‘Free market’ or meat market?
While nurses across the state celebrated Nurses Week this year with food, conversation and social interaction in many of our facilities, there was a bittersweet sensation permeating the atmosphere.
The nursing profession is under attack with attempts to chip away at our scope of practice in ways explicit and implicit. Patient care is being reduced to check lists and codes. All of our facilities are making cuts of one kind or another: RN staffing, ancillary staffing, benefits reductions, access to care for our communities, essential services reductions.
This leads to the obvious question: what exactly are we are celebrating?
Things to celebrate
We still can find something to feel great about every day even in this challenging environment when we make a difference in one, two or many patients’ lives. I guarantee you that NONE of these interactions are recorded in Press-Gainey surveys or patient satisfaction scores — they are too visceral, too REAL.
Many of us still work in a team, sometimes a phenomenal team, when we resuscitate a trauma victim in the ER, negotiate a complex case in the OR, pull someone out of danger in the ICU, walk a difficult patient out of a negative outcome in a med/surg unit, work with the out-patient community to live healthier lives, send a sick child home — back to a family filled with hope and a positive future.
We have a union that, in the face of the vicious attacks described above, serves as a tool to organize and win small and large victories. We can’t lose sight of what we win, when we win, and what we PREVENT our employers from doing. NYSNA nurses are luckier than the many nurses who have no representation, cannot bargain collectively and face repression with impunity.
Our health system in this country is in total disarray. To reclaim our profession and love our jobs, the entire system needs to be overhauled from one built around profit for insurers, pharmaceuticals and CEOs — based on insane reimbursement formulas — to one built around CARE. This is why we have put so much energy in the struggle for “Improved and Expanded Medicare for All,” embodied in the “NY Health Act,” one of our signature pieces of legislation. We recognize the bankruptcy of the Federal Government’s initiatives and so are focused on what we can do as a state.
As a direct result of the current system over the years, the supports we need as professionals have been removed or altered. Education has been reduced to on-line faux-learning, with the time needed to learn classified as “non-productive time” and therefore frowned upon by our penny-pinching management.
We have the power to fight every one of these ill-conceived changes — on each unit, in each department, in every facility and as a collective in our union. Our power derives from our ability to work together.
History of nurse activism
Like all history of everyday people, we are often not taught about the battles of previous generations that struggled against the odds to get us where we are today. Less than 40 years ago, nurses’ salaries were at the bottom rung of salaries of most service workers (less than sanitation workers, as one example). Through strikes, job actions and a mushrooming of unionization, salaries QUADRUPLED over a short period of time, pension benefits were won, health plans were introduced and the infancy of the concept of staffing ratios began to develop.
These gains were not generously handed to us by employers, government agencies and hospital corporations. They were won after many protracted battles, filled with sacrifice, pain and the persistence of committed caregivers — like many of you in the profession today. We need to rejuvenate that spirit if we are to salvage our health care system and our profession.
Single payer and safe staffing = inseparable
The concept of the “Free” Market in health care is the mantra for the pushers of the American Health Care Act (AHCA) today. But that concept is a misnomer. Nothing is free — that’s for sure. And the thinking that people must pick and choose from lists to obtain care; that providers have to do the same to offer care; vulgarizes the science and art of healthcare. Such a system relegates all of us to factory-like working conditions and the dehumanization of what must be the most intimate and humane of all social interactions — what we do as caregivers. It’s an obscenity.
Even if we win staffing ratios, we don’t want more of us so that we can fill in boxes and check lists and codes — we want more of us so that we can treat our patients. We want to be able to mentor new nurses and “give back” what we have learned to the next generation. We want to be able to thrive in our workplaces and have the supports we need to love what we do, every day.
We cannot do that in a market-based system, where patients are seen as non-entities, as a diagnosis with prescribed length of stays and regimens, as pieces of meat to be moved through the system with callous indifference. Only a single payer system creates a baseline (not a panacea but a beginning) from which to heal our broken system.
Nurses Day on Florence Nightingale’s birthday in her homeland
Every year on May 12, there is a service held at Westminster Abbey in London wherein a lamp is passed along a line of nurses, one by one, to symbolize the passage of knowledge from one nurse to another. The last nurse places that lamp on a high alter. We can best honor our ancestor nurses and ensure our legacy by sharing our knowledge with one another and placing our humanitarian values on a high alter, continuing the fight for a healthcare system that truly embodies the reality that “Every patient is a VIP.”