休福利(也是全是最差的)

雖然不能照顧我們的病人,這個醫院的護士明天會罷工顯示我們的決心和承諾,要爲我們的病人和專業的實踐爭取最好的。”Barbara Tiller,工會共同主席兼一名輸液/導管/認證放射有經驗的護士提出,“我們一直在嘗試説服塔夫茨的管理層,因爲醫院拒絕爲我們提供資源,適當的病人分配,和足夠的補償去確保提供最優質的病人護理。我們明天會在街上的,塔夫茨的護士是不會退縮的。

注冊護士星期二至星期四的公共時間表

712日星期三早上7時:如果塔夫茨管理層拒絕接受一個公平的合約去保護病人和尊重護士,一天的罷工正式展開。護士和支持者會在醫院800號華盛頓街的正門外集會。抗議將會展開,並在24小時的罷工和醫院有可能會閉關的期間持續進行。
712日星期三中午12時和下午5時:在醫院800號華盛頓街的正門外,與護士,職員,社區支持者和地方領袖一起集會示威。
713日星期四上午659分:注冊護士一天的罷工終結。護士會在800號華盛頓節門外集會,當日值班的護士計劃返回塔夫茨醫院照顧病人。塔夫茨醫院已威脅會4天把護士關在外面。 
塔夫茨醫院罷工替工護士的真相
在塔夫茨的護士24小時罷工的期間,管理層打算帶入全國國地的臨時替工護士,他們對醫院毫不認識,跟塔夫茨的護士不一樣因爲不是專科,麻州護士協會認爲這個做法會危害病人護理。
歷史,學術性研究,和有工會的注冊護士全都能作證,臨時的替工護士是不能取代暫時失去一班有專業領域的護士,他們並非常熟悉自己的病人和醫院的運作。在2010年,國家經濟研究局的一項調查總括,“招聘替工明顯不會有幫助:在罷工的情況下,有聘請替工的醫院不會比沒有請替工的醫院有更好的服務。在各種情況下,需要深切護理的病人在護士罷工的時候惡化的機會會變得更高。”http://www.nber.org/digest/jul10/w15855.htm

2000年期間,在Worcester St. Vincent醫院一班麻州護士協會的護士曾經罷工,當時醫院行聘用了替工護士,來自同一間塔夫茨醫院正打算會聘用的罷工補替護士公司,有三名護士被解雇,分別因爲替工護士在病人手術后丟下了病人,還有帶錯了嬰兒給一個母親,這些全部都有在Worcester Telegram & Gazette WCVB視頻有新聞報道記錄的。根據Channel5的報道,有另一名病人被輸入了幾乎致命過量的嗎啡,正因爲一名替工護士誤會了醫生的指示。https://www.youtube.com/watch?v=I1LfVT2Ot3I

“即使在正常的情況下,也需要幾個星期才能訓練一個有經驗的護士去提供良好的護理”工會共同主席兼一名輸液
/導管/認證放射有經驗的護士提出。“他們怎可以有期望一班來自全國不同地方,在這間醫院又毫無經驗的護士,能讓醫院安全地運作?這是不負責任的想法。與其發出最後聲言和花費數百萬美元去忽視我們,不如聽取我們的意見,提供一個公平,和能真正重視病人護理安全,而不是為了企業利潤的協議。

最大爭議的問題:
護士們談判時最注重的問題仍然是:
·         需要改善現時的護士人手分配,讓全醫院有更安全的病人分配
·         需要更多注射護士和臨床資源護士
·         需要在所有輪班開始的時候有沒有病人被分配的護士長。護士長是一名注冊護士,他的主要工作是管理每一個輪班各方面的護理職責,包括處理病人的出入來委派護士的輪更。不需要被分派去照顧特定的病人,塔夫護士長才能在最繁忙(例如換更)的時候,支持最有需要的病人和護士
·         需要改善工資,才會令醫院行業有競爭性,方可改善招聘護士和保留護士行業
·         需要保護並改善退休計劃,讓醫院行業有競爭性。

擔憂工作人員和病人護理的安全
在現時塔夫的工作環境,不同部門和樓層的護士每天都要對抗不安全人手問題的局面,因爲很多部門都報告時常有不安全的人手問題。結果是有太多注冊護士經常有太多或不安全的病人分配。每天,醫院都會廣發短信要求護士能頂替有空檔的輪更,因爲管理層用僅僅夠的手法管理醫院人手。

