BMC nurses: 'We're at the end of our ropes' without a fair contract

By Julia Doherty and Lisa Annunziata

As nurses at Boston Medical Center (BMC), we care deeply about the hospital's mission of providing exceptional care for all. That's why we choose to work here. But we're concerned that BMC is facing growing instability driven by burnout and turnover of nursing staff — as a direct result of inadequate wages, growing health insurance costs, and ongoing safety concerns.

One of us is a pediatric nurse who's worked at BMC for a little over a year, and the other is a labor and delivery nurse who's coming up on 16 years at BMC this September. For months, our union, 1199SEIU, has been attempting to negotiate a fair contract that addresses these issues and puts BMC on the path to a healthier workforce.

But BMC management's recent contract proposals lack the necessary investment needed to fill critical vacancies, train and retain new staff, and ensure a long-term commitment to the communities BMC serves. And in the end, it's our most vulnerable patients who stand to lose.

Boston Medical Center has the busiest emergency room in New England, with a Level 1 trauma center that treats the most severe, life-threatening injuries. If you're involved in a car crash, fall victim to a violent crime, or experience a heart attack or stroke, there's a good chance you'll find yourself at BMC.

We also serve patients with greater needs than other area hospitals. Many of our patients have significant pre-existing conditions, and nearly half are covered by Medicaid.

Nurses at BMC thrive on rising to meet these challenging working conditions. We're dedicated to meeting the unique needs of our diverse patient population. If you work here, you have to be. You certainly didn't choose it for the pay.

BMC nurses have one of the lowest starting wage rates across Boston-area hospitals, at just $38.05/hour, compared to $41.71 at the Brigham & Women's Hospital and $43.01 at Tufts Medical Center. The average wage for nurses is $59.03; according to MIT's living wage calculator, that's not enough for a single parent in Suffolk County to live on. That's something one of us understands all too well, as a single mom who commutes an hour and 45 minutes each way from Connecticut because I can't find an affordable place to live in Greater Boston. Many nurses have taken extra jobs teaching, school nursing, consulting, or even picking up bartending shifts to help make ends meet.

The top pay rates for the most experienced are lower too, so many younger nurses work a few years at BMC and then leave for a better-paying job; 70% of the turnover at BMC is those in their first five years at the hospital. One of us has a wall above our nurses' station of all the nurses that have left to take positions at other hospitals because they were burned out, and needed to pursue higher pay or better benefits. As a result, 72% of BMC nurses today have less than 6 years of experience.

It's not just about wages; our healthcare benefits also fall short. Recent plan changes forced one of us onto a PPO plan with a $5,000 out of pocket deductible in order to continue seeing my neurosurgeon. By May, my health savings account was wiped out for the year, and I had to start dipping into my savings to pay for routine medical costs.

For years, experienced BMC nurses trained the next generation of early-career nurses, passing on their experience to the enthusiastic newcomers, who would eventually become skilled veterans themselves. But in recent years, that system has broken down as our wages and benefits have fallen short.

Because turnover is so high and wages aren't enough to fill all open positions, management has resorted to hiring a large number of traveling nurses — temporary workers who, while skilled at their jobs, aren't familiar with the way things are done at BMC, which can lead to safety problems and delays in providing care. And these traveling nurses cost far more than permanent staff would, even under the union's wage proposals.

Safety issues at BMC have also contributed to the sense of instability felt by nurses, and contributed to high turnover. BMC can't control the conditions outside its doors, but when there aren't enough staff in the emergency room, and when staff don't have enough training in public safety measures and protocols, it's a problem. When nurses are properly staffed and trained, it helps reduce safety issues and gives them adequate time to care for patients with complex needs.

Between the large number of vacancies and the high needs of our patients, current staff are overworking themselves. If you have a new hire, you must create time to train them, and that's time not spent on patient care. That puts even more burden on the few experienced nurses who stay here and harms our ability to serve our patients.

The offers BMC management have presented to nurses do not make us feel valued; it's disheartening that we are worth pennies rather than being viewed as valued employees that they want to be around for years.

If something doesn't change, BMC will lose even more valued nurses to other organizations or other job opportunities, and it will impact our patients. We don't want to be among those who leave, but we're at the end of our ropes.

Julia Doherty is a registered nurse in the pediatric department at Boston Medical Center, and Lisa Annunziata is a registered nurse in the labor and delivery department at Boston Medical Center.

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