A letter explaining the staff reduction was sent to employees like Kayla Toney last week.
"There's not a day that I don't go without thinking about it and stress about it and people will say don't stress about it until that time comes, that's easier said than done," Toney said.
Wednesday the hospital's leadership team discussed the layoffs for the first time publicly.
"Saying goodbye to any of our staff is a very difficult thing," Steve Holmanm, CEO of Union Hospital said.
"This is a significant impact on lives," Sally Zuel, VP of Human Resources said.
"This is something you're seeing nationwide, we've already seen it in Indianapolis now we're seeing it more local," Dr. John Bollinger, Union Hospital's chief medical officer said.
Just like other hospitals across the country, Union says it's battling a rapidly-changing healthcare environment.
Further complicating things is the implementation of the Affordable Care Act.
"Sequester was one that we've seen significant revenue decreases from, but also from the Affordable Care Act we've seen decreasing from medicare and medicaid," Holman said.
Union Hospital has seen a nearly 10-percent drop in overnight patient stays. Another drop in revenue for the healthcare system.
"We were just reminded this morning of an in-patient hip replacement surgery that is now done in such a fashion that people can leave in one day, versus a three to four day stay in the hospital," Pat Board, Union Health System CEO said,
The job cuts will primarily impact support staff.
"Direct patient care areas are not as much impacted by this," Holman said.
An impact Kayla Toney doesn't even want to think about.
"I have a lot of responsibility so this is important to me to keep my job. And I rely on this job so it would be really bad if i was to lose my job," Toney said.
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