A Strike Offers a Window Into What Nurses Want

From a Washington Post column by Helaine Olen headlined “A strike offers a window into what nurses really want: enough staff”:

Danny Fuentes works as a nurse in New York City’s Mount Sinai Hospital’s transplant unit, where his father once received a new liver. It takes a lot for him to leave his patients and march on a picket line. But he did it this week as part of a three-day strike against his hospital and nearby Montefiore Medical Center, an action that ended this Thursday with a tentative contract, because, he said, it was in the best interests of his patients.

Fuentes says his unit is frequently short-staffed, and, as a result, he is caring for too many people at one time. “They have so many tubes coming in and out of them, and they need medication,” he told me. “It’s just not safe.”

Nurses such as Fuentes are increasingly playing a role in the ferment that’s called the Great Resignation. Like many others questioning their relationship to their employers and their profession, they are seeking not just a larger paycheck but also better working conditions and more control over the terms of their labor. But in demanding better staffing, nurses carry a greater urgency than overworked baristas — since, as they frequently point out, deficits in staff can be dangerous for the patients they serve, too.

Look at what happened this week. The hospital offered Fuentes and his fellow strikers a fairly impressive raise of 19 percent over three years — and still they balked, citing the staffing issues as a sticking point. When they finally agreed to a new contract, it was one that includes mandated minimum staffing ratios, enforced through arbitration and possible financial penalties should the hospitals fail to comply. The nurses wanted more than money; they wanted help.

Who could blame them? At Montefiore, some have complained they are so overworked they can’t always make time to eat. At Mount Sinai, nurses say the emergency room is wildly understaffed, with one nurse sometimes expected to tend to up to 18 patients.

There are opposing narratives about how things got this bad. Everyone recognizes that nurses came under enormous strain during the pandemic, and many left. But hospitals now say they can’t get enough help because they are facing a national nursing shortage, although National Nurses United says that’s not so. Registered nurses, they say, simply won’t take some of the jobs on offer because of concerns about working conditions or compensation.

The new contract at Mount Sinai and Montefiore should offer a test of these two competing theories. Between them, the two hospitals have hundreds of unfilled openings. They will now be adding to their job listings, but they’ll also be offering improved wages and working conditions.

One thing is certain: The situation for our nation’s nurses is unsustainable. Mount Sinai and Montefiore are the tip of an iceberg; surveys show widespread dissatisfaction in the field. Burnout is all but endemic, with 75 percent of nurses saying they’ve experienced it at least once since the pandemic began, according to a poll conducted last year by Trusted Health. And already low faith in management has cratered, with a majority of nurses recently surveyed saying they didn’t believe hospital administrators would respond adequately to a clinical care concern. Many nurses have voted with their feet, trading staff jobs for better-paying, short-term positions, retiring, or leaving the field entirely.

This is hardly the first strike or near-strike where staffing has emerged as a primary issue. In California, a threatened strike by nurses with Kaiser Permanente was averted with a more than 20 percent salary boost over four years, but also a contractual promise to hire an additional 2,000 nurses. Another threatened job action, in Minnesota, was called off after hospitals not only offered a significant wage increase but also gave nurses an “unprecedented” say in staffing-level decisions.

Whatever budget challenges hospitals face, the burden shouldn’t fall on nurses to compensate for staffing issues. A few states are taking notice. California began enacting mandated minimum nurse-to-patient staffing levels almost two decades ago. Massachusetts requires one nurse for every one or two patients in its intensive care units, depending on severity of patient need. Most other states offer almost no legislative guidance. (New York passed a law in 2021 demanding safer nursing staffing levels at hospitals and nursing homes, but it has not been fully enforced.)

At the federal level, too, action has been limited, despite the clear need. In Washington, Sen. Sherrod Brown (D-Ohio) and Rep. Jan Schakowsky (D-Ill.) have repeatedly introduced legislation that would set minimum nurse staff levels in hospitals across the country. Congress would do well to take it up.

As frustrating as the strike has been for all involved, we owe nurses thanks for drawing attention to our national failure to invest adequately in the caring economy. The combination of the covid era with the Great Resignation has left nurses less likely to sacrifice their well-being, and that of their patients, to benefit the health-care industry’s bottom line. If their actions this week force two hospitals toward sufficient and sustainable staffing, that’s a healthy development for all of us.

Helaine Olen is a contributor to Post Opinions and the author of “Pound Foolish: Exposing the Dark Side of the Personal Finance Industry.” Her work has appeared in Slate, the Nation, the New York Times, the Atlantic and many other publications. She serves on the advisory board of the Economic Hardship Reporting Project.

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