Nursing chief: ‘Patient care will improve’

Although a good number of nurses’ aides are being laid off on March 12, patient care at Enloe Medical Center will not suffer, the hospital’s vice president of nursing services, Carol Butler, said Tuesday (Jan. 23). In fact, she insisted, it will improve.

“I know it seems counterintuitive,” she explained. “It may be difficult for people to grasp that we can do a better job with fewer people, but that’s the case.”

In an interview with the CN&R that was joined by Laura Hennum, Enloe’s public relations coordinator, Butler sought to allay any worries people might have that patient care would suffer as a result of the layoffs announced two weeks ago.

First off, she said, of the 91 certified nursing assistants given layoff notices, 26 got job offers the same day. The hospital had to do it that way so that, if the new positions’ work days or hours didn’t meet the CNAs’ needs, they would still be eligible for a severance package, Butler explained.

In addition, another 28 “brand-new jobs” in the yet-to-be-formed “patient handling teams” have been posted. “We hope to hire a good number of the CNAs that are being laid off for those positions,” Butler said.

The result is that the hospital will continue to employ 54 CNAs as support for its registered nurses—but will do so in a way that is more effective than before, Butler said. That will include creating patient handling teams to do the heavy lifting that often requires four people.

In fact, the hospital has been working for more than a year to redesign “how nurses do their jobs and what support they need,” Butler said. As part of that process, she and others have been talking with representatives of hospitals elsewhere to learn how they manage patient care.

Many hospitals have eliminated CNAs, especially in the past three years, since California established strict nurse-patient ratios, Butler said. In response, patient handling teams have become common and have had a couple of very positive impacts. The number of nurse injuries from lifting patients—always an occupational hazard—have been reduced dramatically, and with that workers’ compensation costs have dropped.

Ann Rice, chief executive officer at UC Davis Medical Center, in Sacramento, told the Sacramento Business Journal that lift teams there contributed to a substantial workers’ comp expense drop in 2006—as well as keeping nurses injury-free and working.

At Enloe, the lift teams will be deployed from a central location, Butler said. “Right now we have a lot of nurses and aides doing patient transport,” she said, “which takes them away from patient care.”

She has set up a special group composed of nurses, charge nurses and CNAs to figure out how the lift teams will work and determine the most valuable jobs they can do.

Butler and Hennum both discounted rumors that further layoffs are in the offing. There are no such plans, they said. But Hennum acknowledged that, with the escalating cost of the hospital’s expansion and other expenses, “going forward, we have to be really diligent in how we handle everything—and hyper-vigilant about costs. That said, our ultimate focus is on patient care.”

Nor is the hospital going to be sold, Hennum said. Its Board of Trustees is absolutely committed to maintaining it as a stand-alone, locally run, nonprofit facility.

Asked whether Enloe was “a Collier Hardware in an era of Home Depots,” Butler laughed, thought for a moment, and then said she liked the analogy. “I like to shop at Collier,” she said, noting that the store offers excellent service and expertise. “But if the community doesn’t shop there, Collier will go out of business. The same is true for Enloe. Health care is an extremely challenging industry these days. We need the support of the community, the doctors and our employees.”