Over the past few months, nurses across the country have gone on strike (or threatened to) as a last resort to address dangerous hospital staffing shortages. Two key examples of this emerged on Thursday.
The first one was end of a three-day strike by nurses in New York that came after a union representing about 7,000 nurses reached tentative contract agreements to improve staffing levels at Mount Sinai Medical Center and Montefiore Medical Center.
The second was a rally at a hospital owned by HCA Healthcare, West Hills, California. Officials traveled from state to state to call attention to dire staffing levels at the health system’s more than 150 hospitals in 19 states. The purpose of the rally was to show HCA that its employees know how profitable the company is and that they will not be able to tolerate the working conditions much longer.
If HCA does not demonstrate that it is taking action to address its workers’ concerns after the rally, workers will likely strike, said Rosanna Mendez, executive director of a nurses union affiliated with the rally MedCity News.
To find out more about the recent wave of nurses’ strikes, I spoke with Theresa Brown, a nurse and New York Times best-selling author who often writes about the underappreciated role of nurses in the US health care system.
“I’ve never met a nurse who happily embraced a strike – people don’t just like to strike. A nurse who goes on strike does so out of a sense of necessity,” she said.
Nurses strike only when they believe it is the only option left to protect patients and provide quality care. This comes after hospital management failed to adequately respond to repeated requests to address staffing issues, Brown said.
Understaffing obviously causes burnout and harms nurses’ mental health and well-being, but those issues aren’t really what’s driving nurses to strike, she said. It is a well-researched fact that understaffing has dangerous and sometimes fatal effect on patient care.
When nurses are assigned more patients than they can handle, patients die who otherwise wouldn’t, Brown pointed out, adding that this fact is checked through numerous academic studies. Patients also tend to suffer more adverse events, such as urinary tract infections and central line infections, when units are understaffed, she said.
“That sounds very dramatic and I think it’s hard for people to understand exactly how that could be.” They might think that all nurses do is run around, give medicine and empty nightstands, but that’s a misunderstanding of the job. The nurse is the canary in the coal mine for every patient,” Brown stated.
Nurses cannot closely monitor patients when they are overtired. This is problematic because most people who are in the hospital are quite sick. As Brown said, hospitals are “trying to get rid of people as quickly as possible,” so patients occupying rooms are often in acute conditions that could deteriorate at any moment.
Hospitals need adequate staffing levels so that nurses can be there to check on their patients and notice when something goes wrong – which is impossible if one nurse is juggling a dozen patients. Brown thinks hospitals don’t realize how important this is.
“I think there’s an underestimation of the importance of staff – which is just willful blindness at this point. The data is there. It’s very clear. And unfortunately, we’ve seen this incredible focus over the last two decades on health care systems being like any other business — with an extreme focus on profitability,” she said.
When nurses talk to their employers about the staffing shortage and its negative impact on patient care, they’re often told that budget constraints are preventing the hospital from addressing the problem, Brown said. This puts nurses in an incredibly difficult mental and emotional situation – they see their patients not getting quality care, but are told there is no way to fix it.
That’s why nurses are on strike — they think it’s the only way to get their employer to take action, Brown said.
“My hat’s off to the forwards and my heart goes out to them because it must have been incredibly difficult to do what they’re doing. They would only do it because they thought it was the ultimate opportunity to get patients the care they needed. Nurses don’t work for the money or the fame – they do it because they’re dedicated and they care,” she said.
Photo: FilippoBacci, Getty Images