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Business Of Replacing Nurses
A Profitable One, Says Owner

Barre-Montpelier Times Argus, May 10, 1998

        Times Argus Staff

   Ten years ago, Daniel Mordecai got an urgent call from lawyers representing officials at seven hospitals in San Francisco. There had been a strike by the hospitals' nursing staffs, and the management teams were in a panic. They needed help fast.

   At the time, Mordecai was in charge of a small nursing agency in Denver. Somehow the lawyers had gotten his name, and they had a frantic, if somewhat unusual, request: Could he send them some nurses, and quick? The price, the lawyers assured Mordecai, would be right.

   And it was.

   "They were paying much more than we were charging," the Denver businessman concedes. "It was too good to pass up.

   The impromptu dealings in San Francisco would prove to be the seminal event in what over the next decade would become, for Mordecai, a lucrative fulltime business.

"The nature of our business is one that requires a lot of pressure. So we try to find people who enjoy travelling. There's a certain type of person who likes to be on
the go. Our nurses like to travel
... and they are very well reimbursed."

Daniel Mordecai, U.S. Nursing Corp.

   Mordecai is the president and founder of the Denver-based U.S. Nursing Corporation, the company furnishing Morrisville's Copley Hospital t with short-term nurses while unionized nurses walk picket lines in the wake of a contract stalemate.

   In these past 10 years, Mordecai has made a living out of providing temporary, often short-notice, critical care nursing to hospitals embroiled in labor disputes with their own nursing staffs,

   Since the company's nascent days, it has flown in thousands of temporary nurses to hospitals of all sizes, including several major university health centers, all across the country. Last year alone, U.S. Nursing Corp. paid more than 2,000 nurses, many of whom had answered want ads in local papers around the country, to take the reins at health care facilities across the United States.

   Indeed, what might strike some as an over-specialized line of work has proved increasingly profitable to Mordecai and his team of health care Providers. And their corporate mission, he is quick to point out, couldn't be simpler.

   "Our position is that we are in the business of staffing hospitals; we staff hospitals all over the country," says Mordecai, whose organization has several regional branches, including one in Boston. "We specialize in doing business with hospitals that have labor issues."

    While the privately-owned company maintains a full-time staff of only about 25 to 30 employees, Mordecai guesses there are between 8,000 and 10,000 nurses who remain regularly on-call for U.S. Nursing.

   Many are given only a week's notice before being shipped off, indefinitely, to work long hours at a strange, new hospital in an unfamiliar community.

   "The nature of our business is one that requires a lot of pressure , he points out. "So we try to find people who enjoy travelling. There's a certain type of person who likes to be on the go. Our nurses like to travel ... and they are very well reimbursed."

   The firm has enjoyed an extremely high profit margin. After all, a hospital strike is not like a factory strike. When people's lives are at stake, replacement workers are in a good position to call the shots, to get Precisely what they want.

   Neither U.S. Nursing Corp. nor officials at the 53-bed Copley Hospital are willing to discuss they actual figures.

   Says Mordecai: "The pricing structure is proprietary, and of course it needs to be cost-effective. But it would be inappropriate for me to discuss specifics."

   Hospitals pay a flat rate to U.S. Nursing, which then provides individual payroll checks to its nursing staff. The price an individual hospital pays to the firm hinges on everything from the number of nurses required to the nature and intensity of day-to-day hospital operations.

   Nurses will be paid higher at a large urban medical center, for example, than a small, rural community hospital in Lamoille County.

   While Copley officials say the use of temporary nurses has driven costs up, they have been guarded when pressed to be precise.

   "It is costing us more than it does to have our normal nurses here, yes," allowed Toni Kaeding, a Copley spokesman. "But it's okay; Copley is handling it."

   Mordecai says his company's nurses must pass a rigorous screening process, are at the top of their field and are fully licensed to practice in the states to which they are sent. (For political reasons, none the company's nurses is ever from the area where a strike occurs.)

   'We are in full compliance with all the laws," he says.

   U.S. Nursing has 200 clients, some of whom regard the company as a sort of insurance program in case a walk-out occurs. Others use it for consulting, which Mordecai describes as the lower-profile side of the business.

   'It can get overwhelming," he says. "At any given time, we may have two or three strikes going on."

   Mordecai, who never identifies hospitals the organization is staffing, says there is only one right now.

   He touts his company's practices as "an extremely logical business" but others see the situation differently.

   Critics call the replacement nurses scabs" or "strike-breakers." Many question
the nurses' qualifications and the level of care Copley patients will receive while the regular nurses remain on the picket lines.

   Janet Bass, speaking for the Federation of Nurses and Health Professionals, the union with which Copley's striking nurses are affiliated, lambastes the substitute nurses as profit-driven underqualified workers who never stay in one place long enough learn tricks of the trade.

"Everything is going great. I think everybody has been pleasantly surprised."

Toni Kaeding,
Copley spokeswoman

   "They provide underqualified, inexperienced nurses in general, who receive little or no orientation when they get to the hospital," she says. "It has been our experience with strike-breaking nurses that care is lost."

   Bass says she believes the temporary nurses are getting paid about three times as much as Copley's striking nurses, and that the money would be better spent on the regular nurses' salaries or put toward improving overall working conditions.

   "These are nurses whose careers are made by swooping in to foreign places and then leaving," Bass says. "There is no commitment to the hospital or to the patients. The union nurses are out there because they care about patient care."

   Bass cites an incident in 1993 at the Jersey Shore Medical Center, where U.S. Nursing Corp. provided nurses after the hospital's own team walked out over contract disputes.

   During the strike, complaints of problems among the nursing staff arose and the State Department of Health was notified. An investigation led to two cases in which the SDH cited negligent care by the nursing company.

   To union opposition, who view the nurses' group not only as anti-labor but often as greedy opportunists who capitalize financially on the hardships of fellow workers, such examples of inadequate employee performance have become mantras of a sort.

   Copley officials have made known their appreciation of how well the new nurses have adjusted and performed.

   After one week, the U.S. Nursing Corp. nurses have risen to the task, Kaeding says, even assisting in an emergeti, surgery their first night on the job.

   "Everything is going great," Kaeding says. "I think everybody has been pleasantly surprised."

   The temporary nurses have been housed at the Stowe Inn on Route 10 and could not be reached for comment. A clerk at the inn's front desk said the have been enjoying their stay in Vermont many of them venturing to other areas of the state on their free time.

   Meanwhile, should the strike persist, U.S. Nursing Corp. plans to rotate in Copley team, periodically bringing in other nurses and sending some home probably in two-week intervals.

   Those who leave Copley most like will go back to their home states and wait for another strike in another part of the country.

   "This is what they do," says Mordecai. "They like to travel, they're intelligent and they're used to going into strange places they've never been before and getting the job done. It is a very logical business."