I have seen a disturbing trend of late. Quietly, medical and nursing facilities have been laying off staff in higher numbers. Not just housekeepers and janitors either; but nurses and CNA’s. In my state, a couple weeks ago a highly rated hospital closed down a unit and laid off 23 nurses and aides. Another facility was going to trim down a nursing unit by 15 beds, and would have laid off about 20 LNA’s and several nurses; the facility changed it’s mind on this, for now.

What’s going on? Did we ever think CNA jobs would be targeted for lay offs? Times are getting tough.

Cape Cod Hospital has notified an employees’ union it intends to eliminate about 17 full-time positions, including jobs held by cleaning staff, shuttle bus drivers, nursing assistants and food service workers.

The hospital is looking to save $800,000 through a combination of layoffs and not filling currently vacant positions, said David Reilly, spokesman for Cape Cod Healthcare Inc., the parent company of Cape Cod and Falmouth hospitals.

The job loss affects only Cape Cod Hospital, which is feeling the brunt of a multimillion-dollar revenue decline.

The 16.9 positions are “full-time equivalents,” meaning each is the equivalent of a 40-hour-a-week job. But the job loss could actually affect more than 17 individuals, since several of the jobs are shared by part-timers.

Revenue is the income a facility receives to pay for it’s operating costs. Much of this money comes from the federal government and state government, as well as from insurance payments. But, because these sources are not increasing their rates of reimbursement to the facilities, we have a shortfall.

Don’t assume belonging to a union will save CNA jobs:

‘The entire health system is feeling the pressure,” said Jerry Fishbein, vice president of 1199 SEIU, United Healthcare Workers East, whose union represents the workers whose jobs will be eliminated.

As required by collective bargaining stipulations, the hospital gave the SEIU a “30-day notice” of its intent to lay off the employees.

The next step is for the union to meet with hospital officials to see if they can whittle down the list, said Fishbein, whose union has 1,200 members at Cape Cod Hospital. “At the end of the day, there will undoubtedly be some layoffs. We certainly think the numbers should come down. It’s process of negotiation.”

This process might save one job, or position. It’s not comforting to know this process, negotiation, is all the unions can offer us when we face a job loss.

Last month, Cape Cod Healthcare CEO Steve Abbott announced that the organization had suffered a $17.6 million revenue loss in seven months.

The company responded by laying off 11 employees, mainly in mid-management and clerical positions, requiring a dozen senior executives to take a 10 percent pay cut and asking employees to consider early retirement.

The cut backs weren’t enough. So now they take it to the next level.

“Cutting back on the nursing assistants is a big problem for us,” said Stephanie Francis of the Massachusetts Nurses Association.

The two nursing assistant jobs scheduled to be eliminated could require nurses to pick up the slack and spread themselves thinner among patients, she said. Such a move would be in direct opposition to the Patient Safety Act being proposed on Beacon Hill, which requires a certain ratio of nurses to patients, Francis said.

Well usually the nurses whine when it’s THEIR job on the line; they complain when they are replaced with the less skilled, lower educated unlicensed assistive personnel (as we’re known as); they cite patient care problems when there are more of US then them. Since UAP don’t fall under Nurse s scope of practice rules, this claim is disingenuous at best. BUT, at least she’s sticking up for the aides in this case.

Abbott, who is retiring this summer, has blamed some of the hospital’s financial woes on the rise of off-site, privately run surgical centers and on an independent physician association, Physicians of Cape Cod, that he says is making fewer referrals to Cape Cod and Falmouth hospitals and their affiliated laboratories and services.

By sending patients to private organizations for procedures that receive lucrative reimbursements, the physicians in the I.P.A. are forcing the nonprofit hospitals to absorb more and more of the cost of serving the community, Abbott said.

More disingenuous stuff here. First off, remember this is Cape Cod. Kennedy country. John Kerry country. Where the rich live and house up for the summers. These people will not utilize the services of a public hospital no matter what. Cape Cod is full of private facilities that offer services at far cheaper rates than the public hospitals, believe it or not. Private sector doesn’t always mean more costs. The people who reside in this area do have a right to pick and chose where they will receive their health care, surgeries and the like. I do know these private facilities offer jobs to nurses and CNA’s and pay them better.

Do we take away this choice in the name of saving jobs? I think not.

What is certain is times are changing. More and more medical and nursing facilities are going to be forced to make cutbacks; this will result in patient care being put in jeopardy in many situations. I would expect to read more and more similar articles in the next decade or so, too. The trend is only just beginning. Brace yourselves.