The news that one of Washington, DC's largest hospitals has fired several nurses and other staff for failing to report for their shifts during the district's heavy snowstorms caught me and other healthcare leaders by surprise.
Washington Hospital Center wouldn't discuss the decision or its fallout with me, due to pending grievances filed by a nursing union. I hope to speak to senior leadership at some point to discuss how their decisions have affected their relationship with the hospital's remaining nurses.
The hospital's version of events, gathered from news reports and a letter that CEO Harrison J. Rider III sent to employees, is that it alerted staff to the approaching storm and made clear its expectation that all staff would report for work. The hospital noted that it tried to help employees get to work, in some instances, by arranging to pick people up at their homes.
The hospital fired 18 nurses and six other staff for failing to report for work, but after review, three nurses were reinstated. Last week, Rider sent a letter to employees saying, "While I am very pleased that we found merit in some of the cases we reviewed, we have not found any redeeming circumstances in the behavior of the others, so we are proceeding with the dismissal of 21 total associates."
The union that represents some of the nurses—Nurses United—has filed grievances and believes the firings are unprecedented in the hospital's history. Stephen Frum, chief shop steward for the 1,600-member union, has worked at the hospital for nine years and says hospital policy does not state that employees will be fired for missing work in such situations. "The hospital has managed these things really well for a long time," says Frum. "In this instance, they chose to depart completely from how they have effectively done this before."
Frum says the fired nurses disagree with WHC's account, which has raised concerns among nurses who still work there. The union called a meeting last week which garnered the largest turnout ever for a union meeting at the hospital.
"[People are] angry, scared, and upset about what had happened," says Frum. "After going through two historic storms, which was a really big deal, to go through that and not have our institution stronger and more united and have a good feeling. [The storm] was tough, it was hard, people were sleeping on the floor, but we got through it and patients were OK." Instead of coming together and feeling more united for a job well done, Frum says the hospital is left fractured and confused.
The situation reminds me of the debate sparked when H1N1 became a public health threat. The New York State Department of Health wanted to mandate all hospital, home health, and hospice staff be vaccinated or be fired, which caused an uproar and the state backed down, claiming low vaccine supply.
During this issue, organizations weighed the pros and cons of mandating vaccination and many decided they did not want to play the role of parent and enforce healthcare decisions for their staff. They felt they had more success providing education about the vaccine and explaining the patient safety imperative, rather than issuing a draconian edict.