Should nurses strike?

pickledpepperRN · Jun 24, 2003

TxsugarLVN:

It's OK. We all work hard and care so much. With the experience I gained since then I would have tried to get enough linen and deal with whoever forged my signature on those charts. It may not have been successful because the other aides were very young, stayed out most of the night, and had poor grooming (green necks from cheap jewelry and chipped nail polish.)

Fab4fan: Your facts are 100% correct. Seems management has totally fooled those others or they did not read the NYSNA link or the CNA link posted here already.

I will repeat one fact. Believe it or not.

I wrapped a young man in a body bag because management chose to send a nurse home four hours early to save money!

He died for lack of a nurse and there was NO STRIKE! It happens EVERY DAY!

5, 000 times a year in the USA!

-jt · Jun 25, 2003

Exactly. And thats why we dont just quit & abandon those pts. We STAY & take a stand to make it better. The way I see it, your description about "abandoning the pts" fits more the RN who puts in her 2 week notice & just jumps ship, leaving those pts in those conditions, than it does the RN who gives a 10 day notice that she will no longer tolerate her pts being put in those conditions.

Striking for safe pt care is not "negligence". The pts are not abandoned by a strike. Its a very controlled thing. Theres a 10 day notice for the hospital's preparation. There is a set start time. Nobody just walks out on the pts. Report is given & all pts are turned over to RNs - be they managers, clinical specialists, educators, whatever, they are all RNs. The Dept of Health is on site everyday. Admissions & elective surgeries are canceled. Pt care for the few pts who may be left is closely monitored and striking nurses are sanctioned to go back to in to handle emergencies in their specialties like NICU, ER, ICU, etc.

Going on strike is a legal thing with many strict guidelines that must be followed. Its not "negligence" but knowingly allowing unsafe conditions to persist & doing nothing about it may just well be.

-jt · Jun 25, 2003

Putting the issue of strikes aside for the moment, the above comments are frightening. We should be giving some sound advice to new nurses - as Don has - like the above is NOT acceptable. And if you do accept it, you are allowing a danger to yourself, your pts and your co-workers. There is a huge difference between "hard work" and dangerous work environments. If they still arent teaching you in nursing school that you are not expected to be a martyr, learn it now.

It does not make you a "good nurse" to be putting up with such dangerous situations. In fact, its quite the opposite. You cannot provide the appropriate care that the pts need when you are working under those kinds of conditions. And you cannot protect that pt population from each other if you are the only person there trying to maintain control. You are doing no one any favors by accepting these kinds of work environment- least of all your pts. But while you remain silent, your employer will not see a need to provide any more staff, you will be left in that dangerous environment, and your pts wont be getting the full, quality care they need either. To not object to all that is not being the pt advocate that you are supposed to be.

Besides, you are putting your own life in danger. Nurses have been killed or severely disabled in similar situations as yours. The RN in Florida and Mary Grimes in Illinois are just 2 that immediately come to mind. It is within your rights to demand a safe workplace but you will get only what you are willing to accept. Our contracts explicitly state that no RN will be left alone with the pts on any unit at any time.

You are a nurse. You are not a doormat. Your nursing license does not require you to put yourself in danger. But it DOES require you to SPEAK UP about unsafe conditions - and that is not "complaining". That is voicing your concerns as a professional and carrying out your professional responsibilities as required by your Nurse Practice Act, your RN license, and your National Professional Code of Nurse Ethics.

bender73 · Jun 25, 2003

Originally posted by fab4fan
For the love of Mike, the patients are not "left alone" when there is a strike. They are transferred out sometimes; often, hosp. admin. will hire scabs. The patients do not go without care.

I will not put my license in jeopardy simply because a hospital wants to cut corners on staffing. I can get another job; replacing a license is not as easy.

For those who feel nurses are "whiners" for protesting unsafe staffing and mandatory overtime, I have an invitation for you: Get on a plane, whose captain has already flown a full day but has now been mandated an additional 8h...oh yeah, and the company decided to do without a co-pilot for cost-saving measures.

And this may sound petty, but I have to say it: bender, please learn the difference between your/you're.

Oh brother. I am sorry that my grammar has offended you!!! YOU ARE correct, that is petty...this is not a term paper. :rolleyes:

Don't equate flying a plane to nursing, the analogy is un-educated and ridiculous. I was a pilot (until grounded due to a deviated septum) and I can easily figure out the correct drug doses I need to order when I am tired and hypoglycemic from not eating. I likely could not land a plane safely given the same circumstances. Flying a plane requires a lot more alertness, vision, skill, and feel...those factors are easily affected when tired and hungry to the point of being jittery. You can still, although not feeling great, provide RN/NP/MD care when not feeling 100%.

