Will Nurse Exploitation Continue Beyond COVID-19?

[Peachynursey]

On 8/31/2020 at 8:49 PM, RN-to- BSN said:

Sadly, nurses are hailed as pandemic heros and are taken advantage of at the same time. The author is right, corporate is making money out of our compassion and professionalism.

Due to my strict nature, they don't dare to call me on my day off. Vacation not approved? I will call in. I have to go on my vacation, life is too short to care about where staffing is too short. Not involved in a committee? Nope, that's too stressful. When I work, I'm a team player, when I'm home leave me the heck alone. Charge nurse? No, not for me, most are the manager's pawns.

Friends, please, try to separate work from life, the managers will never give up stressing you out. Don't let them.

This is perfect!! You are my hero!! I tell this exact story to everyone I know. I think about my employer when I’m on the clock but once I’m off the clock they get nothing. 

[TriciaJ, RN]

We really need strong nursing unions.  Without a collectively-bargained contract and a unified voice, we get nowhere.  We do not get much public support because the public has no idea what we're up against.

I think the ANA needs to run televised public service announcements educating people about what nurses do and how short-staffing affects patient care and safety.

[ChristopherB, BSN, RN]

Even before the whole pandemic started, I've thought about leaving nursing because of my experiences of how nurses are treated.  Also, I've been looking for nursing positions with no patient/family contact.  

Around the time that the pandemic started, I was hired by a medical device company to do hospital staff education, then it was put on hold due to the pandemic.  It was a slight pay cut, but seemed so worth it at the time.

[subee, MSN, CRNA]

On 9/2/2020 at 12:55 AM, TriciaJ said:

We really need strong nursing unions.  Without a collectively-bargained contract and a unified voice, we get nowhere.  We do not get much public support because the public has no idea what we're up against.

I think the ANA needs to run televised public service announcements educating people about what nurses do and how short-staffing affects patient care and safety.

And they should be telling the public that we still don't have adequate PPE.

[Diane Greco Allen]

On 8/31/2020 at 9:10 AM, J.Adderton said:

 

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Exploitation. It is a strong word that might not ring true in your own nursing career. But for many nurses, the word is a looming “elephant in the room” that just will not move. The COVID-19 pandemic removed my rose-colored glasses and I now see things a bit clearer. I don’t want to accept “the normal” treatment of nurses. Read on to learn how exploitation fits into my nursing experience.

A Story of Our Own

As nurses, we each have unique experiences that builds our story and this article is a piece of mine. I graduated nursing school in 1993 and obtained a master’s degree years later. I’ve spent years of my career away from the bedside in leadership and education roles. Four years ago, I returned to bedside nursing at a large hospital in Alabama. In the hospital, amid COVID-19, is when I felt most devalued in my career. Today, my story is wrapped around the uncomfortable feelings of frustration and anger.

This Normal Will Never Change

According to Gallup polling, nurses rank highest in honesty and ethical standards when compared to a list of other professions. Nurses have held the most trusted spot for 18 consecutive years. Why? Because people trust us to put people first and do the right thing. With or without the pandemic, the profession will continue to provide compassionate care while maintaining human dignity and respect. This is the “good stuff” that attracted me to nursing so many years ago.

I Feel Exploited Because…

I know nursing will always be a demanding job that changes rapidly. I also understand healthcare is a business and there will always be financial constraints to deal with in nursing. However, I am drowning in resentment that my desire to make a difference is being devalued by an employer seeking to deepen financial pockets. My employer is placing unsustainable demands on nurses without providing the necessary resources or support to be successful. Hospital leaders depend on nurses to go above and beyond to meet patient needs, even if it comes with personal cost.

Eventually, like many of my co-workers, I will reach the end of my rope and leave. A large group of new hires will start orientation and the cycle will repeat itself. There is something arrogant in the executive philosophy “nurses are expendable because there is a pool of nurses just waiting to sign on”. Management practices that would be outliers in other professions have been normalized for bedside nursing, for example:

• Standing policies, based on best practices, are in place to protect staff and patients from COVID-19. Staff are then provided with 1 surgical mask for protection and it is to be used over multiple shifts. Should the 1 mask become soiled, the nurse must track down the house supervisor for a replacement.
• Your supervising nurse calls and asks you to come in on your off day because your department is short-staffed. When you arrive, the house supervisor pulls you to another floor. You explain the agreement was that you would come in on your off day to fill a gap on your floor. The house supervisor simply states, “it doesn’t matter, you agreed to come in’.
• You float to an unfamiliar unit and you have no experience with the treatment orders. When you voice concern, you're told, “a nurse is a nurse and nursing is nursing”.
• Raises are infrequent and never exceed 1% of your hourly pay. Everyone, regardless of performance, dependability, or productivity, receives the same raise.
• Exhausted nurses ask management to provide some relief by hiring agency or contract nurses. They are told this was not an option because employees would resign to work for the agency, and it did not fit into the budget.
• A group of nurses approaches their manager and voice safety concerns with the current staffing grid. The manager agrees and takes the concern to administration. Later, your manager announces a small change has been made to the nursing assistant grid, but the nursing staffing grid was reduced.
• You have accrued a significant number of paid days off and want to take a vacation. However, you are asked by management to hold off plans until staffing is better.
• You are a charge nurse and visitor’s behavior is making you and the nurses uncomfortable. You contact the house supervisor and are told: “I’m tied up but...you got this”.
• It is rare you actually get to take a full lunch break, if you eat at all. When you submit the paperwork to be paid for missed meals, you are told to better manage your time in the future.
• The hospital changed the vendor for wound care in order to reduce costs. Bedside nurses did not have the opportunity to pilot the products or participate on the deciding committee. Bedside nurses did not know of the change until the new supplies just “appeared” in the supply closet. Unfortunately, the bandages are difficult to use and skin prep is no longer provided.

