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About 300 registered nurses at Butler are members of the Pennsylvania Independent Nurses union, and have spoken out to have the proposed specialty center remain under the ownership of the hospital.

“We’re worried the new specialty surgery center would threaten the financial health of Butler Memorial,” said Tammy Kaufman, RN, a staff nurse at Butler and vice president of the Pennsylvania Association of Staff Nurses and Allied Professionals. “Since ambulatory surgical procedures are one of the most profitable services performed at a hospital, we feel that Butler’s patient care services would be dramatically impacted if these services are removed from our community hospital.”

Kaufman and her colleagues also have concerns regarding patient safety at the new surgery center.

“Right now, there is talk of building the facility on a separate site, which could put patients at greater risk if an emergency occurred during a surgical procedure,” Kaufman said.

Nurses at Butler also have expressed concern about their jobs. Staff likely to be transferred to the new outpatient surgical center would have an average of 25 years’ experience, but could lose seniority if they were transferred to the specialty hospital where they would be considered new employees.

Higher chance of survival

Despite the controversy, many patients, physicians and nurses remain sold on the concept of boutique hospitals. They say specialty facilities offer patients not only more focused care, but also a better chance of survival.

At Fox Chase Cancer Center in Philadelphia, researchers and health care professionals work side by side to develop and participate in clinical trials that broaden their knowledge of cancer treatments.

Cliff Speer, RN, works in the hospital’s phase one clinical trial unit that specializes in clinical trials that use medications that are not yet available to the general patient population.

Before joining the staff at Fox Chase last year, Speer worked at a pediatric medical center where he became burned out on the myriad social and domestic abuse issues he encountered daily.

“Coming to Fox Chase is the best thing I’ve ever done in my career,” Speer said. “It totally changed my outlook on nursing. I don’t feel as if this is a job, but rather an opportunity to connect with patients who need both physical and emotional care.”

On a typical day, Speer works with both patients involved in clinical trials and oncology patients who have been admitted with medical problems. If the protocol patient is particularly time-consuming, he or she will be the only patient Speer cares for during his shift.

“The environment here at Fox Chase is one of total support and focused patient care,” Speer said. “Specialty hospitals give nurses the chance to have multiple resources within easy grasp to help us give patients proper care.”

Speer also praises the staffing ratio, which is never higher than two patients to one nurse during day shifts, and 4-to-1 during the evenings.

“I’m often able to take a half hour at any given time just to sit and talk with patients to see how they and their family are coping with the disease,” he said. “This is a luxury that most nurses don’t have.”

Speer said the only downside in working in a specialty cancer center is learning to deal with the deaths of patients and helping their families cope with the loss.

“We become close to the protocol patients because we are often their last hope for treatment and in some cases, we offer a delay in the inevitable,” Speer said. “We also experience all of the highs and lows of cancer treatment with patients and their families.”

Texas has seen one of the most rapidly expanding markets for specialty hospitals because of its population growth. Also, Texas is one of several states that doesn’t require investors in a new hospital to prove it’s needed and won’t financially harm existing facilities.