Even when the cards are stacked against us
This is what I hear most often when speaking with nurses across the regions. We’re so demoralized that we don’t know where to begin to describe our alienation. And while staffing is the primary logistic reason for our frustration, the lack of respect for us, our dehumanization by employers and “systems” set the stage for our unhappiness and even patient outcomes.
Senior nurses mourn the loss of that sense of pride we felt, knowing we were part of shaping the future of an uplifting profession. Nursing is still respected, but we know that much of what we offer to our patients--and to new nurses--is shrouded in mandates built around checking boxes, scanning codes, endless “metrics” we’re hounded to meet, and new protocols to master—that change constantly.
Newer nurses are thrust into environments that violate what we’re taught in nursing schools, with subsequent culture shock so intense that many move out of hospitals, even out of nursing, within a year. Remember the maxim: “From Novice to Expert?” Nowadays it’s “From Idealistic Graduate to Survivor.”
Nurses in the “in-between” group have a love/hate relationship with our jobs. We recognize that something is terribly wrong. But just keeping people alive, trying to make a difference when staffing and support is lacking—is simply exhausting. We rarely have the energy to tackle big picture items, even our own exploitation.
We move from unit to unit, title to title, facility to facility, looking for satisfaction. Some try to capture a sense of accomplishment, knowing that we did make a difference. Sadly, others have given up, finding that so many roadblocks in our attempts to provide compassionate care that we surrender, mechanically doing “the best we can” until the shift ends.
And what about the patient?
Our patients get lost in this bureaucratic sea of red tape, supposedly to improve outcomes, but really engineered to ensure billing. Nursing documentation is actually designed to capture charges to patients and insurers for services rendered. The cutthroat race for profits has now fully taken over clinical services.
How many administrators are MBAs, not MSNs? Clinical decisions about staffing, the physical plant, job descriptions, who does what and when—these are now under the purview of bean counters instead of clinicians. And while nurses and other caregivers are the victims of these poor and even dangerous decisions, it’s the patients who suffer at the end of the day.
The role of the union
What is the role of a union and professional organization, committed to defending workers’ and patients’ rights, nursing practice, and the overhaul of a dysfunctional health care system? How do members see “the union?” Do we see ourselves as part of it, of shaping it, of utilizing its structures to rectify wrongs? Or do we see it as a thing apart, a “fixer” that somehow miraculously steps in to resolve decades of injustices?
Our employers want us to see the union as a “third party,” an interloper in what should be a “loving” labor-management relationship. When the members obtain gains either through a contract fight, a grievance or a job action, the employers try to take credit for the very thing they fought tooth and nail against!
No employer ever “gave us” anything and neither did any “third party.” The members won these things, because we are unionized, and we use that potent tool to achieve our objectives. Sometimes we win big, sometimes we win small, and sometimes we just make a dent in the power of the employer.
It’s hard to see that solutions are not manufactured overnight. We live in a society of impatient people wanting quick fixes and soundbites. But that’s not real. We’re many, but we are up against mega-corporations whose influence goes beyond our hospital walls. They think they’re monolithi. They’re wrong. In spite of their power and manipulation, we’ve chipped away, brick by brick, at their fortresses.
Nurses and our unions won PPE that wasn’t forthcoming, saving countless lives of front-line caregivers during the height of the Pandemic.
Finally, we won the HERO Act that codifies workplace safety. We have a first ever Staffing Bill, that, just like the California law, will require very hard work on our part to fulfill its mandate.
We continue to wage our battles against our bosses’ cynical use of COVID to violate our rights. We’ve won some of them, but to win big, we must continue to connect the dots between nursing, a total transformation of our health care system and more just ways of creating revenue.
It’s scary to think the future is in our hands.
But it is.