What the Global Nurses Movement Teaches Us
This winter, I traveled with National Nurses United leaders to Costa Rica to meet with union nurse leaders from around the world. We had great conversations with nurses from Angola, Australia, Brazil, Canada, Chile, Costa Rica, Dominican Republic, Guatemala, Honduras, India, Israel, Italy, Kenya, Malawi, New Zealand, Paraguay, South Korea, Sri Lanka, Turkey, Uganda and Uruguay.
Universal Issues
One thing that unites nurses from every part of the world is the fight for safe staffing. Every union leader had a story about how their hospitals tried to cut costs by cutting nurse staffing to the bare minimum. In some countries, the staffing ratio in the intensive care unit (ICU) is 1 to 15. Imagine being able to save lives and deliver quality care under those conditions. Mind you, these are not war-time conditions; this is daily staffing in a typical ICU in Chile.
Health equity is another universal issue. Here in New York and the U.S., we see disparities in funding in rich and poor hospitals. We see how the rich hospitals maintain their profitability by relying on the public and safety-net hospitals to care for a disproportionate share of uninsured, underinsured and Medicaid patients. These funding disparities can lead to worse staffing, worse equipment, worse outcomes and healthcare disparities for our patients.
In less-wealthy countries with even worse income inequality than the U.S., these disparities are even worse. In Costa Rica, we saw a rich, cash-only hospital across the street from a poor hospital that cares for every patient. The poor hospital had a long line of people outside its doors. People can wait for days to be seen.
Union Rights Around the World
We also heard from our global nurse union siblings about how they fight back and advocate for health equity, and some of their stories really shook me. In many countries, it is not legal to picket, and you can even get arrested for talking about racial healthcare disparities and hospital staffing conditions. In Honduras, the president of the nurses’ union is under threat of arrest. It takes incredible bravery to be a unionist and patient advocate under these conditions.
Maybe it’s not surprising that the countries with extreme income inequality also lack many of the basic labor rights that we take for granted in the U.S. The suppression of unions and working people’s power has led to high poverty and poor hospital conditions in places like Honduras.
Think It Can’t Happen Here?
We need to really look at where we’re heading in the U.S. This is a time when unions are under attack like we have not experienced in a generation. Funding cuts, including proposed massive cuts to Medicaid, and firings are making practically defunct the institutions that we thought would always be there to protect workers’ rights — though slowly and not forcefully enough — like the National Labor Relations Board. Massive cuts to the Occupational Health and Safety Administration will make our workplaces less safe. And we can expect the Trump administration and Congress to roll back even more laws that protect workers’ rights and union rights.
The U.S. already has the highest income inequality of any wealthy industrialized nation, and our inequality is growing. In 1965, CEOs made 21 times as much as the typical worker. By 2022, they made 344 times as much as the typical worker. With workers’ power under attack and with corporate power going more unchecked every day, it’s more important than ever that we put our difference aside and fight back.
As union nurses, we have been able to accomplish so much together. We have been able to come together and bravely advocate for our patients. We have improved conditions in our healthcare facilities by working together. We have had the protection of our union to speak out without fear of retaliation. Now we must work together to defend our rights. We may soon be in a fight for our very existence as union members, and it will take all our bravery and solidarity to win this fight.
Sources
Read sources in the online edition of NY Nurse, at www.nysna.org/new-york-nurse.
Nurses from across the globe gathered in Costa Rica for a Global Nurses United meeting.