The union-management animosity at Holy Family Hospital in Methuen, MA, did not end with last July's vote by nurses to join the Massachusetts Nurses Association/National Nurses United.
The National Labor Relations Board has taken up a complaint that a veteran nurse at the hospital was fired last year by Holy Family's parent Steward Health Care Systems, allegedly for her role in the organizing effort. An administrative judge will hear the complaint on Feb. 14.
Steward Health Care Systems denies the allegation and has issued a statement saying that "participation in union organizing activities played no role in the decision" to fire nurse Mary Ramirez, 61, who'd been at the Holy Family for 18 years.
These two narratives could not be farther apart. MNA/NNU calls Ramirez a martyr for the cause. Steward alleges that Ramirez endangered the life of a patient and slyly hints that she may have had a drug problem.
Steward says Ramirez was fired "because she intentionally changed a doctor's orders, committed an intentional medical error, and failed to enter the fact that she administered a powerful narcotic (morphine) into a patient's medical record. Ms. Ramirez admitted these facts to a fellow nurse, who then reported her actions to management."
Steward went on to claim that Ramirez's "intentional change to a doctor's orders, falsification of a medical record, and attempted cover up, combined with the fact that she had been previously placed on probation for two years by the Board of Registration in Nursing for diverting patient medication for her personal use, were the reasons for her termination." Along with terminating her employment, Steward also reported her actions to the Board of Registration in Nursing.
The fight has gotten so ugly that the two sides can't even agree on a name. MNA/NNU refers to Steward Health Care Systems as Cerberus-Steward Health Care to draw attention to the private equity firm that has bought 10 Massachusetts hospitals in the last 18 months.
The fight at Holy Family has become so toxic, and this is seven months after the union vote, that it is easy to forget that this is a hospital and not a tire factory or a rendering plant.
Probable Consequences
How will all of this play out? If it's anything like labor disputes at other hospitals, at some point the two sides will come to an agreement and some sense of normalcy will return to Holy Family. They'll issue media statements about working together to create a healing environment for the good of the community, let bygones be bygones, blah, blah, blah.
It is still worth asking about the long-term effects. Regardless of what an administrative law judge determines next month on the NLRB complaint (which either way will almost assuredly prompt an appeal by the losing side), scars will remain and public doubts, quite deservedly, will linger.
After reading the charges and counter-charges issued by Steward and the union—regardless of their validity—why would anyone in Methuen, MA, seek medical care at Holy Family Hospital?
Again: Based on what the two sides are saying about one another, the public in Methuen would be within bounds to see management as greedy and vindictive, and staff as angry, reckless and incompetent.
For that matter, at a time when skilled healthcare professionals are at a premium, why would any physician, nurse, or administrator take a job at Holy Family knowing they would be entering a volatile environment that is hardly conducive to healing or congeniality?
Unfortunately, the acrimony at Holy Family may be a harbinger. As the fight for diminishing healthcare dollars intensifies in the coming years, it would not be surprising to expect more labor strife in hospitals across the nation.
With less money, management will be less inclined, or able, to negotiate as margins shrink. Staffing and scheduling issues, compensation cuts, and quality of care challenges will create resentment and fear in the healthcare workforce, making the call to organize all the more appealing. Sophisticated, battle-tested healthcare labor unions such as the NNU will tap into that worker angst and enjoy even more success.
It is not hard to foresee the healthcare landscape broken into entrenched and polarized camps, with labor and management snarling at one another across a no-man's land. Caught in the middle will be the patients hoping to dodge the crossfire.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.