A tiny seed is having a big impact on breast cancer care.

In partnership with Central Oregon Radiology Associates (CORA), St. Charles Cancer Center has begun using Magseed—a tiny, iron oxide “seed” that is implanted in a cancerous breast tumor to mark its location for surgery. Equipment needed to use Magseed was purchased with money from Sara's Project, a St. Charles Foundation fund dedicated to easing the challenges of breast cancer for people in Central and Eastern Oregon.

The Magseed is a substantial improvement over the metal wires that were formerly used to guide surgeons to tumors that are otherwise too small to find, said Dr. Kelly Hewitt, a University of California San Francisco fellowship-trained breast surgeon who joined the Cancer Center in October.

“As you can probably imagine, that can be fraught with issues,” said Hewitt, who prior to her fellowship worked as a general surgeon in Newport, Ore.

The thin wires, which usually had to be placed the day of surgery, could sometimes become dislodged when the patient traveled from the radiologist’s office to the hospital, or in the operating room, she said. And because the wires could be unwieldly, they had to be taped to the patient’s breast until she was in the operating room.

“From a system standpoint, it’s also a scheduling nightmare because they have to put the wire in at a certain time and coordinate it with surgery, etc.,” she said.

Placed by a radiologist in the breast tissue, the radiation-free Magseed marker won’t move or break, and can be placed days, weeks and even months ahead of surgery, Hewitt said. During surgery, she waves a wand-like localization device over the breast that guides her to the seed, targeting where the incision needs to be made.

“It really lets me pick my incision based on aesthetics and safety,” Hewitt said. “Sometimes the wire can kind of dictate where you have to go, but with the seed, it gives you more flexibility.”

Hewitt said she has even implanted the Magseed—which is so small it can’t be felt by the patient—in lymph nodes that need to be removed as well.

The only fellowship-trained breast surgeon in Central Oregon, Hewitt said she is excited to be able to use this new technology to improve care for patients.

“It’s all about perfection and doing something that is both oncologically safe—so, getting all of the cancer out—but then also making it look as nice as possible,” she said. “So, having the best aesthetic outcome in combination with the best oncological outcome.”

Heads up: Dr. Kelly Hewitt will present "Breast cancer in 2021: Diagnosis to survivorship" at our next installment of Doc Talks on March 29.

In recent weeks, media outlets, health care organizations and others around the world have been marking the one-year anniversary of COVID-19’s unwelcome arrival into our lives.

What a year it has been.

When I think back, I cannot remember when or where I first read about this new novel coronavirus, which started in China in late 2019 and spread to the United States in January of 2020.

What I can remember is the day the first presumptive positive case of COVID-19 was confirmed in Central Oregon: March 11, 2020. I remember attending a hastily organized mid-day meeting, where the overriding mood was not one of worry or panic, but of confidence and resolve. We had been preparing for that moment for months, and we knew that while the disease was unpredictable and the future was uncertain, our health system was ready to handle it.

I also remember watching my colleague, Dr. Jeff Absalon, and other local officials speak at a press conference that afternoon. “This,” said Dr. Absalon, St. Charles’ chief physician executive,  “is what we do.”

To be clear, he was not talking about holding press conferences. He was talking about caring for people who are sick.

That is what we do here at St. Charles, every single day. It is our commitment to ourselves, our commitment to each other, our commitment to our communities and our commitment to you.

Of course, there have been tough stretches over the past year. Preparing for and responding to COVID-19 has been a massive operational undertaking for our health system. It has dealt a financial blow to our organization. It has changed the way we do just about everything, from the bedside to the board room and all points between. And it has certainly tested our frontline caregivers and our first responders.

Have there been uneasy moments? Definitely. We are human beings, after all. But again and again over the past year, I have seen our people rise to the challenge, whether that challenge is figuring out how to quadruple a hospital’s patient capacity without expanding its footprint or how to give a dying woman the birthday celebration she deserves, even in isolation. Now, they’re heavily involved — alongside Deschutes, Crook and Jefferson counties and the Oregon National Guard — in the complicated regional effort to end this pandemic by vaccinating as many people as possible as quickly as possible. And they’ve done it all during a time of unprecedented upheaval in both their professional and their personal lives.

