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Employees decry 'culture of fear' at Bartlett

Nurses and doctors say understaffing results in 16-hour shifts

Posted: Friday, April 16, 2010

Many Bartlett Regional Hospital employees live in fear of being demoted, reassigned or fired for speaking out or disagreeing with hospital leaders.

Michael Penn/Juneau Empire
Michael Penn/Juneau Empire

That's what two surgeons, a nurse and a social work case manager communicated to the Assembly at a joint meeting with the Bartlett board of directors and hospital leadership Wednesday night.

Others said they were afraid to speak publicly, but expressed the same view.

Nurses and doctors said due to understaffing, nurses regularly work between 50 to 60 hours per week. Shifts can end up being 16 hours, they said.

Orthopedic spinal surgeon Gordon Bozarth said there is "a great fear of disciplinary action among the nursing staff" and added that the patient/nurse ratio is "highly inappropriate."

General surgeon Allan Schlicht said what he sees is leadership not by inspiration, but by intimidation.

At the Wednesday meeting, hospital CEO Shawn Morrow said personnel satisfaction has been "at the forefront of our minds for a long time." Board members said they have been working to address staff concerns, but change happens slowly.

"In my mind, it's no question it's been the priority," said board member Linda Thomas.

A 'touchpoint'

In testimony, Bozarth, Schlicht, Bartlett Social Work Case Manager Holly Cockerille and Registered Nurse Martha Leak referenced changes in senior leadership as contributing to the problem.

Schlicht called the relationship between staff and leadership "adversarial;" staff members said there was a much more positive atmosphere under longtime hospital CEO Robert Valliant, who passed away recently.

In August, 87 hospital employees signed a letter addressed to Morrow and distributed to the board of directors questioning why former Critical Care Unit manager Janice Gray, a 25-year Bartlett veteran, felt forced to resign, and expressing concern over nursing leadership.

"At present, we are afraid to ask questions or offer ideas for change. We are afraid to voice our thoughts, and fear that any difference of opinion may be seen as confrontational, negative, or trouble-making, and that our jobs may be jeopardized," the letter said.

When questioned by Assembly member Bob Doll about the board's response to the letters of concern, Hospital Board Chairman and emergency physician Nathan Piemann, who was not chairman in August but was present at the meeting by phone, deferred to then-Chair Loren Jones, who was not present at Wednesday's meeting. Piemann said he would follow up with an answer to the question at a later point.

Minutes from the August meeting indicate only that there were "several staff members and physicians present to voice their concerns over a recent termination of a long-term employee" and that "several letters were read regarding their wish for a 'shared governance.'"

Schlicht also wrote a letter of support for Gray, as did Dr. Henry Akiyama and Dr. Melissa Hynes. Hynes' letter was signed by numerous other Bartlett doctors.

"A highly effective, bright, and energetic nurse was essentially forced to resign," Hynes' letter says.

The Critical Care Unit staff also signed a letter to Morrow saying Gray's loss is "devastating" to Bartlett.

Gray, who was not at Wednesday's meeting and is in arbitration with the hospital over her resignation, said she couldn't comment on her situation, but added her situation is just "a touchpoint" in the problem.

"It's a culture," she said. "It's not just one thing."

Other managers are currently being or have been reassigned or demoted, nurses said.

"It has been said by leadership that these are subjective fears," Leak said at the Wednesday meeting. "Whether or not they're subjective, they're real, and many people share them, and unfortunately, it's not being addressed."

"Just because you're paranoid doesn't mean they're not out to get you," said Cockerille, who also spoke about the "undercurrent of fear" at the hospital.

Morrow said hospital administration has instituted quarterly forums and something called "the burning box," in which employees can drop anonymous "burning questions," and other measures to promote openness. They also said they are reorganizing to "clinical microsystems," or small groups of people that work together to provide care.

Board members said personnel satisfaction has been "a top priority."

Hospital staff, however, said leadership's actions aren't in keeping with its language. Bozarth said he is "not seeing or hearing anything I haven't already heard in the past year," and some said staff are afraid to attend the quarterly forums.

Morrow declined to comment publicly after staff testimony and was unavailable for comment Thursday.

Chief Nursing Officer Cathy Carter was unavailable to comment.

Moving forward slowly

Nurses and other staff emphasized that the hospital still offers, as Bozarth put it, "incredible quality of care."

"We'd like to make this hospital our own and be brought in as far as making changes," he said. "We feel like essentially, we're not in the loop."

"We want to provide the very best care for our community, and a healthy workplace is conducive to achieving that goal," said Registered Nurse Susan Thompson.

"Shared governance doesn't come from the top down, and that's a bit of how it's being approached now," Leak said. "Staff needs to be much more involved on a unit level on what's being done."

Hospital board member Kristen Bomengen said the improvement process is "painfully slow."

"We wanted to make sure we got as much information as we could before we made a decision to move in one direction," she said. "The involvement on the part of board members has been very intense. Seeking agreement among a large group of people takes time."

Piemann said the board takes comments "very seriously."

"I think it's important we spend some time reflecting on this and coming back to employees and medical staff," he said, adding that the board has been discussing these issues. "We appreciate what you've brought forward, and we are listening. Thank you."

Bartlett Hospital is owned by the city. Its operations are controlled by its board, which is appointed by the Assembly. The Bartlett board and the Assembly will meet again in about three months.

"We try to hold boards accountable," said Mayor Bruce Botelho. "In this respect, the briefing (Wednesday) night was an exercise of that function."

• Contact reporter Mary Catharine Martin at 523-2276 or maryc.martin@juneauempire.com.



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