Aftermath of the Strike

Nurses chant "Go home scabs" and "Shame on you" as replacement nurses are bused away from Abbott Northwestern

[Metro Minnesota] hospitals prepared for the strike by bringing in extra non-union staff, hiring 2,800 replacement nurses and reducing patient counts by transferring patients to non-affected hospitals.

Dr. Penny Wheeler, chief medical officer of Allina Hospitals & Clinics, said the preparations paid off, that patients at all of the affected hospitals received quality care with no major problems.

I’m calling shenanigans.

On a cloudy Thursday, June 10th, nurses across the Minnesota metro took to the streets to fight for patient care. Many people, including the hospitals, continue to purvey the misguided idea that the only real reason for nurses to strike was money. Ask any nurse and they’ll tell you the truth: it was about caring for their patients. Don’t listen to the doctors who only spend fifteen minutes at a time with each patient. They don’t have a clue of what it means to really care for a patient. As for the management and the higher ups in the hospitals, Allina’s recent activity in changing 403b retirement plans to 401k’s can serve as a thermometer as to the direction they are going: to a for-profit business.

This whole ordeal boils down to contract language determining nurse-to-patient ratios. MNA and their nurses want defined ratios, according to their website:

Safe RN Staffing Levels: Nurses are asking for contract language that provides the appropriate number of nurses to care for patients. National studies prove time and again that RN-to-patient ratios are critical when it comes to patient safety and quality of care. Safe RN Staffing Levels have also proven to actually SAVE hospitals millions in costs.

MNA provided the hospitals a 10 day warning to strike, giving the hospitals plenty of time to prepare. During the strike, hospitals brought in replacement nurses, about 2,800, from all over the state. They also took many precautions to keep everything safe: Surgeries and elective procedures were mostly canceled for the day, non-union hospitals increased their staff loads to prepare for higher censuses, many patients were discharged, and more MD’s, NP’s, technicians, nurses assistants, and other non-direct care staff were asked to work for the day. All union hospitals decreased their censuses as much as possible. Essentially, replacement nurses were provided with an average ratio of about 1.5 patients to each nurse, something uncommon to the standard nurses and an obvious means to keep everything running smoothly.

But in contrast to the trouble-free, “smooth” day that the hospitals portray, there was some trouble in paradise. Nurses from all over the metro, upon returning to work, have begun filing incident reports detailing the errors made by replacement nurses and the general trouble felt by patients from hospital to hospital. Many simple things happened, such as replacement nurses giving a patient their medication and admitting they know nothing about it or even how to pronounce the name. Some technicians reported needing a nurse but not being able to find a single one on the floor. There was even a story of a man who, after being unable to find a nurse on his floor to fix his IV, walked down to the line to get one of the picketing nurses to take care of it.

Those all seem relatively innocuous, but there was one rumor of a man who needed attention for a minor problem with his lab values but was ignored. He eventually had heart troubles and had to be taken to the ICU. As for whether he survived this, the information is not available.

This is not meant as a hit on the nurses who took over in lieu of the regularly staffed nurses (however many were rather antagonizing to the striking nurses and certainly do not deserve the benefit of the doubt), but to simply bring up the point that these replacement nurses were by no means ready for the position they were placed into. Many were placed on floors in specialized units, such as cardiac or ICU, which require a certain amount of knowledge, skill, and experience. The hospitals obviously did not consider this when they staffed these units.

Overall, labor disputes are ugly and rather childish, with both sides making digs at the other. The hospitals claim that their effort to avoid the strict language dealing with ratios is based around money, but they felt that increasing staffing and paying some $2,000 per day per nurse (as well as paying for housing and a charter bus system to bus the nurses in and out) was a worthwhile use of their money. In addition to these costs were the costs for laying down stripes to mark the border of their properties, paying for painters and paint, maintenance crews, security, and a host of other services (not to mention the potential for lawsuits) that in the long run must have cost them, or will cost them, millions of dollars. If it was really about being simply unable to pay the extra cost to accomplish these ratios, where did this money come from?

On the other side, the question has been raised: is MNA requesting this strict nurse-to-patient ratio of based on shift, or maintaining the same ratio throughout all shifts? If so, one could understand why negotiations are breaking down. One must wonder often times, with these nagging labor disputes, if the union is drawing their members into a strike simply to make a point to the employers.

Regardless, the matter at hand is that this single day strike was by no means the simple and easy day the hospitals are making it out to be. There were problems, and there continue to be problems. And if the hospitals choose to ignore the whole thing and allow the open ended strike to happen, they are truly playing with unseen forces. This will only end in poor patient care and a disgruntled staff. Perhaps it is time to be a little progressive, make some compromise, and stop paying management and the higher-ups six, seven, or eight figure salaries.

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