On Uneven Ground

bilde“We had a major success with staffing! The company agreed to staffing ratios”. Applause erupts, smiles from the tired faces wearing our glorified pajamas.

Her words swirled about in my brain. I saw images- the faces of patients-, hours of the day- lifting, bending, pressing syringes, rushing down halls-, and all the moments of crisis I’ve carried with me through the years. The weight of the hospital pulls on your soul.

The hall was set with folding tables and cheap plastic tablecloths decorated the sad displays of institutional food. Bizarre textured wallpaper seems wrapped around the whole room, blanketing the scene in dull flesh colors. The union meeting took place in one of the conference rooms of the hospital, the same place where we receive trainings about how to smile, how much money is being lost, and why our work is never enough.

Staffing is a word, but in hospitals it’s everything. It means how many patients a nurse takes care of. Bad staffing can produce situations of such intense work that you literally have no idea where you are, responding second-to-second without any view of what happened or what comes next. Staffing is why we cry in the break room for patients who died in shameful avoidable situations, when we grimace in pain in the bathrooms having suppressed our bodies to complete too many tasks, and when we feel the emptiness of futility to help human beings face-to-face with reasonable needs and nothing to be done. Senseless.

I raised my hand. “Wait, I don’t understand. Why would management sign a staffing ratio agreement? What does the agreement actually say”.

The president replied, looking nervous “well, what we have is an advance but it’s not our goal. They agreed to put something in paper. That doesn’t mean we got ratios, but at least we got them to publish it”.

Quickly I saw what had happened. “So you mean that basically they just have to tell us whatever numbers they want, and there’s no teeth to back it up”.

Unphased, “This fight will be long. In California it took 15 years of working with lawmakers to get the staffing ratio law. We have begun this work, but until we have our people in Congress it will be a tough fight”.

It’s true, in California decades of lobbying did pay off. Of course there were strikes and job actions, but the nurses unions in California systematically built alliances with democratic lawmakers, and took the opportunity with a democratic governor in office and a democratic legislature. A law mandating minimum staffing levels for nurses was passed, and ever since California has been at the top of patient outcomes in hospitals and along with the morale and day-to-day life of its nurses.

In Miami, things are different. All the nurses standing in the room understood. The barrage of tasks, the intolerable pressures, so much suffering; it would all have to wait. “What about the fact that we’ve had no raises in 5 years?” a coworker asks.

A woman in a white lab coats is staring into her Styrofoam cup of cheap coffee. Blank stares around the room. “This is the victory party?” I ask myself, “I can’t imagine when they announce defeat”.

The union expressed something succinctly that runs through our workplaces and communities everyday. Again and again we hear how the problems we face can be solved by the intervention of powerful individuals on our behalf. There are religious versions of that (waiting for a messiah), authoritarian versions (worshipping leaders), and democratic versions as well.

“We’re in an election year, and we’re going to need to carry these victories in our contract door to door to elect pro-labor politicians,” a union staffer said in almost robotic enthusiasm.

To the union official, and to be honest most of my coworkers, our future lies in building movements that get behind the capitalists and politicians. Sit and wait; that’s the message we get most of the time. The union has few answers for the day-to-day struggles of the nurses.

Neat stacks of flyers are arranged on the table; orange, yellow, and green paper. “Contract Victory!” one says. “Contribute to the political fund” says another.

Sometimes people speak about our movement as though it could be neutral. We’re told that workers organizations shouldn’t take sides on political issues because it may divide us. The problem is that we’re on uneven ground. In fighting for legislative change, we create new barriers to overcome. How we fight for it matters.

The nurses start to slip out during the final speeches of the President and union functionaries. “10 minutes is up, and there’s the patients upstairs who must be…”

It is the difference between waiting and watching people being abused and neglected for years, or doing something ourselves. We will be told constantly that we are powerless, that nothing can be done, and that the only solution is to support the same people and institutions that are inflicting these wounds. With staffing ratios this is not some abstraction, but rather the bread and butter of our fight. How much of a difference will it make to our lives if we decide to fight the inhumanity of hospital staffing together with our labor and protests versus if we allow our struggle to become institutionalized and taken from us, resting on the good intentions of a loyal patron? The weight that workers carry in hospitals alone comes with this isolation. As long as we trust ourselves to institutions outside of our control, we will be its victims. If we can take it into our own hands to create something better, the possibilities are endless. Everyday in healthcare the outcome is apparent. Faith in the elections, leaders, and the system makes us impotent, and their victories only increase our dependence.

Ours is a different path. If we want to beat back this system and not just it’s symptoms, we must pledge against all the representatives in government and keep the struggle on our terrain. Dignity for nurses and patients will be against the politicians, management, and parasitic companies not because of them.


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