If it sounds like I have an answer for everything that is because I have done a lot. I work hard and play hard. I require only about 4-6 hours of sleep to function at full capacity. I can barely eat and function fine. I never back down from a challenge...I welcome it. I don't fear much. I work out 6 days a week. I get what I want because I work hard for it. I am highly motivated and will never settle for 2nd best. I don't complain to management, I just do what it takes. Its not that I am afraid of management nor am I their lemming...I just know the job I have to do going in and then I do it. When it gets rough, I grind it out and get a rush out managing a difficult situation. When it gets really rough, I push myself and get an even a bigger rush of managing a near impossible situation. After a hard day of working I hop on the treadmill, hit the weights, and think back of all the things I did in the day. Then, I wake up and do it all over again. Work hard...play hard.

Maybe I am in the 1% category. I have had a job ever since it was legal to have a job. I once paved for a company in 90+ degree heat with 12 hour days...loved it. It built character and taught me what hard work was all about. People built our great nation with lots of callouses and long days...and did it to put food on the table. These are the characteristics of a person that I respect. I don't respect people looking for an easy ride or an easy dollar.

Sorry, I went off track. I'll get off my soap box. The point being, I see a lot of RNs looking for an easy dollar and use "patient safety" as an excuse when they damn well know that striking is indeed abandonment and that goes directy against their argument. If you don't like the conditions then feel free to lobby, write letters to politicians, make your own website, or whatever. Do what you want to make the public aware of your feelings if you choose...this is a free country. However, if you walk out of the hospital and abandon your patients, I have lost total respect for you.

Do you really think people who drive by a hospital and see 50-100 RNs holding signs and picketing makes them think "Oh those poor over-worked nurses?" No, they are thinking how sad, I hope the patients are ok inside and what are they bickering about now? You know it. Think about how you felt when you have driven by a bunch of people striking at a factory or something. I'll go out on a limb and say most people ignore the signs and get annoyed when they see picketers. I doubt you stop your car, get out, and ask them what their concerns are. No you drive by on your way to dinner, pass it off as scenery, and forget about it miles down the road. It solves nothing other than to annoy management and fellow co-workers that are forced to strike by the union or suffer the consequences of being "labeled" badly if they cross the picket line. In the end you might get what you want, but in the process you have only labeled yourselves and caused others to lose respect for you.

RNPD · Jun 25, 2003

Several points about nurses and strikes:

1) No one forces nurses to strike, including the union. It is an individual decision made by the union members, not the union reps.

2) Striking is a last resort, and only occurs when management pushes for a strike. Yes that is correct. If admin would negotiate instead of dictate, nurses would not strike. We are willing to strike only for safer staffing however, even with decent raises on the table. The 6 month nurses' strike at Nyack hopital will attest to that. So it isn't all about money-although it is impossible to attract nursing staff to poorly paid facilities.

3) Nurses do not abandon patients when they strike. Hospitals choose to ignore the 10 day notice and carry on business as usual. They hire scabs and manage to find millions of dollars to pay their contracts, although they can't manage to find enough money to give their staff a raise, or to continue the benefits they already have and insist on givebacks. And, BTW, nurse to patient ratios are always much better for the scabs. And plenty of ancillary staff is available as well. So patients actually receive more attention during a strike, although the replacements often give substandard care. Many unfortunately are willing to work wherever they are placed regardless of experience or expertise, as long as they get that paycheck. They also put their patients in harm's way by working excessive and exhausting hours. (BTW, if I was willing to work those excessive hours, I would get just about the same paycheck as the scabs. The hourly rate isn't really that high once hours worked & OT is factored in.)

4) patients ARE in danger due to short staffing. Dr Linda Aiken at The University of PA recently proved this and her research was published in JAMA in Oct '02. For every patient over 4 that a staff nurse cares for, each patient has a 7% greater risk of dying after routine surgery. This is related to "failure to rescue". It was seen quite poignantly at Mount Sinai in NY when a man in his 50s who was quite healthy, donated a part of his liver to his dying brother. The overworked RNs and RESIDENT (take note here bender) missed the subtle signs of an impending crash due to overwork, high patient loads and exhaustion. Had they reacted quicker, that man would be alive today. Mount Sinai was cited and fined by the DOH for inadequate staff. Mt Sinai's respnse-they announced a layoff of RNs 6 months later (Pending). The reponse of most hospitals to this published research?-most staff nurses today continue to care for between 8 and 10 patients on the day shift-more on off shifts. Therefore, RNs have a moral and legal responsibility to advocate for safe staffing and to refuse to work in a situation that puts their patients and themselves in danger.

