CA Hospital Patient's Death Betrays a Trust

Surveys show that the public reveres nurses as the "most trusted" professionals. It's a well-deserved reputation built one patient at a time over decades of dedication and advocacy.

Sadly, that trust was violated in the death of Judith Ming, 66, and that makes her tragedy all the more disturbing. 

The circumstances surrounding Ming's death on Sept. 24 at Sutter Health's Alta Bates Summit Medical Center in Oakland, CA remain under investigation. The accident occurred during the second-day of a five-day lockout of unionized staff who had walked off the job during a one-day strike on Sept. 22.

Preliminary reports indicate that Ming, who for months had battled ovarian cancer, died one day after a replacement nurse accidentally put a nutritional supplement into a catheter that entered her bloodstream. For the sake of expediency, anyone not familiar with the story can read this detailed account.  

Ming's death was tragic enough. Unfortunately, what followed was a travesty, as the California Nurses Association/National Nurses United, Sutter Health, and the California Hospital Association executives abandoned decorum and traded barbs and pointed fingers.  

"An incident like this is chilling and strikes right to our nurses' concern about their ability to advocate for their patients," CNA/NNU Executive Director RoseAnn DeMoro, told the San Francisco Chronicle. "It was irresponsible to lock out those nurses."

DeMoro's comments prompted a return salvo from Sutter Health, which posted a statement on its Website expressing deep regret for Ming's death, but also castigating union leaders for "exploiting the tragic death of this patient to further their own bargaining purposes, which is a shame."

The California Hospital Association also weighed in. "It is inappropriate and irresponsible for the California Nurses Association labor union to exploit this tragedy to further their union agenda," CHA President and CEO Duane Dauner said.

"This is the same union that has taken nurses away from patient bedsides more than 100 times during the past three years. It also is unfortunate that the nurses union is questioning the qualifications of other nurses providing patient care," he said.

No need to pick sides in this fight. There is plenty of blame to go around.

DeMoro is asking us to believe that the lock-out was "irresponsible" but that somehow the strike that prompted 23,000 nurses at several hospitals across the state to abandon their patients for one day was not.

Yes, the patient was harmed during the lockout, and not on the strike day, and it's not clear if any patients were harmed during the one-day strike. What if they were? Would the striking nurses have been accountable then? Would we have even heard about Ming's death if the mistake had been made by a union nurse before or after the lockout?

According to the federal government, adverse events in hospitals kill tens of thousands of people each year and we don't hear much about individual cases. Would CNA/NNU have demanded accountability and challenged the competency of one of their own? Or, would they have blamed staffing ratios?

CNA/NNU, please don't tell us this strike was about patient care. There is nothing wrong with fighting for better pay and benefits. If it had been about patient advocacy, however, you would have stayed at the bedside.

Strikes disrupt patient care. Unions know that, and that is why strike threats carry weight. At least one study indicates that mortality rates jump by nearly 20% when patients are admitted during strikes. Unions know that hospitals will be hard pressed to find qualified replacement staff on-the-fly because there is a nationwide nursing shortage. So, when that labor disruption leads to the injury or death of a patient, nobody should be surprised and shocked.

As for Sutter Health, this tragedy illustrates how management gets the union it deserves. Sutter claims the five-day lockout was necessary because that was the shortest contract they could sign with the nurse staffing agency. That may be true, but contracts can be redrawn.

Kaiser Permanente hospitals, for example, were also the target of one- and three-day strikes last month but their union nurses were back on the job the next day. Perhaps the five-day lockout at Alta Bates was a punitive measure from hospital leadership to hit nurses in the paycheck and discourage them from future strikes. Clearly there was brinksmanship at play here, and apparently at least one patient suffered for it.  

Sometimes in these labor disputes, healthcare professionals forget what line of work they're in. Hard noses, bare knuckles, and sharp elbows might work at a tire factory or a pier on Long Beach, but they aren't appropriate in a healthcare setting.

Hospitals are supposed to be places of healing, treating sick and frightened people at their most vulnerable. And because of their noble and important work, healthcare professionals are held in high esteem. They are also paid more than most people, and held to a higher standard of behavior and accountability.   

Try to imagine how Jim Ming -- Judith Ming's husband of more than 30 years -- is reacting to this unseemly public relations war waged over his wife's death. Maybe if labor and management had spent as much energy avoiding the strike as they did on damage control after Judith Ming's death, this tragedy could have been avoided.

The next time they go to the bargaining table the union and management should invite Jim Ming. He could remind them of what their priorities should be.