The "last, best and final offer," hospital officials said, was a necessary money-saving measure in difficult times; it was uniformly opposed by the nurses union and called "unfair, unnecessary" and disrespectful by a nurse who addressed the board.
The motion to approve the contract carried with a 3-2 vote. Board members Patricia A. Einarson and Uwe R. Kladde opposed the motion, while Wesley F. Alles, David Reeder and John L. Zoglin voted in favor.
Upon passage of the motion, a murmur of discontent rippled through the crowd of about 50 nurses who had gathered to demonstrate the union's opposition to the offer.
"It's a joke," one nurse said to colleagues as she walked out of the meeting room. Nurses are unhappy with changes to their benefits package and say that the compensation structure outlined in the new contract is inadequate.
During the meeting, many nurses whispered disapproval and made incredulous expressions as hospital administrators explained why they felt the changes and cuts were needed.
Ken Graham, CEO of El Camino, said that lower reimbursement rates due to healthcare reform and falling patient volumes due to the recession forced the hospital to make the cuts. He stood by his recommendation that board approve the new contract. "We do not believe this will be perceived as anything but responsible by the community," Graham said.
Charlene Glinieki, a registered nurse and chief people officer for the hospital, said she sympathizes with the views of the union, but agreed with Graham.
"Obviously we would prefer not to need to implement these changes," Glinieki said. However, she added, in order to meet the financial challenges the hospital is facing, "these changes are necessary."
Pat Briggs, president of the hospital's nurses union, Professional Resource for Nurses, told the board that she feels that a better contract could be drafted, if only the hospital would give the nurses bargaining unit more time.
"We want one more chance to go back to the table and reach an agreement," Briggs told the board, noting that she and other nurses understand the tight financial situation the hospital is facing.
Of the 15 items that were altered or cut in the new contract, Briggs said PRN members could live with most. There were four major points of contention, however.
Previously, nurses accrued paid time off while they were taking time off — on vacation, sick leave or while attending conferences or classes for their required continuing education, for example. Under the new contract, nurses will no longer accrue time off when they aren't working. "That is a major cut in our benefits," Briggs said.
The second sticking point had to do with retirement benefits. The hospital used to contribute more to the retirement accounts of veteran employees. Those who had been with the hospital between 15 and 19 years were matched with 5 percent of their contributions. Those who worked more than 20 years at El Camino were matched with 6 percent. Now, the hospital will only match 4 percent of the nurses' contributions.
Third, Briggs said, nurses who regularly worked evening and night shifts earned a better rate for their paid time off. It was a motivator, which encouraged nurses to take the unpopular shifts. With that incentive gone in the new contract nurses may be less eager to take those shifts, Briggs said, which could adversely impact the stability of staffing those shifts.
The final issue, according to Briggs, is that the hospital is stalling on giving the nurses a wage increase until September 2011. Furthermore, the wage increase, when it comes, will only be 3.5 percent — low compared to other health care institutions in the area, Briggs said. The last time nurses saw a wage increase was in 2009. She said that nurses' wages have been "stagnant" for the past 30 years, barely keeping up with inflation and cost of living increases.
"It's just too much," Briggs said of the cuts and changes to the contract.
"I would disagree," said Chris Ernst, a spokeswoman for El Camino. "We are all taking the same cuts the nurses are taking."
No hospital employees will be seeing salary increases and no one will earn paid time off while taking time off anymore, Ernst said. She also noted that while all the nurses who wished to continue working at the hospital were able to stay, some in administrative positions lost their jobs.
Over the summer El Camino Hospital announced that it would have to lay off 140 employees, including support staff, nurses and administrators, in order to deal with falling revenues. The majority of support staff and nurses jobs were saved, however, after union negotiations shuffled employees around to different positions within the hospital.
The hospital implemented a multitude of cost-saving measures to non-labor-related expenses before making cuts to compensation and benefits packages, which were a last resort Ernst said. Cuts to labor, compensation and benefits throughout the hospital are projected to save the organization more than $10 million — about 14 percent of the $70 million the hospital aims to save through its Accelerating Continuous Excellence, or ACE, program.
Ernst did not how much of that $10 million would be saved by the changes made to the nurses' contract.
Before taking a vote, board members voiced their opinions on the dispute. Both Einarson and Kladde indicated that they saw no reason why the hospital could not continue discussions with PRN, which triggered applause.
"We hear you," board member Reeder said, addressing the nurse. "None of us want to be where we are today."
He said that the hospital had experienced a long streak of financial stability, but said that things have changed and that the cuts to the contract were necessary. "We are in a recession that just isn't going away."
Board member Alles brought up the recent fervor over what some have said are unreasonably high salaries, benefits and pensions drawn by police and fire fighters. Alles acknowledged that, like police and firefighters, nurses work to save lives. However, he said, as a community hospital, funded in part by the tax payers, El Camino has an obligation to ensure that it compensates nurses at a sustainable level.
"I think the contract that is being proposed is competitive," Alles said.
"It is a specious argument and criticism in general," Briggs said, responding to Alles. "It is a particularly egregious argument in relation to the nurses at El Camino Hospital."
Nonetheless, whether Alles' point is valid, Briggs said she is worried that the imposition of a contract most nurses feel is unfair would adversely affect the work life, and subsequently the productivity, of El Camino nurses.
"The nurses are extremely unhappy," she said. "Morale is extremely low."