John Buell

Politics of Nursing

I am alive today because of the skill and dedication of medical professionals. I use the plural intentionally. In February, shortly after my daily swimming and exercise bike regime, I went to Mount Desert Island Hospital for an outpatient diagnostic procedure to assess a persistent heartburn problem. While in recovery from the procedure, nurses observed a sudden and very dramatic increase in blood pressure and immediately notified the surgeon. I was resedated, taken to the hospital’s ICU for further examination, in the course of which physicians determined that I had several major heart problems ( despite a lifetime of pain free exercise and very careful diet).

Tests led to transfer to the larger regional hospital, Eastern Maine Medical Center (EMMC), for a bypass, replacement of an aortic valve, and reconstruction of the aortic arch. This surgery commenced a few days later, but also had to be interrupted when the surgeon encountered further blockages and a clot not observed in the initial test. Deciding that this case would entail very specialized and difficult surgery, he then transferred me by helicopter to Brigham and Womens in Boston. I received careful one on one care in the ICU during my continued medication and testing there. And I depended heavily on their support following the twelve hour surgery that left me confused and physically drained.

When nurses at EMMC authorized a strike this April, it evoked some familiar responses in the course of the long blog commentaries following each news story in the local Bangor Daily News. As in my case, some readers wrote in describing how nurses had been key to their recovery, how overworked they were, and how patient staffing ratios even at elite institutions could often imperil patient safety.

But some of the anti-nurse union blog posts touched other themes increasingly endemic to American life. Unions were accused of hypocrisy in their expressions of concern for public safety: “A nurse that would walk out on their patients should be barred from ever taking care of a another patient. They should be permanently stripped of their credentials. I hope the hospital locks them out for a month this time and then fires every one that voted for a strike.”

Strikes by medical personnel are problematic, but these critics make an all too familiar error. Those who criticize the strikers often neglect the day to day violence inflicted when everyday policy leads to the neglect or even maiming of significant portions of the patient population.

A familiar criticism of strike actions also lies in the claim that, unlike WalMart, many of the hospitals facing criticism are not profit making institutions. They are run by nonprofit corporations whose boards hire the administrators.

If they take in more in revenue than they spend, the surplus goes not to wealthy stockholders but into the corporation for future socially beneficent projects.

The label nonprofit can, however, be deceptive. Nonprofits, charities etc are today regarded as the alternative to the welfare state.

But everything from the Heritage Foundation to the Institute For Policy Studies is or has a nonprofit arm. Many of the wealthy view charitable giving as a means of reinforcing their world view.

University of Southern Maine professor David Wagner’s What’s Love Got to Do With It provides a powerful critique of the role of charity in our society. Wagner points out that in many cities, YMCAs, which once primarily served poor and minorities, are increasingly run by nonprofit boards that see their task and their rewards—high director and administrative salaries—as tied to service to upper middle class professionals.

Those interested in assessing the merits of particular strikes would do well to know the boards. Who sits on them, how knowledgeable and responsive to hospital practice and personnel are they?

Do they rely on their handpicked administrators or have they actually walked the halls and spoken to the nurses and doctors doing real patient care?

Are they more interested in expanding — and profiting from — more bricks and mortar?

John Buell lives in Southwest Harbor, Maine, and writes regularly on labor issues. Email jbuell@acadia.net.

From The Progressive Populist, May 15, 2011