Episode Transcript
[00:00:10] Speaker A: You're listening to the weighing in podcast, the show that brings you inside the Daily Gazette's featured news column.
And now here's your host writer of the weighing in column, Andrew Waite.
[00:00:29] Speaker B: And we're out here again. We're out here again. And that's a shame. I want to thank all of you for coming tonight. It's an honor and a privilege to be the executive director of this great union and these awesome, awesome nurses. It's nice and in the house.
[00:00:47] Speaker C: So that sound from a vigil on Wednesday night, when nurses at Ellis Hospital in Schenectady were calling for changes to fix chronic short staffing, which is at pretty alarming levels. So a recent analysis by the New York State Nurses association found that Ellis units are understaffed an average of 93% of the time. This was between February and November. So, for instance, in one medical surgical unit, nurses are asked to care for as many as seven patients when the standard calls for no more than four.
And all of this comes as Ellis nurses and NySNa are engaged in contract negotiations with Ellis leadership, and they're asking that these shortages be addressed through requests like fair wage increases and an apprentice program. Basically, they want to make Ellis a desirable place where they can attract and retain nurses.
Of course, Ellis leaders counter all of this by saying there's really just not much more they can do that we're dealing with a national shortage of nurses, and facilities across the country are seeing the same kinds of issues. But the nurses say that that's basically a mischaracterization. And in fact, only 53% of licensed nurses in New York are practicing, according to NYSNA. And that points to, frankly, it being a solvable problem if you can improve working conditions and increase wages and recruit more people who have licenses to actually work the profession that they are licensed to work in.
So as I listened on a fairly cold night, I found myself pretty easily swayed. It probably didn't take too much because I'm the son of a nurse, and I just believe that we should be supporting nurses, especially after they sacrificed so much during the pandemic. But after listening, this is the piece I came away with.
[00:02:40] Speaker A: You're listening to the weighing in podcast with columnist Andrew Waite.
[00:02:54] Speaker C: With the temperature hovering just above freezing, the more than 50 nurses and supporters huddled Wednesday night in front of Ellis Hospital were cold. But mostly they were heated. They were heated because of chronic understaffing inside the Schenectady Hospital and at Bellevue Women's center. It's a situation so precarious that an analysis by the New York State Nurses association found between February and November of this year that Ellis units have been understaffed an average of 93% of the time. They were heated because nurses have been attempting to negotiate a contract with Ellis administrators since March, to little avail. Their goal is a deal that would address the woeful staffing levels, which were supposed to have improved following the passage of last year's state minimum staffing law. Specific demands include a fair wage increase, the creation of an apprentice program and adding to the number of nursing positions to ensure staff can have meal breaks. But after 19 trips to the negotiating table, Ellis nurses say they haven't made meaningful progress. Ellis's leaders contend that the hospital's understaffing is part of a broader nursing shortage across the country. But that argument gets the nurses heated, too. The issue, nurses say, is not that there's a scarcity of them. In fact, only 53% of licensed nurses in New York state are practicing, according to NYSNA, a union that represents more than 42,000 members. The issue is that practicing nurses are stretched too thin, often forced to skip breaks and meals during twelve hour plus shifts, leading to burnout and fewer people wanting to stay in the profession. The state is facing a shortage of good healthcare jobs, not healthcare workers themselves, a NySNA spokesperson said. So the nurses are heated not just because of the difficult working conditions they routinely face. They are heated because those poor conditions lead to low staffing levels that put patients at risk. Christine Walters, a 60 year old postpartum nurse and lactation specialist at Bellevue, has dealt firsthand with the short staffing as a patient. About six months ago, Walters told me she felt severe back pain during her shift, suspecting immediately it was another kidney stone. So after work, still wearing her Ellis badge, she went to the Ellis emergency room. After 5 hours, she was still waiting. People beside her said they'd been waiting nearly twice as long, so she went home and suffered until she could call her urologist in the morning. It was a tough night, said Walters, who lives in Princetown. I'm a member of this community. I came to the hospital that I work for and I couldn't get seen.
Sure, Ellis has since changed its ER intake policy to make the process more efficient, but essentially what they've done is taken them from one waiting room and put them in another waiting room, said ER crisis unit nurse Fred Derocher. And Ellis's understaffing is felt across its facilities, not just in the ER, according to NysNA analysis. For example, in one medical surgical unit, where nurses often see elderly patients. Nurses have been asked to care for as many as seven patients, according to Nysna. They aren't supposed to be assigned more than four.
Ratio standards differ by units. Another medical surgical unit was understaffed 96% of the time, with nurse to patient ratios exceeding the safe staffing standard in 528 out of 551 shifts. That's simply unacceptable. During the pandemic, we heralded nurses as heroes. This is how Ellis treats them. Without you, there is no care in healthcare, Neizna executive director Pat Kane told the crowd outside Ellis on Wednesday. There is no health either, quite honestly. But Ellis seems not to have accepted that idea. In response to Nysna's demonstrations, which nurses participated in during non working hours, Ellis, medicine president and CEO Paul Milton said in a statement that Ellis has been listening. Ellis has been innovative in its approach to retaining and attracting nursing staff and providing them with an excellent place to work, a place where they are valued. We have worked closely with our affiliated nursing school and other educational institutions to build a sustainable pipeline of new nurses for the Ellis team, Milton said. Over the last twelve months, we have been able to gain real momentum and are moving in the right direction in creating that pipeline. In addition, Ellis's president said, staff are offered competitive salaries and benefit packages. Recently, Ellis provided nurses with a very generous pay increase, increased bedside support and implemented a comprehensive retention program across the hospital that has resulted in a better than market nurse retention rate and a reduction in overall turnover, Milton said. But if none of that can address short staffing, which could have serious consequences for patients, is it any wonder why NYS and the nurses had ample support Wednesday night with elected officials from Schenectady City Council president Marion Porterfield to US Representative Paul Tonko coming out to speak in solidarity? Not surprisingly, many of them were heated, too. Who suffers? The patients suffer. Our communities suffer, said state Assemblyman Angelo Santa Barbara. We want good health care, quality health care. How can nurses do that if they are overloaded? How can they do that if they don't get the rest that they need to do their next shift? These are issues that affect all of us, all our families.
