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Wednesday, May 28, 2014

County Mental Health Hospital Nurses Ask Abele for New Hires

Forced overtime and staff shortages are compromising safety

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Nurses who work at the Milwaukee County Behavioral Health Department (BHD) say deficient staffing levels are causing safety problems for workers and patients.

Two weeks ago, a nurse was repeatedly hit on the head by a patient at the Milwaukee County Mental Health Complex. She’s been out of work as a result of the severe eye injury she suffered while working the 15th hour of mandatory back-to-back 8-hour shifts.

“This job is a calling, what we do,” said nurse Jim Cichy, a 28-year veteran at BHD. “And to be able to do it properly we need to be rested and we need to have enough staff in order to do it. I just want Abele and the new board to know that we are about quality care, we want to provide care for our patients, but we can’t do it in our current condition.”

Gathering first on the courthouse steps last Wednesday, representatives of the nurses union went to County Executive Chris Abele’s office, where they delivered an updated list of demands to address the staffing shortage. The recommendations include ending the mandatory overtime policy and placing guards on all hospital units 24/7 until staffing is adequate.

The establishment of the new Milwaukee County Mental Health Board, which hasn’t officially launched yet, makes Abele solely responsible for mental health services in the county.

After seeking help from BHD management, representatives of the Wisconsin Federation of Nurses and Health Professionals (WFNHP) Local 5001 raised their concerns last year and met with Abele on April 10, yet heard nothing back from him.

On Wednesday, Abele’s aide Rayna Andrews met with the nurses, at first seeming disdainful of their requests, but, after hearing about their experiences at BHD, appeared to be more receptive to working with them toward a solution.

“We’re working on things as quickly as we can,” Andrews said.

The nurses told Andrews how short staffing has impacted their work at BHD. The patients at the complex are in crisis and can be unpredictable or violent at times. The nurses said each unit is understaffed and many nurses and certified nursing assistants (CNAs) are forced to work mandatory extra shifts, turning a regular 8-hour shift into a grueling 16-hour one. The nurses said they cannot provide safe and high-quality care if there aren’t enough nurses on call and those who are working are exhausted.

“We want things done quickly because we are staffing a hospital, not a county parks system,” said BHD nurse Jeff Weber, president of WFNHP Local 5001. “We are taking care of human beings, the most vulnerable in our community.”

According to Milwaukee County Department of Human Resources data collected by the union, there are 36 registered nurse vacancies and 56 CNA vacancies at BHD.

For the ten months between November 2012 and August 2013, the county did not hire even one nursing assistant, the county data indicate. No nurses were in the latest training session, Weber told Andrews, and the nurse recruiter position was terminated last year.

“That tells us that nothing is going to change,” Weber said.

Andrews countered that the department had recently hired 40 new nursing assistants, but that seemed to be news to the nurses in attendance last week. The county data show that 38 CNAs have been hired since September 2012, but 94 quit during that same period, leaving BHD with a current deficit of 56 CNAs. (Abele’s spokesman Brendan Conway didn’t respond to the Shepherd’s request to clarify the CNA hiring.)

Andrews said that the more than five weeks that have transpired since the nurses met with Abele simply wasn’t enough time to make any changes. She also noted that the county executive had attempted to provide $1 million in retention bonuses for nurses, but that item didn’t survive in the final county budget.

The board had vetoed that item because the Abele administration hadn’t provided any details about the bonus plan.

 

Mandatory Overtime Is Compromising Care

The nurses seem most concerned about BHD’s mandatory overtime policy, which requires staff to work an extra 8-hour shift after a regular 8-hour shift. Registered nurses can be paid double for that extra overtime shift, Weber said, but most say the money isn’t worth it. If they work, they aren’t alert enough to provide quality care and keep themselves and their patients safe. If they refuse a shift, they face termination. The nurses say this policy has reached “epidemic” levels, with hundreds of forced shifts each month, and contend that private hospitals do not allow this practice in their own facilities.

Weber told Andrews they he had discussed the matter with Abele and argued that forced overtime leads to high overtime costs and is fiscally irresponsible. But instead of ending the practice or hiring more nurses, Weber said that Abele told a reporter that he was going to end extra pay for mandatory overtime.

Although Abele seems to be committed to providing the retention bonuses for BHD staff, that item isn’t on the list of demands that the nurses want Abele to address. The nurses are asking Abele to immediately contact staffing agencies to fill all nurse and CNA vacancies; transfer extremely aggressive patients to state facilities; create an intensive orientation for all new hires; hire a nurse recruiter; restrict mandatory shifts to a maximum of four hours until the policy is eliminated; create a bonus program for those who voluntarily pick up extra shifts; establish an “on-call” voluntary backup staffing program; allow nurses to choose vacant shifts; immediately place guards on all units, at all times, until staffing is adequate; and maintain the current 18-bed cap on all acute care units.

Weber told the Shepherd that union representatives had meetings with BHD administration following their meeting with Andrews, and that he was hopeful that some changes would be implemented.