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‘Spread Too Thin’ – Staten Island Nurses Grapple With Dangerous Understaffing

According to nurses at Staten Island University Hospital/Northwell, management hasn’t given the union a straight answer about why it’s not hiring permanent staff to replace the nurses who’ve left, or addressed why so many nurses have protested their assignments.

NEW YORK, N.Y.—Nurses at Staten Island University Hospital/Northwell charge that the chain that owns it is endangering patient care by refusing to replace more than 50 nurses who left or retired over the past year.

The union contract they recently ratified has “decent language” about staffing minimums, says Dawn Cardello, co-president of the New York State Nurses Association’s local bargaining unit at the hospital’s South Beach campus, but getting the Northwell Health chain to adhere to it has been a problem.

“The situation was so bad we had to speak out about it,” Cardello told LaborPress Aug. 18, one day after nurses and supporters held a press conference and rally outside the hospital. Normally, she says, vacant positions are posted so that other nurses can apply for them, but that hasn’t happened with more than 50 in the last eight months.

Staten Island University Hospital is a 668-bed specialized teaching hospital. NYSNA represents about 1,300 staff there, says Cardello: registered nurses, case managers, nurse-anesthetists, and some nurse practitioners. The emergency room handles about 92,000 patient-visits a year, according to the hospital’s Website, and it also operates a smaller facility near Staten Island’s southern tip.

Northwell Health owns and operates 23 hospitals and more than 830 outpatient facilities in New York City, Long Island, and the city’s northern suburbs. It bills itself as the largest private employer in New York State, with 76,000 employees, including more than 18,500 nurses.

“We recently agreed on a three-year contract with the New York State Nurses Association that represents the union’s and the hospital’s position related to staffing,” a Northwell spokesperson said in a statement to LaborPress. “We consistently monitor the hospital’s fluctuating census, recognizing that staffing is a dynamic process influenced by many factors including patient acuity, unit and hospital census, and the needs of all patient-care areas. We’re committed to appropriate staffing, which is paramount to patient safety, and continue to work with our partners at NYSNA to meet that end.”

Nurses are not allowed to refuse an assignment, Cardello explains. But if they believe it’s unsafe — for example, a nurse on a medical ward who normally takes care of six patients at a time being required to handle seven to 10 — they can file a “protest of assignment” form indicating that complaint.

The union now receives about 800 such forms a month, she says, “an alarming number.” In a typical month, it generally gets less than 150, and the most she remembers having seen in her years on the bargaining unit’s executive committee was about 250.

The hospital has been bringing in temporary nurses, but that was supposed to be only for the peak of the COVID-19 epidemic last year, Cardello says. There is language in the union’s contract that mandates hiring permanent staff if more than a certain number of agency or “flex-staff” nurses are taken on, she adds.

“You’re spread too thin,” she explains. For example, a nurse on an understaffed ward might have to leave one patient sitting in stool because she’s busy administering medications to a cancer patient in severe pain.

“It doesn’t allow the nurse to spend the time with the patient that they need,” she says. “As a nurse, you want to make a connection with your patient. That in itself helps the healing process.”

She went into the profession “because I wanted to care for people,” she continues. “I tell my students, ‘If this is not within your heart, then don’t do it.’”

NYSNA says the neonatal intensive-care unit has been among the hardest hit. “A Neonatal ICU nurse should have no more than two babies at one time to deliver the highest level of care to them,” nurse Jennifer Jara said in a statement released by the union Aug. 17, but “we have unfortunately had three to four ICU patients due to lack of nurses.”

“That unit is working short,” Cardello says. “With three or four, it’s dangerous.”

The issue is not just physically taking care of “the most vulnerable patients,” such as newborns 11 weeks premature who must be kept in incubators and often have serious health problems, she explains. “You need to provide a lot of family support. You need to take the time and have compassion when those parents come in.”

Management hasn’t given the union a straight answer about why it’s not hiring permanent staff to replace the nurses who’ve left, or addressed why so many nurses have protested their assignments, she says.

It’s “using COVID as an excuse” for not doing so, she adds, “but it’s really just corporate greed.”


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