Pago Pago, AMERICAN SAMOA — Nurses that initiated a strike against the hospital management are demanding that their increments that were effective December 1, 2022 be paid; and that gov’t pay out their excess leave; remove the chief nursing officer and adjust the salary for the clerks and orderlies.

These are the demands needed for them to return back to work and the deadline for the demands is Friday, Dec 23, 2022.

This is outlined in a grievance letter addressed to the Chief Executive Officer, Moefaauo Bill Emmsly, submitted by the nurses who cried foul when they did not receive their promised increment and overtime the are owed.

“It is with great respect and humility that the undersigned nurses submit our letter of grievance for your review and immediate action.

“We have been battling these Unsafe issues for too long and it’s getting worse. We truly believe that there is a solution to every problem. There is also a light at the end of the tunnel.”

According to the letter, current nursing leadership/ management are not approachable or open to receive questions, comments, or concerns.

“When concerns/ complaints are brought to leadership, they are not being heard. They are not receptive.

“Nursing leadership is one sided and leads with a ‘my way or highway’ approach.

“There is a severe lack of communication across the board, specific to staffing and scheduling, staff members are asked by leadership to come in to cover their unit, but then the Patient Care Coordinator will pull them to another unit.”

The nurses asked the CEO to remove their current Chief Nursing Officer (CNO) Simamao Tuato’o due to “gross incompetence” and appoint Sandra Ho Ching as CNO.

Efforts were made by Samoa News to get comments from Ms Tuato’o but was unsuccessful.

Regarding staffing, the nurses pointed out that it’s critically unsafe.

The nurse patient ratios in accordance with the National Nurses United, the largest Union and professional association of registered nurses in U.S history recommends the following patient ratios; Medical/Surgical: 1:4; Emergency Room: 1:3; Intensive Care: 1:1; Psychiatric: 1:4; Rehabilitation: 1:4; Labor and Delivery: 1:2 and Pediatrics: 1:3.”

Furthermore the nurses indicated that as patient advocates, they are advocating for safer ratios.

“Life-Threatening errors in patient care are being made d/t [due to] unsafe ratios. Our hard-earned licenses are at risk every day.

“The minute we accept a report we risk losing our licenses by taking on more than what we can safely handle.”

According to the nurses the Human Resource Rep is not efficient.

“Nurses’ applications are held for months and they end up going to the Department of Health.”

Pertaining to per diem for nurses, the letter pointed out that newly graduated nursing students are hired as “per diem nurses”.

[Per diem work refers to a per day compensation received by some workers. They receive their wages by the day or by the quantity of work done. Rather than full-time jobs, these types of workers are usually on temporary or short-term contracts. For example, travel nurses are paid by per diem.]

“They have not, and do not receive proper orientation but rather shadow current nurses for a short time on shift.

“One new grad was hired as per diem even though she was able to work three days a week and could be hired as staff.

“She made a life-threatening medication error.”

Regarding overtime, the nurses point out that it is compulsory.

“Our schedules are posted on average at 60 hours a week. Leadership knew months in advance the number of nurses [that] were leaving.

“The only solution they came up with was the Fiji nurses program. This still does not provide immediate relief. It will require months of training.

“When asked about a retention plan we were told that they need to focus on bringing in the Fijian Nurses first.

“How can we replenish nurses if they keep leaving. Most of them have left d/t poor management. Students' contracts are not being honored. They have not received a full 80 hrs of pay as stated in their contract,” according to the letter.

They recommend that Per Diem nurses need to have three years of acute care experience and receive proper orientation.

“Require them to work two weeks full time for orientation. “New grad nurses need at least 3 months of orientation; develop a retention plan: tuition reimbursement, increase pay etc.; pay students what was promised in their contract; 80 hrs of regular pay per pay period and if they work during that time, it will continued as overtime but paid at the regular rate not time.”

Furthermore the nurses pointed out there is “no work life balance” for them.

“Work life balance is not encouraged. It’s all work.

“We sacrifice extensive time away from our own families to care for others.

“If we ask for a day off due to a family function we are told that work should be our priority.

“If unable to find coverage for a shift we request off, no matter the reason, we must report to work or risk disciplinary actions.

“Our own health and well-being is continually at risk.”

According to the letter, the nurses regularly work 24-36 hour shifts and this is unhealthy and unsafe.