同時,醫院管理層堅持用破碎的系統臨時重新分配工作作為解決長期人手問題的解決方法。這導致注冊護士被分派到不熟悉和/或未經培訓的部門和樓層工作去照顧病人。此外,還沒有足夠的專科護士幫助患者的注射需求或緊急情況。
“我們已經提出過不同的提議,和一修改過的提議兼再進一步修改的提議,去改善人手問題。” Tiller說,“但管理層一直沒有足夠的答復是正真能解決問題的核心。他們堅持提出有關人手的提案都是脫節和衹是表面性的。我們需要的是很簡單:多些全職注冊護士和專科護士,和護士長不需有預先病人分配。這就足以保障我們的病人的安全。”
市場競爭性的工資
除了是全波士頓有最差人手問題的醫院之外,塔夫醫院也是全市提供最低的工資和最差的退休計劃給護士的醫院。“醫院的提議全部沒有正當地解決這些問題。”Havlicek Cornacchia 說,“沒有市場競爭性的工資和福利,塔夫是不能招聘和保留醫院需要的護士,也衹會另人手問題每況愈下。”

管理層還提議凍結大約350個注冊護士的制定福利養老金計劃,並建立一個有分裂性,不公平,又復雜的追趕機制,作為高風險的403b)配對計劃的一部分。這個變動將導致大多數護士的退休金有重大的損失。同時,已經在制定的退休計劃中的注冊護士將繼續獲得全城市所有護士最低的雇主報酬。
護士已經提出過一項創新的建議,將會令所有注冊護士受益,同時每年仍能節省醫院數百萬美元。這項計劃是一項多雇主定義的福利養老金計劃,將為塔夫茨的底線增加到高達1100萬美元,消除8500萬美元的養老金負債。管理層拒絕就這個問題進行真正的談判。
“塔夫茨的薪酬和退休福利並不具有競爭力,”Tiller說。 “我們知道,塔夫茨知道,而城裡的其他醫院都知道。因此,我們已經成為所有其他設施的護士培訓場所。新畢業生來到這裡,他們汲取了經驗以後,他們會離開去繼續發展。這個循環是不會停止,直到醫院讓我們有好的競爭力。而在此期間,會使我們的病人受苦。”
Tufts Medical Center Nurses Will Wage One-Day Strike on July 12 As Last-Ditch Talks Fail to Reach Agreement

RNs plan 24-hour strike as nurses’ concerns over patient safety, lack of resources, retirement takeaway remain unresolved; Tufts threatens four-day lock out

BOSTON – The 1,200 registered nurses at Tufts Medical Center, who are represented by the Massachusetts Nurses Association, will conduct an historic one-day strike tomorrow as the latest round of negotiations held today at the federal mediator’s office failed to achieve a settlement that ensures patients have the highly skilled nursing care they deserve. The strike will begin at 7 a.m. on Wednesday and run until 6:59 a.m. on Thursday, July 13. It will be the first strike by nurses in Boston in over 30 years, and the largest nurses’ strike in Massachusetts history.
 “We came to the table today hoping to reach an agreement, but Tufts management is determined to force a strike and a subsequent lock out of our nurses,” said Mary HavlicekCornacchia, an OR nurse and bargaining unit co-chair. “This decision really shows administration’s lack of respect for its nurses and for the safety our patients.”
The nurses are seeking much needed improvements in staffing levels to ensure nurses have more time to spend with patients as well as an increase in their salary to keep them competitive with other Boston hospitals (Tufts nurses are the lowest paid nurses in the city) and to preserve and enhance their pension benefit (which is also the worst in the city). 

“Instead of caring for our patients, the nurses of this hospital will be out on the strike line tomorrow to demonstrate our resolve and our commitment to fight for what is best for our patients and our professional practice,” said Barbara Tiller, union co-chair and an IV/PICC/CRN nurse. “We have been trying for months to convince Tufts management that our patients and nurses are suffering because they refuse to provide us with the resources, appropriate patient assignments, and the compensation we need to ensure quality patient care. We will be on the street tomorrow, Tufts nurses will not back down.”

RN Public Schedule for Tuesday-Thursday

7 a.m. Wednesday, July 12: One-day strike begins. Nurses and supporters will gather outside the main entrance of the hospital at 800 Washington St. in Boston. Picketing will begin and continue through the duration of the 24-hour strike.

12 p.m. and 5 p.m. Wednesday, July 12: Rallies outside the hospital at 800 Washington St. in Boston with nurses, staff, community supporters, and local leaders.

6:59 a.m. Thursday, July 13: One-day RN strike ends. Nurses will gather outside the hospital at 800 Washington St. in Boston and those scheduled to work plan to enter Tufts to care for their patients. The hospital has threatened to lock out nurses for four days.

The Truth about Tufts Strike Replacement Nurses

During the planned 24-hour strike by Tufts nurses, TMC management plans to bring in mercenary replacement nurses from all over the country who do not know the hospital, are not highly specialized like the Tufts nurses, and who the Massachusetts Nurses Association believes will endanger patient care.

