Nurses' Strike Ends, Can Resentment be Set Aside?

On December 22, just in time for Christmas, striking nurses from eight hospitals in eastern Kentucky and West Virginia voted to accept a contract offer from their employer, Appalachian Regional Healthcare (ARH). The vote ended the strike that began October 1, 2007 and dragged on for nearly three months, causing financial hardship for both the striking nurses and the healthcare system.

At the outset of the strike, 600 of the 750 ARH nurses walked off the job. Dozens of nurses did not join the strike, citing obligations to the patients. During the course of the strike, about 100 more crossed the picket lines and returned to work. Approximately 500 nurses were still on strike at the time the new contract was ratified. As might be expected, a rift now exists between the nurses who either did not join in the strike, or see it through to the end, and those who stayed off the job for the long haul.

I have never had an affiliation with a union, nor do I come from a union family, so I don’t have passionate feelings one way or the other and I can see both sides of the story. While three months without a paycheck would be a financial bind for most workers, I can see that in certain situations, doing without would simply not be feasible and could, in fact, be dire. In the case of a single mother of young children, no second income, and no family support system nearby, homelessness could be a very real possibility.

On the other hand, those who remained off the job for the duration of the strike, putting pressure on the employer to agree to contractual changes, no doubt endured financial stresses, as well. Now, the nurses who did not strike will enjoy the benefits of the new contract brought about by the sacrifices of those who held out for three long months. Hard feelings would be difficult to avoid.

I wonder, now, about the working relationships of the two factions. Does resentment taint teamwork, does it affect patient care? I’m curious to know the answer. My hope is that all nurses remember that the bottom line is not the terms of the contract, not the sacrifices made or not made. The bottom line is the patient. It is always about the patient. If the resentment can’t be let go, it should, at least, be left outside the doors of the hospital.

Patients Want to Know, Did You Wash Your Hands?

Can I, as a nurse, accept a patient’s questioning of procedure? Can I accept suggestions from patients? How about constructive criticism?

A few months ago, I learned a classmate from nursing school has co-authored a book that aims to encourage people to take more responsibility for their medical care. The goal is to reduce numbers of medical errors and mishaps.

The book is chock full of information that is specific to a variety of medical situations. The authors lay out simple tips for entering the mysterious world of medicine armed and ready: what to read ahead of time, what to take with you, what to look for, what questions to ask. One tip is that a patient should ask his caregivers if they have washed their hands.

Now, I know that good hand hygiene is the first line of defense in preventing infection, but would I get my hackles up if a patient asked if I’d washed my hands? I don’t think a patient has ever asked me that question, so I have no experience in testing my hackles. But, I’d better start cramming for the test because my friend, the author, encourages her readers to do just that—ask, ask, ask.

I think, “Have you washed your hands?” is a perfectly valid question. I suppose I could forget to suds up between patients so what’s the harm in a reminder? And, no, I don’t find the idea of a patient’s asking the question offensive or annoying.

I do get a little nervous, though, when I think of the reaction certain doctors might have to being asked that question by a patient.

What are your thoughts?

Nurses in the Media

I am regularly sent, via e-mail, postings from The Center for Nursing Advocacy (TCNA). TCNA acts as a media watchdog, on the lookout for inaccurate portrayals of nurses in all areas of media, particularly television.

TCNA wants to stamp out the media’s misrepresentation of nurses and the nursing profession by rattling more than a few entertainment industry cages.

Infractions are detailed on TCNA’s Web site, along with a form letter that lists the offensive comments and characterizations in a specific show. TCNA urges nurses to send letters of complaint, written in their own words, to the producers of the offending programs. But, in cases of writer’s block or time constraints, we can just click a button and, whoosh!, TCNA’s well researched and articulate letter, with our name affixed, finds its way to Hollywood. I’ve used the convenient click-the-button correspondence on a number of occasions.

I’m appreciative of TCNA’s mission and efforts. I agree that there are too many portrayals of nurses that are inaccurate and sometimes sexist and offensive. Comedy programs often turn female nurses into caricatures. Nurses in micro-mini uniforms that show enough cleavage to stir envy in Pamela Anderson, and wearing white fishnet stockings and high heels, may exist in the writers’ far-out dreams. I, however, have never seen in any hospital anywhere a nurse dressed like that doing chest compressions or a gastric lavage. I’ve never seen a real-life nurse dressed like that, period. No one has. Listen up, Hollywood. Rein in your erotic fantasies and give nurses the respect we’ve earned and deserve. And, while you're at it, I'd like to see male nurses given a share of the TV/movie spotlight, specifically showcased as the highly educated, capable, life saving professionals they are--not a standing-in-the-background fixture poised to fetch whatever for the doctor.

Note to TCNA: don’t get too nitpicky. A recent letter to Gray’s Anatomy went on for some length, starting with blatant missteps, then moving on to a long list of, in my opinion, obscure offenses. Creative minds likely have short attention spans. Their interest in reading interminable criticisms of a single show is bound to wane. Slay the bigger, more obvious issues and the little ones will become collateral casualties.

Nurses Strike in Appalachia

My familiarity with labor unions is minimal. I have never been a member of a union. For several years, when I was in elementary school, my mother worked as a long distance telephone operator (remember those?) for the Bell system and they were unionized. I vaguely recall Mother doing her time on the picket line in a short-lived wage dispute. That is the extent of my union association.

In eastern Kentucky, however, unions are a part of the culture. With their early roots in coal mining, unions have a long, passionate and sometimes violent history in that area of the country and many residents have a rabid allegiance to them.

Since October 1, the 750 unionized nurses of Appalachian Regional Healthcare (ARH) have been dealing with the stresses, hardships and animosities associated with a labor strike.

Six hundred of the 750 ARH nurses are taking their turns on the picket lines and it seems there’s no love lost for the 150 others who are crossing those lines to continue working.

Striking nurse Jerry Blevins says the work stoppage is all about patient safety. The union is seeking a contract that requires adequate staffing and reduces or eliminates mandatory overtime. I certainly agree with the strikers that being short staffed and overworked is a hazard for the patient—and no fun for the nurse—and I sympathize with their cause.

Nurses who have crossed the picket lines cite financial needs and an obligation to caring for the patients as their reasons for doing so. As a result, they have incurred the wrath of the strikers, had their names posted publicly on a blacklist, of sorts, and a few have had their car tires slashed. Putting myself in the place of those still going to their jobs, I can also understand their stance, particularly in certain circumstances. The mere idea of being a single mother of three little kids, with no family support, and suddenly having no paycheck, is terrifying to me.

ARH is the Appalachian region’s largest hospital system, with seven hospitals in eastern Kentucky and two in West Virginia. Jerry Haynes, CEO of ARH, is a native of Harlan County, a union hotbed. He recognizes the strong union heritage of the area and the stubborn nature of its people but is not in agreement with the union’s claims of ARH’s compromising patient care.

A large healthcare system is a business, after all, and fiscal responsibility is imperative, so I felt empathy for management, as well—until I did a little research. ARH, with deeper pockets than the union, has hired consultants to guide them in this confrontation. A self-promotional blurb by the consultants describes the firm’s “effective restoration of a union-free employment environment.” No matter how prettily it’s stated, it is still union busting.