Will we remain divided and conquered?

Nurses Activism

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"Divide and conquer" is one of the oldest tricks in the book, and it works on us. Man, does it ever work on us. I was just checking out a thread about male nursing, and you know what divided our little tiny camp? RNs vs. LPNs. The division costs nursing at large big time. And what is nursing? Nurses, plain and simple. Who are we? For starters, I just dug these links up:

http://bhpr.hrsa.gov/healthworkforce/reports/rnsurvey/default.htm

http://bhpr.hrsa.gov/healthworkforce/reports/nursing/lpn/c2.htm

The first one says there were some 2,697,000 RNs in the US in 2000.

Of these, 495,000 were not working as RNs.

The second, that there were 889,000 LPN licenses in the US in 2000.

Of these 596,000 were not working as LPNs.

OK, follow along with me if you will:

1. Our biggest complaint is being understaffed.

2. They say there's a nursing shortage on.

3. Almost 31% of us aren't working as nurses.

And,

4. There are way more LPNs not working than RNs.

Sure RNs should demand better staffing, which can be gotten without resorting to overseas recruiting by raising pay. And it seems to me that if RNs are legally defined as supervisors of LPNs, then as a group they should be advocating for LPNs to get paid decently so they can find it worthwhile to come back into the workforce. Just by looking at the figures, I'm thinking LPNs are underpaid a whole lot more than RNs are underpaid. And if we do that maybe instead of blaming each other we can build a nursing community, a voting bloc with huge clout. Let's face it, RNs by themselves don't have enough clout. But barely. To my thinking, RNs plus LPNs would definitely tip the scales. Connect the dots. We need a national organization that represents the interests and concerns of LPNs and RNs with members meeting on terms of equality. OK, at work the RN may supervise the LPN, but in a meeting, each should get an equal voice. We need each other.

Specializes in NA, Stepdown, L&D, Trauma ICU, ER.

:yeahthat: The problem remains that nothing will change unless we force it. For all our venting and moaning on here, most of us love our jobs. To push the issue, there would have to be some sort of mass movement, like a strike, but bigger. It would have to reach beyond one hospital system, one city, one state. To get the nationwide attention we need, it would mean putting our jobs, livelihood and maybe even licenses on the line. I just don't know how many of us are ready to do that, as much as we'd like to see better staffing & pay, management sticking up for us even in the face of press-gainey.

anonymurse

979 Posts

I'm opposed to striking for pt. safety reasons, and I don't think it's necessary, anyway.

What I want to see is LPNs and RNs dialoguing on equal footing about those concerns they share in completely. We share a concern with pt. safety, which leads naturally to staffing, which leads naturally to pay. These three issues are entirely interdependent.

The split between LPNs and RNs most reminds me of the split between doctors and nurses, especially in the yearning of the RN to be recognized as a professional in the same manner a MD is. This is sad, because the LPN is the biggest casualty of the professionalization of nursing--not the substantive part, but the externals.

Yes, the pursuit of professionalism has produced much substantial improvement in and recognition for nursing. But our claim to the label has meant nothing. We've been barking up the wrong tree there. Mere recognition of a job group as a profession doesn't get things done. Look at the clergy--one of the three original professions.

Certainly, those RN-only organizations whose goal it is to establish standards of practice or education for RNs have it right. But the exclusion of practical nursing from representation in issues in common serves no purpose but to substantially reduce our numerical leverage.

We need lots of healing. I remember when a LPN ER tech reported for a mandatory ER nurses' meeting and was excluded. "But I'm a nurse," she said, thinking they didn't know. And the response was "No, you're a tech."

mvanz9999, RN

461 Posts

Specializes in Accepted...Master's Entry Program, 2008!.

I think the issue lies with Americans in general. PhriedomRN is correct. There must be a nationwide movement to make certain demands, and I don't see that happening. As a nation, we are simply too divided.

I seriously doubt that all RNs will advocate for increased pay/conditions for LPNs until they feel their own needs are met. Regardless of how correct this is in theory, individuals are simply not going to do it.

I have noticed that a large amount of the shortage is attributed to licensed RNs not practicing as RNs. Without any comparison data, this is meaningless. How many teachers, computer engineers, lawyers, pilots (etc) are not actually practicing in the field in which they are licensed or trained? Maybe this aspect of the nursing shortage is a non-issue. Are 25% of licensed attorneys not working in their field? I don't know. But without comparison data, it's meaningless to keep returning to this statistic. It may be that the same data holds true across virtually ANY profession.

anonymurse

979 Posts

A seat-of-the-pants guess has me thinking that an across-the-board comparison of occupational migration would be distorted, because nursing is one of those fields people are trending toward exiting to rather than from. In particular, with the greying of the market, the lack of ageism and "shortage" conditions are definite motivators in comparison to other fields. The frustration nurses feel with patient load and the unsafe conditions it creates has no real parallel in sales, programming, hospitality and so on. I believe it means something vastly different when a nurse leaves practice than when, for example, a RE agent switches jobs or takes a break.

anonymurse

979 Posts

I think the issue lies with Americans in general. PhriedomRN is correct. There must be a nationwide movement to make certain demands, and I don't see that happening. As a nation, we are simply too divided.

