Grassroots/Hank Kalet

Nurses Fight the Power

Nearly 100,000 healthcare workers have walked off the job over the last year, angry about conditions that are driving many from the field.

A three-day strike by Kaiser Permanente nurses and support staff in six states resulted in scheduling changes, while strikes in Minnesota, New York, and elsewhere have help alter work rules.

Nurses at Robert Wood Johnson University Hospital, in New Brunswick, N.J., have been walking the picket line for going on three months (as I write this, the nurses and management remain far apart) as they seek to improve their own job conditions and by extension create safer and more effective care for their patients.

I’ve visited the picket line several times, and talked with dozens of striking nurses. The related the stress short staffing creates on the system, the ways in which it creates unnecessary “triaging” in departments where nurses are forced to make decisions on which patients are in greatest need.

Robert Wood Johnson is the state’s pre-eminent trauma hospital, and considered the flagship hospital of the giant and sprawling RWJBarnabas Health System, RWJBarnabas serves — according to its own estimates — about 3 million patients annually in a state of 9 million residents. It is a product of healthcare consolidation and privatization, a collection of non-profit facilities nested in a larger corporate structure, and like so much of healthcare its decisions are too often driven by revenue considerations and a desire to cut costs.

RWJ officials would dispute this. They have repeated argued that the nurses are treated well and that the hospital — one of six in the system — treats its staff well and provides the best care available for its patients.

The key word here, I think, is “available.” RWJ is situated within a larger American healthcare system that underserves its patients across the country. We spend significantly more per capita and as a percentage of Gross Domestic Product on health care in the United States than the next biggest healthcare spender among industrialized nations. We also place at or near the bottom in most measures of health. Our life expectancy is about three years lower than then average industrialized country — a figure that masks the great disparities in care and health that exist.

One reason for this is that we do not guarantee access to care. Our system is a hodgepodge of private health insurance and public programs designed to plug gaps for the poorest and oldest. Hospitals often end up as the healthcare provider of last resort, which strains facilities and drives up cost for those who do not qualify for Medicaid but still live in precarious economic conditions.

At RWJ, the nurses say these distorted economic incentives interfere with their ability to provide the level of care needed. I talked to a group of nurses who work with neurology patients. Their patient loads vary, they said, but should hover around four or five per nurse. Often they are caring for more than that, which forces them to push beyond what is fair to them and to their patients.

“It sucks to always feel like you’re shortchanging the people,” Will Mumford told me, “even if you’re putting in 150%. A lot of us don’t take lunch, don’t take breaks, we work constantly and still stay late and chart afterwards, because we’d rather do as much patient care as we can and make it up on our time.”

This was a common refrain among the dozens of nurses I’ve talked with at RWJ — and similar to stories I heard from the California Nurses Association and the Coalition of Kaiser Permanente Unions.

These stresses have been evident for years, but Covid — which required an all-hands-on-deck response from the healthcare industry — underscored that healthcare is at a crisis. Nurses were stretched beyond capacity and many have left the profession, making it even harder to maintain staffing levels. Overwork continues, driving out new nurses and creating a nasty spiral downward.

For the nurses, their only recourse is the same one other workers have turned to in recent years, to varying success. My union, the Adjunct Faculty Union at Rutgers won huge raises and the beginnings of job protections for adjuncts, while other faculty unions have chipped away at the precarious positions adjuncts and graduate workers face. Workers at Starbucks, Amazon, and numerous retail chains have been organizing and fighting for more democracy in their workplaces, which entails better pay but also control over scheduling and health and safety protocols.

Business is pushing back, but the genie is out of the bottle. Workers are uniting and fighting for themselves, for their students and patients. We are all in this together.

Hank Kalet is a poet and journalist in New Jersey, lecturer of journalism at Rutgers University and a member of the union executive board who participated in the Rutgers strike in April. Email: hankkalet@gmail.com; Twitter, @newspoet41; Instagram, @kaletwrites; Substack, hankkalet.substack.com.

From The Progressive Populist, November 15, 2023

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