Could the new support staff union improve the staffing shortage at UVM Medical Center?

Throughout the pandemic, the University of Vermont Medical Center has faced a persistent issue that impacts everyone who interacts with the hospital: staffing shortages.

There are days when 32 patients only have one Licensed Nursing Assistant (LNA) to assist them, when they should have three or four LNA's, according to UVMMC Staffing Office Specialist Jacob Berkowitz. This leads to patient care being more rushed and lower quality, because staff are overextended and burnt out, said LNA Jordan Bushway.

"If 30 patients are supposed to count on one LNA for helping with walking, for helping with getting them drinks when they can't get them themselves, or monitoring them, making sure that their vital signs are okay, helping them breastfeed," Bushway said."That's not going to make their experience the way it should be."

The hospital has been severely short on staff throughout the pandemic, and some staff say it's affecting their ability to care for patients. A new staff union wants the hospital to spend less on six-digit executive salaries and instead increase the five-digit salaries of staff as a way to attract new staff and increase retention of experienced staff. But hospital President and Chief Operating Officer Dr. Stephen Leffler says that such a redistribution of wealth isn't a good idea, and staff pay is just one of several factors impacting retention.

More than 1,000 job openings

At one point during the pandemic, the hospital had over 1,000 job openings, and now has about 750, according to Leffler.

"Through the pandemic, hospitals across the country had staffing shortages,” Leffler said. “We were not immune to that at the medical center.”

One cause of the staffing shortage is that employees in a variety of positions have been quitting the hospital, Leffler said.

"We're working extremely hard right now to improve retention of the staff that we have, and including to bring in new positions," he said.

Due to low staff retention, new staff keep having to be trained, so patients are being cared for by less experienced staff, Bushway said.

The hospital's 2,000 support staff are aiming to increase retention by bargaining with the administration for improved wages, benefits, and working conditions through their newly-formed union. UVMMC Support Staff United was established through election on Jan. 27, with support staff voting 997-163 in favor of the union and technical staff voting 123-18 in favor.

This was Vermont's largest private-sector union election, according to the American Federation of Teachers Vermont, which now represents the support staff through the Vermont Federation of Nurses and Health Professionals.

"Throughout this process, The University of Vermont Medical Center has focused on ensuring all support and technical staff had an opportunity to have their voices heard," Leffler said. "We believe the election administered on-site by the National Labor Relations Board met that goal, and expect to be in contact with the union soon to begin negotiating in good faith a collective bargaining agreement."

Efforts to plug the 'sieve' of support staff leaving

If you've ever been a patient at UVMMC, there's a fair chance that you had your vital signs checked, body bathed, or call light answered by an LNA making less per hour than a South Burlington McDonald's hostess.

Bushway has been working as an LNA in the hospital's Mother-Baby Unit since 2016, and can't catch a break — literally. She said that over the past several months, she has regularly been the only LNA on her floor of about 30 patients, and often doesn't have time for a lunch break.

"What we want to do here is make a difference and improve people's lives," Bushway said. "We can't do that if we don't have the staff. And we can't do that if our staff that we do have is so burnt out that they can they can't even take a 30 minute lunch break."

Bushway isn't alone. According to data obtained from Berkowitz, the hospital's in-patient units have recently been in need of up to 19 more LNA's than they currently have on duty. The following table lists the number of LNA's the hospital was in need of but didn't have for one week in February, according to Berkowtiz's numbers:

"There isn't a day that goes by when we're not severely short on support staff," Berkowitz said.

The staffing issues are partly caused by low staff retention rates, which has led to a workforce that is overall less experienced in patient care, Berkowitz said.

To increase retention, a priority of the union is to increase the support staff's minimum wage to $20 an hour, which the union believes is the minimum livable wage in Vermont.

"The hospital has been like a sieve for support staff leaving over the last couple years," Berkowitz said. "Nobody's going to want to work during a staffing crisis post-pandemic in a hospital that is paying important support staff positions less than you could make working at a restaurant."

Staff pay is one component among many that impacts retention, Leffler said. Employees leave for reasons including career path changes, shifting to part-time work, having a baby, traveling, and retiring, in addition to pay.

"We've lost people for every reason you can imagine,” he said. “It's not always only just about wages. That's one part of it, but there's many, many reasons people leave.”

The hospital's careers website lists starting pay for support staff as low as $16.63 per hour for environmental services workers, who clean the hospital; $17.34 per hour for labor and delivery assistants, who work under nurses in the Birthing Center; and $15.93 per hour for unit secretaries, who, as stated in their job description, serve as a "pivotal communication link" for the health care team.

"We're the backbone of the hospital," Berkowitz said. "Without us, the work that nobody else wants to do doesn't get done."

Redistribution of the wealth?

Patient Service Specialist Maria Levesque said the hospital call center where she works has lost two employees over the past six months, causing call wait times to increase to 30 minutes on some days. Levesque said the pay and working conditions were major reasons for why her coworkers quit. The starting wage for a call center representative is $15.61 per hour.

"The wait times are so long that patients are angered," Levesque said.

Levesque said she is living paycheck to paycheck, struggling to afford food and rent. She said the hospital could afford to pay support staff more because it pays its executives so well.

"Where the money is currently allocated, we'd like to negotiate with administration for a more fair division of funds," Levesque said.

According to UVMMC's most recent Internal Revenue Service Form 990, the hospital's 26 highest-ranking executives each made over a third of a million dollars, including bonuses, for October 2020 through September 2021. The total annual compensation of these 26 executives adds up to $13,441,759.

Leffler, who made $673,173 plus $51,113 in bonuses for 2020-2021, doesn't think a redistribution of the hospital's wealth is a good idea.

“The Medical Center and the Network has a pay philosophy to try to pay every single person who works here, from entry-level positions to our highest paid positions, a competitive salary," Leffler said. "Having a certain limit or cut off where we would no longer pay competitive wages isn't a good plan. It's hard to enact."

Levesque said the hospital's 2,000 support staff are not receiving competitive salaries.

"We're talking the people that wash your loved ones and change their bed pans. We're talking about people who tirelessly are constantly cleaning up and keeping the hospital sanitized," Levesque said, "people that are taking care of you."

Contact April Fisher at amfisher@freepressmedia.com. Follow her on Twitter: @AMFisherMedia