MultiCare fighting groundbreaking rest break arbitration

When an arbitrator ordered MultiCare Tacoma General Hospital to cease using the “break buddy system” by Jan. 15, 2016, WSNA members across the state celebrated. It was a groundbreaking validation of what nurses know from experience: You can’t get a real break when you know your colleague is carrying a double load of patients — yours and theirs.

MultiCare responded by filing a lawsuit in federal district court to get the “final and binding” arbitration award overturned, and the company has put proposals on the negotiating table that attempt to invalidate everything WSNA fought for — and won — in court.

WSNA’s battle with MultiCare, which started when we filed the original lawsuit in 2010, continues. We are fighting back in federal court and at the negotiating table. In early March, we took the issue public with a guest column in the Tacoma News Tribune, entitled “MultiCare is putting profits before patients at TG,” authored by WSNA Assistant Executive Director of Labor Relations Christine Himmelsbach.

One of the major challenges facing health care today is the problem of fatigue. Over the last few decades, hospitals have reduced staffing, so that there are fewer nurses to care for patients than there would have been 30 or 40 years ago. At the same time, hospital stays have become shorter. And the nursing workforce is aging. As of 2013, the national average age of registered nurses was 50 years old. With the physical, mental and emotional demands of nursing, it is no wonder that many nurses regularly suffer fatigue at work.

The rise in fatigue is bad for nurses and patients alike. Numerous studies have shown that fatigue increases the chances of mistakes, including potentially life-threatening medication errors.

Because of our concern for nurse fatigue and its impact on safe patient care, WSNA filed a lawsuit against MultiCare in October 2010. Nurses at the company’s hospitals, including Tacoma General Hospital, were not consistently afforded the rest breaks they are guaranteed by law and contract. This was not a problem limited to infrequent emergency situations, when any nurse readily foregoes a rest break to provide the urgent care needed by patients. Nurses reported missing rest breaks thousands of times per quarter at Tacoma General alone.

After three years of protracted litigation, during which the number of rest breaks missed by Tacoma General nurses climbed from just over 2,000 per quarter to nearly 6,000, WSNA and MultiCare agreed to settle the case. Under the terms of the settlement, MultiCare agreed that every hospital department would adopt procedures that ensure that each nurse is “relieved of patient care duties for a 15 minute rest period every four hours of work.” MultiCare also agreed that its procedures for providing rest breaks would not in any case violate the established staffing plan.

MultiCare also agreed that any disputes arising out of the settlement would be resolved by final and binding arbitration.

Unfortunately, the settlement failed to fix the problem. In most departments, the rest break procedure adopted by MultiCare was the “buddy system,” under which each nurse is responsible for arranging with a co-worker for his or her own relief while on break. Under this arrangement, the number of patients for which a nurse is responsible typically doubles when the nurse relieves a co-worker for a break. The only advantage of the “buddy system” is that it saves money (and increases profits) for MultiCare.

By 2015, the number of rest breaks missed by nurses at Tacoma General skyrocketed to more than 14,000 per quarter. In at least one department, nurses missed more than 60 percent of their breaks.

Since MultiCare was plainly failing to live up to its obligations, WSNA submitted the issue to final and binding arbitration, as agreed in the settlement. After a full and fair hearing at which WSNA and MultiCare presented evidence, the arbitrator jointly chosen by the parties ruled that MultiCare was violating the settlement agreement.

The arbitrator ruled that MultiCare failed to ensure that nurses receive the breaks they are guaranteed. The arbitrator determined that MultiCare’s preferred method of dealing with rest breaks — the “buddy system” — is not only ineffective, but also does not meet the requirement of adopting a system to relieve nurses for their rest breaks, since the method routinely doubles the number of patients for which a nurse must provide care in violation of the established staffing plan. The arbitrator therefore ruled that MultiCare must discontinue the “buddy system” and ensure that nurses are actually relieved from work during their breaks.

Despite MultiCare’s agreement in advance that the arbitrator’s decision would be final and binding on all parties, the company rushed into federal court in a desperate attempt to nullify the arbitrator’s ruling. At the same time, MultiCare is demanding that WSNA agree to cancel the arbitrator’s decision in WSNA’s next contract and is threatening to discipline nurses who report missed rest breaks in accordance with that decision.

In truth, profits at MultiCare Tacoma General are more than enough to provide safe nurse staffing. Tacoma General pulled in $65 million in profits in 2014 alone — that’s $160,000 a day.

WSNA and the nurses at Tacoma General will continue to fight until nurses get the rest breaks they are entitled to and they deserve.