Yves here. This message confirms what Lambert pointed out in the context of the election: that nurses are one of the most effective labor groups. Here, they are fighting abusively low hospital staff. Not only will this campaign help slow down the decline in the quality of care, but it should help slow the exodus of nurses, who otherwise suffer from overwork and hurt feelings.
Among the handful of neurological patients seen by Judy Danella one day in March 2023, three were so ill they had trouble swallowing.
She fed each of them in turn, delivering spoonful after spoonful of pureed food, patiently nurturing them to better health, even as she herself was stretched minute by minute in a chronically understaffed facility.
Danella and her union colleagues at Robert Wood Johnson University Hospital in New Brunswick, New Jersey, battle the understaffing crisis every day strain the US healthcare system to the breaking point.
Healthcare employers across the country have long refused to hire sufficient numbers of nurses, certified nursing assistants, dietitians and other essential staff, preferring instead push skeleton crews to the bone and put profits before patients.
But now, the same healthcare workers who fought COVID-19 are fighting for the safe staffing levels needed to protect their communities every day and prevent the already fragile healthcare system from collapsing in the next pandemic.
U.S. Senator Sherrod Brown of Ohio and Representative Jan Schakowsky of Illinois filed legislation in Congress on March 30 to establish mandatory minimum numbers for nurses in hospitals across the country. But in the meantime, citing the ever-increasing urgency, unionized workers continue to advocate for similar measures state by state.
Danella and fellow United Steelworkers (USW) members, for example, will rally with workers from other unions at the New Jersey Statehouse on May 11 to demand passage of bills establishing minimum staffing levels for registered nurses in hospitals, ambulatory surgery centers and public psychiatric facilities.
“You want to give the patient the best possible care,” said Danella, a registered nurse and president of Steelworkers Local 4-200, which represents about 1,650 registered nurses at Robert Wood Johnson Facility, a trauma center in level 1.
The legislation, already introduced in the Senate and the General Assembly of the Statewould require one registered nurse for every four patients in an emergency department, one for every two patients in intensive care and one for every five patients in a medical/surgical unit, among other provisions.
The bills would also give nurses a voice in the design and implementation of staffing systems that model future needs, deploy “floats” to fill gaps, and provide other adjustments to better serve patients requiring extra attention. It’s the kind of flexibility and forward-thinking needed to provide proper care for all patients, especially on days when Danella needs 90 minutes to feed three people.
“You put your work first,” Danella said, explaining how she deals with the constant stream of text messages alerting her to more tasks assigned to her throughout her shift. “You somehow get through the day and you get by.”
Although Danella relies on her experience to handle anything the hospital throws at her, industry-wide understaffing puts patients nationwide at risk.
In Washington, for example, another state where trade unionists are fighting for safe staffing levels, 48 percent of healthcare workers in a recent survey cited incidents of patient harm or death due to a lack of staff.
And in Michigan, where unionized workers have spent years fighting for minimum staffing ratios, 42% of nurses recently said they know deceased patients due to lack of staff. In 2020, nurses at a Detroit hospital filed a lawsuit claiming they were unlawfully fired for pointing out that understaffing was contributing to dozens of unnecessary deaths in the emergency department.
The Safe Patient Care Act, legislation that would have required hospitals to meet minimum staffing levels for registered nurses, died in Michigan’s Republican-controlled legislature during the 2022 session. Now Jackie Anklam, president of Steelworkers Local 9899, hopes the Democratic majorities that took control of both houses in January will also enact minimum ratios for nurses and other groups of health care workers.
“It should be for everyone,” said Anklam, whose local union represents hundreds of workers at Ascension St. Mary’s Hospital in Saginaw, noting that union members in every department are contributing to a collective rescue mission.
Anklam said current shortages are forcing pharmacy technicians to work brutally long days. Understaffing also traps certified practical nurses with a high workload. And instead of hiring more environmental services workers, she says, the hospital is increasing the workload.
The staffing crisis affects not only hospitals, but also institutions across the continuum of care.
The USW and other unions want Centers for Medicare and Medicaid Services (CMS) establishing minimum staffing levels in nursing homes and other long-term care facilities, funded largely by federal dollars, which serve growing numbers of aging Americans.
The ratios would not only save lives, but also reduce the time residents wait for therapy as well as help with dressing, bathing and using the restroom.
Additionally, Chris Sova, a registered nurse and president of Steelworkers Local 15301, said minimal staffing would help reduce the stress workers experience as they rush to answer one call after another.
“In the background, it’s a constant ringing,” said Sova, whose members at the Bay County Medical Care Facility in Essexville, Mich., pride themselves — despite their own staffing issues — on responding to high-speed calls.
“It’s like water dripping in the middle of the night,” Sova said. “It’s just one of the many things that weigh you down.”
While workers are being paid extra pay due to understaffing, he added, “they just want more help.”
Danella knows the hospital industry will continue to oppose staffing minimums and cut costs to fatten its bottom line. But she said unionized workers refused to back down because continuing shortages will only exacerbate staff turnover and put even more lives at risk.
“It’s just a domino effect,” she said.