Citing staffing concerns, Chestnut Hill Hospital nurses picket amid contract negotiations with Temple

Nearly 300 nurses and technicians at Chestnut Hill Hospital picketed Wednesday outside the Northwest Philadelphia medical center to raise concerns about staffing levels.

The nurses are negotiating their first contract after unionizing with the Pennsylvania Association of Staff Nurses and Allied Professionals in 2023, following Temple Health’s purchase of a 60% stake in the hospital in partnership with Philadelphia College of Osteopathic Medicine and Redeemer Health. The hospital was previously owned by Tower Health.

Now Chestnut Hill nurses say they are caring for too many patients, without enough technicians or assistants to help with other tasks on the ward. They also contend that Temple is using the 148-bed hospital to handle “overflow” patients when there’s no room at its four other hospitals.

The union is also advocating for higher wages for nurses as well as medical technicians, who are in a separate PASNAP-affiliated bargaining unit.

» READ MORE: Nearly 3,000 residents from major Philly health systems are unionizing

Union leaders say they want contracts after eight months of negotiating, and noted that nearly a year has passed since Chestnut Hill staff initially voted to unionize. Temple said in a statement the timeline for contract negotiations is similar to those at its other hospitals.

Temple should be negotiating with nurses on wages that would “retain the nurses they have and attract more nurses coming in,” said Kadena Smith-Fleming, a licensed practical nurse who has been negotiating the union’s contract.

In its statement, Temple Health said that Chestnut Hill is not being used for overflow patients, and that along with every other Temple hospital, it employs more nurses now than it did before the COVID-19 pandemic.

“We continue to recruit ambitiously to fill open positions at Chestnut Hill Hospital with nurses who can provide world-class patient care, and we don’t think that PASNAP is going to help attract world-class nurses by picketing in front of the hospital,” a hospital spokesperson wrote in an email.

Noting that Temple has successfully negotiated contracts with several other hospitals in its health system, the spokesperson said: “It appears as though PASNAP has decided to negotiate their contract at Chestnut Hill Hospital in the media rather than at the bargaining table.”

Union officials also noted that Chestnut Hill was rated 15 out of 100 on staffing levels in national hospital safety rankings that were recently released by the hospital rating organization Leapfrog. It was the lowest rating among all hospitals Leapfrog ranks.

Temple said the result was a consequence of transitioning the hospital’s IT systems from Tower: They didn’t have enough data to complete all questions on the safety watchdog’s questionnaire, health system officials said, and that hurt them in the rankings.

» READ MORE: Check to see how Philly-area hospitals ranked in Leapfrog's fall safety ratings

“That blankness led to lower scores,” the health system wrote in its statement. “We’re stunned PASNAP didn’t know the low score was due to lack of data submission and had nothing to do with staffing.”

Megan Gorman, a spokesperson for PASNAP, said nurses “had no idea” whether their hospital has been better staffed since COVID or why the hospital’s Leapfrog rating was low.

“What we do know are the conditions in the building, on the units, at the floors, at the bedside. Those conditions are very concerning, and that is why we are advocating so passionately for better, safer staffing,” she said.

In particular, nurses raised concerns in a news release about staffing levels on the hospital’s geriatric psychiatric ward, where they said two nurses were caring for patients in a 20-bed ward.

Temple said that the ward sees on average 11 to 12 patients and that the two nurses assigned to them provide an appropriate ratio.

Smith-Fleming said her concerns about staffing aren’t limited to nurse-to-patient numbers.

Usually, she said, she is responsible for five to six patients on the medical-surgical floor at Chestnut Hill. But those patients have different care needs that sometimes require more staff to adequately treat. Monitoring a patient who can walk to the bathroom under supervision, for example, takes more time than keeping an eye on a bedbound patient, she said.

Nurses also say that a shortage of assistants and techs means nurses have less help on the wards. “On some days, we have one certified nursing assistant or patient-care technician on a unit of 26-plus patients,” Smith-Fleming said.

In the intensive-care unit, the recommended staffing ratio is one nurse to two patients, said Barbara Strain, an ICU nurse who has worked at Chestnut Hill for 20 years. She said nurses in the Chestnut Hill ICU typically care for two to three patients at a time.

She appreciated recent efforts at the hospital to keep staffing ratios low and wants to see them formalized.

“We just want that in our contract,” she said.

Strain also wants help with care that does not require nursing skills. The ICU doesn’t have an aide and employs only a part-time secretary to answer phones, help families navigate the ward, and perform other tasks, leaving nurses to also take on those duties when the secretary isn’t working.

“It’s adding on other responsibilities. And one nurse [taking a patient to an MRI scan] could be off the floor for an hour, so the other nurses have to fill in,” Strain said.

Nurses say their concern about staffing levels is tied to patients’ quality of care.

Debra Ruetz, a registered nurse who has worked at Chestnut Hill for 13 years, said staff have come to know many of the patients who have sought care at their neighborhood hospital for years. “We see a lot of repeat patients, and they like coming. They’re like family in a lot of respects, and you don’t want to treat your family badly,” she said.

“We’re hoping this picket will draw attention to Temple — and the fact they need to sit down and negotiate and be fair.”