Nurses at Saint Joseph's and Saint Mary's hospitals protest over unsafe staffing shortages

Nurses at Tucson’s Saint Joseph’s and Saint Mary’s hospitals say patients are facing unsafe care because too few registered nurses are available to handle the number and acuity of people in the hospitals. About 80 nurses and supporters gathered outside Saint Joseph’s Hospital, 350 N. Wilmot Road, for a protest organized by the National Nurses Organizing Committee, while nurses at Saint Mary’s planned a separate patient safety rally. The demonstrations put local concerns about staffing, patient outcomes and hospital management into the broader context of Arizona’s severe nursing shortage.

At Saint Mary’s, telemetry nurse Jaclyn Steinke said her unit is intended to operate with one nurse caring for four patients, but nurses are sometimes assigned six. Mellissa Fatula, a nurse in the medical-surgical unit who has worked at Saint Mary’s for seven years, said assignments there have reached seven patients, even though four is considered the appropriate maximum under best practices. At Saint Joseph’s, nurse Todd Herres described a similar problem, saying the hospital does not have enough nurses for its patient load.

Nurses told reporters that excessive assignments can delay care and increase risks on already busy hospital floors. Herres said staff members are seeing more patient falls, delays in administering medications, including medications needed to save lives, and patients remaining outside intensive care even when their condition suggests they should be there. Nurses have also raised concerns about poor patient outcomes and higher mortality associated with heavier nurse workloads. A union statement cited research involving more than 11,000 patients at 75 hospitals in four states, which found that lower patient-to-nurse ratios and better work environments were linked to stronger survival rates after in-hospital cardiac arrest. Another study cited by the union found that the risk of death rose 7 percent for every additional patient added to a nurse’s average workload.

The staffing dispute has been developing for months. Nurses represented by NNOC and National Nurses United have been negotiating with Carondelet Health Network, which owns both Tucson hospitals and is part of Tenet Healthcare, a for-profit corporation based in Texas. In December, Saint Mary’s nurses approached management about ratios they considered unsafe. They later submitted dozens of Assignment Despite Objection forms, documenting patient assignments they believed could not be handled safely. Nurses said management has not agreed to changes they consider necessary, including hiring more registered nurses and assigning a rapid-response RN to every shift.

The union also says management has retaliated against nurses who speak up for patients and coworkers. Last week, Saint Mary’s ended the employment of Dominique Hamilton, an intensive care nurse who had worked there for eight years and was known by colleagues as a patient advocate. Nurses called for her immediate reinstatement and described the termination as unjust. Richard Dooley, a registered nurse who has worked in Saint Mary’s cardiac unit for 11 years, said nurses have had difficulty communicating with administrators and claimed they were even prevented from going to management offices. Julia Marques, a nurse in the medical-surgical acute unit, said nurses believe they must use their collective voice to press for the care patients deserve.

The protest comes as Arizona and hospitals nationwide confront a shortage of nurses. The American Association of Colleges of Nursing estimates that more than 267,000 additional nurses will be needed in hospitals across the country by 2028, despite the nation having more than 5 million registered nurses. The National Center for Health Workforce Analysis projects that Arizona will need 28,000 nurses by 2030, placing the state among those with the most serious shortages. Herres said insufficient hiring has helped drive the crisis in both Carondelet hospitals. Fatula offered a different emphasis, saying nurses are available in the community but are increasingly unwilling to work under conditions that produce extreme compassion fatigue.

Nurses have also connected staffing concerns to workplace protections during the coronavirus pandemic. Fatula said staff members wanted assurances that shortages of personal protective equipment, such as those experienced during earlier surges, would not return as another increase in cases developed. National Nurses United criticized the federal Occupational Safety and Health Administration for not establishing permanent standards for health care workers during the pandemic. Fatula said an emergency temporary order issued in June was at risk of expiring. More than 1,200 Arizona health care professionals also signed a letter urging Gov. Doug Ducey, the Arizona Department of Health Services and other health care leaders to provide more support to hospitals and workers as the omicron variant spread.

The union announced that Saint Mary’s nurses would hold a patient safety rally on Friday, Feb. 27, from 8:15 to 10 a.m. in front of the hospital at 1601 W. St. Mary’s Hospital Road. Nurses said participants would come from off-duty hours or after night shifts, rather than abandoning active patient assignments. Their stated goal is to pressure Carondelet to address staffing levels, protect nurses who report safety concerns and improve conditions across hospital units. NNOC represents 300 registered nurses at Saint Mary’s, while National Nurses United reports more than 225,000 members nationwide.

Carondelet said both hospitals would remain open and fully operational during the demonstrations, with emergency departments continuing to serve patients. In statements, the network said patient care would not be interrupted and called the union’s protest approach unnecessary and unconstructive. Management said negotiations had made progress and that it would continue bargaining in good faith. The network also described its response as based on solutions to a national and local nursing shortage. Nurses, however, say the shortage has created an avoidable crisis at the bedside and are asking hospital ownership to resolve it through staffing improvements rather than leaving individual nurses to absorb the consequences.