Critical Mass

Photo by James BunoanLast summer, Velma Moore wasn't feeling well. So she paid a visit to her doctor, who said she had terminal cancer and only a few months to live. By summer's end, she was dead.

For the previous 30 years, Moore had worked as a nurse at St. Jude Medical Center, a nonprofit Fullerton hospital affiliated with the Catholic health ministry of the Sisters of St. Joseph of Orange. A veteran of the Critical Care Unit (CCU), she ultimately supervised all 400 of the hospital's nurses and was such a valuable and hard-working employee that, even after she became ill, the hospital begged her to come back to work on busy days, which she did.

Yet, despite her three decades with the hospital, Moore's health plan didn't include hospice care. So her co-workers in the CCU took turns at her bedside.

“They just volunteered to take care of her until she passed away because the insurance wouldn't cover it,” said Pao-fen Hernandez, who works alongside about 100 other nurses inside St. Jude Medical Center's CCU. “Nothing like this had happened before. It got people thinking about the fact that their health-care package wasn't taking care of them like it should be. . . . It got them thinking about joining a union.”

Hernandez and several other unit nurses—some of whom have worked at St. Jude Medical Center for nearly 20 years—are organizing their co-workers to join the California Nurses Association (CNA), which represents 46,000 nurses at 150 facilities throughout the state. Their chief goal: combat the constant turnover of nurses, which they blame for a low patient-to-nurse ratio at their hospital.

But in light of what happened to Moore, the nurses also want something else: a health-care package that guarantees the same level of medical care they provide to their patients.

The physical and emotional demands of nursing justify such coverage, according to Shelley Stanovich, another CCU nurse. Besides caring for patients, she says, she lifts and transports them throughout the hospital. Because many patients weigh more than 200 pounds, nurses often suffer from chronic back pain and injuries. “I just got back from taking time off because of a back injury,” Stanovich said. “I didn't get paid for the shifts I missed.”

Tasks she and other nurses also perform range from maintaining an array of equipment to housekeeping and blood taking. When they're not working three 12-hour shifts per week, they're often in school. In order to keep pace with advances in medication and equipment, California nurses are required to take between 30 and 100 continuing-education credits each year.

“We have a good staff, and when we have the level of staff we need, we give a great level of care,” Stanovich said. “But most of the nurses we have trained in the past couple of years are no longer here. We have 13 brand-new nurses being trained in the CCU right now.”

“It's not just in the CCU,” added Marilyn Gentry, a 15-year employee. “Understaffing is a terrific burden for all the nurses. There has been almost a 100 percent turnover in nurses since I started here. There's only one or two of us left. A lot of nurses are leaving because the pay at other hospitals is $5 to $10 more per hour.”

Calls to St. Jude for this story were directed to Doreen Dann, the hospital's chief operating officer. She confirmed that Moore had been house supervisor at St. Jude Medical Center before she passed away, but she said all nurses had the option of choosing hospice care as part of their benefits package—although that type of coverage could involve a monthly premium.

Dann described the hospital's pay and benefits package as “extremely competitive” with other hospitals and asserted that St. Jude Medical Center was doing everything it could to address the “needs and concerns” of its nurses.

“There is no question that there is a very difficult balance to give nurses the [pay] increases and benefits they are looking for,” Dann said. “We have a responsibility to make sure the cost of health care doesn't shoot through the roof. At the same time, we are here to invest in our employees and in technologies and meet the needs of our community.

“We have consistently utilized a mechanism of open dialogue and have been meeting with the staff and working through whatever questions they have,” Dann added. “We do a lot of educational forums; we also do a lot of intimate meetings with employees of different departments of the hospital to elicit feedback on the many programs we have.”

Nurses who spoke with the Weekly said the hospital has responded to the union campaign by trying to convince as many nurses as possible to sign cards saying they don't want to join one. But such tactics may actually backfire.

“A majority of the nurses are pro-union, but they're afraid of losing their jobs,” Stanovich claimed. “Nurses are being disciplined for talking to other nurses about joining the union and are forcing nurses to attend meetings with management. At one of those meetings, they showed an anti-union film. If anything, it gave more power to the union movement.”

“We did share a video with our employee base,” Dann acknowledged. “It was a very short video, but it allows the nurses to understand what is involved with signing a union card.”

The video may not be having its desired effect.

“We want to organize to have a voice—some sort of say in what we're given,” said Jan Molina, who has worked at St. Jude for 17 years. “We've had several meetings with management, asking for them to improve our working conditions, but they are not addressing our concerns. They always say they'll look into it, but they never do.”

Nurses interviewed for this story said that they did not choose their professions for the money. They agreed that St. Jude Medical Center, being a nonprofit hospital that relies on fund-raisers and community donations to meet its annual budget, is not exactly a cash cow.

However, the nurses also find it curious that the hospital filed records with the Internal Revenue Service in June 2000 that show St. Jude chief executive officer Robert Fraschetti earned a whopping $494,156 the previous year. Those same records show that Dann earned $231,605 that year.

Ted Cahill, a CNA organizer, said that the Sisters of St. Joseph hospital chain—which runs several facilities in California—has spent at least $1 million fighting union efforts up and down the state. The chain has also hired Cruz N Associates, an Inland Empire-based union-busting law firm, to fight union drives at hospitals in Eureka and Apple Valley.

Dann confirmed St. Jude has retained Cruz N Associates, which she did not characterize as union busters, but rather “a law firm that specializes in union issues.”

“They can offer some of the information we need,” she said. “What are the legal steps that lead to unionization? What are the long-term consequences to employee morale? We've asked them to research questions as varied as 'Are union organizers allowed to wait by employees' cars?' to 'What does a CNA campaign look like?'”

“The response of this nonprofit Catholic hospital chain has been scare tactics and intimidation,” Cahill said. “The Catholic Church has been clear in its support of workers' right to organize. We find it disappointing that the church has chosen to spend scare resources on union busters.”