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    Friday, June 25, 2004

    And the Strike Played On: The strike is getting ugly. Although it isn't AFL-CIO ugly, it is getting uncivil. Or maybe it started out that way. The nurses have revealed that the hospital's negotiator pulled a Cheney:

    Hey, we know you shut the cell phone off. You guys got to quit these *#$&@^! games.

    What's that about? Well, it turns out that with fifteen minutes left before their contract expired, when they were still negotiationg the terms of a cooling off period, the nurse's union told the hospital they were shutting off their phones and not taking any more calls. (They were tired.)

    Now they're shocked, shocked, that the hospital refused to sit down with them the next day to resume negotiations. I've absolutely no experience with negotiations and labor disputes, but the union doesn't appear to be handling this well. Not at all. Telling someone you will no longer be taking their calls is the same as saying you're through talking.

    Granted, the hospital respresentative did not distinguish himself with his response, but neither did the nurses. Reading their version of events, one can't help but come away with the feeling that this battle is more about personalities than it is about healthcare insurance or wages or pensions. And that's sad, because the strike is not only hurting the hospital. It's hurting the community.

    And Another Thing: The nurses' seem to think that they've got an edge here when it comes to public sympathy. But letters like the one below (not from Akron) suggest that they shouldn't over-estimate the coinage of their image as angels of mercy. That image is becoming sadly tarnished, everywhere:

    Unfortunately, we have experienced first hand the difference in today's hospitals and nurses from those of the past. My dad (age 77, diabetic, double amputee, strokes, heart attacks, etc.) was taken to the ER of one of the "best" hospitals in the city yesterday afternoon, because he is suffering from fluid in his lungs due to congestive heart failure.

    When I went to see him at 7:30, I expected to find him settled in a room. Instead, he was still in the ER. Not only was he in an uncomfortable position (it is very difficult for him to move himself around), but he had not had anything to eat or drink since noon. Nor had anyone checked his blood sugar or given him insulin. The ER doctor had given a cursory look at his chart, and seeing that he had had trouble swallowing in the past, assumed that he was aspirating his food and wanted to put in a feeding tube. My dad refused it, and it made the doctor angry. Fortunately, another doctor correctly diagnosed the problem and put my dad on IV lasix (sp?), antibiotics, and breathing treatments.

    No one bothered to make him comfortable or even shown him where the TV controls were. He was just left there in a room by himself staring at the walls. I turned on the TV for him, but when I left at 9:15, he still had not had anything to eat or drink and was still in the ER.

    Visiting him in his room tonight, I found that the bathroom in his room wasn't clean (it certainly wasn't used by my dad). Also, he told me he hadn't drunk his milk at dinner, because no one brought him a straw or opened it for him. When the nurse brought him his snack, she just left a package of string cheese, crackers, and unopened milk on his tray and breezed out. If I hadn't been there, he wouldn't have been able to open or consume any of that either. Then when the respiratory tech came in and put the mask on my dad for his breathing treatment, he put it over my dad's glasses, which pushed his galssed into his face. Again, if I hadn't been there, it would have stayed that way.

    Some of these may seem trivial, but overall it shows either laziness or a lack of compassion and concern that is really sad. My poor dad is about as helpless as a person can be, and yet, nobody seems to care enough to see that he is at least somewhat comfortable. They do the absolute minimum and leave.

    My dad has no idea what the doctor thinks or has planned. He saw the doctor for about 5 minutes this morning. Either he didn't understand what the doctor said, or the doctor really didn't tell him much. I think my dad feels like he's being treated like a piece of meat. It's the first time in all his illnesses that I've seen him so discouraged and ready to give up. Right now, I think I'd rather be desperately ill at home than be hospitalized.

    UPDATE: Another reader makes a valid point:

    I read your post that starts like this: "The nurses' seem to think that they've got an edge here when it comes to public sympathy. But letters like the one below (not from Akron) suggest that they shouldn't over-estimate the coinage of their image as angels of mercy. That image is becoming sadly tarnished, everywhere"

    However, the majority of the letter dealt with the ER doctor that got mad, the bathroom that wasn't sufficiently cleaned by the housekeepers, the RT that mis-placed the treatment mask, and the doctor that barely spent 5 minutes with him the next day.

    I agree that the lack of comfortable position and the fact that someone (could have been the nurse, could have been the CNA) just plopped down the dinner tray/snack without inquiring as to whether the patient needed things opened for him is not very nice, but was the nurse assigned to that patient running around like the proverbial chicken, or was he/she out at the desk doing a crossword?

    Overall, I think you unfairly pointed out nurses with that letter, when it's clear that other disciplines also participated in this patient's lack of care.

    That's true. We're all responsible for the decline in modern hospital care. Too busy, too rushed.

    UPDATE II: Another reader disagrees and makes the connection between managing women and the strike:

    You missed a major point in your own article. [see the post above this one - ed.] Most of the nurses are female and you have problems with female employees, soooo it is not a big leap to understand some of the problems in settling the strike. Ego. Add to this my outside view of hospital administration being made up mostly of women and you have a very difficult situation.

    I have a problem with a group making above average wages, in an area with a declining economy, complaining about working conditions. When you go to the hospital they could care less about the patients, only about their next break, it is hard to feel sympathy.

    Well, I didn't entirely miss the point. I posted the two in close proximity because I thought they were somewhat related. Although, I think the union's concerns (the loss of benefits) are ones that are widespread among all unions - the way they're negotiating and the tenor of their website does smack of the same problems that a lot of people have complained of in managing an all-woman staff. That is, a preponderance of the emotional at the expense of the rational. And at this hospital, by the way, the administration is overwhelmingly male.

    And I agree. I have trouble sympathizing with a group who is making above average wages in a region with a declining economy, too.

    UPDATE III: And another reader also thinks that the reputation of nursing as a profession is declining:

    I'm emailing about the update that said you unfairly pointed out nurses when it's clear that other disciplines also participated in this patient's lack of care.

    Background: My father has been in hospitals about every 2-3 years, for the last 14 years, due to complications related to his heart stopping 6 times in one day. He is now having the same water in the lung problems mentioned in the original email.

    In regards to nursing, we‚ve found the ICU staffs have always been top notch. The regular floor and EM treatment have been a mixed bag. He had a hunting accident and one pupil is always dilated. It‚s obvious when a nurse comes in, if they haven‚t read the chart. On some floors, there‚s an annoying tendency of the staff to gossip for hours at a time and do the minimum required.

    The good, professional nurses stand out because they are the exception instead of the norm. The opposite of how it used to be. I realize nursing is a tough job, and all the paperwork doesn‚t make it any easier, but nurses are the backbone of care that is received. If they are just putting in their time, it shows.

    This is true. I know a lot of top-notch nurses who have switched from the medical floors to the ICU precisely because they wanted to be able to actually care for patients rather than be a documentor, medication handler and supervisor of nursing aides. Once upon a time, the standard of the ICU was the same for the regular medical floors. Patients were cared for by nurses, not by aides.


    posted by Sydney on 6/25/2004 07:14:00 PM 0 comments


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