LABOR

Nursing Wounds

The nation is in the midst of a care crisis. Between 2004 and 2014, the nation will need to fill more than 1.2 million nursing positions. "Providing nurses a collective voice through unionization" is the most direct way to raise nurses' pay, attract qualified candidates, and improve patient care. Yet under President Bush and his National Labor Relations Board (NLRB) -- "easily the most anti-worker labor board in history" -- more than 3 million nurses and nurse practioners have lost their right to form a union. A recent study in the Health Affairs medical journal "found 6,700 patient deaths and 4 million days of hospital care could be avoided each year by increasing [the] staff of registered nurses," which lowers the long-run cost for hospitals. This week in Nevada, approximately 800 nurses were locked out of their hospitals after trying to negotiate for increased staffing and improved patient care. They had been intimidated by union-busters, suspended for supporting unions, and were working without a contract since June. While the association representing the two Nevada hospitals said it has the best interests of the "community" in mind, its refusal to negotiate with the nurses jeopardized the community's health care. The association, United Health Services (UHS), yesterday agreed to let the nurses return to work on Saturday and "meet for up to 30 days with a federal mediator to try to resolve sticking points," but the work to ensure quality care is far from over. Sign the petition to improve nursing staffing standards and patient care.

NEVADA'S CARE CRISIS: Nevada suffers from a severe nursing shortage. An August study ranked the state last "among the 50 states in the number of registered nurses per 100,000 residents. The study found that Nevada had 514 registered nurses per 100,000 residents in 2000, well below the national average of 780 nurses per 100,000." The condition of the two hospitals affected by the lockout, however, is especially abysmal. Quality Care Nevada -- a project of SEIU Nevada -- recently put out a report giving the care at Desert Springs Medical Center a grade of a "D" and the Valley Hospital an "F." For example, the heart attack mortality rate at Desert Springs is 9.8 percent, whereas the hospital's expected mortality rate is just 7.1 percent. At Valley, 14.3 percent of all heart attack victims die, compared to the hospital's expected mortality rate of 9 percent.

DEMANDING IMPROVED PATIENT CARE: With the poor state of the two United Health Services hospitals, it should have come as little surprise that the nurses demanded better patient care. Nurses at the hospitals agreed to not strike "after elected officials in Nevada called for a 30-day cooling off period, but those nurses and other workers were locked out when they showed up for work on Monday." UHS blamed the nurses for the breakdown, stating, "We don't want the community to be held hostage to their threats." But the refusal of UHS to negotiate with the nurses was the only thing preventing the community from receiving better care. The nurses wanted similar "nurse-to-patient ratios similar to a California standard the SEIU gained in recent contracts with corporate owners of several other Las Vegas hospitals. California nurse-to-patient ratios provide for as few as one patient per nurse in trauma units and operating rooms, two patients per nurse in intensive and critical care units, and no more than six patients per nurse in general medical and psychiatric units."

INCREASED STAFFING LEADS TO BETTER CARE: Because of a shortage of nurses, "you don't get medications to patients on time," said Joan Wells, a nurse with Valley Hospital. "They (patients) could by lying in their own excrement for who knows how long. You can't even do the basic things you want to do." Jane McAlevey, executive director of SEIU Local 1107, notes that at the two UHS hospitals, nurses are often responsible for 8-10 patients at one time. According to a study in the journal Medical Care, the "risk of death and failure to rescue patients with complications" is nearly "30 percent higher in hospitals where nurses' average workload [is] 8 patients than in hospitals where nurses [care] for 4 patients." Lowering a nurse's workload by one patient decreases the mortality rate by 7 percent. Additionally, a shortage of nurses often leads to staff working long overtime hours. Approximately "85 percent of nurses work longer on a daily basis than their scheduled hours. Recent research has documented a substantial increase in the rate of errors associated with nurses working more than twelve consecutive hours, and close to half of hospital staff nurses commonly work longer than twelve hours."

INCREASED PAY LEADS TO INCREASED STAFFING: In addition to long overtime hours, heavy workloads, and lack of support staff, the Government Accountability Office has found that inadequate wages are contributing to the nation's nursing shortage. According to a report by the Institute for Women's Policy Research, "Increasing pay for nurses is the most direct way to draw both currently qualified and aspiring nurses to hospital employment." Therefore, hospitals that are willing to offer higher salaries "are able to attract more nurses, leading to more adequate staffing and improved patient care."

UNITED FOR BETTER CARE: The most direct way to improve wages and increase staff is by providing workers with a collective voice through unionization. Nurse-to-patient ratios are "18 percent higher in the most unionized cities as compared to cities with the lowest levels of nurse unionization." Nurses who are union members generally make 13 percent more than non-union nurses. Stewart Acuff of the AFL-CIO notes, "Nurse unions lead the way in advocating for lower patient-to-nurse ratios and limits on mandatory excessive overtime, both of which have major consequences for patient care. It is no accident -- and has been documented by solid scholarly research -- that heart attack survival rates are higher for patients in hospitals where nurses have a union than in hospitals where nurses do not have a union." Tell Congress to support the Employee Free Choice Act that would establish harsh penalties for employers who harass workers while they are attempting to organize.

LABORING UNDER THE BUSH ADMINISTRATION: Currently, 32 million workers -- 25 percent of the workforce -- have no right to form a union under federal, state, or local law. Even though productivity has steadily risen, the restriction on workers' rights has contributed to lower wages and a "middle class in turmoil," according to a Center for American Progress report. A majority of today's workers say the number one issue they face is that the wages they are paid are not keeping up with the cost of living. De-unionization accounts for 15 percent of the increase in wage inequality among men over the past quarter-century, according to David Card of the University of California at Berkeley. Under the Bush administration and the National Labor Relation Board's anti-worker policies, unions have been significantly weakened. David Bonior of American Rights at Work noted in 2004, "A staggering 92 percent of employers force employees to attend mandatory captive audience meetings where workers often must listen to hours of anti-union presentations by corporate representatives. ... Seventy percent mail anti-union letters to workers' homes." The portion of private sector workers covered by union protections has fallen steadily from 23.2 percent in 1979 to 8.5 percent in 2005.