Mt Sinai deaths - RNs protest short-staffing

[-jt]

The State Dept of Health has cited POOR STAFFING as a cause in the death of a healthy liver transplant donor at Mt Sinai and has opened investigations on the deaths of 22 other liver transplant patients there whose families had complained of poor staffing and inadequate care.

Amazingly, Mt Sinai then announced it will conduct LAY-OFFS of 450 workers and elimination of vacant RN positions. How they think cutting more staff is going to solve their already short-staffing problem is impossible to figure out. The RNs have been protesting the hospitals plan to cut more staff. Reporters were all over the place at their latest protest this week. One thing about our nurses - they sure arent afraid to talk.

Photos of the Mt Sinai RN protest can be seen at: http://www.nysna.org/NEWS/press/pr2002/pr_sinai.htm

Mount Sinai Nurses Protest Unsafe Staffing

Picketing held March 21

NEW YORK, March 14, 2002 - Proposed layoffs at The Mount Sinai Hospital will further threaten patient care, according to the facility's registered nurses.

Insufficient staffing has already been cited by the State Health Department as a factor in the death of a patient at the facility in January, and additional layoffs will only make matters worse, the nurses say.

As a result, the nurses expressed their frustration over this situation with an informational picket from 11:00 A.M. to 2:00 P.M. Thursday, March 21, in front of the hospital on Fifth Avenue between 98th and 101st streets.

The nurses, represented by the New York State Nurses Association (NYSNA), are trying through their current contract negotiations to develop solutions to the hospital's staffing problems. But management refuses to even acknowledge that there is a problem, and is continuing with its plan to cut an estimated 450 positions.

So far, 15 registered nurse positions have been eliminated and NYSNA anticipates there will be more. An entire unit has already been shut down, a move that NYSNA believes is the result of irresponsible cost cutting that has no regard for the needs of patients.

Furthermore, despite management's public assertion that few of the proposed layoffs would involve direct patient care, NYSNA contends that staff cuts in areas such as housekeeping would leave responsibility for their duties in the hands of registered nurses. This, in turn would further draw RNs away from their bedside patient care duties.

NYSNA represents 1,821 RNs at the Upper East Side facility. Their most recent three-year contract expired on January 1.

With more than 33,000 members, NYSNA is the leading organization for registered nurses in New York state and is one of the largest representatives of RNs for collective bargaining in the nation. A multipurpose organization, NYSNA fosters high standards for nursing education and practice and works to advance the profession through legislative activity. For more information, contact Mark Genovese at NYSNA: 518.782.9400, ext. 353.

http://www.NYSNA.org >>>>>>>

comments may be sent to [email protected]

[Mijourney]

Hi -jt. Why? Why are so many positions being eliminated at Mt Sinai. Does this possibly mean that heads near the top will roll? Is the hospital being bought out or closing? It would be interesting to know how and where Mt Sinai has spent its money. At this point, Mt Sinai is probably in danger of losing its transplant program completely. I can't imagine that third party payors would want to continue to pay for services in a hospital program that seems to have quality of care problems.

[-jt]

It had nothing to do with it. The hospital hired the Hunter Group LAST YEAR to make recommendations to help get it out of its fiscal crunch. (wonder how many millions it paid for that?). And these cuts were what the Hunter Group recommended. Its just so galling that especially in view of the state declaring that a healthy elective surgery pt died BECAUSE OF POOR STAFFING, the hospital made an announcement that it is going ahead with these staffing cuts anyway. The rest of the transplant programs remain in operation. Only the one adult-to-adult living donor transplant program has been suspended for 6 months - all the others continue - including pediatric. And the count for Mt Sinai transplant pt death cases being reopened by the NY State dept of health for further investigation to see if poor staffing and other preventable causes were to blame has risen to 28.

And STILL the hospital insists on making these cuts & that they will have no effect on pt care.

