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By
Judy Sheridan-Gonzalez, RN

One hundred years ago, women in this country did not have the legal right to vote.

Fifty years ago, African-Americans in most southern states risked their lives if they attempted to exercise their right to vote.

How aware are we of our people’s history; the heroic struggles of so many that came before us so that we could enjoy the things we now take for granted?

I’ll bet at least half of our readers are unaware that the Supreme Court struck down Section 4 of the Voting Rights Act only last year!

Even if written into law, sacred rights require constant vigilance.

There are open – and insidious – attacks on such rights every day.

Freedom of speech and freedom of thought are only two examples.

Big brother: in our schools and hospitals

Right now, in a suburb of Denver, Colorado, there is an attempt by a right wing school board majority (by a vote of 3 to 2) to “adjust” the AP history curriculum so that it is more “patriotic” and emphasizes the “free enterprise system,” rather than mention “civil unrest” or the “questioning of authority” to correct injustices.

Ironically, this attempt has been met by protests on behalf of students, parents and teachers, who are demonstrating, circulating petitions and engaging in “civil unrest,” the very thing that the School Board wishes to omit from US history!

The proliferation of standardized tests, scripted curriculum and prescribed thinking in our schools is much like the overkill we see in our hospitals. Nurses are besieged with standardized computer-driven assessments and data collection, scripted speeches we are directed to give to patients, adoption of new ways of thinking about patients – throughput, lean management, reducing length of stay, satisfaction surveys, endless new “initiatives,” theoretically to “streamline” care.

The manner in which nurses are forced to practice in today’s environment is a betrayal of what we learned in nursing school and what we entered the profession for in the first place. Teachers, social workers, even doctors express many of the same frustrations.

Factory model human services

All people are individuals. They learn, think, get sick and heal in different ways. The challenge and the joy of being a professional is built around tapping our knowledge base and life experiences to impact our patients, clients or students in our own unique way. The key element in this construct is the relationship we build with those for whom we are providing services.

There is a psychological purpose behind this factory-like environment that healthcare facilities have turned into. The transfer of time spent with patients to time spent with machines – computers, scanners, pumps and the pyxis – distorts our nurse/patient relationship as our priorities shift from human interaction to data entry. Even our relationships with colleagues have shifted to computers instead of conversation. E-learning has replaced classroom instruction; text messaging, electronic reports and virtual conversations have replaced real ones. Doctors can enter orders, nurses can administer medications and treatments, both can document care – without ever actually speaking or even knowing each other!

A salient example of this clinical alienation was seen in the Dallas Ebola case, where the nurse documented the patient’s travel to Liberia and the doctor apparently never saw it.

That is because the purpose of all of this technology is not about care – it is about reimbursement.

The patient as commodity

In our current healthcare system, Revenue has replaced Relationships. Patients, like students in our schools, are seen as numbers and income generators, not as unique individuals. Thus, the mandate is for professionals to march in lockstep to a prescribed set of values, practices and thinking in order to implement “the program”.

By buying into complacency, we de facto accept that we are no longer capable of independent thinking, reasoning and, yes, protesting. This is why what happened in Colorado is a chilling view of what could become the way forward if the current trajectory of things is to continue. If we allow ourselves to view our patients as income for the hospital, following all of these ideological trends without question, half the battle is lost.

Beyond voting

Paying thoughtful attention to who we vote for is important. Actively holding politicians to campaign promises is even more valuable. However, the most crucial thing we can do is to question what we hear, are taught and are directed to do by those in power. With the strength of our numbers and our protected rights as union members, we can actually change things for the better. We already have.