Kissimmee nurses accuse HCA of flouting new floating policy despite danger to patients

Just three months after nurses at HCA Osceola Hospital in Kissimmee approved a new three-year contract between their union and employer, nurses say that HCA is continuing to understaff their hospital, putting patient safety at risk.

Although HCA did not commit to hiring more staff as part of the agreement, the for-profit hospital did agree to a new floating policy meant to ensure better safety for patients and peace of mind for nurses.

Elisabeth Mathieu, a nurse of over 30 years in the hospital’s emergency department, however, said HCA is going back on their word by floating nurses to units without proper training — in violation of their contract.

“We nurses fight to enforce it,” said Mathieu, a chief representative for nurses on behalf of her union. Sending nurses to staff units without proper training, she warned, poses “a safety issue.”

“If you were a patient, you wouldn’t like the foot surgeon to be the one doing your brain surgery or your heart surgery,” explained Mathieu. “The same way, nurses have credential[s] in certain areas. And our cluster, when we negotiate our contract, we make sure nurses are fully trained,” she said.

The goal — and contractual commitment from HCA — is to ensure a nurse who specializes in a certain area of medicine, for instance, isn’t floated to a unit they aren’t familiar with or aren’t trained to adequately perform their duties.

“Sometimes they feel like they can try to get away with it,” Mathieu said of HCA. “We definitely stand up to that to protect patients, and nurses as well, because the nurses also don’t feel great moving to an area that can cause potential danger.”

Sending nurses to units they’re not trained to work in can risk preventable medical errors, from missing or misinterpreting patient symptoms to not understanding correct procedures. This can also create anxiety for nurses, and thereby potentially impact the quality of care they’re able to provide.

HCA Healthcare, a Nashville-based health system, owns and operates multiple healthcare facilities in Central Florida, and has more than 2,000 sites of care in 20 states. Just two in our local area — HCA Florida Osceola Hospital and HCA Lake Monroe hospital in Sanford — staff nurses who are unionized with National Nurses United, a labor union of nearly 225,000 registered nurses nationwide.

Nurses at Matthieu’s hospital — one of HCA’s top 50 most profitable — first voted to unionize in 2010, representing one of NNU’s earliest victories in a state where only about 6 percent of the workforce even has union representation.

Adequate staffing levels has consistently been a concern of nurses over the years, and nurses have rallied outside their hospitals — outside of scheduled work hours — to raise awareness of the issue multiple times.

On Thursday, nurses at Mathieu’s hospital joined a national day of action with thousands of other nurses in their union — including nurses at about half a dozen other hospitals in Florida — to again highlight their call for safer staffing levels. A group of nurses rallied outside of HCA Osceola hospital early Thursday morning.

“We want a patient to know that nurses who are actually at the bedside … are actually fighting for them on a daily basis,” said Mathieu.

Hospital executives have pointed to a shortage of nurses in Florida to in part explain their woes, which they project will only grow worse over the next few decades. But Matthieu, who talks to nurses throughout her hospital on behalf of her union, rebuffed this argument.

“We are short-staffed, but there’s no shortage of nurses,” she argued. “Nurses are tired, because there’s not enough of us at the bedside to provide the quality care that we want to give to our patients.”

The hospital is constantly recruiting and retraining new nurses, she said. But new recruits are often under-prepared for the physical, mental and emotional challenges that come with being short-staffed — an issue that she said also increases the risk for injury on the job. “When you’re going 12 hours nonstop, it’s a problem,” she explained.

HCA Healthcare, which did not respond to a request for comment ahead of publication, has consistently dismissed nurses’ claims of short-staffing. “Our staffing is safe and appropriate, and we are proud of the quality care we provide,” Trip Farmer, a spokesperson for HCA, told Orlando Weekly last March, in response to a similar rally organized by nurses.

Nurses — and labor unions such as National Nurses United and 1199 SEIU — have blamed staffing woes in part on corporate greed. HCA reported revenues of over $17 billion in the third quarter of 2024 alone, and a net income of over $1 billion during the same period.

The company also spends hundreds of thousands of dollars on lobbying the Florida Legislature, according to compensation disclosure reports, not to mention direct contributions to state and federal elected officials across the country.

Corporate greed in the healthcare industry has been a central topic of discussion following the killing of UnitedHealthcare CEO Brian Thompson. According to KFF Health News, about half of U.S. adults say they have difficulty affording healthcare costs. The United States is the only developed nation in the world without a form of universal healthcare coverage for its residents.

“We nurses have been fighting so much for Medicare for All, for them to be receiving decent care,” said Mathieu, referencing a single-payer healthcare proposal first popularized by Vermont Senator and former U.S. presidential candidate Bernie Sanders. Her union, National Nurses United, has advocated in favor of Sanders’ Medicare for All proposal, arguing it would help eliminate health disparities, control costs, and guarantee access to needed care.

“I don’t know if people realize how hard it is, either to work as a nurse or to fight and to make sure decent, compassionate care is delivered daily in a way that we can be proud of,” Mathieu continued. “It’s something that we nurses are fighting for — we definitely want the community to know that.”

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This article appears in Jan 15-21, 2025.