Of course, we know that Ellis has struggled financially. But this summer, Ellis was handed a golden opportunity in the form of increased revenue through a changed Medicare reimbursement rule. It would move us probably over the next two years from a deficit situation to a positive situation. That's how important this is, Milton told me in April, before the rule was finalized. Shouldn't a top priority then be investing this additional revenue in the staff who provide critical care.
Ellis is in the middle of a likely merger with St. Peter's health partners, part of Trinity Health. Milton says the merger is needed to keep the hospital viable. But that merger has a lot of people on edge, and not just because of how a deal with a catholic affiliated institution stands to curtail reproductive care. As negotiations with nurses continue to stall, there's an open question about whether failing to sufficiently invest in nurses is financially motivated, and it's fair to wonder what such a merger may mean for the kind of overall care Ellis will be committed to providing in the future, said Assemblyman Phil Steck. For 40 years we've been merging hospitals, and while the costs have kept going up, the quality of care has gone down. I highly question the viability of this merger. It's going to cannibalize this hospital from a standard of care perspective. Steck believes Ellis's only future may be as a public hospital, which would be funded by the state. But such a drastic change is a long way off. More pressing is what's happening inside Ellis's facilities right now. Susan Williams, a level one trauma nurse for 18 years, works at Ellis's medical Center of Clifton park. She said she's recently been on shifts at the emergent care center, during which two nurses have been on when six nurses were needed. The facility doesn't turn anyone away, so being short staffed means working longer hours. Williams has recently worked shifts stretching 14 hours till 01:00 a.m. Only to turn around and work another 12 hours the next day. Even more alarmingly, being short staffed can force some difficult choices. I don't want to be the one who has to decide this person is having chest pain. That person is having shortness of breath because they are having a stroke. Who am I going to see first? Williams said. That's a question that should leave us all heated.
[00:10:37] Speaker A: You're listening to the weighing in podcast with columnist Andrew Waite.
[00:10:51] Speaker C: And now it's time for reader response.
Last Sunday I wrote about recovery ready workplaces and the idea that we can change workplaces approach to people who are in recovery from substance use disorders.
And then I heard back from Mark, who had this to say. Sounds like a great idea. There have been EAPS employee assistance programs for decades that have treated those with substance use mental health problems. New York State has one. Private companies often contract with an outside EAP, and when I was employed full time, I would receive referrals from area EaPs. My own company, Conifer park, had a contract with a local EaP as well. From 2003 to 2012, I was the substance abuse Eap for quad graphics in Saratoga on a part time basis. I had a colleague who handled primary mental health issues. They had a medical section on site called Quad Med, which employed an MDPA and two nurses. If an employee was seen to be under the influence or if there was an accident on the factory floor, they would be sent up to quad med to be alcohol drug screened. If positive, HR would meet with them and give them 72 hours to contact me to set up an appointment. I would then do my assessment and either see them individually or refer them to an outpatient clinic and even an outpatient facility if warranted. If they followed through and were consistent, they would be able to keep their job.
So just like Mike Carpenter, Quad was a compassionate agency. But it also made good business sense to retain workers because often I would see someone with several years of experience who was valuable to the company as long as they were in the condition to use their experience for the benefit of the company, themselves and their families. So thanks for that, Mark. Indeed, the point of that piece was about encouraging more employers to embrace the idea, because honestly, even if people on the provider side are all in, if you don't have employers who are embracing the concept of a recovery friendly workplace, it's not going to go anywhere. So it's encouraging to hear that some of that is out there, but there needs to be kind of a standardized approach, which is what this coalition that I was reporting on is hoping to develop. And so hopefully we can see more of that.
And then lastly, I wrote about the Schenectady city Council's struggles to pass a budget, which actually, finally, this Thursday, I'm recording this on Friday. So last night they actually finally did pass a budget. I wrote a piece about how next year's negotiations may be even more divisive than this year's, because right now the council has American Rescue Plan act funding, and next year they might be scrounging for funds, which might make the conversation even more desperate than it was this year. And this year's negotiations featured Mayor Gary McCarthy threatening to sue the city council over the budget. So in response, I got this from Lois and Niski. Una, I'm pondering the sentiment of your article, and it occurs to me to submit these questions to the universe. Have we become so self centered that compromise is impossible? Has inability to compromise become so pervasive that it is infecting our politics, our nation, our culture, and the world incomprehensible? And I have one last thought we must, as parents and teachers, teach our children about compromise. Otherwise, the movies we see about the end of the world may become a reality. I think it's good to give Lois the last word today.
Thanks to Aaron Palaya, who handles marketing for this podcast, and Jim Gilbert takes care of the production. I'm Andrew Waite. Take care.
