California authorities are investigating the death of a patient at an Oakland hospital that police and hospital and union officials said resulted from a medication error made during a labor dispute between nurses and the health system that runs the hospital.
Police and officials at Alta Bates Summit Medical Center told the local media the woman died after she received an incorrect dose of medication administered by a replacement nurse. At the time, regular staff nurses employed by Sutter Health System were locked out following a one-day strike by 23,000 nurses across the state.
The California Nurses Association, the state nurses' union, blamed the woman's death on the lockout. After Thursday's strike, the association said, nurses at Alta Bates Summit Medical Center tried to return to work Friday, but hospital officials turned them away.
The union called the lockout "dangerous" and questioned whether the nurses hired as replacements were clinically qualified to care for the patients.
"Nurses are in the hospital caring for our patients who don't have the proper training, who aren't familiar with our equipment, and there's been a tragic death," said one nurse who participated in a Sunday vigil outside the hospital. A video showing highlights of the vigil is posted on the union's web page.
The hospital, however, said the fill-in nurses were all highly competent and experienced.
"Every single one of the nurses is an experienced nurse that has been working in the areas to which they are assigned," Dr. Steve O'Brien, the hospital's vice president of medical affairs told local media. "We did not skimp on any of the nurses."
The hospital explained that it was contractually obligated to hire replacement nurses for a certain number of days, which was the reason for the lockout. Staff nurses can return to work Tuesday.
The union said it's fighting against Sutter Health System's demand for 200 contract concessions that the union said would undermine patient safety.
Ethicists not associated with either the hospital or the nurses who waged the labor dispute say this type of situation indicates serious problems within the health care system.
"We do not want to have labor disputes where health care professionals are involved," said Kenneth W. Goodman, director of the Bioethics Program at the University of Miami and professor of medicine at Miami's Miller School of Medicine. "It's a sign that our processes for providing adequate compensation have failed, and if we're seriously committed to patient-centered care, we need to make sure this kind of thing doesn't happen."
The union said it's fighting Sutter Health System's demand for 200 contract concessions that the union said would undermine patient safety.
The American Nurses Association, the professional organization representing nurses across the country, obligates nurses through its Code of Ethics to advocate for change on behalf of patients. In order to meet that goal, the association does permit nurses to strike.
"Bedside nurses may be the only ones who see the dangers, injustices and recurrent issues associated with short-staffing, problems getting resources, and the administration's focus on cost concerns sometimes at the expense of patient 'good,'" said Pamela Grace, associate professor of nursing and ethics at Boston College's Connell School of Nursing.
But she added that nurses must also ensure that patients are safe during a strike by providing advanced warning of their action and by minimizing suffering.
Regardless of the reasons for a strike or a lockout, experts stress patient care should be the only priority for both sides.
"Nurses and administrators should take no actions, no matter how financially compelling, that could harm patients," said Robert Field, a professor of law at Drexel University in Philadelphia. "There is no question that the hospital is responsible for insuring that all of them are capable of giving competent care."