A previous news article posted here earlier gives the hospitals rationale for continuing the cuts which it started last Christmas - to save $25 million per year:

The facility also said the action would 'provide savings that will significantly reduce the hospital's current deficit and help meet Mt Sinai's long-term goal of achieving a strong financial platform'.

The workforce reductions include management and staff, the hospital said, and were made in response to recommendations by the Hunter Group, a healthcare financial consulting group retained by the Mt Sinai Board of Trustees in 2001 to help the medical center address financial shortcomings."

(Advance For Nurses - NY/NJ edition)

https://allnurses.com/forums/showthread.php?s=&threadid=15056 >>>

and THEN in todays newspaper (Easter Sunday):

(someday they will have the guts to print everything the nurses tell them, instead of just cutting it all down to generic surface comments, but its a start......)

March 31, 2002 -- Senior nurses at Mount Sinai Medical Center say many sick patients don't get the bedside attention they need, and that the hospital's cleanliness has slid so far downhill even the operating theater is "dirty."

One veteran nurse told The Post that when she was a surgery patient at the Manhattan hospital she had to wait, in pain, after buzzing for help.

"You rang the bell and knew it was going to be awhile until somebody answered, and then awhile until they came," the nurse said. "If things got extremely busy or the staffing was short, it could be a long time."

The comments come at a time beleaguered Mount Sinai's liver-transplant unit is under investigation. The state Health Department has blasted the hospital for "woefully inadequate" care in the Jan. 13 death of Mike Hurewitz, 57, a newspaper reporter who choked on his own blood three days after giving half his liver to his ailing brother.

The state suspended live-donor transplants at the hospital for six months.

The department is also investigating 28 other deaths of liver recipients, including many who, like Hurewitz, developed infections in the hospital, officials said.

Mount Sinai told the state it has beefed up staffing and medical supervision on the liver ward, and proposed other improvements in a "plan of correction."

But the nurses, who are currently renegotiating their contracts, say patient care at the prestigious teaching hospital has gone downhill.

"It has the reputation of being one of the best, and patients must be surprised they don't receive the kind of care they should," said Therese Wittner, the New York State Nurses Association rep at the hospital.

In recent years, the cash-strapped hospital, which eliminated 450 jobs last month, has tried to save money by cutting nursing and housekeeping positions.

The hospital has also combined jobs such as transporting patients and cleaning rooms.

Even the operating room is neglected and not as "white glove" clean as it used to be, nurses said. Patients waiting to go into surgery are often left to watch as blood-stained gauze and other debris is hauled out, they said.

The ratio of patients to nurses is high all over the hospital, they said. Nurses caring for seven or eight patients at a time try to tend to the sickest first.

"When something untoward is happening with a patient, there's no guarantee somebody is going to be there instantly and do something about it," said Marva Wade, a Mount Sinai nurse for more than 30 years. >>>

http://www.nypost.com/news/regionalnews/44701.htm

[Mijourney]

Hi -jt. Then it looks that the board and administration are applying the typical scapegoat routine to nurses and other frontline staff. Again, I have to ask where did the money go to? We know that the reputation for the good care outcomes from Mt Sinai was largely due to excellence in nursing care as well as excellence from other frontline practitioners. I'm going to guess that the budget shortfall is as a result of all the wonderful technology bought and used as well as the money that goes into recruitment of world class physicians, R&D, and other medical and science oriented programs. I've never visited Mt Sinai before, but I have to believe that construction and development played a role. Of course, it would be interesting to find out how much was spent to have a consulting firm evaluate the situation. It may be that construction and consulting fees come out of another part of the budget and are separate from the one set aside for technology and direct patient care. Keeping physicians who bring in revenue and their advanced technology intact is usually deemed more important than keeping nurses, therapists, and other ancillary staff. There should be some way to find a happy medium in having the best of both worlds. Am I totally off base?

