Tufts Medical Center nurses back at negotiating table

After weeks of bargaining, the nurses of Tufts Medical Center, who have been working to reach a contract with the hospital in the months since their July 12 strike, are continuing negotiations. Last summer's action was the first nurses' strike in Boston in more than 30 years, fueled by demands for higher wages, more expansive retirement benefits and safe staffing levels.

Since their first meeting on Aug. 31, the unionized nurses — who have been working closely with the Massachusetts Nurses Association (MNA) in their effort to redraw the contract — have met with representatives from Tufts Medical Center on two additional occasions. According to Rhonda Mann, the director of communications for Tufts Medical Center, further negotiations are scheduled for today and Thursday.

“We continue to have good discussions at the bargaining table … [and] are hopeful that we will come to resolution soon. I think there has been some movement which is good… We will just keep being at those discussions listening hard and seeing what we can do to try to resolve this as quickly as possible,” Mann said.

Since the strike, the hospital has responded by presenting revised contracts to the 10-member nurses’ bargaining committee, which is composed of nurses from pediatric medicine, the outpatient adult clinic, the breast health clinic, the operating room, the recovery room, the intensive care unit and the IV nurses and floor nurses, according to staff nurse and bargaining committee member Mary Havlicek Cornacchia. Rounding out the team are several associates from MNA, an MNA attorney and a representative from MNA’s public relations department.

Mann explained that on the medical-center side, representatives such as Chief Nursing Officer Terry Hudson-Jinks, nursing leadership from various departments, the hospital’s chief general counsel and labor relations experts have worked to marry the nurses’ requests with the hospital’s capabilities.

When talking about the most recent negotiations, Cornacchia said that the hospital had given ground regarding some of the nurses’ demands, but that the changes were still insufficient to meet their needs, although the off-the-record nature of the negotiations meant she could not go into great detail regarding what changes were suggested.

“It’s a revision of the original offer … It’s been a little frustrating for our membership … People think it means backdoor dealings, which is not the case," Cornacchia said. "A lot has been accomplished with some of the off-the-record discussions that have occurred since we’ve been back to the table."

Cornacchia did allude to the nurses gaining some ground on key points of contention; for example, she explained that the hospital has recognized the need for filling staffing gaps. Still, Cornacchia maintains that the nurses are adamant about resolving the three issues that originally drove them to strike: retirement, wages and staffing.

Clinical Resource Nurse and co-chair of the bargaining unit Barbara Tiller, who is also on the nurses’ side of the negotiating table, explained that settling on a viable retirement plan that both sides are comfortable with has been a central challenge in the saga of negotiations. The nurses have been trying to reach a contract since December 2015.

Tiller said that, in the most recent negotiation session, when she attempted to table the issue of retirement momentarily, talks hit a stalemate.

“I said ‘Why don’t we go ahead and talk about staffing and wages?’ and [the hospital bargaining committee] wouldn’t talk about those things unless we settled on the pensions,” Tiller said.

Tiller highlighted a multiemployer-defined benefit plan, a Taft-Hartley pension fund, that was designed by the MNA and Caritas Christi Health Care, which is one of the largest health care networks in Massachusetts. She explained that the nurses are advocating for this plan in lieu of a multiemployer pension plan, in which the hospital would pay a large financial conglomerate to administer the plan.

The Taft-Hartley plan that the nurses are supporting would lead to better retirement benefits for the nurses, provide a guaranteed retirement benefit to every nurse at the medical center and, Tiller argues, would save the hospital a significant sum of money, as they would not have to insure their money with a larger outside conglomerate.

In its fact sheet about the negotiations, Tufts Medical Center argues the nurses' proposed plan would provide the nurses fewer benefits and cost the hospital more.

Cornacchia said that staffing remained a hot-button issue among the nurses and pointed to fairly consistent understaffing, while Mann maintained that the hospital has been drawing in a huge pool of talent. Mann cited recent statistics as evidence.

