This story was updated at 7:32 p.m. on Wednesday, June 17, 2020, with more information.
An Erlanger nurse upset with working conditions and staff cutbacks is trying to unionize nurses at Chattanooga's biggest hospital.
Jeff Holland, a licensed practical nurse at Erlanger for the past three years, said the COVID-19 pandemic and its impact on staff has "created an environment where employees are working in fear and intimidation for their jobs."
Holland said nurses are being asked to care for more patients even while the hospital has cut some benefits for nurses and other staff and dismissed some nurses unwilling to take on the bigger patient loads. Studies show that an understaffed and overworked nursing force decreases hospital efficiency and increases the risk of medical errors.
"Erlanger Hospital has created the perfect textbook conditions to validate the need for a union to protect its employees rights and benefits and in order to provide safer conditions for its patients in regards to nurse/patient ratios," he said.
A Facebook page Holland created on June 1 to rally nurses to support the unionization effort, known as "Erlanger Pro Union," has already got nearly 400 followers.
Erlanger officials said in an emailed statement that the hospital "strives to continuously listen to employees and take seriously any concerns brought forward."
"We are in an unending journey to improve and make Erlanger Health System the best healthcare system for our patients, our staff and our community," the statement reads.
Before the pandemic, Erlanger and Chattanooga's other acute-care hospitals struggled to recruit nurses — a problem seen across the country as many nurses leave the hospital bedside in favor of lower stress, higher paying jobs with better hours. The need is greatest for registered hospital bedside nurses, often called medical-surgical nurses, that care for sick and recovering adult patients.
As a safety net hospital, Erlanger already operates on thin margins. Then, when COVID-19 struck, officials estimated the hospital lost $35 million in net patient revenue during April due to temporarily suspending elective procedures, decreases in admissions and other coronavirus-related expenses.
As a result, the hospital enacted a "temporary expense reduction plan" in March by furloughing some administrative employees, cutting leadership pay, reducing overtime, suspending vacation accruals, suspending job recruitment for administrative positions and suspending retirement contributions by the company. Last Friday, Erlanger laid off 11 non-clinical executives.
Gregg Gentry, chief administrative officer for Erlanger Health System, said all of these decisions were made after thorough discussion and with thought toward how to minimize effects on employees. None of those laid off were involved in direct patient care, he said.
"Our efforts, very diligently and deliberately, have been not to impact patient care," Gentry said. "But, as much as possible, pull money out of the administrative costs of running a health care system and be able to grow the percent of dollars that apply to the clinical side."
Gentry acknowledged that Erlanger's expense reduction plan — particularly the pause in paid time off accruals — has been a key source of frustration among employees. Traditionally, Erlanger staff accrue paid hours of personal time off every pay period as opposed to receiving a lump sum of time off at the beginning of the year.
The policy applies to every employee throughout the health system, Gentry said. Some employees who have had their work schedules reduced are using their paid time off to fund their schedules, he said.
"We didn't take away hours, but we stopped the accrual," Gentry said, adding that "we are in daily discussions" about when and how quickly Erlanger can restore those accruals.
Holland said he understands that Erlanger is losing money, "but there are other ways to cut money without devaluing nurses."
"When you're faced with this virus every day and the possibility you might take it home to your family, you're already stressed out, and then the hospital comes along and says it's going to take some of your benefits away," he said. "A lot of nurses are scared. They're intimidated and stressed out from all the COVID."
Holland said he has never previously belonged to a labor union and is still talking with different labor unions, including National Nurses United and IBEW (International Brotherhood of Electrical Workers) Local 175, about helping with any organizing campaign.
Holland sent a letter to Erlanger management last week outlining his concerns and telling about his union organizing efforts, which helps protect him from being fired for his organizing efforts.
In his letter to Erlanger management, Holland contends that hospital officials "seem to be concerned only with making or saving money (even if it's at the expense of those working on the frontlines) and lording control over the staff."
Holland requested that Erlanger, as a sign of good faith to its workers, restore paid time office, company matched payments to employee retirement contributions and incentive pay. He also asked the hospital to reevaluate the recent firing of some nurses, who he said didn't want to have to manage so many patients at one time.
In a Times Free Press survey of more than 100 local nurses conducted in June 2019, nurses cited detached administration, low pay and burnout as key factors that caused them to either dislike their jobs or leave nursing.
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