Dark day at Enloe

It’s never easy for bosses to tell employees they’re being laid off, and we don’t doubt that the administrators at Enloe Medical Center who decided last week to lop off 5 percent of the hospital’s work force found it painful to do so.

And we know that running a hospital in this era of runaway costs, rapid technological changes, changing physician expectations, unionized employees, declining reimbursements and unfunded mandates is a balancing act requiring tremendous creativity, skill and, sometimes, the willingness to take unpopular steps.

Having said that, it’s unfortunate that Enloe’s administrators kicked off what they describe in a press release, rather grandly, as an “intensive performance plan to meet ‘best practices’ guidelines in productivity efficiencies and quality improvement for patient care” by announcing they were laying off 179 people, 60 of whom would be hired back.

The group most affected—indeed, virtually eliminated—is certified nursing assistants, or CNAs. They’re the folks who take care of the personal needs of patients, from bathing and making beds to taking them to the toilet. In most units there’s about one CNA for every 12 patients. Now the CNAs’ duties will fall to the registered nurses, who already have plenty on their hands.

Enloe administrators have said they intend to work with the nursing staff to accommodate the increased workload pressure this change will create. To begin, the hospital will set up “lift-and-move” teams to help with lifting patients in and out of beds and chairs and transporting them—duties that nurses cannot perform alone.

More important, Enloe administrators know they are in a transition period during which nurses will be placed under greater stress. They have pledged to work with RNs to make the best possible decisions about how to make this change less difficult. It’s impossible to eliminate a valuable group of care givers without affecting the quality of patient care, but the impact can be minimized if all parties cooperate.