As BMC, nurses union clash over contract, a look at the patients caught in between

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The fourth time Robert Sawtelle had cancer, he underwent a nine-and-a-half-hour operation.

"They said they got it all," Sawtelle said of the cancer. "But apparently they didn't."

Now, the North Adams resident is scheduled for another surgery at Berkshire Medical Center. But that procedure is set for this week, which coincides with a planned strike by registered nurses at the hospital.

"If the strike is going to affect anything whatsoever, I'll wait," he said last week. "I shouldn't have to. This is something you can't put off. This is cancer."

His wife, Denise Sawtelle, also was nervous.

"My biggest concern is ... is he going to get the same care?" she said. "I'm worried about him. I have every right to."

Nurses represented by the Massachusetts Nurses Association are set to walk off the job at 7 a.m. Tuesday, the culmination of failed contract negotiations between the nurses and management that began in September 2016. The strike will affect three locations: Berkshire Medical Center and the BMC Cancer Center at the Hillcrest campus, both in Pittsfield, and Berkshire Health North in North Adams.

Alex Neary, co-chairwoman of the local union's bargaining committee, previously told the Eagle that she and others felt compelled to strike because they believe the hospital had not been willing in contract negotiations to consider union requests to augment staffing.

The hospital has said it "cannot agree to their unrealistic and unsustainable staffing demands," and the changes sought by the union would not improve care.

While the Massachusetts Nurses Association characterized the strike as a one-day action, the hospital plans to bring in "experienced, qualified" replacement nurses for five days to ensure quality patient care, according to a statement released last month by Berkshire Health Systems, parent company of Berkshire Medical Center.

The nursing agency requires a minimum five-day contract for replacement nurses, according to the statement.

In an email to The Eagle, BHS spokesman Michael Leary declined to comment further on the strike. He said a news conference would be held Monday.

Some of the residents The Eagle stopped in downtown Pittsfield last week to talk about the strike had been following potential strike news more closely than others. But most could agree on two things: they didn't know what was coming, but they knew they didn't want to be admitted to the hospital when it happened.

Unlike Robert Sawtelle, Allison Carlson doesn't have anything scheduled at BMC during the week of the strike.

If she did, she'd reschedule it — unless it was necessary, she said.

While eating lunch at Dottie's Coffee Lounge in Pittsfield, she recalled how nurses at BMC cared for her after the birth of her two children.

"After I had my oldest, the nurses were so good; I sent them flowers after," said Carlson, who has lived in Florida for many years.

Ellen Janis, who was working at her laptop at a table in The Marketplace Cafe on North Street, said her 5 1/2-year-old son was born at the now-defunct North Adams Regional Hospital.

She had a great experience there because of the nurses, she said. "They're kind of the boots on the ground, you know?"

If she had to have a procedure done during the time of the strike, Janis said she'd "definitely" be nervous.

There's legitimate reason to worry about medical care during strikes, said Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology, who has studied the effect of nurses strikes on patients.

"On average, they'll do worse," he said of patients who are admitted to hospitals during strikes. "It's a riskier situation."

He cautioned that it shouldn't be assumed all patients will necessarily receive worse care during a strike — some patients will be unaffected.

Gruber, along with Cornell University Assistant Professor Samuel A. Kleiner, studied the effect of nurses' strikes in New York that occurred between 1984 and 2004 on patient outcomes.

Their publication, "Do Strikes Kill? Evidence from New York State," found that nurses strikes increased in-hospital mortality — defined as patient death within 10 days of admission — by 18.3 percent, and 30-day readmission by 5.7 percent relative to baselines for patients admitted during a strike.

The study examined 50 strikes at 43 hospitals, eight of which had multiple strikes during the studied time period. The median strike length was 19 days.

Results did not vary significantly with differences in patient demographics, disease severity or treatment intensity, according to the study.

In situations like the BMC strike, the state Department of Public Health conducts on-site monitoring to ensure patient safety and quality care, said DPH spokeswoman Ann Scales in an email to The Eagle.

The DPH also works to ensure the hospital has a comprehensive plan to provide care consistent with its license, including appropriate staffing measures, she said.

Denise Sawtelle, who worked at BMC in a non-medical capacity at the time of its famous 69-day strike in 1981, recalled how scared she was just recently when her husband had to go back to the hospital to treat an infection.

"He's in and out all the time," she said. "He's been through a lot."

Nurses can do what they need to do, said Robert Sawtelle, who has served as a Windsor firefighter and worked for Roto-Rooter in Cheshire prior to becoming ill. He just hopes someone will be there to do the job well.

"I just want to know if they're going to be able to take care of me properly," he said.

Reach staff writer Patricia LeBoeuf at 413-496-6247 or @BE_pleboeuf.


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