When I make rounds, I’m often taken aback by the skill and dedication nurses possess as they confront obstacles to care delivery. There are two threads that always stand out, however. The first is the lack of staff.
Not all nurses identify this in terms of its nuances. We’re so conditioned to accept sub-optimal staffing that we think “a good day” is getting out on time; as if leaving on time is a coveted privilege!
Many believe that working through meal breaks or running ragged all day is written into the terms and conditions of our employment. When I ask nurses why they don’t take rest breaks, or why they chart on patients during their meal breaks, some say, “Well, it was my choice. I needed to get out on time today.”
Meetings and classes are held in a number of our hospitals. Management says nurses are not interested in attending. Nurses say they’d like to go, but who’ll take care of their patients when they’re away? Everyone else is overwhelmed. They’ll have to “catch up” when they come back to the unit – and forfeit leaving on time.
There are nurses who are ill, yet still come to work. Some worry that they’ll leave their colleagues short. Others fear retaliation from employers who are under the bizarre impression that nurses don’t get sick. Current employer policies discipline nurses who are legitimately ill! Hospitals shift the blame for short staffing on sick calls or medical and family leaves, rather than on chronic understaffing.
More than 90 percent of nurses are women. We are the primary caretakers of our extended families. We get pregnant, have babies, look after sick parents (whom the current healthcare system routinely mismanages), and get injured on the job at a higher rate than most other workers. Our society’s policies ignore that most families depend on our income to survive.
Minimum staffing ratios are designed to predict and plan for all of the above and to ensure that, no matter what, patients will get the care they need, by having enough registered nurses at the bedside. That is why we go to Albany – to fight for laws that protect us all.
The other thread is more multi-faceted: inefficient systems; lack of supplies, support, education, and follow up; patient recidivism; clinical decisions and practices driven by insurance companies, not practitioners; frustrations with the healthcare our own families receive; fears of prohibitive costs of care when we’re no longer able to work.
The overarching solution to these problems is single-payer healthcare, which would align us with the rest of the developed world. It is a key NYSNA legislative initiative that would build a comprehensive alternative to the harmful healthcare for profit system that victimizes us today.
Safe staffing ratios and single-payer healthcare are the motor behind which a humane delivery system, putting patients before profits, can be constructed. We, NYSNA nurses, have the potential to be among the engineers of momentous change that our cities, states, and nation so sorely need.