Commentary
Forget a pay raise; just help us care for patients safely
by Lisa LetourneauEditor's note: This commentary is adapted from one of the answers sent on Wednesday to Today's Question.
I am a nurse, and very proud to be one. After a career as a noncontract employee, I never imagined that I would be grateful to be represented by a union. Years later, I see that it is only with the help of the union that nurses have a voice.
It amazes me, and saddens me profoundly, that the public does not understand what the nurses' contract fight is about, and that so many people are turning against us. Obviously, the huge effort by the Twin Cities hospitals to turn public opinion against us is working. This is not about money. It is about ensuring that language is written into the new contract that protects us from having more patients than we can safely care for.
The union is asking for a 3 percent pay raise, but we know we won't get it. Many nurses have asked our union representatives to drop the issue of a pay increase and have been told it's nothing more than a bargaining chip to get the hospitals back to the table; John Nemo, the MNA spokesperson, has said this publicly and clearly. We are fully prepared to concede any raise if the hospitals are willing to have a discussion about safe staffing levels, our real issue. Ninety percent of nurses voted to reject the hospitals' offers (93.5 percent where I work, according to the union). The real story should be why we so overwhelmingly rejected the offer and risked a strike. Hospital administrators should be asking themselves what led to this significant rejection of their offers, and how we can begin to repair the damage and move forward together with a shared vision. They should be clamoring to get back to the bargaining table, ready to stay there until an agreement is reached, rather than walking out at 2 in the afternoon on a recent Friday saying that not "one word, one sentence" of what we had to talk about was of interest to them.
We understand that these are difficult times and that we all need to be flexible. But what does flexibility mean?
Apparently it does not mean management giving up huge raises and bonuses. It does not mean spending more than the merest token amount of time on the units with the staff to get a real understanding of the workers' and patients' needs and the workflow.
Instead, flexibility means staff doing more with fewer and fewer resources. For nurses it has meant more "heads on beds," so that you get a new admission or surgical patient within minutes of discharging one, even as your other patients haven't been checked on as often as they should. It means giving up anything resembling a break to go to the bathroom or have something to eat or drink, because you don't dare step away. It too often means clenching your jaw and holding back tears because you have to be in three or four places at once.
We can't possibly be any more flexible than we have been in recent years. Hospitals spokeswoman Maureen Schriner likes to say that the nurses at Twin Cities hospitals give excellent care, and we do; but neither she nor anyone in management seems to understand the lengths a nurse goes to and what he or she sacrifices on any given day in order to provide that care.
The nurses want to get back to the table; we want this to be resolved and to move forward. But we also want our employers to realize that we are too often at a breaking point, and that we need language that protects us from tragedy. The public is hearing that we're asking for "more staffing." We do need to hire more nurses. Almost every day and every shift in May, nurses were begged to work double shifts because the units were so short staffed. Double shifts are expensive (time and a half to double time) and dangerous; do you want the nurse caring for you to be on his or her 14th hour on the job? Conversely, if we are overstaffed, nurses are always willing to take a "low census" day without pay. In the system I work in, we took almost 10,000 such days last year, saving the corporation $3.6 million.
On my busy medical/surgical unit, we currently have a ratio of one nurse to four patients at one time, which could mean five or six patients over the course of a shift with discharges and transfers. Isn't it reasonable to ask for language that protects us from doing even more than we do on a barely controlled day? This is what the negotiations and a potential strike are about.
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Lisa Letourneau, R.N., St. Paul, has worked as a nurse on a medical/surgical unit for four and a half years, and in health care for 15 years.
Comments (11)
I'd suggest that you ask for some management personnel to job shadow nurses during some of the busy shifts so that they understand.
"On my busy medical/surgical unit, we currently have a ratio of one nurse to four patients at one time, which could mean five or six patients over the course of a shift with discharges and transfers." So once 2 of your 4 patients in a shift goes home, you shouldn't get 2 more for the rest of your shift? I can't tell whether RN's understand that their demands will increase costs millions of dollars that could lead to more hospital layoffs, delays in equipment replacement, and increases to EVERYONE's insurance premiums, or whether they just don't care.
Public sentiment across the nation is not in support of the MNA. During these rough economic times and changing healthcare climate, the hospitals are trying to prepare to meet unprecedented cuts in reimbursement and an influx of patients due to healthcare reform. I suggest the MNA help the nurses by allowing LPNs in the hospitals to allow nurses to do nursing work. Asking for a raise during these economic times when MN nurses are paid an average of $10,000 more than the national average is not realistic. You will not find any other industry that pays workers full benefits for working only 16 hours a week. Pensions are a thing of the past. MNA needs to do their part. Non-union workers have taken pay-cuts and the hospitals had to cut workers to plan ahead. This is a national crisis that is affecting us on the West coast as well. I feel sorry for Minnesota nurses that have bought into the MNA national agenda. The MNA chose an area with some of the safest hospitals, best quality outcomes and best paid nurses to launch their national campaign. Poor decision. I hope this is all resolved soon.
