County stands by UMC layoffs after heated debate

By Kyle B. Hansen

Tuesday, March 2, 2010 | 4:14 p.m.

Clark County commissioners let their previous decision stand in allowing the layoffs of 16 certified nursing assistants at University Medical Center, but only after what was, at times, a heated discussion with hospital officials.

Commissioners revisited the layoffs Tuesday after approving them in their Feb. 16 meeting. Part of the discussion stemmed from complaints from the employees who will be terminated, some of whom said they found out about the layoffs from TV news reports after the meeting.

Commissioners said they thought the layoffs were part of the hospital’s response to problems that have plagued its emergency room, including a woman who gave birth at home after waiting for hours at the hospital.

Commissioner Chris Giunchigliani said she spent four hours at UMC on Friday talking to employees.

“What came across repeatedly was that it seemed like we were getting rid of a whole bunch of people under the guise of a situation that unfortunately happened in our emergency room and that, with no disrespect to anyone, the lowest on the totem pole were the ones who were blanketly gotten rid of without recognizing that the CNAs absolutely have a duty,” she said during Tuesday’s meeting.

But hospital officials said the decision had been in the works for months and the layoffs would bring the hospital in line with similar institutions that no longer use nursing assistants in emergency rooms.

“The business has changed, the business model has changed and the practice has changed,” hospital CEO Kathy Silver told commissioners.

Silver said UMC queried other hospitals of similar size about their emergency room staffing.

“The answer that came back to us was that they don’t use CNAs in their emergency department,” she said.

To replace the nursing assistants, Silver said the hospital was adding five registered nurse positions to the emergency department and a number of warehouse technicians and patient transporters that will do most of what the CNAs had been doing.

Giunchigliani said she wanted to make sure the hospital had discussions with the doctors, nurses and other staff members before it made the decision.

Silver said the hospital was trying to find other departments where the CNAs could apply, but she said there were only two CNA openings within UMC. However, she said the hospital would try to help the employees find other positions that might match their skills.

Commissioners asked hospital management to report back to the next Board of Trustees meeting on the progress of finding the CNAs positions in other parts of the hospital. The County Commission also serves as the trustees board.

The discussion was heated at times, especially over the recent meeting Giunchigliani had with hospital employees.

The commissioner raised her voice when talking to Silver and UMC chief of staff Dale Carrison, who said Giunchigliani compromised patient safety and used a “four-letter word” to an employee who brought up the layoffs.

Sun columnist Jon Ralston reported that the employee has sought whistleblower protection.

Service Employees International Union president Al Martinez, whose union represents both the nursing assistants and the registered nurses at the hospital, told commissioners that the union opposed the layoffs and would endanger patients in the emergency room.

Union spokeswoman Amber Lopez Lasater said recent problems at the hospital show more staffing is needed, not less.

“This seemed to be the last kind of move the hospital should make in terms of the way they address patient care,” she said.