I have said it before and I’ll say it again: I feel incredibly proud and fortunate to lead the 4,600 caregivers who make St. Charles Health System such a great place to provide and receive care. Through a year of dizzying ups and downs, they have been a steadying force every step of the way.

Sincerely,
Joe

St. Charles and OFNHP met with federal mediator to continue negotiations on a first-time contract 

Bargaining teams for St. Charles Bend and the Oregon Federation of Nurses and Health Professionals met Wednesday for continued negotiations on a first-time contract. This session included a federal mediator in an effort to move the process forward. 

The parties exchanged proposals through the mediator in confidential sessions. 

“The bargaining teams engaged in some joint sessions throughout the day and the presence of the mediator was very helpful,” said Aaron Adams, president of St. Charles Bend. “We are hopeful we can get back to the table soon for further discussion.” 

The St. Charles bargaining team shared with the OFNHP team that the hospital is eager to get back to the table and resolve the situation, but continues to find it challenging to both bargain and run the hospital during a strike. For this reason, St. Charles has asked the union if its members would be willing to return to work so the hospital can create an environment in which its team could better focus on bargaining.  

“No one wins in a strike – not the health system, not our caregivers, not our patients, not our community,” Adams said. “We want the strike to end so we can get back to the table, resolve the contract and focus all of our energy on the most important work of all – caring for our patients.”

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,600 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

                                                                        ###

OFNHP continues to be unresponsive

Now on day five of its strike, the Oregon Federation of Nurses and Health Professionals (OFNHP) has neither declined St. Charles Bend’s March 3 supposal nor provided a counter, or otherwise made any attempt to respond to that proposal since the strike began. 

The parties are still scheduled to meet with a federal mediator for the next bargaining session on March 10. In the meantime, operations at St. Charles Bend continue uninterrupted with qualified replacement workers covering shifts throughout the hospital. Surgeries and other procedures are taking place as scheduled. 

“We’ve not received a return to work notice from the union, which is the first step in the process of bringing our caregivers back to work,” said St. Charles Bend President Aaron Adams.  

Two core issues still remain on the table: compensation and union security.   

The teams have agreed upon wages for the first year of the contract. Under this agreement, the average hourly wage for techs in the bargaining unit will be $41.94 per hour. This equates to an annual base salary of $87,000 a year for a full-time equivalent position, not including overtime, premium pay, shift differentials and other benefits. However, wages for years two through five of the contract are still being negotiated. 

The union has also requested a closed shop, meaning all St. Charles technical employees’ jobs would be conditional upon joining the union and paying 1.4% of their base wage in dues or paying agency fees and giving up voting rights. St. Charles has asked for an open shop in order to give its caregivers a choice on whether they are members of the union. 

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,600 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

                                                                        ###

At St. Charles Bend, patient care is proceeding as normal

St. Charles Bend technical workers represented by the Oregon Federation of Nurses and Health Professionals (OFNHP) went on strike at 8 a.m. Thursday for an indefinite period of time. Representatives from the hospital and union are scheduled to meet again March 10 with a federal mediator.

“I'm looking forward to getting this situation resolved and welcoming our caregivers back,” said St. Charles Bend President Aaron Adams. “They are missed already.”

St. Charles has engaged with an outside agency to recruit dozens of highly skilled replacement workers who will cover shifts at the hospital for the duration of the strike.

“Each person is thoroughly vetted by the agency and St. Charles to ensure they have the proper qualifications and work experience to competently perform their role,” said Vice President of Human Resources Rebecca Berry. “Additionally, they go through an on-site onboarding process.”

St. Charles scheduled limited surgical procedures for Thursday and today, and some cases were moved to St. Charles Redmond. Now that that the replacement workforce is in place, the hospital anticipates operating normally as of Saturday.

