Why are Minnesota nurses striking?

14330064_1068930329888826_3689538360743517410_nBy Carrie Mortrud, RN 

Some people might be asking the question: Why are Minnesota Nurses Association (MNA) nurses on strike at five Allina hospitals? As a former Allina nurse and now MNA staff who works for the nurses, I want to share my perspective.

For Allina, this labor dispute appears to be about breaking the nurses and breaking their union rather than resolving some labor disagreements regarding, workplace safety, nurse staffing, and insurance benefits. The nurses came to the table to work on a few but major issues, including nurse staffing. As a bedside nurse, I knew this problem all to well. Unfortunately, it’s also why I left patient care, which I loved, to work on nurse staffing issues in hopes of creating a permanent fix.

Nurse staffing is a problem. The hospital only sees nurses as a cost to them rather than a source of income, because nursing is part of the room and board charge. Nursing is not a separate line item on your bill. You see a charge for sterile equipment, materials, medications, therapies and medical care but not nursing care. Yet you wouldn’t be in the hospital if you didn’t need 24-hour care! You would be treated at an outpatient clinic. When the nurses say there is a staffing issue, you should believe them or at least question those responsible to provide enough nurses to care for you.

I cannot tell you how many times I hear scenarios like this: “My cardiac (heart) patient yesterday waited 17 minutes before calling me into his room to tell me about his chest pain. He thought I was too busy with other patients who were more critical.” Yes, once in awhile a patient puts on their call light because they need another blanket or some crackers, but more often than not its because they need assistance walking to the bathroom or they need pain relief because without it they are not breathing deeply enough to avoid pneumonia.

Or God forbid they are actually having a cardiac arrest while on the cardiac floor. Patients are prioritizing and triaging their own care while in the hospital because their nurse is too busy with too many critical patients to spend the appropriate time necessary with them.

This problem of nurse staffing also highlights the issue of the charge nurse taking or not taking a patient care assignment while also running the unit. Charge nurses spend a majority of time coordinating patient flow such as admissions, discharges, transfer and transports, responding to codesand making assignments for the next shift. Their equally or more important role of, being a resource for the other nurses often goes unfulfilled when they are also responsible for direct patient care.

My professional personal experience with having a charge nurse available to problem solve and trouble shoot happened early on in my nursing career. I was working on a busy evening shift on the telemetry (heart monitoring unit) unit. I had a female patient in her 50’s who had nagging back/scapular discomfort for a couple hours. At first, she and I both thought it was due to her having to lie still for a heart test she had earlier in the day. After repositioning her multiple times and administering some Tylenol, I scraped together some extra minutes and gave her a back rub but it didn’t relieve her pain.

When the night charge nurse came on and came around to check on patients and see how the night went we started talking about this patient. She asked if I had rechecked the patients EKG strip or heart rhythm strip. I hadn’t rechecked it, I followed protocol which was record and assess one at the beginning of the shift and then again if the patient has chest pain. She wasn’t having chest pain. The charge nurse explained to me that in women, sometimes heart attacks present as back or scapular pain. My heart started racing, what had I missed?

We ran a new EKG strip and sure enough the measurements had changed, my patient was experiencing irregular heart activity and was likely having a heart attack on the heart unit in my care in the hospital.What might have happened to that patient had the charge nurse been assigned patients that she needed to get report on rather than check in with me? Truly every moment matters. Nurses need another nurse to collaborate with, to plan care with, to assist you get well. Nurses save patients from thousands of errors a year, maybe more. The more and more time that gets cut from their time to work together diminishes the quality and safety of the care you receive. It really is that simple.

Minutes mattered for this patient, sometimes it’s even seconds. I witnessed seconds making a difference in someone’s life as well. Too many code blues on patients in the ICU, where literally seconds made a life and death difference. Some patients survived and others didn’t.

I also personally know that seconds matter. On a Saturday four years ago, my husband had a massive cardiac arrest and died on our bedroom floor. As the minutes passed, I administered CPR waiting for the paramedics to arrive. As the minutes passed, they only told me they were trying, but I knew. I knew as a cardiac nurse you can’t “work on” someone for that long and not just be delaying the inevitable. I knew they were simply delivering electricity to his heart to transport so an MD could pronounce him dead. The emergency room doctor told me he wasn’t even sure if my husband had been in the ER at the time, if he could have saved him. Minutes matter and sometimes it’s even seconds. Do you want to be the one waiting minute after minute for someone to answer that call light while you are in pain, while you are scared you are having a heart attack or while your loved one waits? Of course not.

Nurses become nurses because they want to care for people. Consider supporting the nurses because they just want a safe environment for you, for them to care for you. They want reassurance their health insurance will cover them and their families so they can care for you when you need them. Finally, they just want enough of them scheduled at one time to do just that, provide nursing care while you are in their care. #allinatogether #unionforever

 

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