I seriously doubt that all RNs will advocate for increased pay/conditions for LPNs until they feel their own needs are met. Regardless of how correct this is in theory, individuals are simply not going to do it.

Yes. The "Bowling Alone" phenomenon strikes again. However "Better Together" gives some idea how, even in this age, communities can be built. It's necessary to get people together and let them interact naturally away from the workplace. I agree it's a long haul, but I think it's do-able because we are already family. We simply don't know how closely we're related just yet.

Specializes in NA, Stepdown, L&D, Trauma ICU, ER.
I'm opposed to striking for pt. safety reasons

We share a concern with pt. safety, which leads naturally to staffing, which leads naturally to pay. These three issues are entirely interdependent.

That's exactly my point about most of us loving our job. I can't speak for every nurse, but I get a huge amount of satisfaction knowing that I made a difference in the outcome of my pt. I enjoy helping people, that's why I do what I do. We don't want to strike because it's going to impact the people stuck in the hospital who now have no nurses to care for them. Nevermind all the times their care has been affected by piss poor staffing, the times the nurse has been too busy kissing the orifice of a complainer in the name of pt satisfaction to properly attend to the one who really needs her. Those things won't change until we make them. We aren't going to force TPTB to make those decisions until we unite, as *caregivers* (RNs, LPNs and even the PCTs) and leave them with no choice. If there is a better idea to get the attention of a nation full of aging baby boomers so they join our fight because it impacts them even more than us, I'm all ears.

Simplepleasures

1,355 Posts

Ive tried to make a difference and was promptly fired, am now in lawsuit, greatful for the state law that protects whistleblowers.I have written national newspaper columnists, local newspapers, many lawyers involved in healthcare law, the DOJ, the oversight agencies,my fellow nurses, many heathcare reform advocacy groups all over the country. The concensus of these conversations is, NOTHING will get done in this present Administration. Until a Congress with some clout can get out from under the powerful lobby of the healthcare , drug and insurance industries, all the great initiatives brought forth by the ANA and other groups will go nowhere. Hopefully this new Congress can get some of these inititive off the ground. There have been Senators and Congressmen working on these issues, but were pretty much stymied by the congress of the last 6 years. I got this info straight from a group that has had nurses testify in front of Congress.The first thing nurses can do to protect themselves and make their work place better is unionize, now I know that will bring out all the anti union folks, BUT it is better than nothing until state and better yet federally mandated nurse patient/ ratios come about. In the meantime it would be great to get a POWERFUL Nation Wide Union as the CNA proposes, why are we as a group so opposed to this concept? Seems we will remain divided and conquered , until we STEP UP.

anonymurse

979 Posts

The problem with the national unionization plan is simply workability. I just took a look at the map in the Wikipedia article. Talk about a nation divided! The states colored red are right-to-work states:

http://en.wikipedia.org/wiki/Right-to-work_law

As you say, a political change could make it possible for Congress to begin examination of staffing issues. But for the issue to receive consideration 2 years from now when the winds change, it has to begin rising to prominence in the public eye right now.

And it obviously has to have more numbers behind it than have previously been mustered, not just nurses but consumers too. AARP. Consumers Union. Folks like that.

And nursing has to be unified in its stance, instead of having RNs played off against LPNs.

mvanz9999, RN

461 Posts

Specializes in Accepted...Master's Entry Program, 2008!.
A seat-of-the-pants guess has me thinking that an across-the-board comparison of occupational migration would be distorted, because nursing is one of those fields people are trending toward exiting to rather than from. In particular, with the greying of the market, the lack of ageism and "shortage" conditions are definite motivators in comparison to other fields. The frustration nurses feel with patient load and the unsafe conditions it creates has no real parallel in sales, programming, hospitality and so on. I believe it means something vastly different when a nurse leaves practice than when, for example, a RE agent switches jobs or takes a break.

While you are right at a high-level comparison, a more basic comparison would be viable. I just don't know where to find that data. Of course patient ratios are only in health care, but you could reword it to something like "X number of nurses do not work as nurses due to the conditions they are required to work in. This would include patient ratios, total hours/wk, pay, etc".

Similarly, you could look at attorneys and say "x number of attorneys do not work as attorneys due to case load, total hours/wk, pay rate, etc". Same with teachers, or any other profession really.

I guess what I'm asking is if X number of workers are not working in their chosen field due to something in that field. In I/T, a lot of people have left due to lack of jobs, lower rate of pay, lack of upward mobility, and so on.

anonymurse

979 Posts

In I/T, a lot of people have left due to lack of jobs, lower rate of pay, lack of upward mobility, and so on.

Yup! That's why I say:

I believe it means something vastly different when a nurse leaves practice than when, for example, a RE agent switches jobs or takes a break.

mvanz9999, RN

461 Posts

Specializes in Accepted...Master's Entry Program, 2008!.

I don't see the difference. What is the difference when an attorney leaves law practice because they don't like the pay, hours or caseloads AND when an nurse leaves because they do not like the pay, hours or patient loads?

There is no difference.

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