Nurses at Mount Sinai Hospital represented by the New York State Nurses Association won historic contracts earlier this year that not only set safe nurse-to-patient staffing ratios, but also included enforcement language that said the hospital could be fined if it did not adhere to agreed-upon staffing ratios. Ratios are set based on several factors, such as the number of patients in a unit and how sick they are.
The agreed-upon ratios state that in the NICU, nurses are supposed to be assigned a maximum of two patients at a time. In cases where patients have more severe illnesses or require advanced respiratory support, nurses should be assigned one patient per shift.
The NICU was short-staffed by six nurses during at least two shifts, the agreement said. Throughout the month of March, the unit was consistently understaffed by four or five nurses.
There were an average of 24 nurses working each shift for a census of 52 patients, the documents said.
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Meghan Hurlbut, a NICU nurse at Mount Sinai, said that it's apparent when her unit is down by four or five nurses. NICU nurses take care of critically ill babies, and need to meticulously assess monitors and respiratory equipment to prevent their patients from having serious medical emergencies.
“If you have three or four sick babies, you are not able to stay ahead,” Hurlbut said.
Lucia Lee, a spokeswoman for Mount Sinai, said that the hospital is “appropriately resourced to provide excellent care for our NICU babies and families.”
Lee said that the agreed-upon ratios with NYSNA do not recognize the fact that the 46-bed NICU is made up of two sections—one that is for babies who require intensive care and the other for intermediate or continuing care. Based on the clinical needs of the baby, nurses in the intermediate unit may be staffed at a ratio of three or four patients at a time, she said.
“That said, let us be clear,” Lee added. “These penalties are an unfortunate consequence of an agreement negotiated with NYSNA in the waning hours of the strike and do not recognize the superb team care that makes our NICU one of the safest in the nation.”
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The arbitration agreement states that Mount Sinai Hospital owes nurses who worked in the NICU on short-staffed shifts a total of nearly $159,000. But the arbitrator gave the hospital a 20% discount to reflect the costs of its efforts to address the staffing crisis, bringing the total to $127,000.
Approximately 150 nurses are eligible for payment. Mount Sinai Hospital is required to pay its NICU nurses by the second pay period after the arbitration, which is by the end of this month.
Mount Sinai Hospital, located on the Upper East Side, has 1,134 beds. The facility is part of Mount Sinai Health System, which has eight hospitals in New York.
This story first appeared in Crain's New York Business.