National Nurses United

Trouble Mounts for Sutter as RNs Strategize Next Steps t appears that Sutter Health's relentless drive toward the bottom line is finally catching up to the hospital corporation. In the last couple of months, Sutter has come under fire for not providing its registered nurses and other healthcare workers their full meal and rest breaks, and for often not paying the associated penalty pay. According to initial observations of a state labor investigation, Sutter could be on the hook for millions in unpaid wages in just the Sacramento, Calif. area. And in San Francisco, Sutter's efforts to ultimately shut down St. Luke's Hospital as an acute-care facility because the hospital was a money-loser for the corporation—even though it serves thousands of lower-income Latino, Asian, and African-American neighborhoods— is meeting intense RN, community, and government resistance. The San Francisco Board of Supervisors is considering legislation to prevent Sutter from abandoning service to the southern part of the city, and is calling for possible litigation to stop Sutter's medical redlining—the practice of discriminating against certain communities by race or economics. Both problems—missed meals and breaks, and closures—are part of ongoing bargaining issues for some 5,000 RNs currently in negotiations with Sutter. The Sacramento investigation has reinforced CNA/NNOC's proposals for dedicated meal and break relief RNs. Sutter RNs at 13 facilities have gone on two strikes so far, one in October and another in December, to pressure the hospital chain to seriously bargain over their key demands: increased RN staffing to improve patient care and allow RNs to take breaks; better pension and retirement I JANUARY | FEBRUARY 2008 benefits; improved healthcare for both working and retired Sutter RNs; and the creation of lift teams so that nurses won't disable themselves moving patients on the job. Unfortunately, Sutter is not negotiating over the nurses' major proposals. "They have no new positions," said Jan Rodolfo, an oncology RN at Alta Bates Summit Medical Center, a CNA/NNOC board member, and chair of the Sutter RN bargaining team. "In general, they're not responding on the large issues." RNs are devising creative ways to garner greater public support and awareness of what's at stake for healthcare in their communities, such as using window signs and distributing information at churches and outside supermarkets to step up the pressure on Sutter. CNA/NNOC-represented Sutter nurses were not surprised to read about the state's investigations into Sutter's failure to pay nurses for not being able to take breaks. Many Sutter RNs, particularly those that work on general medical and surgical floors, report that getting to take a real break or eat a lunch away from the unit is a rarity. Sutter usually does not staff units with enough people so that RNs can leave their patients without adding them onto another nurse's patient load. Most RNs, finding this practice unsafe, simply skip their breaks or eat their meals outside patient rooms. Sutter RNs would like to see better staffing and dedicated break relief RNs hired to solve this problem. "I have to relieve everybody, but nobody relieves me," said Jeanine Chatman, an ICU charge nurse at San Leandro Hospital and a member of the Sutter bargaining team. "We keep ratios at the expense of getting to eat or going to the bathroom." Though Sutter is now in trouble for failing to compensate RNs for missed breaks, nurses say they'd prefer to actually take breaks instead of getting more money. But Sutter appears to want the best of both worlds. At Sutter Delta Medical Center, RNs working 12-hour shifts were recently asked by management to sign a document waiving their right to their second 30-minute unpaid lunch period. Under California law, workers are supposed to receive a 30-minute meal period for every five hours worked and employers must pay an hour's wages for missed meals. A recent California Supreme Court decision found that employees could go back three years in seeking penalty pay for missed meals and breaks—opening up a huge liability for Sutter that it hoped to close by requiring its employees sign waivers. One medical surgical RN said her unit refused to sign the waiver. "We told management that we're going to continue work as we always have, and that, no, we're not signing anything," she said. Over in San Francisco, Sutter was forced to answer to the Board of Supervisors about why it wanted to shut down acute-care services at St. Luke's Hospital in the city's low-income Mission District even as it planned to build a grand, new complex atop the city's tonier Cathedral Hill neighborhood. Already, Sutter has eliminated the psychiatric ward and a medical surgical floor at St. Luke's and is about to move neonatal intensive care as well. St. Luke's RNs, staff, and government relations have been working closely with local and state officials to keep the hospital open. In December, the Board of Supervisors voted to require Sutter to file a master plan that considers citywide health needs as part of the construction permitting process. In January, Sup. Ross Mirkarimi introduced legislation that would put the board on record as opposing the closure of St. Luke's and directing the city attorney and other departments to investigate charges of medical redlining by Sutter. Meanwhile, a San Francisco city report found that Sutter's California Pacific Medical Center, of which St. Luke's is a part, had the widest gap in 2007 among the city's nonprofit hospitals between what it received in tax breaks, nearly $70 million, and what it spent on charity care, roughly $5.2 million. RNs are counting on an organized, united Sutter RN membership and increasing public pressure to prompt management to return to the bargaining table for serious discussions in the coming months.—staff report CALIFORNIA W W W. C A L N U R S E S . O R G REGISTERED NURSE 5

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