The challenges we face

Nurses and health professionals are witnesses to the dramatic changes in healthcare over the past several decades. Many of us have confronted attempts to erode our practice, reduce our level of benefits, deny us the resources and staff we need to practice safely, and weaken our collective union power. When we are organized — when members are engaged and active — we can defeat these attacks, even improve our conditions.

Unfortunately there is no magic elixir we can offer that transforms nurses into dedicated activists. Those of us who are involved sometimes feel like “I am the only one.” This is why collective action, member education and strategic planning are so important. WE CANNOT WIN ON OUR OWN.

Most employers do everything they can to keep unions out or to weaken or attack unions once they are voted in. Why? A union contract modifies employers’ supreme powers. A well-organized bargaining unit can do almost anything — within or outside of a contract — to improve our lives and the lives of our patients.

Point #1: A Union is not a “thrid party”

Management rhetoric barrages workers with the idea that organizing into a union indicates that a so-called “third party” gets “in between” the nurses and the hospital. This picture of reality starts off with a basic false assumption: that the two parties (management and workers) are in some sort of love relationship. Let’s break it down:

Hospitals need workers; nurses need jobs. We may love our patients and our profession but it’s hard to find a nurse without some conflict with management.

While we all “need” each other (they need us to work, we need a paycheck), it is the work we do that generates the wealth of the institution. The hospital pays us by sifting out the profits generated by our work and doling out a smaller amount to us. Hospital administration thrives on squeezing more “productivity” out of us in exchange for fewer benefits. “Doing more with less.”

We are not “one happy family” with egalitarian input into policies, practices and processes. In fact, nurses are always saying that if management would only LISTEN to us, they wouldn’t need to pay high priced consultants to fix problems. Common sense tells us that healthcare workers who do the work are the ones who know what our patients need.

Management often does not give nurses and other hospital workers the respect that our knowledge, commitment and experience demand. In fact, at times we are treated as if we are children who need to be controlled or distracted.

Protocols and policies are generated to meet “the bottom line,” rather than to meet the needs of patients and caregivers, which almost always go hand in hand.

Point #2: Shared What?

While nurses and administrators have an obligatory relationship, it is often not a joyous one. Increasingly, managers are less clinical and more “business-oriented,” less immersed in nursing practice and more concerned with “metrics” and “customer service,” off the unit more than they are on the unit so they can attend meetings that pull them even further away from patients.

When they return to our reality-based world they do not ask us what we think, need or want. They tell us what the newest initiatives, processes and approaches will be, as mandated by a slew of others who reside even further away from the bedside.

It is in vogue for higher level administration to create “committees” that they classify as “self-governance” or “shared governance” structures. But who are they kidding? Any suggestions that staff have are only considered if they cost no money and fit into the pre-determined “program.” Ideas and suggestions that we have are then modified by the real decision makers — the “Bean Counters” — who are most certainly not direct caregivers.

Point #3: Never Give Up

Frederick Douglass knew what he was talking about when he said, “Without struggle there can be no progress.” NO ONE SAID THIS WOULD BE EASY. Until nurses and caregivers reach the level of organization within our unions and workplaces that mimics the 1930’s, we will be waging an intense battle. That fight continues even as we achieve that level of organization — but it takes on a different, more powerful character.

Douglass reminds us that “Power concedes nothing without a demand.” When we organize collectively and articulate our demands, we’re halfway there. The numerous tactics we learn in Steward Training about how to enforce these demands show our members and our bosses that we mean business. Always remember that small victories lead to big ones. Revel in them.

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