New York State Nurses Association nurses in the Montefiore Moses emergency department who returned to work after the 28-day strike are once again at odds with hospital leadership, alleging an atmosphere of retaliation and unilaterally-imposed workflow changes that they say put themselves and patients at risk.
The union is preparing to file charges against the hospital and, if necessary, complain to the state Department of Health about the new procedures, the Bronx Times has learned.
In a Feb. 15 letter, written by union negotiator and former NYSNA president Judy Sheridan-Gonzalez on behalf of the executive committee, nurses demanded an immediate meeting to discuss their opposition to changes implemented while they were away and the atmosphere of surveillance they say greeted them upon return. The letter was sent to three Montefiore officials overseeing nursing and emergency departments and shared with the Bronx Times.
According to the letter, nurses at the 111 East 210th St. hospital are encountering an “environment of total chaos.”
“In addition to the union’s demand to cease and desist [retaliation actions], the Moses ED staff is more than willing to meet with you to discuss issues related to care and flow so that together we can collaborate about the best and most efficient way to deliver the excellent care our community deserves,” the letter said.
Sheridan-Gonzalez told the Bronx Times the effort was supported by many NYSNA nurses, including more than 50 in writing, but yielded no response from Montefiore as of the afternoon of Feb. 16.
The Bronx Times reached out to hospital leadership and did not receive comment in time for publication.
Throughout the strike and before, Sheridan-Gonzalez and colleagues were especially outspoken about overcrowding in the bustling Moses emergency department. They spoke at multiple rallies about Bronx patients receiving treatment while packed in the hallway, within arm’s reach of each other, lacking privacy and dignity and often resulting in flared tempers.
Sheridan-Gonzalez, who lives in the Bronx, accused hospital executives of corporate greed at a Jan. 14 rally outside the Moses campus.
“Our fight is for the soul of his hospital, for the practice of nursing, and for the defense of our marginalized communities that are being treated like second-class citizens,” she said.
But since the nurses returned to work without the reliable systems they used to manage patient flow, the result has been what Sheridan-Gonzalez called “a total clusterf—k.”
‘Not a workable system’
Montefiore nurses returned to work Feb. 14 with an 86% vote to ratify the new contract. However, in the short time since, Sheridan-Gonzalez said she’s received nonstop calls from colleagues concerned about the new practices, and the union conducted two meetings over the weekend to draft the letter and plan next steps.
One change the nurses oppose is that head nurses can now be “covered for” by others who lack training in that role, according to Sheridan-Gonzalez.
This is problematic because head nurses perform triage and are highly experienced and trained to detect signs that suggest a patient’s condition may become more serious, she said. For instance, a patient admitted with moderate abdominal pain could later worsen to a perforated bowel and it takes an experienced nurse to spot the warning signs, she said.
With this change, “They’re having people without any experience functioning in charge and triage roles. And they’re terrified because they don’t know really what to do,” Sheridan-Gonzalez said.
Nurses in that position, if even for short periods of time, are also not receiving appropriate compensation for the difference, according to the letter to Montefiore.
In addition, ED nurses are upset about losing the simple whiteboard-and-magnet system that allowed them to easily track which patients were with each nurse, who would treat the next incoming patient, who was on break, and which nurse a patient would transfer to at the end of a shift.
In the nurses’ absence, the hospital removed the whiteboards and implemented a new system that Sheridan-Gonzalez compared to “a telephone game,” which is likely to cause miscommunication and delays in care, she said.
In the letter, she explained that the new system “puts patients at risk of being misdiagnosed or mismanaged” and exposes the hospital to greater risk of negligence claims.
It’s not just something new that takes time to adjust to, Sheridan-Gonzalez told the Bronx Times. “This is not a workable system.”
“You don’t know when you’re getting your break, you don’t know who you’re working with, you don’t know who’s getting the next patient, you don’t know anything.”
The Bronx Times spoke with another Moses ED nurse who agreed that the new system is disastrous and requested anonymity due to concerns of management retaliation.
The nurse said he is very concerned about the risks of assigning undertrained nurses to lead roles, even for short periods, such as breaks.
In addition, he said the new procedure can assign too many critical patients to one nurse back-to-back and adds an unnecessary middleman to the chain of communication. “The fear is that something is gonna get lost in translation — something critical,” the nurse said.
In addition, he said the changes were imposed without notice or opportunity for feedback. “If you say no, then you’re not a team player, and you don’t want to help out. I do — I just want to keep my license.”
In addition to workflow concerns, the nurse said he feels his department, which was “the most vocal” during the strike, is now being scrutinized.
System leaders previously seen in the building every few weeks are now present for hours each day, and the red NYSNA logo surgical caps that nurses commonly wore are no longer allowed, he said.
Overall, Montefiore nurses took “a bum deal” in negotiations, the nurse said. “The fight has not stopped. Honestly, we have not won anything.”
Reach Emily Swanson at eswanson@schnepsmedia.com or (646) 717-0015. For more coverage, subscribe to our newsletter and follow us on Twitter, Facebook and Instagram!
