Not without a fight

The hospital industry will never do the right thing. It’s up to us to organize ourselves to win what we need to care for our patients.

By Bonnie Castillo, RN
Executive Director, National Nurses United

National Nurse Magazine - Oct | Nov | Dec 2022 Issue

The hospital industry never learns because it doesn’t want to learn. And hospitals don’t want to learn because it’s more profitable for them to operate under their business-as-usual model, public health be damned.

Nearly three years after the Covid-19 global pandemic changed life and nursing as we know it, we are facing nearly the same circumstances -- if not worse -- during this 2022-2023 winter cold and flu season: Covid is still thriving and vigorously circulating, and now we have added cold and flu as well as respiratory syncytial virus (RSV) on top of Covid at a time when all public health measures to prevent transmission of airborne diseases have been thrown out the window.

Just like with Covid, they had every opportunity to prepare for this winter surge that is devastating the country and landing so many of our most vulnerable patients in the hospital.

Everyone has been calling the virulent brew of diseases a “triple-demic,” but we nurses have renamed the problem a “quademic” to account for that fourth factor: the crisis standards of care hospitals inflict upon patients and on us because of their greed.

So in addition to the actual illnesses themselves, our patients are experiencing wait times in emergency departments that are no longer counted in hours, but days, and there is a shortage of beds -- especially pediatric beds -- because units have been shuttered due to lack of profitability. And, of course, there’s the biggest crisis that we are all experiencing: extreme short staffing of RNs, because so many of us are unwilling to put our licenses and patients at risk under morally injurious and unsafe working conditions and hospitals -- rather than fundamentally fixing the problem by staffing up appropriately -- would rather squeeze blood from a stone by forcing us to make do with less, work overtime, or double and triple up on shifts.

Our answer to the industry’s prioritization of profits over people is the same as it’s always been: organize, organize, organize in order to act collectively and in solidarity to win what we need to take care of our patients and our communities. It’s at the heart of everything we do.

We organize ourselves at the facility level to push back against all the unsafe working conditions our employers try to impose upon us, whether it’s chronic, severe short staffing; situations that foment workplace violence; or the complete lack of health and safety standards we know we need to protect ourselves and our patients.

We bargain tough contracts that continually raise the bar for patient protections, working terms and conditions, and the economic standards we know we need to recruit and retain experienced nurses to continue working in direct care. The deals NNU’s affiliates have bargained this year do just that, from Minnesota’s Twin Cities and Twin Ports contract that directly addresses safe staffing, to the just-ratified master contract for 21,000 Kaiser Permanente nurses in California that is unarguably one of the most robust agreements in the country and the world.

We advocate at the local, state, and federal levels for the policies and legislation we know we need to hold employers accountable. Just this past month, the Occupational Safety and Health Administration finally sent to the Office of Management and Budget proposed standards for what health care employers must do to protect their workers from Covid. Now we are carefully watching and pressing to make sure that that agency provides a timely review and the permanent Covid OSHA standard can be issued without delay. Make no mistake: this Covid OSHA standard would never have made it this far without our support and pressure.

And, of course, we continue to organize non unionized nurses and seek out like-minded nurses to join our national nurses movement. We can’t do it without one another. Our string of unionizing victories across the country, including states like Texas and Kansas where it is considered difficult if not impossible to unionize, show that nurses are hungry to join together as a union to stand up for themselves and for their patients. And we are beyond excited that the New York State Nurses Association has recently affiliated with National Nurses United, growing our membership to more than 225,000 nurses and contributing their experience and expertise to our ranks.
 
As always, the fight is not easy. We know what we’re up against. But it is the right fight to be waging, and nurses will never give up our vision for a healthier and more equitable world, not just for our patients, but for our wider society.

Bonnie Castillo, RN is executive director of National Nurses United.