It saddens me that treating nurses unfairly for financial benefit has been normalized. Now, I don’t think administrators gather in a room and diabolically plan to take more from nurses than they are giving in compensation and resources. But, the burden COVID-19 has made some motives and mistreatment more visible.

Values Taken for Granted

I recently read a New York Times opinion article, The Business of Health Care Depends on Exploiting Doctors and Nurses, written by Dr. Danielle Ofri, a physician at Bellevue Hospital and New York University. In the editorial, Dr. Ofri asserts the U.S. healthcare industry profits from the work ethic of physicians and nurses, stating:

I feel devalued when hospital executives take the work ethic of nurses for granted. Nurses will continue to experience limited resources, low compensation, and high patient to nurse ratios because... despite all these barriers, the business of healthcare knows most nurses will:

• Absorb new tasks, even when additional resources are not made available.
• Do everything possible to maintain quality of care, including working when burned out, sick or facing demanding outside responsibilities.
• Be loyal employees, even when inadequately compensated
• Will be resourceful when supplies are few or not available at all

Nursing Beyond COVID-19

As I write this article, I recognize my own learned helplessness. I don’t want to be the complacent and passive nurse that accepts “it is what it is”. And I admit, sometimes the norm seems impossible to change. But it is empowering when I take small steps to stand up, voice my opinion, ask for what is needed, and make suggestions for change. I may need the courage to walk away from my job and find something better. Can you imagine what post-COVID-19 would look like if all nurses expected to find something better? I imagine it would not be long before the work ethic of nurses would no longer be taken for granted.

Yes, nursing exploitation will remain long after COVID-19, just as it did long before. But, the profession’s invaluable role in fighting the pandemic has been noticed. The voice of nursing has become louder, more organized, and larger in number. Exploitation at some level may be part of the future, but there are many reasons to hope working conditions beyond the coronavirus will improve for all nurses.

What is your story?

I am out of clinical nursing for over 20 yrs but here you loud and clear. I married a surgeon and realize how devalued nurses are from what I hear. I also am a Mother of 4 young adults and suffered burnout and pancreatitis after taking care of both of my parents with cancer for 18 years. I can't imagine working at a time like this. I feel as you do committed to the high standards of the nursing profession. I have had some serious problems with MD's who did not understand burnout and pancreatitis. I wish you well as you determine your path. I am not certified as a Functional Medicine Health Coach.

[subee, MSN, CRNA]

It boggles the mind that so many nurses are still anti-union; I am talking about a union composed entirely of nurses and no one else.  As we have become widgets in corporations,  our value is decreasing.  I just spoke yesterday with a new grad in NYC and he told me that the passing grade for the NCLEX has been lowered to 60 questions because they are so anxious to get nurses on the floors.  As we lower our standards for passing this exam, we will certainly lose more authenticity in making our argument that we are "professionals" and not "semi"- professionals.

 

[159Nursesrule, ADN, BSN, CNA, EMT-B]

Wondering would you encourage your son or daughter or other family members or friends to go into nursing?  Why or why not?  

I have family members who were considering nursing and I advised them to see another route at this time.  One has decided on Radiology with a focus on ultrasound and MRI and the other has decided to become a Dental Hygienist and will include a degree in Education with the hopes of one day teaching.

[OUxPhys, BSN, RN]

I would but Id tell them it depended on which area of nursing they were going into and the employer. However, had I done more research I probably would have done something in radiology or imaging or nuclear medicine.

[subee, MSN, CRNA]

Hmmmm.  I still would but only if they could get a really good education that would give them the option to pick and choose where they work.  But I do encourage young people to consider the other options like radiology and lab jobs that they may not be aware even exist.  Even dentistry and radiology are becoming more corporate so people in those jobs may become widget for someone else on the other side of the country.  I remember when hospitals were totally independent and working in them was a more personal experience.  Incorporation is just one of the evils of society that we have to take with the good things that have evolved.  

[Kooky Korky, BSN, RN]

On 9/1/2020 at 7:56 AM, Brownelfin said:

I work in one of four inpatient rehabilitation hospitals in a large healthcare system.  When I was hired, we had a “closed unit” arrangement with the nearest of the other rehab hospitals such that we could only be pulled to work in either of these locations.  The nurses in these two hospitals had fought hard for this arrangement.  After the pandemic began, the System enacted an ‘emergency staffing policy’ eliminating the closed unit arrangement and forcing us to float to either of the other two hospitals as needed.  At first I was on board, willing to do my part in this unprecedented situation.  However, as the pandemic has dragged on in this country, the nurses of our location are increasingly being sent to the other two hospitals - farther away, with unfamiliar care orders, supplies and processes - at the last minute.  It is extremely stressful to work in an unfamiliar unit without an orientation, especially when you arrive late because it’s an hour away and you weren’t notified of the assignment until you were leaving home for your regular shift.  All of the nurses in my home unit are daily living in dread of being sent for an exhausting day in an unfamiliar and understaffed unit.  We are not offered incentive or resource pay for these shifts, and we recently learned that the decision was made during this time of crisis to stop employing travel nurses, whom are paid more because they willingly agreed to the added stress of going where they’re needed most.  We are most definitely being exploited, but there is no union to organize a response.  In fact, both state laws and local traditional beliefs highly discourage collective bargaining.  I feel powerless to do anything about it.

Why do you not start the union formation process?  Don't moan and sit about waiting for someone else to take the lead.  Yes, it can be scary and time-consuming.  Someone once said, "Nothing good is lightly won, nothing won is lost".  

You are not powerless.  YOU be the change you want to see.