Nurses union says takeovers of north country hospitals creating unsafe conditions

Apr. 11—POTSDAM — The union representing north country nurses says hospitals aren't doing enough to entice nurses to stay. Members criticized local hospital takeovers by larger out-of-area health networks, saying they create conditions that could lead to worsening health for patients.

New York State Nurses Association officials and members spoke out during a Zoom conference in which they called out the hospitals for cutting local services, sometimes forcing patients to go to a central hub, some as far away as Burlington, Vermont. NYSNA held the session amid contract negotiations that members say aren't going well.

Jenelle L. Fuller, a registered nurse at Gouverneur Hospital, said the current benefits package isn't enough to cover nurses' own medical expenses. St. Lawrence Health, based in Potsdam, owns and operates Gouverneur, Massena and Canton-Potsdam hospitals. SLH is now an affiliate of Rochester Regional Health.

"Some of those nurses in St. Lawrence County end up paying up to $1,800 a month for insurance," she said. "Nurses and HC workers should be able to afford health insurance for themselves and their families. We know that's one of the reasons so many nurses are leaving the region and going to traveling and other areas."

Susan C. Quinell, a registered nurse at Canton-Potsdam Hospital, said the facility is operating at dangerously low staffing levels, below the minimum levels St. Lawrence Health set and reported to the state Department of Health. A document on the DOH website spelling out what should be SLH's minimum staffing levels can be read at wdt.me/W4PJqu.

"We've had nights ... where we had 22 patients and two nurses, and then they float a nurse that would check on staff intermittently," she said. "This is not OK to have an unsafe patient load."

"It's a known risk that short staffing can cause injury and harm to patients," she added.

Gregory Reynoso, a political and community organizer for NYSNA, said north country residents should "look at this very carefully, because that's the health care you're getting in your region."

"When a nurse is taking nine patients, they are not able to safely take care of all those patients at the same time," he said. "You and your family in the region may be at risk ... because they have so many patients, anything could go wrong."

NYSNA officials on the Zoom stream said they weren't aware of any patient deaths directly related to the conditions they're describing, but they fear those may only be a matter of time.

Sivan Rosenthal, a strategic researcher for NYSNA, said the local hospitals absorbed into larger health networks have been rearranged according to a management strategy called "regionalization of care."

"It diverts patients to the facility best equipped (to treat them) ... instead of having each hospital in the system treat all kinds of patients," she said.

That model has led to closures of maternity wards at Alice Hyde Medical Center in Malone and Massena Hospital. She said the north country has lost 9.5% of maternity beds between 2000 and 2020. With the recent closure of Alice Hyde's maternity ward and a pause in maternity services at Lewis County General Hospital, "it's actually 22% of those beds," Ms. Rosenthal said.

Ms. Quinell said the problem is compounded by local ambulance services having trouble recruiting and retaining volunteers. In one recent instance, she recalled having to perform an emergency procedure on a woman giving birth who had been driven about an hour in a personal vehicle from Malone to Canton-Potsdam Hospital, rather than wait an hour and a half for an ambulance to pick her up.

"I was not on call one day when my phone rang. They said send help, we have a patient coming and we need somebody to help the doctor," Ms. Quinell said.

"I had to do the surgery in my street clothes ... there was no time," she said, adding that she was wearing proper protective equipment over her clothes. When the patient arrived, "they were literally holding the mother's legs together for fear she might deliver a breach baby. There was no time to think," Ms. Quinell said. "Thank God they both did extremely well. This is what the north country is coming to. This is not OK."

She added that this case is an extreme example of a situation she hopes doesn't become more typical.

NYSNA nurses from Massena, Canton-Potsdam and Gouverneur hospitals plan to picket outside Massena Hospital from 4 to 7 p.m. April 20. They're asking members of the public to consider signing an online petition in support of them at wdt.me/Rd276a.

In response to questions about how St. Lawrence Health plans to address the nursing shortage, SLH officials in a statement said they're offering incentives and "several proposals related to wages and health insurance," but it doesn't get into further details. Here is the complete statement, which came through SLH communications specialist Pamela Klosowski:

"St. Lawrence Health (SLH) has proposed recruitment and referral bonuses during negotiations with our nurses represented by the New York State Nurses Association (NYSNA) union to help increase recruitment and retention at our hospitals. We also presented several proposals related to wages and health insurance to help further address staffing concerns shared by SLH and the Union. SLH and NYSNA are continuing to negotiate over these and many other topics in good faith as part of the ongoing bargaining process and we hope to reach agreements soon."

"It is important to recognize that staffing levels are a challenge for hospitals and health systems throughout the North Country, in New York State and across the nation. In fact, a recent survey from the Healthcare Association of New York State found 100% of hospitals within the state report nursing shortages they cannot fill. Like almost every hospital and health system around the country, we do engage agency nurses, but our focus continues to be on doing everything we can to recruit and retain full-time nurses at our hospitals."

"We have the highest respect for our Registered Nurses and are grateful for their commitment to their patients and to SLH."