‘It just doesn’t seem right.’ Atrium Health reduces nurses’ hours amid coronavirus crisis

At a recent Mecklenburg County commissioners meeting, Atrium Health CEO Gene Woods praised healthcare workers for answering the call during the coronavirus crisis.

But at Atrium — the biggest medical provider in the Charlotte region — some nurses have seen their pay reduced despite the risk of becoming infected with the highly contagious disease while treating sick patients.

Some nurses at Atrium said they are frustrated because they have been left with two bad options: take reductions in their hours and pay to stay in their unit, or work directly with COVID-19 patients without hazard pay and sufficient personal protective equipment.

Hospitals nationwide, including Atrium, have canceled non-emergency procedures and treatments to make room for new coronavirus patients, costing them millions of dollars. Many hospitals have furloughed employees or cut workers’ pay, saying they need to save money.

Atrium is reducing work hours for nurses and asking them to work in units outside their specialty or take paid-time off to keep full pay, six nurses, doctors and medical staff told the Observer.

Dennis Taylor, president of the North Carolina Nurses Association, said that his organization had received complaints statewide about changes to hours and assignments as well as the lack of protective equipment.

“There’s been a lot of fear, mostly about transmitting the virus to family members,” he said. “None of us want to work in an environment where we’re taking something like this home.”

Woods told Mecklenburg County commissioners at a recent meeting that the hospital system was still seeking personal protective equipment and ventilators to meet the anticipated demand.

Atrium refused to make executives available for an interview. The hospital system did not answer written questions submitted by the Observer.

In a written statement, Atrium said employees have received enhanced childcare benefits and assistance with food and lodging.

Atrium said it has offered choices to workers willing to take alternative assignments. Atrium has also set up a relief fund for employees facing financial problems caused by coronavirus.

“Above all, the safety and well-being of our teammates and health of our patients remain our highest priorities, and we are guided daily by our mission to improve health, elevate hope, and advance healing for all,” Atrium said.

Patient advocates and North Carolina’s leading nursing group warn the actions taken by Atrium and other hospital systems could negatively impact patient care.

Reducing nurses’ work hours can leave hospitals with insufficient staffing to care for patients with heart attacks, strokes and other emergencies that are not related to coronavirus, they said.

Nursing has become increasingly specialized and nurses may lack the experience needed to perform well in a hospital unit outside their area of expertise, Taylor said.

“If you treat us right, we’ll go to the ends of the earth for our patients and our employers,” Taylor said. “We’re just asking that people be treated fairly.”

Nurses betrayed?

Six medical employees who work for Atrium told the Observer they were unhappy about how Atrium had treated some nurses.

They requested anonymity because they said they feared losing their jobs for speaking out publicly.

The nurses said they felt betrayed because nurses have been asked to take a financial loss while facing the chance of becoming infected and transmitting coronavirus to their families.

A Mecklenburg County report underscores their health concerns.

The report, updated in February, says as many as 35% of health care workers would likely become ill during a severe pandemic.

As Atrium and other hospitals have canceled elective procedures, industry researchers say the number of patients has dwindled. The peak of coronavirus cases may not arrive in the Charlotte area until June, officials say.

Nurses are usually scheduled to work 12-hour shifts, but when patient volume is down, they are put on-call for that day’s shift. That means they will be asked to work only if there is a sudden surge in patients.

Registered nurses in North Carolina typically make about $31 an hour, according to nursingprocess.org, but nurses can receive as little as $2 an hour while on-call.

Nurses and other employees at Atrium said that in order to receive their full paycheck for the week, they have been instructed to either take paid-time off or float to another unit. One employee said that she decided to rely on her savings during a week when she was called off, rather than work in a unit where she was not familiar with protocol and might be exposed to COVID-19.

Atrium, which is based in Charlotte, has more than 40 hospitals and 900 care facilities ranging from doctors’ offices to behavioral health centers, mostly in the Carolinas.

Atrium did not say how many of its roughly 17,000 nurses were affected by cutbacks.

Novant Health — the region’s second biggest medical system — also has canceled elective procedures and non-emergency treatment in anticipation of more coronavirus patients.

In a written statement, Novant said that it has not furloughed workers and has no plans for layoffs for now. The statement did not say whether Novant had reduced nurses’ work hours, but said nurses were among those assigned to do work in different areas of the organization.

Novant has contributed $10 million to a relief fund to help employees with rent, groceries and other needs, the statement said.

Anthony Wright, executive director of Health Access California, a consumer advocacy coalition, said it is true that some hospitals are facing serious financial trouble caused by the coronavirus and must cut costs.

Others are in a strong position to withstand revenue declines and ensure they are adequately staffed, Wright said.

As part of a plan to prepare for a surge in coronavirus cases, Woods has said Atrium lost “multi-millions” when it decided to cancel all elective surgeries and non-emergency procedures.

But Atrium had more than $4.6 billion in unrestricted cash and investments at the beginning of 2019, according to an annual financial report issued in June, compared to roughly $3.9 billion at end of 2016.

Atrium reported in February that it had an operating income of $284 million in 2019, a roughly 23% increase over the previous year.

“If they have those resources, they should invest in being ready for the rest of the crisis and after the crisis,” Wright said. “COVID-19 is not the only health condition people are going to have at this time. If there is a reduction, we want to make sure that capacity doesn’t go away in the longer term.”

Cash and investments

Atrium and other hospitals rely on elective procedures for much of their income.

Some hospitals have seen revenue plunge by 50 percent since they decided to cancel non-emergency treatments, industry researchers say.

As a result, more than 43,000 healthcare jobs were lost in the first month of the coronavirus economic downturn and the numbers likely are worse for April and May, said Ani Turner, co-director of health spending strategies for Altarum, which tracks employment in the industry.

The trend, she said, represents a major shift for healthcare, where employment continued to grow even through the Great Recession.

“I have heard some people call it a double whammy,” Turner said. “People are literally risking their lives and their families and the healthcare industry is suffering financial losses.”

Hospitals are making staff reductions because salaries and benefits can represent between 50% to 75% of their costs, Turner said.

But Wright, the leader of Health Access California, said hospitals and clinics will need full staffing if the nation ramps up testing for coronavirus.

He pointed out that under the $2 trillion relief package approved by Congress and signed by President Trump, hospitals and health systems will get $100 billion in emergency grants.

Hospitals will also see a windfall when the coronavirus crisis passes from pent-up demand for elective procedures and treatments, Wright said.

“There is going to be a lot of money flowing into the healthcare system,” Wright said. “We hope they are not just looking at the short term.”

Safety concerns

At Atrium, the employees said they are worried.

They said there is a shortage of personal protective equipment, commonly called PPE, needed to safely treat patients when the number of coronavirus cases peaks.

Employees said it is unsettling to see nurses asked to potentially risk personal safety while dealing with financial uncertainty.

“It just doesn’t seem right,” one nurse said.

This story was originally published April 22, 2020 at 11:00 AM with the headline "‘It just doesn’t seem right.’ Atrium Health reduces nurses’ hours amid coronavirus crisis."