The management of Civista Medical Center in Southern Maryland recently learned an important lesson: No matter where an 1199SEIU caregiver works, no matter how hard her fight, her brothers and sisters in the Union will have her back.Though Civista is in the small town of La Plata, about 40 miles south of Washington, 1199SEIU Pres. George Gresham and SEIU Healthcare Division Chair Dr. Toni Lewis both traveled there on Saturday, April 14, to lead a 450-person Rally for Safe Staffing in support of the hospital’s nurses.For four months, Civista’s RNs, members of 1199SEIU, have been locked in tough negotiations for a contract that will update the strong staffing ratios the nurses won in past agreements. Gresham, underlining the importance of the fight, said, “The nurses of Civista have won safe-staffing standards that are some of the best not only in Maryland but across the country.”Unfortunately, Civista management’s commitment to those standards seems to have been slipping in recent years, and the hostile stance they’ve adopted in bargaining raises serious concerns for the future. Early in negotiations, the hospital sought drastic and unprecedented take-backs from the nurses. At the same time, hospital officials made little to no movement on the RNs’ safe-staffing proposals.In March, with management still moving very slowly at the table, the 1199SEIU nurses voted 117-0 to authorize their bargaining committee to consider actions up to and including a strike. That unanimous vote clearly got management’s attention. Civista officials took their take-back proposal off the table—a serious achievement given how bruising negotiations have been—but they still refused to make substantial progress on the nurses’ safe-staffing proposals.So, with safe staffing in jeopardy, the nurses called on supporters to join them at the April 14 rally and Pres. Gresham, Dr. Lewis and hundreds of 1199ers and local community members answered the call in a big way. Under a cloudless sky, they gathered on a large lawn near La Plata Town Hall and let the public know what’s really at stake in the Civista fight.“When management hurts nurses, it’s the patients who suffer,” said Joy Adiansingh, an RN in Civista’s intensive care unit. Currently, patient-to-nurse ratios in the ICU are supposed to be 2-to-1, but Adiansingh noted that persistent short-staffing has sometimes forced ICU nurses to care for as many as three patients, making it much more challenging to provide quality care.David Dutile, an RN in the Civista Emergency Room, told the crowd how the ER’s patient load “has jumped from an average of 120 patients a day a few years ago to as many as 180 or even more now. … That’s why we’re working so hard to make sure we continue to have a 4-to-1 patient ratio in the ER. We’ve asked management to put that safe-staffing ratio into writing, but so far they’ve refused.”Gail Kingman, a med-surg RN, offered historical context, talking about the tough 1999-2000 contract talks that first established staffing standards in the nurse’s contract. Back then, Kingman explained, med-surg nurses at Civista had a crushing 12-to-1 patient-to-nurse ratios. Other units were struggling too, but management said it didn’t have the money to do any better.Feeling they had no other option, the nurses voted to strike and stayed out for two-and-a-half weeks. “The strike was the last thing we wanted to do, but patient safety comes first,” Kingman told the Maryland Independent, the leading local paper, which covered the rally. The nurses’ stand for patient safety paid off. At the end of the strike, the RNs of this small-town hospital had won contractual staffing standards that even most big-city hospitals didn’t have.Today, Civista management is again saying it doesn’t have the money to address the nurses’ concerns. In fact, Civista is thriving. The hospital made a $5.5 million profit in just the first six months of Fiscal Year 2012. Civista has the resources, and the responsibility, to provide proper RN staffing for Southern Maryland patients.In his remarks that capped the rally, Gresha