This legal case based on a staffing exodus from Wisconsin hospital system ThedaCare to Ascension Northeast Wisconsin appears to have started out as an example of the old staffing adages that “rats desert a sinking ship” and “you don’t leave your job, you leave your boss.” Ultimately, it ended with a Wisconsin court issuing a temporary restraining order (TRO) requiring one hospital to make certain employees available to a competing hospital or to cease hiring certain employees until the competing hospital hired sufficient staff, then rescinding that TRO the following week. Download a copy of the TRO here.
ThedaCare v. Ascension Background
ThedaCare is a Wisconsin hospital system with multiple medical facilities south and west of Green Bay, Wisconsin. Ascension Northeast Wisconsin is a competing hospital system in Northeast Wisconsin. According to newspaper articles (Article 1, Article 2, Article 3. Also Copy 1, Copy 2, Copy 3 if links go dead), morale at ThedaCare had apparently deteriorated. One longtime ThedaCare interventional radiology technician became upset when two colleagues were fired for what she believed were inappropriate reasons. She then began looking for another job and found a better paying job at Ascension Health. After finding this job, she encouraged her colleagues to apply there as well. When they received better paying offers, many employees asked ThedaCare to match those offers, but ThedaCare reportedly declined to do so. One ThedaCare employee reportedly received a last-minute offer to match pay, but not time off – which he refused. Eventually, seven of the eleven ThedaCare interventional radiology and cardiology technicians/nurses accepted job offers at Ascension Health.
It was only after the employees had accepted job offers at Ascension that ThedaCare’s trauma director was quoted as saying “there’s only a small crew of people who have this type of expertise, so trying to backfill, or recruit, or substitute people in is not as easy as it sounds.”
ThedaCare v. Ascension TRO
According to several of the technicians, ThedaCare was reportedly unfazed at the prospect of losing four technicians in a short period of time. The loss of seven employees, however, amounted to a public health threat – at least that’s what ThedaCare told a court when it sued Ascension. It was then that Judge Mark McGinnis issued a Temporary Restraining Order (“TRO”) requiring that Ascension Northeast either:
- Make available to ThedaCare one invasive radiology technician and one registered nurse of the individuals resigning their employment with ThedaCare to join Ascension … with their support to include on–call responsibilities, or
- cease the hiring of the individuals referenced … above, until ThedaCare has hired adequate staff to replace the departing IRC team members.“
Sidenote: A TRO is only intended to maintain the status quo until a formal hearing can be held on an issue to determine whether a formal injunction should be issued. The party seeking a TRO must show that if a TRO is not granted, an immediate and irreparable injury will result. Even if a TRO is granted (often they are not), it only remains in effect until a hearing on the issue can be held. By law, TROs expire within a short amount of time – usually two weeks.
ThedaCare v. Ascension Injunction Hearing
A hearing the following week on the ThedaCare/Ascension matter involved testimony from the former ThedaCare employees and from management at both facilities.
The former employees testified about being overworked and underappreciated at ThedaCare. One technician testified that “nobody [at ThedaCare] cared about how magical what we do here was – until today.” Another nurse stated that she had “given my life to ThedaCare” and that “they don’t care.”
ThedaCare’s allegations ignored the sentiments of their former staff members, instead arguing that the loss of so many specialized employees would make it difficult to provide high-level stroke and trauma care to patients in the community. As a result, patients requiring such care could have “hours” of delay due to transfers to hospitals in Green Bay or Milwaukee. Lynn Detterman, president of ThedaCare-Neenah, testified that patients being transferred to Green Bay weren’t even assured of receiving necessary care because hospitals in Green Bay reportedly “had been so full in recent weeks that they were turning away patients from the emergency room.” ThedaCare attorneys urged the court to consider “the possibility of a patient dying during a transfer from Appleton to Green Bay, Milwaukee or Madison because Ascension couldn’t care for them and ThedaCare no longer had the staff. ThedaCare also reportedly argued that its departing employees seemed to have little concern about “the good of the community.”
Ascension argued that ThedaCare had weeks to address the issue before its employees left and did not do so. After the employees left ThedaCare, Ascension noted that ThedaCare had continued to provide high-level stroke and trauma care to the community. Ascension’s attorney reportedly stated to the court “I have no clear understanding of why we’re having this hearing today.”
The judge ultimately lifted the TRO and allowed the employees to leave ThedaCare and begin their new jobs at Ascension St. Elizabeth Hospital in Appleton, WI. In his ruling, he stated that the community wouldn’t benefit by preventing the employees from working while ThedaCare sought additional employees. Judge McGinnis also stated that said ThedaCare could continue using alternate staffing solutions and could cross-train employees who do similar jobs.
The underlying lawsuit alleging that Ascension impermissibly “group-recruited” ThedaCare’s staff will continue.
Takeaway Points
This case just struck me as an example of how hospitals should NOT deal with their employees. It costs much more to find and train new staff than it does to appreciate and maintain your old staff. Before terminating or alienating staff members, consider the following issues:
- Failing to recognize or address rifts in staff morale are a sure way to make staff leave. In this case, staff morale decreased after some employees were allegedly inappropriately fired. That decrease in staff morale caused one member of the team to search for better opportunities at another facility. Once that rift was created, it opened an opportunity for many members of the same team to also leave. An exodus of employees may be a “red flag” to other employees being recruited to fill open positions.
- Remaining staff will recognize losses of important staff members. I’ve seen it happen over and over again. Word of staff departure or termination will spread through the hospital community. In many cases, termination of key staff members may cause other staff members to seek more rewarding or more secure employment. In this case, termination of two employees for reasons that did not make sense to another team member began a cascade of employees leaving ThedaCare.
- Replacing seasoned employees is not a simple task. Especially when dealing with specialized positions, consider how long it will take a newly hired employee to learn the job requirements, become comfortable with a new system, learn the system processes (scheduling, procedures, EMR system, job duties, etc.) and integrate with other staff members. Also consider the extra costs, lost productivity, and decreased morale that will be required for other staff members to train new hires.
- Community goodwill toward a hospital may take a huge hit if staff members who are well known in the community are terminated or leave due to poor leadership. Newspaper articles that repeatedly describe how a hospital system may no longer be able to care for critically ill patients also may have a deleterious effect on community opinions about a hospital.
- A fish stinks from the head down. Often issues in an organization can be traced back to issues in leadership. The fact that so many employees could feel undervalued to the point that they would leave ThedaCare and the fact that ThedaCare management lacked insight to see that their treatment of employees had potential to develop into a potential public health issue creates a significant negative impression about ThedaCare management.
- It’s difficult to sue your way into prosperity. ThedaCare really didn’t think this one through. Did it really think that forcing former employees to continue working at ThedaCare would be a good idea? Did it think that preventing those employees from working at a competing hospital wouldn’t become a top local story? Filing a lawsuit that puts hospital management deficiencies and low staff morale in the public spotlight will result in a Pyrrhic victory at best. When other potential staff members learn that their potential employer filed a lawsuit to prevent employees from working at a competing hospital, they may question whether they want to work at such a facility.
Organizations with high employee satisfaction have less employee attrition, more productive employees, and higher patient satisfaction. When proverbial rats begin fleeing a sinking ship (not intended in a derogatory sense), wise hospital boards should consider going into crisis mode to address underlying issues and to maintain the integrity of the organization.