“We are pleased with how well the transition to the replacement workforce went Thursday,” Adams said. “Technicians came from all corners of the country, and from some of the top medical centers. We’re pleased we have been able to mitigate disruptions to our health care services.”

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,600 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

                                                                        ###

St. Charles saddened by OFNHP members choice to strike 

Although St. Charles Health System leaders provided another confidential supposal through a federal mediator to the Oregon Federation of Nurses and Health Professionals last night in an effort to avoid a work stoppage, the union rejected the offer. At 8 a.m. this morning, some technical workers at the Bend hospital chose to walk out rather than come back to the important work of negotiating a first-time contract. 

“This is a sad day,” said Aaron Adams, president of St. Charles Bend. “We want to come to an agreement with our caregivers and have attempted to do so repeatedly. But we also have an important job to do and responsibility to our community. Our focus is taking care of our patients.”

The St. Charles Bend hospital is open and providing care as usual. Trained replacement workers are on site and the community should feel confident in the care they will receive. 

“It is important to us that you know we are here for you,” Adams said. “No matter what happens in the coming days, St. Charles has been here for our Central Oregon patients for more than 100 years and that won’t change.”  

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,600 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

                                                                        ###

St. Charles and OFNHP unable to come to agreement on next steps 

BEND, Ore. – In an effort to move forward negotiations on a first-time labor contract, St. Charles Health System approached the Oregon Federation of Nurses and Health Professionals Tuesday with an offer to return to the bargaining table with a federal mediator today if the union would revoke its strike notice.  

The union was unwilling to do so. The notice, which St. Charles received on Feb. 22, indicates the 156 technical employees represented by OFNHP plan to strike for an indefinite amount of time starting at 8 a.m. Thursday, March 4.   

“We simply don’t have the resources to focus on bargaining a new contract while we are actively preparing for a strike of our technical workforce,” said Aaron Adams, president of St. Charles Bend. “Our top priority must be ensuring we have replacement workers here to care for our community.” 

The timing of the strike is particularly challenging as St. Charles continues to suffer incredible financial losses due to COVID-19. The health system ended 2020 about $21 million below its financial targets even after Cares Act relief funding – mostly because of extended periods of time where surgeries were canceled due to state restrictions or the high volume of COVID-19 patients. St. Charles is experiencing a difficult start to 2021 as well after posting an operating loss of $4.9 million in the month of January. 

St. Charles is not alone. The American Hospital Association estimates that hospitals lost approximately $323 billion in revenue in 2020.  

“While many other health systems laid off staff early on in the pandemic, we made sure our caregivers continued to receive full paychecks even when we didn’t have patients for them to care for,” Adams said. “We have put our caregivers and our patients first throughout this pandemic, which has been hard on us financially. It is unfortunate that OFNHP is now adding to that financial strain.” 

St. Charles values its caregivers and respects their rights to union representation. Before the strike notice was sent, the health system initiated discussions with a federal mediator to help move forward negotiations in the best interest of all involved.  

Only two core issues remain on the table at this time: compensation and union security.  

The teams have agreed upon wages for the first year of the contract. Under this agreement, the average hourly wage for techs in the bargaining unit will be $41.94 per hour once the contract is ratified. This equates to an annual salary of $87,000 a year for a full-time equivalent position, not including overtime, premium pay, shift differentials and other benefits.  

As for union security, St. Charles has asked for an open shop in order to give its caregivers a choice on whether they are members of the union. The union has requested a closed shop, meaning all St. Charles technical employees represented by OFNHP could lose their jobs if they decide they do not want to join the union.  

“We believe in the rights of our caregivers who are interested in union representation to be represented,” Adams said. “But we also believe those who are not interested should have the same right to decline union membership.”  

At this time, the strike is scheduled to go forward on Thursday morning. The parties are still scheduled to meet with a federal mediator for the next bargaining session on March 10.