To Sarah, to your comment that the MNA should allow LPN's to work in our hospitals. We had many good LPN's at our hospital, however, last year our hospital chose to terminate them.
Dear Deneen, Lisa does not say nurses want to discharge 2 patients and take no more patients the rest of the shift. Somehow I think you are being paid to put out misinformation against hard working nurses. I work in a California hospital with ratios, and our hospitals are not going broke. Nurses who have migrated here from the rest of the country have stated to me that they would never go back to work in their home states. Patient acuity along with required documentation increasingly takes nurses away from the bedside and onto computers. Nurses want more time to do hands on nursing care. Nurses are currently the second most injured job in America. We are looking for ways to retain nurses and keep them healthy while making the profession attractive to others who would take up our noble profession. Ultimately it comes down to what price a human life. What value is our health insurance that we work and pay for dearly. The richest country in the world, and we rank toward the bottom of the industrialized world in healthcare results. We can do better.
As a registered nurse, working at a hospital that is a Minnesota Nurse's Association (Nurse's Union) hospital, but not allowed to participate in this strike due current laws regarding our specific hospital, I would like to say that the author, Lisa Letourneau, has done a very good job of explaining what this current dispute is about. She has described the situation regarding the current status of the nursing profession very well.
Nurses are concerned that their patients are cared for in a safe way, which involves having enough people to care for them so that their safety and quality of care can be maintained at all times throughout their entire hospitalization. We, as nurses, are responsible for our patients well-being and safety. We take this responsibility very seriously, and have been expressing our desire that there be enough nurses on the floor at all times to keep out patients safe.
It is refreshing to finally see in media, what we all as nurses want to say. I am an RN in St. Paul, part of (and PROUD)MNA. Everything Lisa said is SPOT ON. People like Maureen Schriner, who have majors in PR, cannot speak to the quality of care, when there has been no concerted effort to even see what a day in our lives is like. Also, to hear them say how things were business as usual during the one day strike, is ridiculous. I had a patient who went 24 hours WITHOUT receiving one dose of pain medicatioon, which he was getting every two hours for days prior to that, and that the scab nurse, oops, I mean replacement nurses, was actually an ortho nurse, and this patient was in a neuromedical ICU. I also found it interesting that when the managers and CNP's were responsible for the patients, for a time period after the nurses were escorted out, which at my facility was nearly four hours before we were shuttled back in the hospitals, single file, surrounded by security with arms stretched wide, well like prisoners actually, there was not ONE single vital sign, or notes charted AT ALL. Any one of us before this and today, would certainly be disciplined or terminated has we comitted such a serious lack of charting. The nurse practitioner, said she could not or did not have access to the Pyxis(medication dispening system), therefor none of the patients she was covering got any scheduled or PRN medications for over 4 hours. In 20 years, I have never felt so cheated and disrespected
I'm a Minnesota nurse who will be voting tomorrow to go on strike! It's about time!
The TCH (twin city hospital group) are crying poor, according to them it would cost $250 million to staff the hospital's the way the MNA would like. These same non-profit hospital's had a total of $758 million in profit in 2009! Do the math!
Our CEO's take home millions in pay, & bonuses, including $36,000 golf memberships! And the TCH still had a $758 million dollar profit!
Limiting the number of patients a nurse has can be achieved, so that you and your loved ones remain safe! Safe staffing allows your nurse to give meds. on time, cares (like rolling you over so that you don't get bed sores), spend time explaining to you and your family how to take care of you at home, arranging for items you might need at home, discharges are not simple to do and do right!
This is a fight for you!
What a relief to see some civil and intelligent discourse here. The comments sections of the local newspapers have been so disheartening (probably because people can hide their comments behind anonymous monikers). The author of this piece IS "spot on", as one comment above noted. I am a nurse at a large Twin Cities hospital, I love my job, feel honored to be in this helping profession, and interestingly, as a consequence of this terrible contract situation, am finding out what an incredible professional association I am a member of. The Minnesota Nurses Association, a professional association that has existed for more than 100 years, is responsible for so much that I take for granted every time I walk into the hospital where I work. Just go to their website, you'll see that labor relations is only a small part of what MNA does. Thank you MPR for giving voice to someone who isn't a shill for big business. We nurses are concerned for our patients, our profession, and our future. I believe we should be allowed to fight for that with the same diligence as those across the negotiating table from us.
I work with many of these nurses every day. I promise you - every single one I have talked to would not only keep the contract they already have - but do not anticipate getting a raise. If you have never been a patient before who has had to wait to in your hospital bed to receive the care you need and deserve - you have no idea what you are talking about so - please keep your uneducated opinions to yourself.
I would simply urge the hospital administrators to get out of the office and onto the floor. Still, they will never feel our responsibility. I am worried, working at HCMC, where they hired a consulting company to determine our staffing cuts, that we will now be taking care of pts that would have gone to striking hospitals. I have been told over and over that these are"business" decisions, and when I fill out unsafe staffing forms the reply seems to be a "meeting" but no comprehension. I am thinking they want to quickly burn us out to hire new and cheaper nurses.Yes, MANY nights without bathroom breaks or eating.
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