Two unions sent University of Vermont Medical Center a cease-and-desist letter over how the Burlington hospital assigns staff to observe patients at risk of harming themselves, VTDigger reported Aug. 31.
Representatives of the Vermont Federation of Nurses and Health Professionals and Support Staff United sent the letter Aug. 20 to the network’s labor relations director, asking the hospital to pause changes made in June to its patient observation practices, according to the report.
Annie Mackin, a hospital spokesperson, told Becker’s the aim is keeping licensed nursing assistants focused on direct patient care and working at the top of their license and training. Patient observation continues through a combination of designated trained observation staff, known as clinical patient safety attendants, and remote monitoring when clinically appropriate, she said.
Patients with an active physician order for constant observation, those under monitoring for conditions such as epilepsy and suicidal patients not determined to be low risk receive in-person observation rather than remote monitoring, Ms. Mackin said. About 15 attendants work in person with patients on a typical day, and LNAs are still directed to the work if there is enough need.
The unions wrote in the letter that when an LNA is pulled from regular duties for patient observation, the hospital has not backfilled the position, leaving units short-staffed, and that nurses’ input on remote observation and sitter practices is in some cases being disregarded, VTDigger reported. Two LNAs told the outlet they have had concerns about patients assigned to them without an attendant present.
Ms. Mackin said the hospital has not attributed any patient safety incidents to the approach, that reports are taken seriously and investigated, and that UVM Medical Center received the union correspondence and will engage with concerns through appropriate channels.
In a statement to Becker’s, the unions said members ranked safe staffing improvements above wages and benefits as the top priority for this round of contract negotiations. The support staff union, which includes LNAs, has been working under an expired contract since mid-August, VTDigger reported. Ms. Mackin said the hospital will continue honoring safe staffing commitments established in partnership with its union and is focused on negotiating a contract that reflects the contributions of technical and support staff.
Ms. Mackin said the practices are connected to broader efficiency efforts, noting that LNAs are capable of more than patient observation. UVM Health Network is working to close a budget gap after state policy changes reduced annual revenue at UVM Medical Center by about $220 million beginning Jan. 1. The system has since eliminated 76 positions, restructured 66 others and suspended employee insurance coverage of GLP-1 medications prescribed for weight loss as part of roughly $300 million in expense reductions over three years.
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