“Over the last 18 months, we’ve actually hired over 160 nurses to meet the growing needs of the hospital,” Mann said. “We have one of the lowest nursing turnover rates in the country … We have nationally produced data on that. But the MNA was out there saying that people were leaving … We don’t know where they are getting that information, we actually have incredible retention here.”

Mann went on to explain that the hospital assesses and tailors staffing levels daily to meet the evolving needs of patients and conditions in the hospital. In particular, Mann pointed to the hospital’s procedure of examining the patient pool every four hours to consider factors such as acuity level and specific needs that care will entail to make informed staging decisions.

Cornacchia had a different assessment of staffing levels throughout the hospital and maintained that a large volume of nurses have resigned in the time since the strike.

“Some have [left for] retirement, natural attrition, but we’ve [also] had a lot of younger nurses who have come to gain experience leave because they can make more money and have a better retirement package anywhere else in the city,” she said.

The hospital addressed staffing shortages during the week of the July demonstration by hiring agency nurses to fill the roles of the standard nursing staff for five days, the minimum amount of time for which they were able to get replacement nurses.

However, Cornacchia says these agency nurses have stuck around to fill staffing gaps.

“They have a lot of agency nurses … They actually brought in a lot of the strike nurses, they brought them back post-strike to fill staffing gaps … We haven’t had too many people apply,” Cornacchia said.

For her part, Tiller conceded that staffing has recently been excellent, but said that she believes the hike in staffing is due to a strategic move on the part of the hospital.

“They have been staffing up the floors amazingly [with] three or four patient assignments ... I think they are doing it to simmer the nurses down to have them forget what they are fighting for, but they could stop the minute we agree to settle,” Tiller said.

As for the figure regarding the over 160 new hires, Tiller believes this rush of hiring occurred predominately before the strike.

“There are definitely people leaving in droves: we lost 20 people out of the [operating room] since January," she said. "We are losing seven alone in the next few weeks."

She went on to posit that other medical centers, such as Massachusetts General Hospital, are cannibalizing the disillusioned Tufts nurses.

"Mass General is taking advantage of the strike and are reaching out to our nurses … and they are snagging them," she said. "The pay is better, the benefits are better, the staffing is better."

Cornacchia contends that making the scaled-back versions of the staffing changes the nurses initially requested would be impactful in terms of day-to-day performance in the hospital.

“We realize the hospital doesn’t want to comply with safer patient limits, but the couple things we are asking for … would help facilitate the daily flow," she said. "If we could remodel the contract altogether, people would come back to Tufts."

The nurses’ contract with the hospital officially expired last year and, as of now, Cornacchia explained that the nurses do not have a deadline they are working to meet. She laughed as she said that she thinks the hospital fears the nurses will strike again, but quickly clarified that another strike was not in the cards. Instead, she expressed her desire to resolve the situation in a timely and equitable manner.

Mann similarly reaffirmed the hospital’s dedication to meeting the nurses’ needs.

“We remain committed to reaching an agreement … one that allows us to recruit and retain top talented nurses and meets the needs of our current nursing staff, while entrusting the long-term vitality of our medical center remains in place," Mann said. "Our budget is limited."

Still, while Tiller hopes that this week’s talks will yield enduring and effective terms that both parties can agree upon, she remains skeptical of the efficacy of these negotiations.

“People are really discouraged about how they were treated during the period [post-strike]. [It took the hospital] way too long to get back to the table," she said. "There is a mourning period going on, it feels like we are dealing with a group that is only concerned with the bottom line."

In the meantime, Tiller plans on pouring her heart into her work and continuing to advocate for herself and the other nurses of Tufts Medical Center.

“They just take for granted that we’ll keep [working]. I am very discouraged about my relationship with the hospital. But when I am in the patient room it doesn’t matter. I still give them that 110 percent, I still try to care that little extra bit, and that makes a huge difference,” Tiller said.