Brockton Nurses' Strike

Economics and Care

Explicitly, the strike now being conducted by nurses at Brockton Hospital is about contract terms. Read between the lines of reports on the strike, and you see a microcosm of age-old stereotypes about women and men, love and money.

Economic life, we've come to believe, is about individual achievement. The more you get, the more successful you are. "Playing hardball" is to be expected in the realms of business and politics. Visibility and attention are good things. The more a person comes to control and direct, the better. Skills are needed, and often very specialized skills.

On the other hand, caring work such as nursing is painted in quite the opposite colors. This work is seen as being about giving, not getting. It is not so much an achievement, as a natural outpouring of goodness. Gentleness and politeness, not hardball, are the rule. Drawing attention to oneself would seem selfish. Nurses are seen as passively carrying out the orders of doctors. Nurses will work extra hours without complaint, because their caring nature prevents them from leaving patients in crisis and need. Nurses will "float" from one area to another within the hospital, because, it is believed, they have no specialized skills.

The Brockton strike, like others recently, shows how costly this sort of thinking has become. Nurses are burning out and leaving the profession. The nurses who are left are stressed to the max. Nurses are suffering.

Patients are suffering. Patients will die.

The union is trying to point this out. The union is trying to get the financial resources flowing again that will getting staffing back to adequate levels—levels that would give nurses the time and the energy to give the kind of care they believe nurses can and should give. Economics and caring work are not opposed. Caring work is caring, but it is also work. If you want patients taken care of right, you must direct economic resources towards this goal. Real care is neither a natural flow, nor something that can be done by a mindless pair of hands. Real care is done by real people, with real financial responsibilities, and real personal schedules constrained by family and the necessities of life. Real care, especially in an age of sophisticated medical technology, requires substantial skills, and ones that will not easily transfer from oncology to pediatrics. Real care also requires continuity and communication. And it requires respect.

Let's examine the rhetoric the hospital is using in replying to the union. What would be the best way to undermine the struggles of nurses for the resources and respect they need to do their job? What would be the best way to get them to doubt themselves and retreat to their silent, sacrificial role? Playing on these old stereotypes, of course. Looking at the Boston Globe report of May 25, 2001, we can see the hospital hitting three themes. "Hospital executives said the nurses' true motive was to extract higher wages," the Globe reported. Oh-oh. There go those selfish nurses. You don't want to be a selfish nurse, do you? The nurses, according to the hospital executives, also want to "advance their legislative agenda." Look at those hard-ball playing people calling for attention, meddling in politics, engaging, no doubt, in social engineering! How un-nurse-like! And, to twist the knife a little deeper: "Hospital vice president Robert Hughes said the union...walked out without waiting for a response. ‘I'm actually quite appalled by it,' he said." To people who define their identities in large part in terms of connection and care, being accused of being rude and unwilling to communicate strikes close to the heart.

This is, of course, a load of hooey, and a blatant ploy to get nurses to shut up and stay within stereotyped roles and stereotyped thinking. I hope all the Brockton nurses can see through the hospital's manipulative rhetoric. I hope they will continue to demand the resources and work practices they need to be able to do their skilled, responsible and caring work. And I hope we, the people who may one day be vulnerable and badly in need of their professional and very human attention, will all back them up.

Julie A. Nelson, Ph.D., is the author of "Feminism, Objectivity and Economics" and a Fellow at Harvard's Center for the Study of Values in Public Life.

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