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By M. PAUL JACKSON mjackson@leader.net
Monday, February 07, 2000     Page: 1A

WILKES-BARRE – Wyoming Valley Health Care System could face several choices
if contract negotiations deteriorate between the system and the nurses’ union,
experts say.
   
And, none of those choices is pretty.
    The health system could be forced to cut beds or hire expensive,
out-of-state temporary nurses if a strike vote is called by the union,
according to health-care experts.
   
“Hospitals are having a difficult time meeting their bottom line,” said
Dr. Jessie Rohner, executive administrator for the Pennsylvania State Nurses
Association, a nurse advocacy group. “When they start looking for places to
cut back on money, they begin looking at nurses.”
   
On Jan. 26, the two-year contract between the health system and the
registered nurses of the Wyoming Valley Nurses Association expired.
   
The association, which is represented by PSEA Health Care, has been in
negotiations with the health system for weeks, but no agreements have been
met.
   
Talks have included the fate of several nurses at Nesbitt Memorial
Hospital. Some employees have expressed fears that the relocation of the
hospital’s same-day surgery center to Wilkes-Barre General Hospital could mean
job cuts.
   
Neither the union nor the health system has released details on the
negotiations.
   
As talks continue with no resolution, the nurses union might be moving
toward a strike vote – the same situation that developed two years ago as the
nurses negotiated their first contract.
   
Under federal law, nurses must first give hospital administrators a 10-day
strike notice.
   
“If that’s how you have to work with your health management to make things
better, that’s what you have to do,” said Rohner, a former union
administrator for nine years.
   
Rohner did not know specifics of the local contract talks, but said nurses
typically have good reasons for striking.
   
“For nurses to go on strike, it really means they have serious concerns
about what is going on with quality health care,” she said.
   
Faced with reduced federal Medicare reimbursements, more health systems
have turned toward cutting the nursing staff as a way to save money, Rohner
said.
   
The Wyoming Valley Health Care System posted one of the largest financial
losses of any health system in the area between 1996 and 1998.
   
According to the Pennsylvania Health Care Cost Containment Council – an
independent state agency – the system took in $658 million in patient revenue
during that period, but paid out about $700 million in operating expenses.
   
Similar losses have forced other health systems to rework their contracts
with employees, according to state hospital officials.
   
Faced with losses, hospitals “have to look at how they can cut costs and
how they can manage their resources,” said Deborah Saline, spokeswoman for
the Hospital and Healthsystem Association of Pennsylvania.
   
But while hospitals look to restructure contracts, nurses are clamoring for
more benefits, higher salaries and flexible work hours. The differences can
often lead to strike talk.
   
“Nurses don’t want to strike, but in the long run it will improve patient
care,” Rohner said. “The nurses make some gains that are beneficial to them
and to health care in the long run.”
   
Typically, hospitals facing a strike can hire outside nurses from temporary
agencies. Those workers frequently are paid more than staff nurses, adding to
the health-care system’s costs.
   
In addition, a booming job market has made finding full-time, temporary
workers difficult.
   
Hiring temporary workers “is easier said than done,” said Lynn
Gurski-Leighton, the Hospital and Healthsystem Association of Pennsylvania’s
director of clinical services. ~“At this point in time, there are some issues
of manpower shortage in nursing.”
   
As a drastic measure, the hospital could reduce the number of occupied beds
and shrink the number of patients in an effort to force nurses back to work.
   
“You really need to scale down your operations to take care of what you
really need to take care of,” Saline said.
   
Workers at Episcopal Hospital in Philadelphia are familiar with that
decision.
   
The hospital, embroiled in a tough contract dispute with its nurses last
year, cut the number of occupied beds from 100 to 12, hospital spokesman Bob
Villier said.
   
The hospital – one of eight hospitals within the Temple University Health
System – was faced with a walkout of its nurses and had no choice but to take
the beds out of use, he said.
   
“We could not stand by and have that happen again because of the cost
involved,” said Villier, who could not say how many nurses walked out. “When
you do that, it costs the health system money.”
   
The removal of 88 patient beds was drastic, but necessary, he said. And
while the nurses responded by returning to work, the contract remains
unresolved.
   
Episcopal Hospital posted losses of about $9.6 million in 1998, he said.
   
“We couldn’t take another walkout,” Villier said. “This is the road that
we chose, this is what worked for us.”
   
Meanwhile, Wyoming Valley Health Care System officials will not discuss
contract talks, or its plans if a strike occurs.
   
Union officials could not be reached for comment. Hospital officials, in a
statement, said: “It is clear both parties understand their obligation of
service to the community and both parties are working hard to reach an
agreement.”
   
But that might take a while.
   
Gurski-Leighton said she did not know about the situation between the
Wyoming Valley Health Care System and the union, but said in typical
negotiations “it may be several months before they actually get down to an
agreement.
   
“There’s a lot of back and forth, until you get down to the final hours,”
she said.

Call Jackson at 829-7134.