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How a group of California nurses is looking beyond health care to help patients

By Kristine Johnson, / The Tribune, 4/25/17

On a quiet evening in Paso Robles, I met with two nurses, Angie Silva and Brian Ivie, at Spearhead Coffee. Each of us had been working all day; we murmured gratitude into our mugs as we settled ourselves at a heavy oak table.

I introduced myself as a newbie to the Central Coast and told them I’d like to learn more about the California Nurses Association.

“Is the CNA an activist group or a workers’ union?” I asked.

“Both,” they said simultaneously. A glance between the two of them prompted me to ask if they were married to each other. They nodded, adding that they have two small children.

“The CNA’s goals are pretty simple,” Angie said. “We advocate for working conditions and government policies that keep people healthy.”

“Nurses always put people first,” Brian added. “That’s just what we do. People count on us to be there for them at their most vulnerable times.”

They told me how the CNA is instrumental in assuring safe nurse-to-patient ratios in California hospitals, and how those ratios help both nurses and patients.

“In the past, California hospitals sometimes had one nurse for every 20 patients, even in emergency rooms,” Angie explained. “Now, due to the efforts of previous activists, nurses provide more personalized care for each patient.”

I expressed shock that the hospitals hadn’t implemented reasonable ratios prior to the union’s efforts. They explained the conflict between profits and patients in our current health care system. Hospital administrators and insurance companies focus on profits for shareholders. Nurses focus on good outcomes for their patients. The two roles are often at odds with each other.

“We’re patient advocates,” Brian said. He paused and gathered his thoughts. “And, by that, I mean all patients — current and future. That’s why we fight for clean water, nutritious food and safe communities, too.” He explained that environmental justice, proper training of nurses and nurse-to-patient ratios are essential to keeping people healthy and safe.

I asked them to tell me about CNA’s recent efforts.

In association with National Nurses United, CNA resisted the Dakota Access oil pipeline project due to drinking water contamination concerns.

CNA/NNU also resisted the Trump administration’s efforts at repealing and replacing the Affordable Care Act, also known as “Obamacare,” citing concerns over health care access by the middle class and poor.

Locally, the CNA held vigils in San Luis Obispo to support the indigenous people and other activists who were resisting the Dakota Access oil pipeline.

The local group also spoke out against the proposed rail spur and terminal Phillips 66 proposed in San Luis Obispo County. The CNA’s position is that oil trains traveling through our county pose an unacceptable threat to public health.

“Last week, we met with a consortium of activist groups at Metro Brewing in SLO to write postcards in support of California’s SB 562,” Angie said.

“Can you tell me about that?” I asked. “Is that the new California health care bill?” I waited for them to snicker at my ignorance. Instead, they smiled at me with the compassion you’d want from a nurse when you’re sick.

Brian spoke first. “OK, so it’s not hard at all,” he said. “SB 562 — The Healthy California Act — would guarantee health care for every California resident. Vision, dental, doctor visits, pharmaceuticals, hospitals, hospice, everything.”

“How would we pay for it?” I asked.

“Through a payroll or income premium,” Angie said, “based on how much you make. Insurance company profits are removed from the equation, which equals efficiency and health care access for everyone.”

The three of us were silent for a moment. I considered how my life might have been different under such a system. I might have started my business sooner or hired more employees. I might have retired by now, freeing up my job for other workers.

Then, I asked how a single-payer health care system would change their lives.

“As far as how nurses care for patients on any given day, I don’t know that anything would change,” Angie said.

“But overall,” Brian said, “people would be healthier due to an emphasis on preventative care. And sickness would be treated sooner, making for better outcomes.”

“Plus, health care is not a luxury or a privilege,” Angie said. “Health care is a human right.”

As we gathered our empty coffee mugs, I asked if they had heard about the International Workers’ Day barbecue being hosted by SLO County Progressives Democratic Club on May Day. They laughed and told me that they are both members of the club and that they would be there to support their union and the other local unions. I’m looking forward to seeing them again.

Kristi Johnson is a patent lawyer and writer who lives with her husband in San Luis Obispo. She has two college-aged children. Find her at or Twitter

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