National Nurses United

trends we do in nursing and health care, and why nurses are treated poorly and with little respect by our employers when we all know, and the public agrees, that we form the backbone of our health care system—as has been proven during this disastrous Covid pandemic. CK: That's right, Trish. Because in a money-driven health care system, our employers simply see nurses as a cost, not an asset– expendable. TG: I just also want to mention, Cathy, that it is not a coincidence that nurses are not valued within our money-driven system because we are a profession of predominantly women, and the care work we provide is already not valued, or considered of lesser value, than other kinds of labor because, for so long, most of us had no other choice than to provide it for free. Society depends on women to pro- vide care work for free! But as we saw with Covid, society doesn't function when there's no one to care for our children, for our elders, for our households! The money-driven economy, capitalism, completely relies upon the uncompensated care work of women. Much of this was detailed in the white paper we released last year, "Deadly Shame." [This report can be found on National Nurses United's website.] It's really thought provoking and helps explain why year after year, nurses rank number one among the public as the most ethical and trusted profession and people will come out at 7 p.m. and bang their pots and pans for us, but our employers locked up all the PPE and have treated us as completely disposable. CK: I have to say, Trish, Covid-19, for many nurses, really ripped the veil off that warm and fuzzy illusion of appreciation because our government leaders and employers did not value us in the concrete ways that mattered. They did not provide optimal PPE or staffing to keep the nurses and our patients safe. Here we are, more than a year later, and there is still no national, enforceable OSHA Emergency Temporary Standard on infectious diseases to require our employers to do anything beyond what the CDC "recommends." I think Covid was a rude, but needed, awakening for nurses. When I read "Deadly Shame," it was like a lightbulb went off in my head. It just crystallized so much for me and helped me reconcile all of these contradictory stories I was observing. And I imagine what life would be like, what nursing would be like, if we structured our economy around the goal of caring for people. That's what our Medi- care for All campaign is all about. We're trying to make this one sector of the health care system about actually ensuring every per- son gets health care and has an efficient and effective way to pay for and sustain that goal instead of about making insurance companies and CEOs rich. Let's kick out our money-driven system and replace it with a caring system. But until we do, let's talk about where things are at now. And let me give you a hint, the money motive still reigns supreme. So at this time last year, Covid was really hitting the fan. We were in crisis mode. Now that we've been living through Covid for more than a year, and we can step back and look at how things have shaken out, we can confidently say that the hospital and health care industry has taken that age-old adage to heart: Never let a good cri- sis go to waste. TG: That's right, Cathy. What does that mean applied to nursing? It means that our employers want to make permanent the crisis standards of care that many of us were forced into during this Covid pandemic by their lack of planning. Remember, working under cri- sis standards is not ideal and necessarily means we are not providing the higher-quality care we would during normal conditions. Well, once you've lowered your standards, it's a battle to go back to the way things were, especially when you have that profit motive work- ing against you. CK: Exactly, Trish. The industry has sort of a little "wish list" of things that it would like to get out of Covid. So let me give you some examples. A basic one is PPE. For example, we all know N95 respirators are single use only. After every patient encounter, you throw away your N95. But during this first year of Covid, nurses have been forced to do all kinds of crazy things with N95 respirators. Well, now it's well documented that the United States no longer has a shortage, but rather a glut, of N95 respirators. Have hospitals made big announcements about going back to a single-use only policy? No! Because guess what? It saves them money when nurses, who have been traumatized by the scarcity mentality, wear the same N95 for their whole shift and don't ask for a new one. TG: The same goes for staffing, Cathy. During the very worst of Covid, we know nurse staffing, even in ICUs, was abysmal. And we're in a crisis, and so many nurses were quarantined or sick, and caring for their own family members, and, you know, we nurses did everything we could and we managed the best we could, but no amount of MacGyvering could change the conditions we were forced to provide care in. Working under those crisis conditions exacts a heavy toll. So many of us are suffering severe moral distress and injury not just from the abnormally high number of deaths we have witnessed over this past year, but from the internal conflict of participating in a system in which we are prevented from doing what we know to be the right thing. We want to provide a certain level of care, but the skeleton staffing levels won't allow it. The matrix says no, the technologically driven system says it's not needed. Who bears the burden of these denials? Nurses and our patients. CK: Yes, in California hospitals lobbied the California Depart- ment of Public Health to let them "waive" the safe staffing ratios because they claimed they couldn't find enough nurses, even when many of these hospitals had been laying off nurses, or not calling in per diems, or canceling traveler contracts, and doing all kinds of funny business. It was really thanks to all our California nurses fighting back through our union, the California Nurses Association, that we were able to beat back these waivers. TG: And it's not just the number of nurses who are taking care of patients, but whether they also have the right competencies to take care of those patients. My favorite story is from Zenei Triunfo-Cor- tez, one of our NNU presidents who works in the post-anesthesia care unit. Her hospital wanted her to go work in ICU after only a four-hour training and 20 minutes of time on the current venti- lators. Zenei hadn't worked in ICU for 30 years! They wanted all the PACU nurses to sign that they were competent. Thank god, Zenei and all the other PACU nurses put their foot down and absolutely refused. But they have the power of their union behind them to back them up to be able for them to push back and speak up like that. CK: But I can see how at hospitals across the country, where the nurses are not unionized, that those unsafe floating practices became the new norm or were even accelerated, or the assignments became even more outrageously inappropriate. I've heard stories about sending labor and delivery nurses down to the emergency department or having adult ICU nurses go work in pediatrics or NICU. We all know our work is so specialized, and you can't just swap us out like cogs in a machine. A P R I L | M AY | J U N E 2 0 2 1 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 21

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