[-jt]

you hit the nail on the head. They spend to have the best name MDs, the best PR, impressive facilities and technology but then they drop the ball because, as I have been told by my own hospitals administration at the negotiating table, its the DOCTORS, not nurses that bring in the pts & the money. Yet most of our doctors also have privileges at all the other hospitals in our area and many of the pts say they choose to come to ours instead of one of the others for the NURSING CARE.

We'll see what comes of this after the state dept of health is finished with it. They are now re-opening 28 pt death cases for full investigation as well as other cases of family/pt complaints about that hospital

[rncountry]

JT, I can't wait to hear what those investigations say.

[-jt]

well - its going to take a while. The count of transplant pt complication and death cases reopened for state investigation today hit a total of 41....... and climbing.

[NRSKarenRN, BSN, RN]

NY Times April 5, 2002

State Checks 41 Liver Surgery Cases at Hospital Where Donor Died

By SUSAN SAULNY

http://www.nytimes.com/2002/04/05/nyregion/05LIVE.html

State health officials are now responding to requests to investigate 41 liver surgery cases at Mount Sinai Hospital, where a patient died in January after donating part of his liver.

Robert Kenny, a spokesman for the State Department of Health, said 32 cases involved deaths. In the nine remaining cases, survivors requested inquiries based on claims of inadequate care, and two of those cases concerned liver donors.

The state began receiving calls for investigations after the death of Michael Hurewitz, a healthy man who had donated part of his liver to his brother in January. Although the operation was completed without complications, Mr. Hurewitz died three days later, and a state investigation held the hospital accountable and cited poor post-surgical care.

Mount Sinai is considered a leader in the field of adult living-donor transplants, and the January death was the first in the program. Mr. Hurewitz was one of 34 patients in the transplant ward being cared for by one first-year resident, the state inquiry found. The hospital was fined $48,000 and banned from performing living-donor surgery for six months.

The hospital submitted a report to the state last month saying it was making changes to improve the care in the transplant ward. The changes included increasing medical staff levels and barring first-year residents from treating patients in the ward.

[-jt]

Yes. And those changes were that from now on the MD caring for the pts will be a 2nd yr resident instead of a 1st year. And more PAs will be hired. Not a word about more nurses - even as the RNs protest RN short staffing, picket the hospital, and face a potential strike over the issue. Also, not a word about what effect the hospitals insistence on LAYING-OFF 450 workers & eliminating vacant RN postions instead of trying to fill them, at the same time it tells the state it is improving staffing, will have on pt care.

This hospitals idea of "making changes to improve pt care" is to get rid of RNs & other personnel..... and hire a few PAs.

Perfect.

[-jt]

I heard that the unit where the death happened was staffed at a ratio of 1:7 - and the staff was all new nurses. And that when an experienced RN walked onto the unit, she saw the situation & immediately called the code. We dont have safe staffing laws in this state yet - our bills for it are floating around the state legislature & are being lobbied against by the AHA. Sadly, tragedies like that death are the kind of thing has to happen before the lawmakers move. But we arent giving up.....

Mount Sinai nurses return to picket line Tuesday

New York, NY April 19, 2002 - Unable to reach agreement with management on a resolution to staffing problems, registered nurses at The Mount Sinai Hospital will return to the picket line on Tuesday April 23.

The 1,821 nurses, represented by the New York State Nurses Association (NYSNA), have been trying through their current contract talks to establish safe, enforceable, RN-to-patient guidelines as well as strict limitations on the hospital's ability to force nurses to work overtime and to temporarily assign nurses to work in units for which they do not have clinical experience or training. After 20 negotiation sessions, including sessions yesterday and today, hospital management has STILL not offered the nurses an acceptable response to these concerns.

The nurses contend that working conditions such as these will only further deplete the hospital's nursing workforce - which will endanger patient care.

Picketing is scheduled from 11:00 a.m. to 2:00 p.m., in front of the hospital on Fifth Avenue between 98th and 101st streets.

For more information, call Mark Genovese at NYSNA: 518.782.9400, ext. 353.

comments may be sent to [email protected] >>