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Nurses Union Challenges Englewood Hospital's Staffing Strategy

Anthony Vecchione | September 17, 2012

Union officials say while Englewood downsizes, other hospitals in the state are hiring.

The union representing nurses at Englewood Hospital and Medical Center (EHMC) charge that the facility's decision to lay off nurses is "shortsighted" and runs counter to a hiring trend at other New Jersey hospitals. It's unclear how many positions will be affected, although earlier reports put the number at 70.

Jean Otersen, policy director for the Health Professional and Allied Employees Union (HPAE) based in Emerson, said that the layoffs are scheduled to take effect around September 26.

"We won't know the exact number until we are finished reviewing open positions," she said. Among the options that are being negotiated with the hospital are voluntary retirement and shift or unit changes. HPEA claims that Englewood has had a relatively solid profit margin and says that the layoffs are not justified and will affect patient care.

"We believe they will be understaffed and that their finances don't warrant the layoffs," said Otersen.

She adds, some of Englewood's short-term financial concerns have to do with their investment in physician practices. "And if you are going to invest in physician practices in the hopes of bringing in more patients, then the last thing you ought to be doing is laying off nurses," she said.

According to the New Jersey Hospital Association (NJHA), Shore Medical Center in Somers Point is the only other facility in the state involved a labor dispute with its nurses. McKean Kelly, vice president of communications for NJHA, said that nurses at Shore Medical are working without a contract. With the exception of picketing in June, she added, there hasn't been any formal strike threat.

Maria Margiotta, director of marketing and communications, for EHMC said that the hospital is challenged by growing pressures and changes in the hospital industry.

"Given these challenges, the Medical Center has had to make tough decisions, including the necessity of implementing some staff reductions. Despite this, we are committed to minimizing reductions and their impact on staff whenever possible" Margiotta said.

She added that despite personnel adjustments, patients could be assured of safe, quality care. "Quality remains our number one priority always, and that is the basis of all our decisions,” Margiotta said.

EHMC officials claim that declining volumes and increases in charity cases are affecting most acute care hospitals. "This has led recently to a significant increase in layoffs among acute care hospitals nationwide," said Margiotta.

Potential Loss of Nursing Positions

Englewood officials point to a recent report issued by the American Hospital Association, the American Medical Association, and the American Nurses Association, declaring that almost 22,000 healthcare and related jobs could be lost in New Jersey by 2021 -- a result of a 2 percent cut in Medicare spending mandated by the Budget Control Act of 2011.

Nevertheless, the American Nurses Association indicated that the trend over the past several years has been toward hiring more nurses at a modest growth rate.

According to the Bureau of Labor Statistics, jobs for nurses at hospitals increased by 2 percent from 2009 to 2010 (1.49 million to 1.52 million) and 2.3 percent from 2010 to 2011 (1.52 million to 1.56 million). The BLS expects this modest rate of increase to continue through 2012, as the economy picks up and hospitals continue to be a growth sector.

BLS projects that nursing overall will grow faster than all other occupations from 2010-2020, adding 712,000 jobs. Overall employment climbed 3 percent from 2009-2010 adding 71,250 jobs.

Hospital employment in all job sectors increased 5,000 per month on average, adding 84,000 jobs total from 2010 to 2011, according to the BLS.

Moreover, hospitals have hired more selectively during the recession, and may continue to prefer experienced nurses and ones with higher degrees, according to the BLS.

HPAE's Otersen said that she sees other hospitals in the state are organizing into broader systems or working across alliances to figure out the best way to meet community health needs. "We think those hospitals are thriving."

Recently, Hackensack University Medical Center (HUMC) and its Texas-based partner LHP Hospital Group were granted a certificate by the state health commissioner to reopen Pascack Valley hospital in Westwood and Meridian Health merged with Southern Ocean County Hospital.

Otersen said that Accountable Care Organizations (ACOs) are pushing a nurse-centered model and a collaborative model between doctors and nurses in primary care and in hospital settings.

One example of a hospital system that has been expanding consistently over the past three years is Virtua, which is based in Marlton.

Michael Kotzen, executive vice president for population health management said that Virtua would be opening two new facilities in Morristown and Voorhees. They will include ambulatory facilities, physician offices, and fitness centers.

Virtua recently opened a new hospital that required additional nursing personnel and has seen a steady growth of physician organizations over the past several years.

"We added nurses as the patient volume demanded it. We didn't necessarily do it as a result of our square footage increase," said Kotzen. He said that Virtua has had no recent labor disputes with either of its two nursing unions.

Kotzen said that what will drive the need for more personnel -- including nurses -- will be the increased need for access. "As healthcare reform takes effect, we do expect that there will be more folks with insurance and the demand for access to health care will increase."

Kotzen said that health systems would have no choice but to look at alternatives to the traditional physician's office. "You will see and have seen an increase in nursing positions outside of the hospital."

He added that as organizations become accountable for the health of populations, there would be a shift out of the acute care setting into more community-based settings. As a result, the demand for nurses will increase.

Kotzen said that the Patient Protection and Affordable Care Act (ACA) would ultimately lead to fewer uninsured New Jerseyans. "As more people enter the healthcare system the demand for health personnel including nurses will increase, Kotzen said.

Anthony Vecchione is a freelance health/medical writer based in Dumont, NJ.

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