“We are burnt out and are no longer capable of providing the quality care our patients deserve.”

The nurses recommend hiring travel nurses to work until Fijian nurses pass their examinations and also offer special compensation for 24-hour shifts such as double pay for 24 hours or more.

The letter also says the recently disclosed pay adjustment is a slap in “the face”.

“We should not be compared to Samoa, Fiji, NZ or AUS because we are a U.S Territory and as such are Certified/ Licensed / Registered nurses.”

The nurses also cited a lack of annual pay raises/  bonuses and the hospital’s refusal to pay out excess leave.      

Also “orderlies and Clerks that have been working over 3 years need a pay adjustment as well.

“Their work has increased since the shortage. They have been performing duties outside of their scope of practice. They deserve to be compensated before the physicians get their pay adjustment.”

They recommend for the Registered nurses’ manager to receive the pay of $60,000 per annum; Registered Nurses at entry level at $50,000; Licensed Practical Nurses $40,000; Certified Nurses Assistants $25,000 and Orderly Clerk at $20,000.

“If staff receives the above pay scale, we will no longer ask for time and a half for overtime, but the regular rate only.”

Furthermore the nurses say they should also receive an annual increment of 1 percent; $500 Christmas bonus or base bonus on hours worked for the year.

Also the option to pay out excess leave by the first pay-period in December or at least pay out half the amount of excess leave and let the other half roll over until March of the following year.

“Nurses will return to work ASAP if the following recommendations are met by Friday December 23, 2022; when they get their pay Adjustment that was effective December 1, 2022; pay out excess leave; remove our CNO and adjust Clerk/ Orderly salary.”

The nurses letter to the CEO was accompanied by letters from individual nurses.

“I have been a nurse for about three years in LBJ, and I have encountered a lot of emotions when it comes to the leadership of this institution,” wrote a burnt out nurse.

“Our Director of Nursing Simamao Tuatoo, her favorite word for us when we ask for help is to pray.

“How long are we supposed to do that for?

“For example, just recently, there was just one nurse and 19 patients on the floor and when I asked for help she would make me feel like I’m cry baby asking for help.

“She would continue to say you have your helpers the CNA [Certified Nursing Assistant] and the orderlies. I know that but those are not nurses. I am responsible for the 19 patients, and she just blows off my concerns and complaints as if they are not important to her.

“If I ask her that I needed to be at home with my parents, especially with my Dad, she would ask me if there is nobody else to look after my parents, and continue to make me feel guilty about calling in.

“I love my job seriously, but hearing all this from our leader, who is suppose to help and encourage us to work is very disheartening. What I am trying to say is that we really need a new leader and [a] supportive one,” said the nurse.

Another letter led with “enough is enough!

“After three years of working at LBJ, my first increment did not even amount to 10 cents though my workload was worth a lot more than that.

“Overtime was held and not paid.

“I should not be working those hours therefore I would not be paid. I joined the Nursing program and instead of supporting me, PCCs [Patient Care Coordinators] told me to go to work,” said a Medical and Surgical Nurse.

“Sima was the only one who showed her support.

“I called in sick and was told to take a Tylenol and come back to work.

“After covering for my peers for nearly a week straight, I asked for one day off and was denied.

“My first day at work I found out that I was the lowest paying nurse even though my coworkers were in the same program as I, having received the same education.

“Yet, their salary was higher.”

The nurse said she was given the run around.

“What kind of ridiculousness is this?

“We are told not to stay back late; to chart when the nurse to patients ratio is considered illegal …

“PCCs worry more about their numbers and covering the holes and gaps in the shifts instead of worrying about the health of their employees.

“It is not okay to work 24+ hours.

“The license we worked so hard for is put on the line.

“Poor leadership straight across the board.” She said the hospital is paying them peanuts yet they are expected to stay silent. 

“Look what has become of your poor decisions. You’re looking at Fijian nurses when you know damn well, their credentials are not equivalent to stateside nurses and its territories.

“You are willing to spend more money on foreign nurses when you should be looking at our local Community.

“You are not doing anything to keep the local nurses.

“You are not giving them their due diligence. After nearly ten years of this abuse and bullying, I am so glad that together, we are putting our foot down.

“ENOUGH IS ENOUGH,” said the nurse.