It's been two weeks now since St. Joseph Hospital suspended four night shift intensive care unit nurses and a supervisor, and the nurses, their union representative and the community at large still remain in the dark as to what prompted the suspensions.
In a brief statement, St. Joseph's administration offered only that it does not discuss personnel issues. And, it said, "Anytime an employee or patient raises concerns we treat each matter seriously."
Later, in an e-mail to the Journal, hospital spokesperson Courtney Hunt-Munther assured: "The ICU is fully staffed and patients are receiving quality care."
Concurrently, a rumor flew that the hospital had told pulmonologist Dr. Melvin Selinger, the medical director of the ICU, that his services were no longer needed. And there was talk that perhaps the suspensions were related to ongoing union contract negotiations and hints of a pending nurses' strike.
"They need to put the fear of God into the rest of the nursing staff," said Wes Thornton, one of the suspended nurses, who contacted the Journal last week. "And these nurses on suspension, we're opinionated people."
Another of the suspended nurses, who asked to remain anonymous, speculated the suspensions might have specifically to do with a battle over staffing ratios. Currently, California law requires one nurse for every two patients in ICU, and one-to-one for acute cases. "But the hospitals and other outside institutions have been seeking to eliminate this staffing ratio," said the nurse. "And I was told by a union representative that this was going to be a major bargaining issue."
The hospital objects to those speculations.
"The situation involving the ICU nurses is absolutely unrelated to either our ongoing negotiations with the nurses union or Dr. Selinger," Hunt-Munther wrote. She added: "[W]e want to thank Dr. Selinger for his leadership and service over the years. We have no issue with his performance. He continues to be a valued partner in our mission to serve our patients and the people of Humboldt County. This is simply a change in medical director to another pulmonologist -- rotation of medical directors happens in various specialties as various doctors take turns providing med-admin leadership."
Selinger couldn't be reached by press time.
Thornton blames the suspensions and some other staff changes on what he calls an increasingly "factory"-like atmosphere at the hospital, which he said was due to its association with Navigant Consulting. Current CEO Joe Mark first came to the hospital as a Navigant consultant, there to whip the place into financial shape. And recently the hospital brought in Navigant's Debbie Hoffman to serve as the interim Chief Nursing Officer while the hospital conducts a nationwide search for a permanent CNO. Thornton said that shortly after Hoffman came on, staff received an internal memo that Debbie Clark, the hospital's nursing director of ICU and the "Cath Lab" -- part of the heart care department -- had resigned. Thornton suspects she was forced out.
Hunt-Munther had no comment on the Clark matter.
Thornton also said that just before the suspensions -- and, incidentally, right after he'd finally been approved to switch to day shift -- he was called into a private room by Hoffman and a nurse supervisor.
"They asked me, first, if I would please, please take a full-time clinical supervisor position, at night -- the charge nurse," he said. "It would be a bit more pay. But it was non-union. And I was excited about going on day shift. I politely refused. Then they asked me about the 'negative attitude' on the unit at night. I didn't have any answers. And the interview ended on a good note, actually; we had a big discussion about bicycling."
The day after that came what Thornton called "Hell night." A gunshot victim came in and died, and there were the family, the coroner, the paperwork and the question of donated organs to deal with. Then there was a difficult intubation which required calling in an anesthesiologist -- who did it perfectly, Thornton said. And more. It was so busy, said Thornton, he didn't get around to entering the night's data on each patient into a program called "MIStroClef" --- workload analysis software -- before the hospital's 2 a.m. deadline. The software, Thornton added, has irked some nurses, including one who told a nurse supervisor that it wasn't worth a "blank blank."
"The next night," said Thornton, "I was actually dreading going on. There were only going to be two nurses going on that night [including him], and no cardiac nurse -- although, a third nurse was added at the last minute. We had six intubated patients plus a fresh cardiac surgery patient scheduled to come out that afternoon. We had a critical full unit. And then I got a call at 4 in the afternoon from management, and they said, 'We're placing you immediately on administrative suspension because of behavioral problems and serious practice issues.'"
Text messages flew between him and the other suspended nurses. On June 18, they met with the California Nurses Association's Ian Selden, and learned that the hospital should have talked to them before suspending them.
But Selden doesn't think the union contract negotiations have anything to do with the suspensions.
"I think it would be less that it's the middle of contract negotiations, and more that they have a new chief nurse executive and that person may be taking a different tack," Selden told the Journal this week.
He did say it was unusual that the nurses were initially put on unpaid administrative leave, which implies wrongdoing and a need to keep the nurses away from the hospital during the investigation. But that doesn't seem to be the case here, he said. "You'll see this where there's some kind of bookkeeping accusation, or something like that," he said.
That the leave was unpaid was particularly puzzling, he said. It implied a need for discipline.
"I raised a strong objection to that," he said. "And at least St. Joe's reversed that decision, on Friday the 26th, and the nurses are on paid leave now [for the entire leave]. But now it's been two weeks and we're still waiting to sit down with management. And that's a long time to have folks on leave, either paid or unpaid."