Following complaints stemming from recent budget cuts and overcrowding at Dartmouth-Hitchcock Medical Center, nurses at the hospital are considering unionization and are currently engaged in discussions with Massachusetts Nurses Association representatives, DHMC media relations manager Rick Adams said in an interview with The Dartmouth.
Representatives from the Massachusetts Nurses Association first attempted to unionize DHMC in 2008, but those efforts ended in 2009, Adams said.
The renewed interest in unionization was likely the result of a June "Management Action Plan" a six-step plan attempting to fill a $15 million gap in DHMC's budget for fiscal year 2010 that instituted policy changes that were unpopular with several nurses, Adams said.
"We're seeing declining revenues, fewer patients," Adams said. "Combined with that, we're seeing lower rates of reimbursement, particularly with Medicaid."
The Management Action Plan invoked complaints from nurses after it established that the annual wage increase package normally delivered in the summer would be deferred to October, according to Adams.
Nurses also rejected DHMC administrators' decision to suspend one pay period's worth of "earned time," effectively reducing the nurses' vacation period since "earned time" can be used for vacation, illness or holiday time off.
DHMC co-presidents Nancy Formella and James Weinstein announced that they would no longer take away earned time in a Wednesday e-mail to staff members, following an online forum discussing the budget cuts and policy changes, Adams said.
"Of all the feedback that we got, the earned time issue generated about a quarter of the response," he said.
However, since eliminating earned time was supposed to save DHMC $1.5 million, administrators will now have to look elsewhere to make up those costs, according to Adams.
Recent overcrowding at DHMC has also led to discussions of unionization, Adams said. Last week, the 396-bed hospital served 70 patients beyond its designated capacity, the Valley News reported.
DHMC recently experienced a "summer surge," a particularly busy time in the emergency and trauma department due to elevated levels of tourism and outdoor activity, Adams said.
When last week's influx of patients was identified, DHMC workers immediately instituted an "incident command structure," Adams said. The incident command structure which was led by a nurse brought together various employees to brainstorm different ways to accommodate more patients while continuing to provide quality care, according to Adams.
"The nurses were the ones last weekend at the surge to come up with ideas and make sure the flow continued," Adams said. "They stepped up as they always do, and we're grateful for all the great work that they do. By the weekend, we had patient flow at a manageable level."
Organizers from the Massachusetts Nurses Association hosted four informational sessions for nurses at the Courtyard Marriott in Lebanon on Thursday, Adams said. It is ultimately the nurses who decide whether or not they will unionize, according to Adams.
"Our culture here is one of openness," Adams said. "Given the situation we're in right now the financial situation and with the challenges of health care some employees might seek out more information and see if the union is something that will benefit them."
Adams said that DHMC supports the right of every worker to be represented, though a union could negatively change the way nurses and other DHMC staff interact and communicate.
"A lot of the communication and face-to-face problem solving wouldn't be available due to rules and regulations," Adams said. "It would have to go through union representatives, and that changes the nature of the conversation. We think that this would have an adverse effect on the way we do things."
David Schildmeier, director of public communications for the Massachusetts Nurses Association, and union organizer Eileen Norton declined to comment for this article.
Adams said he was unaware of a possible timeline for unionization if the nurses at DHMC decide to seek outside representation.
"We encourage our employees to be well informed about issues like this but we don't have any indication that there's formal action coming anytime soon," Adams said.
