Forget a pay raise; just help us care for patients safely

Editor's note: This commentary is adapted from one of the answers sent on Wednesday to Today's Question.

I am a nurse, and very proud to be one. After a career as a noncontract employee, I never imagined that I would be grateful to be represented by a union. Years later, I see that it is only with the help of the union that nurses have a voice.

It amazes me, and saddens me profoundly, that the public does not understand what the nurses' contract fight is about, and that so many people are turning against us. Obviously, the huge effort by the Twin Cities hospitals to turn public opinion against us is working. This is not about money. It is about ensuring that language is written into the new contract that protects us from having more patients than we can safely care for.

The union is asking for a 3 percent pay raise, but we know we won't get it. Many nurses have asked our union representatives to drop the issue of a pay increase and have been told it's nothing more than a bargaining chip to get the hospitals back to the table; John Nemo, the MNA spokesperson, has said this publicly and clearly. We are fully prepared to concede any raise if the hospitals are willing to have a discussion about safe staffing levels, our real issue. Ninety percent of nurses voted to reject the hospitals' offers (93.5 percent where I work, according to the union). The real story should be why we so overwhelmingly rejected the offer and risked a strike. Hospital administrators should be asking themselves what led to this significant rejection of their offers, and how we can begin to repair the damage and move forward together with a shared vision. They should be clamoring to get back to the bargaining table, ready to stay there until an agreement is reached, rather than walking out at 2 in the afternoon on a recent Friday saying that not "one word, one sentence" of what we had to talk about was of interest to them.

We understand that these are difficult times and that we all need to be flexible. But what does flexibility mean?

Apparently it does not mean management giving up huge raises and bonuses. It does not mean spending more than the merest token amount of time on the units with the staff to get a real understanding of the workers' and patients' needs and the workflow.

Instead, flexibility means staff doing more with fewer and fewer resources. For nurses it has meant more "heads on beds," so that you get a new admission or surgical patient within minutes of discharging one, even as your other patients haven't been checked on as often as they should. It means giving up anything resembling a break to go to the bathroom or have something to eat or drink, because you don't dare step away. It too often means clenching your jaw and holding back tears because you have to be in three or four places at once.

We can't possibly be any more flexible than we have been in recent years. Hospitals spokeswoman Maureen Schriner likes to say that the nurses at Twin Cities hospitals give excellent care, and we do; but neither she nor anyone in management seems to understand the lengths a nurse goes to and what he or she sacrifices on any given day in order to provide that care.

The nurses want to get back to the table; we want this to be resolved and to move forward. But we also want our employers to realize that we are too often at a breaking point, and that we need language that protects us from tragedy. The public is hearing that we're asking for "more staffing." We do need to hire more nurses. Almost every day and every shift in May, nurses were begged to work double shifts because the units were so short staffed. Double shifts are expensive (time and a half to double time) and dangerous; do you want the nurse caring for you to be on his or her 14th hour on the job? Conversely, if we are overstaffed, nurses are always willing to take a "low census" day without pay. In the system I work in, we took almost 10,000 such days last year, saving the corporation $3.6 million.

On my busy medical/surgical unit, we currently have a ratio of one nurse to four patients at one time, which could mean five or six patients over the course of a shift with discharges and transfers. Isn't it reasonable to ask for language that protects us from doing even more than we do on a barely controlled day? This is what the negotiations and a potential strike are about.

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Lisa Letourneau, R.N., St. Paul, has worked as a nurse on a medical/surgical unit for four and a half years, and in health care for 15 years.

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