Nurses group scolds HCA

[NRSKarenRN, BSN, RN]

nurses group scolds hcaa nurses union has charged that the quality of care at kansas city-based hca midwest hospitals has declined because of staff cutbacks and other shortcomings.

kansas city star, may 13, 2004

nurses united for improved patient care based its allegations on a survey of nurses conducted by the union. the results were released wednesday at a news conference.

"the results are alarming and distressing," said mary nash, president of nurses united local 5126. "they're distressing because patient care has actually declined. and it's alarming because nearly one-half of the nurses that responded say they are intending to leave the hca system. and with the nursing shortage such as it is right now, this is disaster."

hca midwest spokesman rob dyer challenged the survey's findings. he said the company added 132 registered nurses to its kansas city area hospitals between march 2003 and march 2004, for a total of about 2,700.

"we have not cut any bedside care areas," dyer said. "if anything, since hca has been in this market, we have given raises to every single nurse and we are continuing to look at their salaries. we very strongly support the nursing staff at our hospitals and their leadership in taking care of our patients."

dyer added that hca midwest is investing heavily in areas such as technology, safety and training at its hospitals.

nurses united represents nurses at three hca midwest hospitals: lee's summit hospital, medical center of independence and menorah medical center in overland park.

union officials said the survey was distributed to more than 2,100 nurses at the 12 hospitals operated by hca midwest, which acquired the former health midwest system last year. they said responses came back from 355 nurses, more than 16 percent.

the findings included:

* 57 percent of respondents said quality of care has declined during the past year, while 35 percent said it has stayed the same.

* 58 percent said the amount of time spent with each patient has decreased in the past year, while 34 percent said it has stayed the same.

* 41 percent said they are considering leaving hca midwest.

* 65 percent said there has been a decrease in support staff such as nursing assistants, nursing unit secretaries, housekeepers, respiratory therapists and pharmacists.

* 63 percent said they are performing more non-nursing duties.

* 48 percent said the availability of supplies has declined under hca's ownership of the hospitals, and 44 percent said the quality of supplies has declined.

marti reitzel, a union member who is a physical rehabilitation nurse at menorah medical center, is concerned about what she sees as staff cutbacks.

"typically on the day shift we used to have a secretary, two nurses and two nurse assistants, five people for 12 patients," she said. "now there will be two nurses and one nurse assistant."

reitzel said she frequently works alone if there are no more than five patients in her unit.

"there have been a lot of nights when i have literally run all night long, trying to keep up with the patients, plus do all the paperwork myself," she said.

dyer said hca midwest employs eight fewer nursing secretaries now than a year ago, but he said that represents normal turnover. he said the company had not laid off any nursing unit secretaries.

dyer also challenged the validity of the survey:

"when we do surveys we use gallup, we do it every year, and we don't use it for pr purposes."

julie ginther, a nurses united coordinator, said: "that type of response by hca to its registered nurses is unfortunately sad and not surprising. the survey is painstakingly valid. it was done so the nurses could be anonymous in their responses and avoid retribution from the employer."

kansas city mayor pro tem alvin brooks, also speaking at the news conference, recalled a 2002 public hearing in kansas city in which officials of nashville, tenn.-based hca inc. pledged to improve the quality of care at health midwest hospitals if it succeeded in acquiring them.

"the survey does concern me, and i hope when you sit down with hca that they will be as concerned as i am," brooks said.

meantime, nash said, nurses united is developing legislative initiatives to improve patient safety and help retain experienced nurses in all hospitals in missouri and kansas. the initiatives:

* establish mandatory nurse-to-patient staffing ratios to ensure that nurses' workloads not endanger patient safety and the quality of patient care.

* protect nurses who raise legitimate concerns about the quality of patient care from retribution by their employers.

* make information about nurse staffing levels and other indicators of quality care available to the public.

to reach julius a. karash,

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