BROOKSVILLE — On more than 200 occasions since last December, registered nurses at Oak Hill Hospital have worked assigned shifts essentially under protest.
In most cases, the nurses feared that a high patient load would compromise their ability to give proper care.
Nurses cannot refuse an assignment but can document their concerns by filing an official objection form with hospital management. In the last nine months, Oak Hill's registered nurses have filed 209 such forms, said Sheila Carter, a labor representative for Oak Hill's registered nurses union.
The hospital administration's failure to act on those concerns is prompting union members to picket Friday from 7 to 8:30 a.m. on State Road 50 near Oak Hill's entrance, union officials said.
"We have no choice," Carter said. "We basically said, enough is enough."
The so-called informational picket is not a strike, Carter said. The nurses taking part are not leaving their posts.
The picket will be the first organized demonstration at Oak Hill since the nurses voted in December to join the National Nurses Organizing Committee-Florida, the state affiliate of National Nurses United. With some 170,000 members, NNU is the country's largest union and professional association of registered nurses. The Florida affiliate represents about 270 Oak Hill nurses.
Hospital spokesman Rich Linkul did not address the union's concerns in an e-mailed statement to the St. Petersburg Times.
"The Hospital has been bargaining in good faith with NNOC-FL since April of this year over a nurses contract," Linkul said. "As bargaining moves ahead, we will continue to provide uninterrupted, high-quality health care to our patients and the community we serve."
The picket will not cause a disruption to hospital services, Linkul said.
Union officials have met with hospital administrators half a dozen times in recent months as they negotiate a contract, Carter said. Among the union's requests is the creation of a task force of nurses and Oak Hill managers to address the causes of the assignment objections, especially the staffing levels. Hospital officials rejected the task force idea, union officials said.
About 90 percent of the objection forms were filed by nurses worried about what they saw as unsafe nurse-to-patient ratios. Nurses also objected in some cases to "floating" assignments, when they are directed to work in a unit beyond their level of clinical expertise.
The union keeps copies of the objections as potential evidence that could help protect nurses in the event of a liability issue that arises during the shift.
The task force is a constructive way to approach the problem, said Dee-Ann Marsh, a registered nurse in the telemetry unit and the union's chief nurse representative.
"Our concerns have already been aired," Marsh said. "We want a task force to help us reach our goals."
Oak Hill falls short on staffing levels in some instances including in the critical care unit, where professional nursing standards call for a ratio of one nurse to two patients, according to a union press release issued Tuesday. At Oak Hill, the ratio in critical care is one nurse to three patients, the release said.
In a hospital that caters to an elderly community, patients often have a host of health conditions beyond the primary reason that brought them there, said Shawn Kramer, another nurse in the telemetry unit.
"We really need to be taking care of less patients so we can give them the care they need for how sick they are," Kramer said. "Sometimes you can't do that with the way the staffing is now."
Bargaining talks have not turned to financial issues but will soon, Carter said. She declined to comment beyond that.
The picket line that will form Friday is the latest front in National Nurses United's effort to spur Tennessee-based HCA to address concerns about staffing levels in Florida and beyond.
Last month, about 50 nurses picketed Central Florida Regional Hospital in Sanford, holding signs reading, "Central nurses say safe staffing now," and "Patients are our only priority," according to an Orlando Sentinel report. More than 140 assignment objections were filed at the hospital between December and August, the report noted.
Another picket line is planned for later this month at Fawcett Memorial, an HCA hospital in Port Charlotte, Carter said.
In February, about 175 nurses rallied in Tallahassee, asking lawmakers to set specific nurse-patient ratios. A bill that would set ratios based on a patient's condition died in committee.
Nurses have kept up the fight via collective bargaining, encouraged by progress in California, which now has nurse-patient ratios. Oak Hill, Central Florida Regional and Fawcett Memorial are among five Florida HCA hospitals whose registered nurses voted last winter to join the NNU.
The nation's largest health care company, HCA has seen an increase in the number of unionized nurses. More than 5,000 nurses who joined the union last year worked in 13 HCA hospitals in Florida, Missouri, Nevada, and Texas.
The company has about 164 hospitals and 106 freestanding surgery centers in 20 states and Great Britain, employing roughly 183,000 people, according to the company's website.
Marsh, who has worked at Oak Hill for about five years, said nurses there have had concerns for a while now.
"Because we organized," she said, "we made a stand to do something about it."
Tony Marrero can be reached at (352) 848-1431 or firstname.lastname@example.org.