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,600 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

                                                                        ###

St. Charles prepares for potential strike of technical employees

BEND, Ore. – St. Charles Health System is continuing to prepare for a strike of its technical employees who are represented by the Oregon Federation of Nurses and Health Professionals. According to the notice received last week, the strike is set to begin at 8 a.m. on March 4 and will last for an indefinite period of time. OFNHP represents about 150 technical caregivers on the St. Charles Bend campus.

St. Charles has filed two unfair labor practice charges against OFNHP with the National Labor Relations Board because we believe the strike notice was not lawful and that the union is not bargaining in good faith.

“The National Labor Relations Act requires that when a first contract is being negotiated the union must provide at least 30-days’ notice of the contract dispute to state and federal mediation agencies so the dispute may be resolved without a work stoppage,” said Rebecca Berry, vice president of Human Resources for St. Charles. “As a result, we believe the strike notice is unlawful and the NLRB is now investigating that issue.”

It is our understanding the NLRB will not reach a decision before the March 4 strike date. Consequently, St. Charles has also filed a complaint for injunctive relief to ensure we can maintain health care services until the issue can be resolved.

A hearing is scheduled related to the injunction request in federal court in Eugene at 9 a.m. on Tuesday, March 2. If the injunction is not granted, the strike will not be paused, but the issue of the legality of the strike notice will remain before the National Labor Relations Board.

“It is our fundamental mission and responsibility as a health care organization to take care of our community,” said Aaron Adams, president of St. Charles Bend. “Although we believe the strike notice is unlawful, we will proceed with preparations to ensure continued care for our patients.”

Until the outcome of the injunction hearing is known, St. Charles is continuing to prepare for a work stoppage. The health system has contracted with an outside agency to hire qualified replacement workers and is also asking internal caregivers who hold technical certifications, but who are not part of the bargaining unit, to help fill hospital shifts. The goal is to reduce disruptions to patient care as much as possible.

“The union has indicated they are striking to get St. Charles to come back to the bargaining table,” Berry said. “We find OFNHP’s reasons for the strike confusing since we already had a bargaining session scheduled for March 10 with a federal mediator. We were also discussing additional, earlier bargaining dates with the mediator prior to receiving the strike notice.”

St. Charles requested a federal mediator to facilitate negotiations in order to speed up the process to reach a final agreement.

“We continue to be unclear as to what OFNHP hopes to accomplish with this strike,” Adams said. “But what we do know is the union’s decision to strike has an impact on our patients, our caregivers, our physicians and our community.”

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,600 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

                                                                        ###

St. Charles responds to OFNHP strike notice

BEND, Ore. – St. Charles Health System was disappointed to receive a 10-day strike notice from OFNHP today for a strike of indefinite duration beginning March 4. OFNHP represents about 150 technical employees at the St. Charles Bend hospital campus.

“We are in the midst of a pandemic where St. Charles and all of our caregivers have been at the forefront of treating our community members with COVID-19. Our organization is also deeply involved in running large-scale community vaccination clinics for three counties alongside our Deschutes County partners,” said Aaron Adams, president of St. Charles Bend and Redmond. “While this strike notice cannot slow our efforts to meet these critical community needs, it just adds new – and unnecessary – challenges when our community needs us most.”

The timing of this notice is completely inconsistent with what OFNHP has been asking of St. Charles. As recently as Saturday, the two parties were in discussion with a federal mediator to see if new dates for bargaining could be set in addition to the March 10 date that is already scheduled. The mediator offered dates on March 3, 4 or 5, which were under consideration when the strike notice was delivered. Because OFNHP has chosen to strike, St. Charles will now be required to direct its time to strike preparation rather than negotiations and will be unable to meet during the notice period.

The St. Charles bargaining team has been waiting since Dec. 3 for OFNHP to respond to its last negotiation offer. St. Charles and OFNHP have met 28 times to negotiate the first-time contract – 23 of them during a global pandemic.