5) The answer isn't if we don't like it get out. That is proven by the fact that hundreds of thousands of RNs have done just that-leading to one of the worst nursing shortages in history-and it is projected to worsen to the point that 800,000 RN positions in this counrty in 2020 are expected to be vacant. Who will care for the patients then? UAPs-which is exactly what the hospitals are praying for. They can then pay them a lot less, all the while whining "but there aren't any RNs available!".

6) So what is the answer? Since the hospitals have done such a lousy job, and nurses can't seem to find their collective voice (due unfortunately to the martyr syndrome, the selfish syndrome, and too many other syndromes to mention ), it is time for federally mandated legislation to save American patients-who will one day be US! It is time that nursing is repsected by allowing us more autonomy in caring for our patients-by not allowing patient care to be driven by greed. Bender, I suggest you read "Code Green-Money Driven Hospitals and the Dismantling of Nursing" by Dana Beth Weinberg, PhD. Also try this article by Weinberg & Suzanne Gordon-a non-nurse nursing advocate; "Cutbacks in nursing are harming patients". It appeared last week in the Boston Globe. here is a web addy

http://www.boston.com/dailyglobe2/168/oped/Cutbacks_in_nursing_are_harming_patients+.shtml

I suggest that those of you who seem to care but really don't seem to get it need to educate yourselves. Start with the above; both are very good. Others like tom I simply have no use for, and no amount of education will help someone like him.

As for should nurses strike and would I cross a picket line? After reading what I wrote do you still need to ask?

pickledpepperRN · Jun 25, 2003

Originally posted by bender73

Don't equate flying a plane to nursing, the analogy is un-educated and ridiculous. I was a pilot

When it gets really rough, I push myself and get an even a bigger rush of managing a near impossible situation.

Maybe I am in the 1% category. I once paved for a company in 90+ degree heat with 12 hour days...loved it. The point being, I see a lot of RNs looking for an easy dollar and use "patient safety" as an excuse when they damn well know that striking is indeed abandonment and that goes directy against their argument.

What about impossible rather than 'near impossible'?

http://www.calnurse.org/gr/tenyearhist.html

Check the link for what thousands of the other 99% of us who need to eat, sleep, and can only be in one place at a time have been doing on our time off.

I am twice your age, worked for 46 years so far, raised two kids who are fine adults, cooked, cleaned, and did the laundry.

I have been injured in accidents, survived cancer, and do volunteer work. I have spent one hundred thousand hours at direct patient care.

I am Not supernurse. Am I abandoning my patients when I say I am too tired after a 12 hour night shift without sitting down, eating, or urinating? Must I stay another 4? More if management in the office asks?

I cannot titrate several medications mcg/Kg/min to the BP, PA, PCWP, PVRI, SVRI, while timing the IABP, suctioning, stripping the chest tube tubing, checking the glucose, titrating the insulin drip, trying to wean the patient from the ventilator, doing Q 15 adjustments of the CRRT, explaining , comforting, and keeping the patient in bed, assisting the family and patient cope, ordering labs, communicating with the physician (rather have OUR critical care NP) feeding the patient, bathing, AND getting the next admit from the ER. Which patient do I leave? Do I assess the new patient while gambling with the original patients life? (What IS the K+?)

Do I hope the new patient is OK? Do I assume someone not assigned and just as busy will help?

When something happens am I abandoning future patients when I lose my license for failing to act as a patient advocate. Remember this is my 20th hour. I am due back in four hours.

The 99% group can only be in one place at a time.

Without the 99% you are one illness or accident away from having no nurse.

We are human.

bender73 · Jun 25, 2003

Is someone missing the point completely? ...RNPD?

I never disagreed with the fact that there are indeed problems. I am not blind to what is going on in the world of nursing. Moreover, I am not in favor of nurses being abused. Some people make me sound like I am anti-nurse and pro-management.

I am merely stating that striking is wrong...as well as adding a little color commentary based on my personal beliefs. Feel free to disagree.

We can go around in circles all day long on the issue, but it will always come down to the undisputed fact that striking is abandonment, plain and simple...and to say otherwise is simply wasted bandwith. There is no evidence you can post to support your arguments that striking equates to quality bedside care during the time of the strike by those standing outside the doors of the hospital. There is plenty of evidence to support the argument that RNs are not working in an ideal environment, I agree.

What it all boils down to is choice, morals, and personal ethics.

