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60 Nurses and individuals from the Public Support The three fired Dallas Regional Medical Center of Mesquite Nurses. Nurses Have over 1,000 letter signed from the community and over 1,000 signature on a pettion. Here is copy of the Sat. June 16th Dallas Morning News Article
Fired nurses protest at Mesquite hospital
Mesquite: Hospital defends action as ICU patient ratio debated
12:00 AM CDT on Saturday, June 16, 2007
By KIM BREEN / The Dallas Morning News
kbreen@dallasnews.com
Three nurses who say they were fired from a Mesquite hospital after refusing what they believed was an unsafe patient load are trying to bring attention to what they consider dangerous understaffing.
JUAN GARCIA/DMN
From left: Sandra Taylor, Diana Sepeda and Nancy Friesen, protesting at Dallas Regional Medical Center, said they were fired for refusing to take more patients than they could handle. Nurses Diana Sepeda, Nancy Friesen and Sandra Taylor said they were fired this month from Dallas Regional Medical Center – formerly the Medical Center of Mesquite. During a night shift in the hospital's ICU in May, each nurse refused to take on three patients because they did not think they could provide adequate care.
"I've never been fired before in 27 years," Ms. Taylor said. "But there comes a time when you've got to stand up for what's right.
"These hospitals are making profits on the backs of these patients."
Paula Reisdorfer, a spokeswoman for Dallas Regional Medical Center, said she could not comment about personnel issues. But the hospital "assigns nurses at a ratio that is appropriate for the acuity of the patient volume at that time," she said in a written statement. Typically, she said, that ratio in the ICU is one nurse for every two patients.
The mission of the hospital is to provide safe, quality care, the statement continued. "As management, we have an obligation to take action to correct any behavior that is not in the best interest of our patients."
The hospital is owned by Health Management Associates, which has hospitals in 16 states.
Gathering support
The nurses have been busy getting their word out, with help from the National Nurses Organizing Committee, founded by the California Nurses Association.
They have been knocking on doors in the neighborhood and circulating a petition.
Earlier this week, the nursing organization flew the women to California for one of the first public screenings of Michael Moore's latest documentary, Sicko, which takes on the country's health system.
On Friday, they held a news conference next to the Mesquite hospital's parking lot.
No law in Texas dictates nurse-to-patient ratios for ICU patients, but legislation supported by the nurses' group would have created one. The legislation did not leave the House Committee on Public Health last session.
The legislation also would have granted whistle-blower protection to nurses.
Nurses are obligated to keep patients safe, the three nurses argue, but they had no alternatives when their supervisors' opinions about staffing levels opposed their own.
"My duty is to the patient, and not to the hospital," Ms. Sepeda said. "We are ethically and morally obligated to be patient advocates."
Ms. Sepeda said that she was assigned to three patients that night in the ICU, including one who was recovering from open heart surgery and was far from the others.
"I could not see him," she said. "I could not monitor him safely."
The three nurses and about two dozen supporters – many of them children – chanted, "Hey, hey, ho, ho, unsafe staffing has to go," at the morning news conference.
"They are going to be the hospital we use" as an example, Ms. Taylor said. The hospital should staff nurses appropriately, she said, "or we are going to drive them into the ground."
Nurses' rights
The three nurses, who hope to get their jobs back, are seeking better staffing ratios in the Mesquite hospital and protection for nurses who act as patient advocates. They say their rights would have been protected under the proposed legislation.
But Texas nurses already have such protection, said Clair Jordan, executive director of the Texas Nurses Association, a professional association based in Austin.
"We think it's very sad that the nurses did not have better advice," Ms. Jordan said. "I certainly support any nurse saying, 'I cannot deliver care safely to this many patients,' " she said. But state law gives nurses a process designed to cover such situations.
Nurses face sanctions from the Texas Board of Nurse Examiners if they neglect patient safety. If their employer gives them duties that they think compromise safety – such as a high patient load – they can invoke a "safe harbor" option and fill out paperwork. The case later goes to peer review.
The system protects the nurse from board sanction, as well as repercussions in the workplace, Ms. Jordan said.
Ms. Friesen said the provision doesn't go far enough because nurses must continue working in an unsafe situation. "To me, it's like a Band-Aid over a hemorrhage."
Rosemary Luquire, senior vice president and chief nursing officer for the Baylor Health Care System, said the normal ratio of nurses to patients in Baylor ICUs follows a national professional standard of 1-to-2.
"There are occasions in most hospitals where the hospital is very full," Ms. Luquire said. Some patients have to wait for another bed to open in order to leave the ICU, and so are not as sick as other patients. "That might be a time when a 1-to-3 ratio may be appropriate," she said.
Sometimes, she said, appropriate ratios depend on how a unit is laid out and how visible patients are to nurses.
Ms. Luquire said the safe harbor law is helpful. "The benefit of it is it gives you an opportunity to really go back and re-evaluate the situation."
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