“While the surge in COVID-19 cases over the past few months has made it difficult to continue bargaining with full bargaining teams, we have invited OFNHP to provide a comprehensive response via email or over the phone. OFNHP has not chosen to do so,” said Rebecca Berry, vice president of Human Resources for St. Charles Health System. “If OFNHP believes that progress is not being made, it needs to look at its own decisions. We were concerned enough about the lack of progress that we suggested bringing in a federal mediator and OFNHP agreed. Now, OFNHP has issued a strike notice without ever meeting with a mediator even though it had already agreed to the specific date of March 10 for our next session. We don’t understand OFNHP’s strategy.”

Because St. Charles leaders are concerned that OFNHP is bargaining in bad faith – and in doing so jeopardizing the patients in our community – the health system plans to file an unfair labor practice charge of bad faith bargaining with the National Labor Relations Board so that these concerns can be fully addressed.

“Again, we reiterate our disappointment in OFNHP’s decision,” Berry said. “St. Charles will take all necessary steps to ensure that care for our community continues in a safe and uninterrupted way.”

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond, Sisters and La Pine. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,600 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

                                                                        ###

Today, we have 17 patients at the St. Charles Bend hospital who are sick with COVID-19.

This isn’t the highest number of hospitalizations for the virus in Central Oregon, nor is it the lowest. But many of these patients have been quite sick, which is an important reminder for all of us about how important it is to continue avoiding catching or spreading COVID-19.

Case counts in all three Central Oregon counties are much lower now than they have been in recent months, but it is still absolutely critical that we continue to follow safe public health practices. Please be diligent about hand washing, masking and distancing – especially with new, more contagious variants of the virus spreading throughout the country. Vaccinations will also greatly help to reduce the incidence and severity of the virus, but access to vaccine supply remains a challenge.

To see how our St. Charles campuses throughout Central Oregon have pitched in to care for all patients throughout the pandemic, take a look at our latest video.

Vaccine news

In the latest on the vaccine front, our tri-county effort continues at the Deschutes Fair & Expo Center, where we are actively providing second doses to thousands of Central Oregonians. This morning, we opened up scheduling for 1,000 first doses to be administered Sunday, and by this afternoon, those were already completely full.

The good news is that the state has issued a new vaccine allocation plan and we will be adding new appointments to the schedule each week. Going forward, we expect Deschutes County to announce information on appointment availability on Fridays, with scheduling opening on Saturdays. To ensure you receive those announcements, we suggest connecting with the county's communication channels. And to be clear, this is a tri-county effort, so this information applies to residents of Crook and Jefferson counties as well.

I want to emphasize this: As they did today, these vaccine appointments will fill up quickly. If you miss out one week, please don't fret. More will open up in the following weeks. You'll have more chances to get an appointment. And we will repeat this process until everyone who wants a vaccine gets one.

If you are eligible to receive a vaccine, you can also check our St. Charles website for appointments at any time. If you need help registering online, refer to this video tutorial. A hotline is available for support from 9 a.m. to 5 p.m. Monday through Friday and 9 a.m. to 1 p.m. on Saturday. The number to call is 541-699-5109.

In addition, the federal retail pharmacy program is now underway. While St. Charles and our partners at the county public health departments are not responsible for this program, we do encourage Central Oregonians to regularly check the following websites for appointment availability:

• Albertsons/Safeway: http://www.safeway.com/pharmacy/covid-19.html
• Costco: https://www.costco.com/covid-vaccine.html
• Healthmart: http://www.healthmartcovidvaccine.com/

Each pharmacy is only receiving about 100 doses per week at this time, so appointments are likely to fill fast.

Finally, many primary care providers are now approved by the state of Oregon as vaccine administration sites. This includes our St. Charles Family Care clinics. This week we are administering 50 first doses to eligible patients through our St. Charles Family Care clinic in Madras. The clinic staff is reaching out to eligible patients directly to set up appointments. Please do not call the clinic to request an appointment as we do not want the phone lines to be overwhelmed.

As you can see, there is a lot of effort going into making as many vaccines available as possible throughout our region. Thank you, again, for your patience, understanding and willingness to help our health system fight COVID-19.

Sincerely,
Joe