-I choose to be with the patient

-Its morally wrong to me to walk out the door and abandon a patient

-My personal ethics will not allow me to strike

Others might hold themselves to a lesser standard or apply justified logic to a situation that I, as well as many others, see as illogical. Its your choice.

bender73 · Jun 25, 2003

Originally posted by spacenurse
What about impossible rather than 'near impossible'?

http://www.calnurse.org/gr/tenyearhist.html

Check the link for what thousands of the other 99% of us who need to eat, sleep, and can only be in one place at a time have been doing on our time off.
I am twice your age, worked for 46 years so far, raised two kids who are fine adults, cooked, cleaned, and did the laundry.
I have been injured in accidents, survived cancer, and do volunteer work. I have spent one hundred thousand hours at direct patient care.
I am Not supernurse. Am I abandoning my patients when I say I am too tired after a 12 hour night shift without sitting down, eating, or urinating? Must I stay another 4? More if management in the office asks?
I cannot titrate several medications mcg/Kg/min to the BP, PA, PCWP, PVRI, SVRI, while timing the IABP, suctioning, stripping the chest tube tubing, checking the glucose, titrating the insulin drip, trying to wean the patient from the ventilator, doing Q 15 adjustments of the CRRT, explaining , comforting, and keeping the patient in bed, assisting the family and patient cope, ordering labs, communicating with the physician (rather have OUR critical care NP) feeding the patient, bathing, AND getting the next admit from the ER. Which patient do I leave? Do I assess the new patient while gambling with the original patients life? (What IS the K+?)
Do I hope the new patient is OK? Do I assume someone not assigned and just as busy will help?
When something happens am I abandoning future patients when I lose my license for failing to act as a patient advocate. Remember this is my 20th hour. I am due back in four hours.
The 99% group can only be in one place at a time.
Without the 99% you are one illness or accident away from having no nurse.
We are human.

Did I say that "your" a bad nurse? Did I say that I expect "you" to be on my level (or me on yours)? Do I think I am any better than everyone here? No. We all have strengths and weaknesses. I could do a 12 hour shift, eat, and probably do 12 hours more...that is not the point. I never said that all things in the world of nursing were perfect.

Perfection aside, the face of healthcare is changing...on many levels. The expectations of today's nurses are changing. You can fight change all you want, just do it without striking and when your not working your shift.

pickledpepperRN · Jun 25, 2003

Just TRYING to explain that patients die because MANAGEMENT would rather have a strike then show those who do the ONLY work the patient is admitted to a hospital for the respect of negotiation with them. When they say, "My way (unsafe staffing and mandatory overtime) or you can strike" what is the choice?

For profit chains routinely buy all the hospitals in an area and close 40%. Patients then die on route to the nearest ER passing a former hospital. Did THEY abandon the patients?

bender73 · Jun 25, 2003

Originally posted by spacenurse
Seems someone is.

You know, for someone twice as old as me (as you stated), why not try acting like it. I have not personally attacked anyone here or posted something as childish as that. I have thick enough skin to ignore that junk, but that is not the point. Comments like that are just useless sarcasm backed by no thought. Debate the issue or ignore the thread.

pickledpepperRN · Jun 25, 2003

Originally posted by bender73
Alright, look, my response was a bit harsh but I am tired of seeing and hearing about pickets, protests, etc.. I'll try to explain my answer of "No" better.

I am a Nurse Practitioner that admits and follows patients at a large city hospital. The attitude of a lot of nurses is poor and is likely reflective of a large percentage of the nursing community.

Yes, I am a nurse. I am an NP and my function at this hospital is 99.9% that of an MD.

My argument is that every time I turn around there is some RN gripe. I work hard and have tremendous pressure. My decisions/orders are not directly supervised by an MD and I don't just carry 3-4 patients...at times it could be 6 or more. I have to constantly answer pages by RNs and run to the ER to write orders on patients. The work can be very stressful and like the residents there, I don't get paid as much as the attendings.

My point being that, like the residents and other NPs, I suck it up. I do my job. What do RNs want? Heck, you have PCAs to help out. Some jobs are simply just demanding...accept it and do your best. It might be hard, but do your job.

Physicians (even the ones in their 50s or 60s) can put in 60+ hours a week and $150,000/yr is not a ton of money with $200,000 in student loans, kids, etc.. They don't strike against the hospital or group practice...its part of the job. NPs don't typically strike. It always seems to be the RNs.

If your short-staffed then you just have to work harder. If I am paged to the ER to admit more patients than I can get done in my shift then I have to stay later...and I am on salary so I don't get overtime!!! ITS PART OF MY JOB SO I DO IT. I might get annoyed but I don't run outside and picket.

RNs, not all of them, need to learn to accept the fact that this is the healthcare system today. Its fast-paced and requires a lot of work.

