National Nurses United

that means trying to understand what they want—not just telling them what they want or insisting that they are wrong about why they do things," she writes. It's a sobering and provocative perspec- tive for registered nurses to mull over in their quest to provide the best patient care possible. —janae Brooks TALES FROM KENTUCKY NURSES By william Montell university Press of Kentucky, 2015 After reading this book, I have to say, William Montell did what he stated he wanted to do when he wrote this book. He wrote that it was his professional desire to help preserve the legacy of local history, life, and culture, and I feel he did just this. The book starts out with the history of Mary Breckinridge, the founder of the Frontier Nursing Service, located in the mountains of southeast Kentucky. Montell details how Breckinridge's own trials and hardships of life influenced her to want to help others. She got training in nursing and went to the remote, small town of Hyden, Kentucky. This is where she started the Frontier Nursing Service in 1925, which became a forerunner in public health. Today, the hospi- tal and school for midwifery named for her still exist. Montell uses excerpts from stories told by nurses who studied and worked at the Frontier Nursing Service to write his book. These stories had been archived at the University of Kentucky libraries. The nurses told about having to ride horseback to see their patients in both the day and night, no matter what the weather con- ditions were, and having to live at the small clinics that were estab- lished in remote sections of the areas that were served by the Frontier Nursing Service. why robbins ignores the role of collective bar- gaining to improve work- place conditions and patient care is really very puz- zling. she focus- es on many of the issues that registered nurses have widely organized around and won policies to improve, especially nurse-to-patient ratios, safe patient han- dling, and workplace violence and injuries. in the chapter "Burnt to a Crisp: How nurses Cope and why some Crack," she describes the various ways that nurses are injured physi- cally and mentally due to short-staffing and other stressful work conditions. she cites experts and research showing that nurse-to-patient ratios correlate strongly with patient out- comes. obviously, says robbins, hospitals should hire more nurses as a solution to this crisis. this probably won't happen anytime soon, she admits, so in the meantime she urges nurs- es to do a better job focusing on self-care! in the last chapter titled, "what you Can do," robbins' rec- ommendations to the hospital industry are naïve and laugh- able really, especially after we've learned from her book how much industry disrespects and exploits nurses. emphasizing the key issue of staffing, she argues that if the hospital indus- try treasured and hired more nurses it would "go a long way toward fixing american healthcare." she suggests that hospi- tals "involve nurses in decision making," and "appoint a con- tact person to objectively handle nurses' concerns." she also makes the rather strange suggestion that policymakers pro- vide grants, fellowships, and subsidies to help hospitals hire more nurses. she completely ignores a key policy precedent for safe staffing in the country, the California nurses associa- tion's successful passage of California's comprehensive, mandatory nurse-to-patient ratios law. readers will also finish the book having no idea that national nurses united has pro- posed federal legislation to win ratios on a national level. today in the united states, 25 percent of all hospital rns, approximately 423,956, are unionized and that number is growing. overlooking this, robbins instead spends an entire chapter focusing on how nurses "eat their young" and bully each other in response to their harsh working conditions. this is what the oppressed do, she explains, citing Brazilian theo- rist Paulo Freire. they can't vent or challenge those who are oppressing them, so they take it out on each other. well, that's not all Freire said. He also explained how the oppressed can work together to understand, challenge, and transform the power structures that are oppressing them and that's what labor organizing is about. to recognize unions, robbins would have to acknowl- edge the power of the hospital industry within the larger context of the u.s. social and economic structure. in this book, she never looks any further than the nurse managers, on the lowest rung and frontline of management, usually defending the bottom line for the invisible Ceos who wield tremendous power over all of us behind the scenes. i chal- lenge robbins to write a sequel investigating their "secrets" and calling it, The CEOs: How Nurses Are Jamming Their Plans and Putting Patients Before Profits. —Martha wallner j u ly | a u g u s t 2 0 1 5 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 19

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