History, academic studies and unionized registered nurses can all testify to the fact that mercenary replacement nurses cannot make up for the temporary loss of nurses who are specialized in their fields and knowledgeable of their patients and the hospital systems. A 2010 study by the National Bureau of Economic Research<
http://www.nber.org/digest/jul10/w15855.html> concluded, “Hiring replacement workers apparently does not help: hospitals that hired replacement workers performed no better during strikes than those that did not hire substitute employees.”

During the 2000 strike by the MNA nurses at St. Vincent Hospital in Worcester, three replacement nurses recruited by the same strike replacement nurse agency Tufts plans to use were fired after separate incidents in which they left a patient alone after surgery and also gave the wrong baby to a nursing mother, according to news reports by the Worcester Telegram & Gazette and WCVB Channel 5<
https://www.youtube.com/watch?v=I1LfVT2Ot3I>. Another patient was given a nearly fatal overdose of morphine because a replacement nurse misunderstood a doctor’s order, according to Channel 5.

“It can take several weeks to train even an experienced nurse to provide quality care under normal conditions in a new hospital setting,” said HavlicekCornacchia. “How can they possibly expect to safely operate this hospital with nurses drawn from all parts of the country who have no experience with our facility? It is irresponsible. Instead of issuing ultimatums and spending millions of dollars to ignore us, they should have listened to us and offered a fair settlement.”

Key Issues in Dispute

The nurses’ key issues in these talks continue to be:

·       The need for improved nurse staffing with safer patient assignments for nurses throughout the hospital 

·       The need for more IV nurses and clinical resource nurses 

·       The need to have charge nurses who are free of patient assignments at the start of all shifts, in all units. A charge nurse is an RN who is responsible for managing all aspects of nursing responsibilities during each shift, from processing patients in and out to delegating nursing rounds. Being free of an initial patient assignment will allow Tufts’ charge nurses to provide desperately needed support to patients and nurses at the busiest time (i.e., change of shift) 

·       The need for wage improvements that will make the hospital market competitive, thereby improving nurse recruitment and retention
 
·       The need for pension protections/improvements that will make the hospital market competitive

 Concerns over Safe Staffing and Safe Patient Care 

In the current environment at Tufts, nurses across all units and floors are contending with unsafe staffing situations on a daily basis, with many units reporting constant unsafe staffing levels. The result is too many RNs are regularly carrying patient assignments that are too large and unsafe. Every day, the hospital sends RNs blast-text messages asking them to pick up shifts that are open due to the bare-bones approach management uses to staff the hospital.

Simultaneously, hospital management insists on using a fragmented and broken system of temporary reassignment as a way of trying to deal with its chronic staffing challenges. This results in RNs being directed to work on units and floors where they are unfamiliar and/or untrained to safely care for patients. In addition, there are not enough specialty nurses to help with patients’ IV needs or in an emergency.

“We have offered a variety of proposals — and amended proposals, and doubly amended proposals — that would address staffing,” said Tiller. “But management’s responses have been so inadequate that they don’t get to the heart of the problem. They insist on offering us staffing proposals that are disjointed and superficial. What we need from them is simple: more full-time RNs and specialty nurses, and charge nurses without an initial patient assignment. That’s what will keep our patients safe.”

Market Competitive Compensation 

In addition to having some of the worst staffing conditions in Boston, Tufts Medical Center has also become the hospital that offers its nurses the lowest wages and retirement benefits in the city. “The hospital’s proposals have not adequately addressed these issues,” said HavlicekCornacchia. “Without market competitive wages and benefits, Tufts cannot recruit and retain the nurses it needs, and the staffing problem spirals downward.”
 

Management has also proposed freezing the defined benefit pension plan for approximately 350 RNs and instituting a divisive, inequitable, and complex catchup mechanism as part of a proposed higher-risk 403(b) matching program. That change would result in significant losses in retirement funding for most nurses. Meanwhile, RNs already in the defined contribution plan would continue to receive the lowest employer contribution of all nurses in the city.

The nurses have countered with an innovative proposal that would benefit all RNs while still saving the hospital millions of dollars annually. This proposed plan, which is a multi-employer defined benefit pension plan, would add as much as $11 million to Tufts’ bottom line, would eliminate more than $85 million in pension liability. Management has refused to engage in any real talks on this issue.

“The pay and retirement benefits at Tufts just aren’t competitive,” said Tiller. “We know it, Tufts knows it, and the other hospitals in the city know it. As a result, we’ve become the nurse training ground for all the other facilities. New graduates come here, they get their experience, and they move on. This cycle won’t stop until the hospital makes us competitive. And in the meantime, our patients suffer.”