Yesterday Minnesota was home to the largest nurses’ strike anyone can remember – 12,000 nurses picketing 14 hospitals. There was a sea of red-shirted union members outside of United Hospital here in Saint Paul, including many from a new generation that hasn’t seen a labor action before. Today, they are back at work without a contract. The action was taken not for more pay or benefits but for something we all take for granted from a hospital – the nurses simply do not feel that the long hours they put in are reasonable or safe. I, for one, cannot believe that it has come to this.
Nurses feel they are dangerously understaffed and have to care for far more patients than they can. Worse, they are often called on to perform in specialty areas that they are not trained to work in. Hospitals, for their part, have not said much to the public through this dispute other than to insist that current staffing levels are adequate and that they know best how to run a hospital.
The public generally supports nurses, which is to be expected. This is just a few notches below mothers going on strike emotionally. When someone is flat on their back, the very idea that the person caring for them does not believe that they are at their very best is frightening and, at some level simply wrong. More to the point, this goes against everything that those of us with manufacturing experience have come to understand through Total Quality Management (TQM) and related methods for providing quality.
If workers do not feel they can safely and effectively deliver quality, their voice simply has to be heard. One of the basic tenants of modern manufacturing is that anyone, anywhere along the assembly line, can shut things down until a problem is fixed. That’s empowerment. That’s a commitment to quality and safety. It’s what workers at Ford and thousands of people who manufacture stuff across the USofA have come to expect as the only way to insure quality products are made.
Do we really value things that much more than people?
Staffing levels are a bit of a grey area in TQM and are always open to disputes. But in the case of a service industry, which is what a hospital is, when the workers are this united in the belief that they cannot provide a quality product there is, by definition, a problem. It at least needs more attention than hospitals have been willing to provide so far. But we are told that no, this is the way it is and there is no room for compromise.
There has to be a lot more to this problem then we’re being told, and I can think of a few issues. State budget cuts have fallen on hospitals quite hard lately, and all of the hospitals involved in the strike are non-profit operations that are constantly being squeezed. If they are really so tight for cash that they cannot even discuss how to provide a level of staffing that brings confidence to their own workers there could be a problem with the system at large. I accept that. But to balance our budget on the backs of nurses is an utterly insane thing to do, if that’s what it’s come to.
Meanwhile, our nurses are trying to be as responsible as they can, calling a one-day strike and threatening more one day at a time as they have to. I think they all deserve our support if for no other reason than they really aren’t asking for all that much. If workers in any field do not feel that they can do a quality job, there is a problem, period. Other fields have come to understand that and embrace it. Why this isn’t built into our health care system is just one more example of how bad things have become.