Nursing Woes at Temple

GONE POSTAL: Temple nurses use a direct-mail campaign to get support.

Mandatory overtime and understaffing could lead to a walkout.

by Audrey Hoffman

Come Sept. 30, Temple University Hospital nurses will either go to work or walk away from a job they say they can no longer perform under strained conditions.

Like many other health care centers in the region, Temple is suffering through a nursing shortage that affects everyone from the nurses themselves to the patients who come there for help.

Temple has one of the busiest emergency rooms in the area and is one of the top centers for heart transplants. And, as the battle between employer and employee continues gathering steam, the latter has taken the vocal stance that losing any of the more than 900 nurses who serve patients could create serious repercussions.

Patricia Eakin has been a registered nurse for 27 years, spending the last two decades at Temple. Serving as president of the Temple University Hospital Nurses Association, Eakin is also the treasurer for the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP).

PASNAP has been Pennsylvania's active nurses' union for the past three years, and has taken to campaigning for better labor practices, all of which helps explain the group's involvement in the Temple matter.

Eakin is currently talking with Temple's administration. On behalf of her co-workers, she's asking for better wages, benefits and work conditions, but while the nurses have taken to spreading word of their concerns throughout the city, the hospital itself has remained relatively quiet.

When asked to discuss the issue last week, hospital spokesperson Gwen Coverdale said nothing had been decided regarding the nurses' contract. She added that negotiations were ongoing.

PASNAP has clearly helped the nurses in their quest, though. Notably, they've assisted with a direct-mail campaign in which postcards have been sent to business heads, politicians, newspaper editors and religious and community leaders in an effort to gain support.

"The purpose of our postcard campaign is to communicate directly with citywide opinion leaders and important stakeholders at Temple University Hospital. We are in a nursing crisis, and realize that we cannot simply rely on the mainstream media to report the facts in a timely way," Eakin says.

From their point of view, the nurses say the issues they face at Temple could become matters of life and death. Nurses now face lengthy work days and say they have more patients than they can handle. While the shortage seems to have created many of the problems, it's also driven nurses out of the profession.

"Shortages have been going on since Florence Nightingale," says Dr. Sean P. Clarke, associate director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania. "But this time it's different, because the demographics are different. Nurses are aging, the population is aging, and if projections are right, we will never get out of this shortage."

Like other PASNAP members, Eakin is pushing for the passage of two new bills. If passed, the Safe Staffing and Quality Care Act and Health Care Worker and Patient Protection Act would limit mandatory overtime and establish nurse-to-patient ratios.

"With many registered nurses working 12-hour shifts, overtime may mean their workday lasts 16 hours. There are limits on how long nurses making decisions on a minute-to-minute basis can work without error," Clarke says.

Last October, Clarke co-authored a paper featured in The Journal of the American Medical Association that claimed nurse-to-patient ratios affect patient mortality rates. To date, California is the only state that's implemented mandatory nurse-to-patient ratios, but 23 other states, including Pennsylvania, are considering doing so. (The Safe Staffing and Quality Care Act would do just that.) Still, Clarke feels that legislation is not necessarily the best solution, but may be a needed step in the right direction.

"Research cannot tell us what the right numbers are," Clarke says. "Are we as safe as possible? No. Are we starting to admit that? Yes."

In the end, Eakin -- along with fellow employees and union members -- says she does not want to leave, or walk out at the end of the month. She says she just wants fair treatment so that she can perform her job safely.

"Nurses are patients' first chance at living, staying alive and recovering," she says. "I've never regretted being a nurse for a minute. It's a wonderful job. You do something that is so important, and patients are very grateful. It's good work."