St. Joseph Regional Medical Center in Lewiston eliminated an in-house crisis intervention team in November that conducted suicide assessments for mental health patients in the emergency department, according to nurses negotiating a labor contract with the hospital.

The team was comprised of mental health clinicians and social workers who made recommendations to emergency department physicians to help them decide which patients could be sent home with follow-up services and safety plans and which ones needed inpatient care, said Joe Shuey, an emergency department nurse who serves on the union bargaining committee.

Emergency department nurses are now required to complete mental health assessment forms for patients that take 45 to 60 minutes to do correctly, Shuey said in a text.

The nurses are highly capable, but not trained specifically in mental health, and only received 30 minutes of instruction about their new duties, he said.

“When the area should be increasing our ability to adequately treat those with mental health needs, the hospital made cuts that greatly diminished what we had in place,” he said.

Teamsters Local 690 in Spokane, the union representing the hospital’s nurses in the talks, raised that issue and two others with the National Labor Relations Board in documents filed in June that were provided to the Lewiston Tribune this week by the union.

The documents were shared as the nurses prepare for a rally from 10 a.m. to 1 p.m. Thursday at Pioneer Park, 203 Fifth St., in Lewiston.

Hospital officials are aware of the three charges and believe the National Labor Relations Board will find them to “be without merit or legal foundation,” hospital spokeswoman Sam Skinner said in an email.

“We will reserve further comment at this time and allow (the National Labor Relations Board) investigatory process to run its course,” Skinner said.

The union’s rally is to educate the community about the challenges St. Joe’s nurses face and is not a walkout or a strike, said Larry Kroetch, business agent for Teamsters Local 690.

St. Joe’s nurses who participate will be doing so when they are not scheduled for a shift at the hospital, Kroetch said.

Union members hope local residents who agree with their push for competitive pay and benefits to retain and recruit talented nurses will share their views with hospital executives, he said.

St. Joe’s respects the nurses right to be represented by the Teamsters, Skinner said.

“We continue to negotiate in good faith and are working toward a fair and sustainable labor contract that meets the needs of our staff, our community and our hospital,” she said, declining to comment further out of respect for the confidentiality of the process.

The two sides have met almost 30 times in the last 12 months and have more sessions set for Aug. 5 and 6, Kroetch said.

“We’re still miles apart,” he said.

The union’s other concerns involve biohazard equipment and insurance.

The hospital eliminated Neptune machines, where fluids suctioned from patients during surgeries were deposited, Kroetch said.

The Neptune reservoirs were large, and the machines were wheeled to a biohazard area where they were emptied and cleaned after procedures were completed. As the machines aged, they were replaced with more standard suctioning systems with smaller 1-gallon containers for fluids, Kroetch said. Sometimes multiple containers are filled during surgeries, and nurses have to carry them to the biohazard area, in a change that increases the risk of falls and fluids spilling.

“We feel our nurses have been put at risk with this new working condition,” Kroetch said.

At the same time, St. Joe’s eliminated insurance that compensated nurses if they had to miss work because they were injured off-site, he said.

After the investigation, the National Labor Relations Board will either drop the matter or issue a complaint and schedule a hearing before an administrative judge for a decision, Kroetch said.

The judge might take any number of actions, such as siding with St. Joe’s, requiring the hospital to bring back the crisis intervention team, Neptune machines and insurance, or fining the hospital.

“It’s often restoring what was taken away,” Kroetch said.

Williams may be contacted at or (208) 848-2261.

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