by Anonymous Nurse A
I have been a nurse for eleven years now, and have worked in a variety of settings (mostly in the ICU). There is a lot of controversy and speculation about unions in the medical field. I have been a part of a nursing union in California for the last three years, and regard my interaction as positive. I have experienced many benefits working in a union.
I will start by contrasting to the negative situations that occurred when I was not protected under a union. When I was an agency nurse in Chicago, I worked in an ICU that did not have safe nurse-patient ratios. I would almost always have three patients; sometimes I’d have two very critical intubated patients, with an additional patient that was deemed not as critical, so it was justified by the manager. It was completely unsafe and in those situations both the patients and nurse suffer. Even very experienced nurses felt this ratio was dangerous and it was widely admonished amongst my peers. However, our concerns were ignored or, worse, we were labeled as complainers or trouble makers for voicing concerns regarding patient safety.
The most concerning experience I had was when I was floated to a med surgical floor mid shift and had eight patients. This is a very unsafe ratio. Especially considering that in the past nurses used to work the ICU with the reverse ratios, having two nurses for one patient. When a single nurse such as myself is responsible for eight critically ill patients, if even one of those patients has any issues or needs extra care, it makes taking good care of the other seven patients impossible. On a floor such as the one where these eight patients were, patients are likely to urgently need nursing attention. This is why ratios are supposed to be kept low. The more attention you pay to one patient, the less attention you have for another. However, without the protection of a union that combines the voices of the people who are actually doing the job the individual nurses are often blamed if they complain about unsafe ratios. It is easy to say a nurse should be able to do something, especially from behind a desk in a room far away from the sick patients. The people on the front lines of medicine know what actually happens on the front lines of medicine. When I was a single person, a single nurse, negotiating with a hospital I felt like I had to take and do whatever the hospital told me to do. I am young and strong and always rose to the challenge but I felt that my concerns were not heard.
Although I have not experienced this personally, my mother is a nurse in Indiana, a state which allows mandatory overtime. My mom has been forced to work over her scheduled shift, up to sixteen hours, on multiple occasions. This is extremely dangerous and increases the risk of medication errors. When I worked for non-union hospitals in Indiana and Illinois, I would rarely get a break during my twelve-hour shift. If I did get a lunch break, I would eat as quickly as possible and be back on the floor within fifteen minutes.
Several years ago, I stepped into the mystical world of “working with a union.” Things changed for me and they changed for the better. I feel supported at work. The problems with unsafe patient ratios do not happen. I eat! I feel that I can bring my best to my patients. The union representatives are not passive shows for PR [public relations]. They make an active effort to protect us. The union representatives leave comment cards and you can reach them by email at any time. Really, you can reach them and they will actively respond. Beyond the unions California has laws for nurse-patient ratios. I think the state laws and unions work together to protect healthcare workers and patient. California law states that in the ICU a nurse can have no more than two patients, and sometimes, depending on the acuity of the patient, no more than one. Contrast that to the multiple patients that I had in the Midwest! Also, here the charge nurses do not take patients and we even have break shift nurses to ensure every nurse gets their breaks. It is a much healthier work environment for both the nurse and the patient!