What exactly do RNs want? An easy day with a few patients? Longer lunches? Coffee breaks? Cigarette breaks? More and more money? I am salary and I don't even get any set breaks. ER docs and NPs work their tails off and eat between patients...and end up staying longer than their shift...all while maybe carrying 10 patients at once and making critical decisions. Do they strike? No.

Its an attitude that is getting out of hand. I can understand some of the gripes RNs have. I really do. But there has got to be a point where enough is enough.

Feel free to flame away at me because I am sure I will get flack. I am in no way saying all nurses are like this. Moreover, I can indeed see some issues that need to be addressed in the system. However, people are losing sight of what it means to do a job. Sometimes that job is just very hard and demanding...and requires one to go the extra mile without running outside to picket or blaming management. All that does is possibly degrade the perception people might have of a nurse.

*It is not my intention to generalize all nurses and this is just my opinion.

pickledpepperRN · Jun 25, 2003

Originally posted by RNPD
Several points about nurses and strikes:

1) No one forces nurses to strike, including the union. It is an individual decision made by the union members, not the union reps.

2) Striking is a last resort, and only occurs when management pushes for a strike. Yes that is correct. If admin would negotiate instead of dictate, nurses would not strike. We are willing to strike only for safer staffing however, even with decent raises on the table. The 6 month nurses' strike at Nyack hopital will attest to that. So it isn't all about money-although it is impossible to attract nursing staff to poorly paid facilities.

3) Nurses do not abandon patients when they strike. Hospitals choose to ignore the 10 day notice and carry on business as usual. They hire scabs and manage to find millions of dollars to pay their contracts, although they can't manage to find enough money to give their staff a raise, or to continue the benefits they already have and insist on givebacks. And, BTW, nurse to patient ratios are always much better for the scabs. And plenty of ancillary staff is available as well. So patients actually receive more attention during a strike, although the replacements often give substandard care. Many unfortunately are willing to work wherever they are placed regardless of experience or expertise, as long as they get that paycheck. They also put their patients in harm's way by working excessive and exhausting hours. (BTW, if I was willing to work those excessive hours, I would get just about the same paycheck as the scabs. The hourly rate isn't really that high once hours worked & OT is factored in.)

4) patients ARE in danger due to short staffing. Dr Linda Aiken at The University of PA recently proved this and her research was published in JAMA in Oct '02. For every patient over 4 that a staff nurse cares for, each patient has a 7% greater risk of dying after routine surgery. This is related to "failure to rescue". It was seen quite poignantly at Mount Sinai in NY when a man in his 50s who was quite healthy, donated a part of his liver to his dying brother. The overworked RNs and RESIDENT (take note here bender) missed the subtle signs of an impending crash due to overwork, high patient loads and exhaustion. Had they reacted quicker, that man would be alive today. Mount Sinai was cited and fined by the DOH for inadequate staff. Mt Sinai's respnse-they announced a layoff of RNs 6 months later (Pending). The reponse of most hospitals to this published research?-most staff nurses today continue to care for between 8 and 10 patients on the day shift-more on off shifts. Therefore, RNs have a moral and legal responsibility to advocate for safe staffing and to refuse to work in a situation that puts their patients and themselves in danger.

5) The answer isn't if we don't like it get out. That is proven by the fact that hundreds of thousands of RNs have done just that-leading to one of the worst nursing shortages in history-and it is projected to worsen to the point that 800,000 RN positions in this counrty in 2020 are expected to be vacant. Who will care for the patients then? UAPs-which is exactly what the hospitals are praying for. They can then pay them a lot less, all the while whining "but there aren't any RNs available!".

6) So what is the answer? Since the hospitals have done such a lousy job, and nurses can't seem to find their collective voice (due unfortunately to the martyr syndrome, the selfish syndrome, and too many other syndromes to mention ), it is time for federally mandated legislation to save American patients-who will one day be US! It is time that nursing is repsected by allowing us more autonomy in caring for our patients-by not allowing patient care to be driven by greed. Bender, I suggest you read "Code Green-Money Driven Hospitals and the Dismantling of Nursing" by Dana Beth Weinberg, PhD. Also try this article by Weinberg & Suzanne Gordon-a non-nurse nursing advocate; "Cutbacks in nursing are harming patients". It appeared last week in the Boston Globe. here is a web addy

http://www.boston.com/dailyglobe2/168/oped/Cutbacks_in_nursing_are_harming_patients+.shtml

I suggest that those of you who seem to care but really don't seem to get it need to educate yourselves. Start with the above; both are very good. Others like tom I simply have no use for, and no amount of education will help someone like him.

As for should nurses strike and would I cross a picket line? After reading what I wrote do you still need to ask?