Hahnemann boosts use of registered nurses in bid to improve care

In a move that defies conventional wisdom, Hahnemann University Hospital is replacing less expensive workers with people who are paid more.

Michael Halter, the hospital's chief executive officer, believes that ultimately the change will earn Hahnemann more money and customers, and create a more loyal staff when the labor market becomes competitive again.

Halter said a pilot study done on one nursing unit found that using all registered nurses to care for patients instead of a combination of nurses and nursing assistants led to higher-quality care, and greater patient and nurse satisfaction. As a result, the entire hospital is transforming to the all-RN model. Halter thinks the move will pay off financially as insurance companies change reimbursement policies to reward quality.

"I believe it'll help us grow," Halter said. The idea, he said, originated with nurses. It has been tried on two units and will begin on a third next week. He expects the entire transition to take six months to a year. Until now, it has been possible to move certified nursing assistants (CNAs) on those units to other jobs, but Halter said layoffs will soon be required.

The hospital has 600 registered nurses and will hire 50 to 60 more. Nurses make from $35 to $50 an hour while aides make about $25, Halter said.

But the union that represents 75 CNAs who likely will lose their jobs is mobilizing to fight the change. The CNAs, whose contract with Hahnemann expires in July, plan to picket starting Tuesday afternoon.

"It's a bad situation and they are in for the fight of their life," said Henry Nicholas, president of District 1199C of the American Federation of State, County and Municipal Employees (AFSCME). "We are not going to let this go down."

Nicholas said that when nursing assistants are gone, patients will have to wait longer for a bedpan or help with dinner.

He called the decision to stop using CNAs "union busting" and said the hospital has a responsibility to employees who have served it well, often for decades.

"There is no legal question. It's a moral question," he said. "It is unjust to throw these people out who have been there for 50 years and beyond just on a humbug."

A hospital spokeswoman denied the change was intended to break the union and said many other union workers would remain. Halter said he was doing what he considered best for patients.