Patient advocacy also means we support one another as professionals
From the Massachusetts Nurse Newsletter
October/November 2011 Edition
By Tom Breslin
Associate Director, Labor Education & Training
From the “You Can’t Make This Up Department”: I was recently talking with a nurse from an NNU-represented hospital who worked in the ER for 35 years. One night a patient came in who was infected with lice. The physician on duty directed that the patient’s clothes be taken away and that the drapes, the stretcher and all equipment in the area be removed to avoid those things being contaminated. The patient ended up lying naked on the ER floor. This nurse intervened and advocated for the patient and had the stretcher and linens put back so the patient had somewhere to lie and so that he could be covered. Two days later she was fired. This is a true story. I am not capable of making up something this outrageous.
The hospital, of course, concocted some other reason for her termination. She is accused of being intimidating toward a scab from a strike a few years ago and swearing in the break room, using the word “ass.” While I realize that swearing in a nurses’ break room has never happened in the history of American health care, even I had a hard time believing that a nurse with her tenure would be terminated for these offenses, even if they actually happened.
I don’t want to make light of this situation. This has had a massive impact on this particular nurse, her family and their future. Her ability to make mortgage payments, etc. is gone and will be gone until she gets her job back. She will have to figure out what to do in the year or so it will take to get her grievance to arbitration in order to provide for herself and her family.
What is encouraging in this situation is that her fellow nurses have taken on her termination and are fighting back as a united bargaining unit.
While this did not happen in Massachusetts, that is not to say that we don’t have our share of similar discipline situations. I don’t think it’s a stretch to say that there are more senior nurses being disciplined and disciplined more severely than in the past.
There may be a variety of reasons for this, but I think two reasons are clear. Whether warranted or not, management wants to cut costs, regardless of whether the hospital is for profit or not-for-profit and regardless of whether they are profitable. The easiest way to cut those costs is to get rid of the people who are at the top of the scale so that they can be replaced with less expensive nurses who also may, incidentally, be less likely to advocate for themselves or their patients.
The second reason is more onerous. It can only take one of these terminations to create and distribute a culture of fear in a hospital and take the life out of a bargaining unit. This obviously benefits management by creating a culture of fear in the unit, decreasing the probability that nurses will speak up for patients in the future. What we need to do is to put life into our bargaining unit so it can quickly and effectively respond to a situation like this.
Whether the issue is a nurse who is being disciplined on a trumped-up documentation issue or a nurse disciplined because she attempted to warn others in the bargaining unit about unsafe and potentially violent conditions on her floor, the issue is continued and repeated attempts by hospitals to silence nurses.
Certainly, grievances should be filed and, in extreme cases like these, will likely be won. After all, the grievance section of our contract is the method that we have to enforce the contract and protect nurses’ rights. But it is important to remember that the grievance process is a tool, not the solution. Grievances by themselves don’t build stronger bargaining units. In addition, the employer might attempt to delay the process by refusing to respond to information requests or other tactics. Nurses often have to wait as long as 18 months to finally get an arbitration hearing. While it is gratifying to win a grievance—either at arbitration or before—winning a grievance one to two years after it has been filed does not always do anything to build the union. An employer will likely be willing to make the trade of having to pay back pay in exchange for silencing nurse activists for a year or two.
The other choice the union has is to engage in collective action in response to the employers’ action. The key here is to engage the bargaining unit, in this case, in support of disciplined nurses. This is critical for the employer to understand that the bargaining unit supports individual nurses and that the nurses are united, mobilized, motivated and will not back away from their role as patient advocates. Bargaining unit support for grievances like these is critical in building a strong visible bargaining unit. Building a model which lends itself to collective action, while a challenge, is effective in not only the grievance process, but contract negotiations, political activity and in every activity the union engages in.
It will be easier for nurses to accept the premise that they have a responsibility to each other if they realize that an action taken against one of them could just as easily happen to any of them. Helping nurses to understand that the advocacy role they accept on behalf of their patients also applies to each other will go a long way toward achieving the goal of building a unit in which nurses support each other and are willing to engage in the actions necessary to force the employer to view the bargaining unit in a much different light.
I do not yet know what will happen to the ER nurse I mentioned earlier. I am confident that she will prevail, that she will get her job back and will return to her practice in the emergency room and to continue to advocate for those who have no voice. I am confident of this because I know that she not only has the unconditional support of the nurses in her hospital, but the nurses there are also willing to take on her issue both to the employer and to the public. This is what I hope we can achieve for all nurses in all our bargaining units.