It was an all too typical, too-busy July day for Reggie Abarquez. A JNESO member and emergency room nurse with 22 years experience at her inner city hospital, she was assigned to seven patients — a fuller load than usual, but not uncommon.

Reggie was also helping with ambulance triage, just as four ambulances arrived. Inexplicably, the hospital had cancelled an agency nurse expected at that time. “I guess, to the hospital, we weren’t busy enough to need her,” Reggie later said.

With several more patients added to her load, she saw one brought in for a seizure early in the day who had signed himself out of another facility. Though he now denied having had a seizure, Reggie followed protocol, examined him, put him on a pulse -ox and placed him on a stretcher, with side rails up, in view of the nurse’s station.

The nurse covering that area wasn’t available, and before she could be found, a Med Student stopped Reggie because he needed help putting a line in another of her patients with extremely high blood sugar. That done, Reggie was stopped again – this time, an elderly patient needed help getting to the bathroom. And, when that was done, another patient had an empty IV drip that needed replacing. Then she was stopped by the daughter of yet another patient, wondering why they were waiting so long…

…And that’s when the commotion began. The patient on the stretcher had overcome the side rails and found the bathroom, only to have another seizure and suffer a head injury. He was taken to another hospital, and the fall was reported to the state. Reggie gave a report of the incident by phone, and then in person. She was told there would be a disciplinary action – what would be her first such action in more than two decades at the hospital.

It began as a three-day suspension. Then indefinite suspension. Then termination.

“I was in shock,” she said.” “I’d never been disciplined before, I’d never even had a bad evaluation. I was doing the job as best I could. Whatever angle I looked at the situation, I didn’t see why I needed to be terminated.”

Especially since ER nurses like Reggie had been warning the management for months that something like this was bound to happen.

Crowding and staffing issues aren’t unique to this Medical Center. Most JNESO members can relate. But the problems here were compounded in 2008, when two other area hospitals, were closed over the protests of the community and JNESO for fears of overcrowding and loss of community access. Those fears were not unfounded: Since the closure of those hospitals, census in the remaining acute care facility’s ER increased on average by about 40 percent, without a reciprocal staffing increase.

The remaining ER has a bed capacity of 14 patients, with a surge capacity of 23, max,” explained David Canham, JNESO Director of Field Services and Organizing. Ever since the closure of those two hospitals, they have been operating at that surge maximum.”

“It was our concern that given the fact many patients come to the ER very sick, the current staffing complement was inadequate,” said Canham.

Since March of 2009, employees of the emergency room, JNESO members and Labor reps had been meeting with nursing administration to address the over-crowdedness, staffing needs and patient flow in the ER. Several petitions had gone around throughout the hospital, as members tried to get management to act.

“We had been warning management that the system was bound to break down, and it would end in a patient getting hurt or worse,” said Canham.

Reggie was one of the nurses who had voiced concerns. “The ER is important to me, I love my job and I’m good at it,” she said. She even turned down an opportunity to transfer to another department because, she said, she didn’t want to leave her friends alone to deal with the problems.

After her termination, Reggie was, in her words, “devastated.” With a husband, three kids and a dog, the loss of income forced serious cut-backs. “I didn’t want to look for another job. I didn’t want to leave the house. It was my first job, all my friends were there,” said explained. “But I received a lot of support from my friends, co-workers and the union.”

JNESO was in a position to help Reggie from the start. Though she “never had been active in the union,” she knew to have a shop steward – in her case, Local Chief Steward Vivian Stewart– present during her meetings with management, and a wrongful termination grievance was filed immediately after the termination. Her case would go to arbitration, where an impartial adjudicator, the Arbitrator ,hears both sides and issues a binding ruling. While that process usually takes several months, the hospital agreed to an expedited hearing for Reggie, and it was held in August.

The hearing was straight forward, with Reggie, a JNESO lawyer, JNESO members and a doctor all testifying on her behalf, detailing the crowded and busy nature of the day of the accident. The hospital on the other hand said the accident was the fault of “Gross negligence, poor nursing judgment and poor documentation skills.”

Several weeks later, on Friday, November 13, the ruling came down. “I wasn’t expecting to hear anything until after Thanksgiving,” Reggie said. “But then this call comes on my cell phone from JNESO, and all I hear is cheering.”

The arbitrator had ruled that Reggie had indeed done everything expected of her in an impossible situation, and that she should not be penalized for the accident in the ER. The increased patient load and staffing issues were mitigating circumstance. The arbitrator’s ruling said Reggie must be returned to work, with full back-pay from the time of her dismissal.

“I can’t describe the relief. All I wanted was to go back to work and be a nurse,” said Reggie. “It wouldn’t have happened without the union.”

“The message we hope Management gets from this ruling is that you can’t expect staff to deliver safe care without appropriate resources,” said Canham. “No nurse can be two or three places at once.”

“I hope things change,” said Reggie, who since her re-instatement is signing up for training to become a shop steward. “No one – not patients or nurses – should have to go through something like this again.”