How clean was the hospital when you were there? How well did nurses and doctors explain things to you? When answering these questions, people in New Mexico ranked state facilities poorly, according to federal survey data that was just released. Local union members say that’s because hospitals like the one in Santa Fe run on staffs that are too small in order to pinch pennies.
Diane Spencer worked at Christus St. Vincent Regional Medical Center for 18 years on the medical/surgical unit before she was fired last week. "I love hospital nursing," she said. "I love the challenge."
She said she knew she might become a target when she started criticizing the hospital. Coworkers warned her. But she felt an obligation to patients. "Nurses go into nursing because we care about people. It’s very hard to see this happen when caring is your main focus."
Spencer has said that staffing levels at the hospital are set by accountants—not medical professionals. She’s testified as an expert witness for the state Legislature for the last three years about how running health care workers ragged negatively affects patients.
"For nurses, we’re not able to give pain medicines in a timely fashion," Spencer said. "We’re able to ambulate the patients to prevent blood clots in their legs or blood clots in their lungs or pressure sores. People do not get fed as they should. They don’t get toileted as often as they should. All of those things are very important when people are trying to get healthy."
She said being short-staffed increases the chances of what’s called ‘failure to rescue.’
"If you are not with a patient frequently enough, you do not see the early signs of a patient deteriorating," she explained. "If you don’t see those and catch them early, then the patient gets a whole lot sicker than they should have."
It was a gray, drizzly day in New Mexico’s Capitol, and Spencer stood at the back of the crowd that gathered for a news conference in front of Santa Fe’s City Hall. She listened to Shane Youtz, lawyer for the local chapter of the hospital and health care workers union, tell the press Spencer just lost her job.
"Diane received extremely good evaluations for most of the tenure she had at the hospital," he said. "In 2012, Diane decided she was done supporting the hospital on its staffing situation and had the courage to speak out."
But after Spencer started testifying, her evaluations got worse, and she was disciplined for minor issues, Youtz said. She was referred to the Employee Assistance Program where a counselor told her, " ‘If you want to continue working for the hospital, you ought to stop testifying at the Legislature,’ " Youtz said. "It was a bit prophetic."
Spencer was eventually fired over a trivial matter, but Youtz won’t divulge details. The union has filed a complaint with the National Labor Relations Board, saying the termination was retaliatory.
Staffing has been a problem for years, according to Delma Delora, a nurse and patient advocate in sports medicine at Christus St. Vincent.
"We were hoping after our negotiations that we’d have better staffing," Delora said, "that things were going to be better, but no."
In October, the union and hospital agreed to a contract that required Christus St. Vincent to hit certain staff levels. To date, the hospital has not been holding up its end of the deal on a consistent basis and has had to pay fines into the Nurse Education Fund.
Delora said having a good health care worker-to-patient ratio is an issue around New Mexico. "I would love to see it in the whole state of New Mexico, that this be taken serious," Delora said. "And that we be able to sit down, put together a plan to really work at trying to improve the situation—seriously. Not just because we have to sign a contract."
Hospital officials would not agree to be interviewed but said in a statement that, according to data from the state’s Hospital Association, the medical/surgical staffing levels are higher at Christus St. Vincent than at most large facilities in the state. And that staffing is only one factor in patient satisfaction.
The hospital wouldn't respond to questions about personnel matters or Nurse Spencer, which is standard, but added that there are policies to prevent discrimination against union members.
And Spencer? Her eyes filled with tears when she was asked whether patients should be going to Christus St. Vincent. She paused. "I don't want to comment on that," she said.
She just wants her job back.
Find out more about the ongoing controversy at Christus St. Vincent—and read the full response from the hospital—at publichealthnm.org. KUNM’s Public Health New Mexico project is funded by the W.K. Kellogg Foundation.
EDITOR'S NOTE: An early broadcast version of this story incorrectly attributed the hospital's comments to spokesperson Arturo Delgado.