I say to my colleagues, nurses and nurses aids, that health care is something you have to be suited for. You can screw up at the supermarket, or at the factory, but if you screw up really bad in health care you donâ€™t get fired. You get arrested.
Bad nurses are dangerous, and they should be fired if they canâ€™t correct their problems. Abuse, neglect, or any other criminal offense should be prosecuted. The least powerful position in health care is lying in a bed looking up. Patients need to be protected.
But some of the worst patient abuse happens far from the bedside. It happens in corporate offices and secret meetings. The law is not vigilant in the prosecution of corporations and individuals who cause widespread harm by greed and mismanagement. It took ages for the blame at the Hillside Nursing Home to find its way up to the owners, Antonio Giordano and John J. Montecalvo who were skimming and defrauding. Almost a million dollars, but how much more was taken legally? Cutting staff, cutting supplies, stretching care so thin that 87 year old Germaine Morsilli developed bedsores. She went untreated so long that even a transfer to another nursing home where she was given decent care couldnâ€™t save her life.
There are national nursing home chains that make huge profits by cutting cost, and staffing is one of the biggest costs. Cut staff, cut quality, Is it a crime when you sit in an office and shuffle papers and the people who suffer are far away? Easier to blame the nurses.
So, two recent stories show health care workers as pawns in a global market. First, from the New York Times…
Rich countries are poaching so many African health workers that the practice should be viewed as a crime, a team of international disease experts say in the British medical journal The Lancet. More than 13,000 doctors trained in sub-Saharan Africa are now practicing in Britain, the United States, Canada and Australia, leaving behind colleagues with impossible caseloads.
A crime. Strong words from The Lancet.
Second story from the L.A. Times, which still has a few reporters left…
For months, the nurses complained that they were subject to demeaning and unfair working conditions – not what they were promised when they came to America from the Philippines in search of a better life. So they abruptly quit.
But in doing so, they put more than their careers at risk: Prosecutors hit them with criminal charges for allegedly jeopardizing the lives of terminally ill children they were in charge of watching.
The 10 nurses and the attorney who advised them were charged with conspiracy and child endangerment in what defense lawyers say is an unprecedented use of criminal law in a labor dispute. If convicted of the misdemeanor offenses, they face up to a year in jail on each of 13 counts, and could lose their nursing licenses and be deported.
The case has unfolded against the backdrop of a chronic nursing shortage in the United States. All of the defendants were from the Philippines, which exported 120,000 nurses last year.
Note the word, ‘unprecedented’. This is a novel approach to managing those human resources. Or maybe we’re taking a page from American history, pre-Civil War.
Democratic Underground, links to a news broadcast that covers some important facts. Most important, none of the patients were harmed by the nurseâ€™s action. Clearly, the facility was able to get other nurses to cover the immediate need. The home served severely disabled children, some on ventilators. The staffing ratio was unconscionable. The home had one or two nurses each shift. How they kept those children alive I donâ€™t know, but all of them were severely stressed and unhappy. For months they tried working through the system, having to argue daily with the supervisors about the dangerous workload, but only came to fear that giving notice would result in reprisals. They actually felt that in two weeks their employer would find a way to take their licence. Finally, on the advice of a lawyer, they all resigned. The last nurse on stayed four extra hours so the children would have some care. That is more than enough time for the manager to call a temp agency and hire some temp nurses. Itâ€™s expensive, but I assume they did that since there was really no other choice.
The news video includes an anguished mother wondering who will take care of her daughter. For a parent in that situation the safety net is very thin.
The most interesting part of the DU post is the comments. One reader asked if nurses take some kind of oath. Actually we do. And weâ€™re held to a high code of ethics. And we can get sued, or lose our licence as well. But we donâ€™t lose all our rights as workers when we choose this work. Forced overtime, threats, danger to nurses and patients from understaffing — these are not acceptable. Some nurses posted comments about unsafe situations they refused, or jobs they had to quit. If you want to know whatâ€™s really happening with health care, youâ€™ll want to read them.
Some say that immigrants do the jobs Americans wonâ€™t do. Thatâ€™s nonsense. Americans will do any kind of work. But we donâ€™t have to suffer being underpaid and overworked if we can quit and find another job. Getting prosecuted for quitting a job is a new development. This seems like a test of the power of an employer to use the law to punish and intimidate a worker who simply wants to quit. If you work for a living, you should watch this case. Guest workers today, who next?