Inside a pending strike: What RWJBH is doing to prevent — and prepare for — a work stoppage

While working to avert strike, RWJBH is spending multimillions to ensure temporary nursing staff of 700 is ready to go should workers go out on Friday

John Doll. (RWJBarnabas Health)

John Doll, the chief operating officer at RWJBarnabas Health, repeatedly makes it clear: The health system is doing whatever it can to avoid a strike by the nursing staff at Robert Wood Johnson University Hospital in New Brunswick — a strike that has been called for Friday morning.

“I’m really disappointed we are at this point,” Doll told ROI-NJ. “We really have tried everything to avoid the workers going out. And we’re continuing to do so. But we need to be realistic around making sure patient care is not interrupted.”

Those efforts have been going on for a month, Doll said.

The health system, in anticipation of a work stoppage, began working on July 1 with U.S. Nursing, a national organization that helps hospitals back-fill nursing roles. RWJBH worked with the group during a strike in 2006, Doll said, so there is familiarity.

That doesn’t make the logistics of the process any easier.

The hospital needs to replace the full-time nurses who would be striking (approximately 700 — or approximately half the nursing staff at the hospital, which also includes part-time staff and managers that are not part of the strike group).

Those 700 workers need to be brought to the area, often by flights from around the country, put up in hotels, provided meals and transport and — most of all — trained.

Doll pointed out the temporary nurses not only will need proper uniforms and name tags, but also training on the computer system they will be using.

This is where RWJBH caught a break. RWJBH is in the middle of a lengthy information technology upgrade training for the entire system — meaning it has been using an off-site location for training for months. The temporary nursing staff will begin training there.

“We’ve got trainers and training space to get the temporary workforce up on our system,” Doll said. “That includes clinical devices, like IV pumps, as well as documentation on our computer system. They’re actually starting Tuesday in advance of the impending work stoppage. They will have a couple of days of training to get settled — so, on that first change, they’re able to hit the ground running.”

With assistance.

Doll said the hospital will make sure IT specialists are there to help the temporary nurses should they have computer issues. There also will be nursing managers present from other locations in the system to help guide the new crew.

Of course, all of this comes at a cost. A huge cost.

Doll said the system already has committed $17.8 million in strike preparedness — some of which is no longer refundable. That nonrefundable number grows each day.

“Think about all the upfront costs for flights and hotels and training,” Doll said. “We can’t get that back.”

Should a strike occur, Doll said the costs break down like this:

  • $17.8 million for the first 7-9 days;
  • $10 million of incremental cost for the next week;
  • $4 million a week after that (as most of the upfront costs will be gone).

All of this begs a question: If the hospital is willing to put so much money into strike preparations, why not just use that money for the nurses?

“That’s a reasonable question,” Doll said. “First, strike investment is a one-time cost, the increase they’re looking for is forever — so, they’re baking into rates for multiple years into the future.

“We’re also worried about the impact on the rest of our health system. We have 12 hospitals, and we want to be paying our nurses at the top of the market wage, and the nurses at Robert Wood are already there before any contract change, based on every bit of publicly available information.

“If we make an investment above and beyond what we put on the table, we’re worried about how it builds in structural costs into the future, not just at this hospital, but the impact on other hospitals.”

Then there’s this: Doll said it’s unclear what the nurses want.

In Doll’s mind, the hospital met the demands of the nurses, reached an agreement that was blessed by the nursing union’s top leaders, only to see it rejected by the rank-and-file.

“I’ll emphasize the point: There’s no guarantee that any amount of money would work, because we have a deal that the union leadership blessed — and we still don’t have a written response of what they want,” he said. “So, throwing money at it is really like throwing water at a sponge.”

What can be done?

For starters, keep talking. Doll said both sides are meeting again Monday afternoon.

In addition, keep all the employees at RWJUH updated on what’s going on.

“This is stressful for everybody, including the non-strike workforce,” Doll said. “I don’t know that there’s a perfect way to deal with this. Our philosophy is to try to keep the lines of communication open.”

Doll said the executives at the hospital have been running twice daily townhalls, which often draw hundreds of employees with questions. They also have made sure everyone is aware of the system’s behavioral health service line, so team members have a place to go if they need to talk.

“I think the No. 1 thing we’re doing is being present as leaders and trying to communicate openly,” he said.

Doll said the goal is to ensure the safety and well-being of everyone: patients, workers, even the potential strikers.

Since the hospital is near a large construction area, Doll said the hospital also is working with local police and officials to ensure there will be a safe place to demonstrate, should a strike occur.

He hopes that day doesn’t happen.

“We are doing everything that we can to avoid it,” he said.

While making sure the hospital is prepared, if it does.