" Nurses are the largest and most respected subculture in health care and we have the power to change. How do we do it? I'm not sure."
Many of you are eagerly and enthusiastically entering nursing careers. I commend your accomplishments. You will receive your first paychecks and beam proudly. The hard work will ... appear to pay off.
Many of you are closing in on completing your nursing degree. I commend and applaud you as well. The Art of Nursing is fascinating as a profession ... on many levels.
Yet, it requires the strengths and constructive activism of all of us to make it better. First for us as practitioners, and for patients. Notice I placed 'us' first. If we do not take care of ourselves (work conditions, great pay, professional advancement) then, truly we cannot fully engage in and be present, in taking care of others.
Many of you reading this will be patients, or have a significant other(s) that is sick. You and your family will essentially become enfolded within a healthcare setting and the healthcare process. You are the one(s) we as nurses care and advocate for. What I have to say concerns you as well ... perhaps more so.
This post is not meant to scare you. This post is meant to empower you, to empower your advocacy efforts, and to inform your future in your nursing practice.
This is the call for action that I responded to on a nursing blog. The quoted statement above is uttered everywhere in various wording on nursing sites, blogs, websites, and in Nurses Lounges, usually by nurses who have worked for five or more years in nursing. Sometimes less. The question and concern are chronic, dating from the early twentieth century until now. The questions are always the same ... how do we make nursing better ... how do we do it? What follows is my response and call to action:
We can talk about this topic and other subjects on websites, blogs, and groups. I see the catharsis in comments and feelings on many nursing sites and blogs. This cathartic effect tends to serve as the action many nurses take to essentially get the anger, frustration, disappointment, etc., off their chests by venting. Then, going back to work and enduring the same old conditions until a new job comes up (new job same BS), or the ability to go part-time, or PRN, or retirement, or the ability to leave the nursing profession altogether.
Until nurses actively support and engage in activities, organizations, individual and collective actions to advocate for nurses and nursing, to advocate for patients, to demand better pay and working conditions,nothing will be changed or accomplished ... other than limitless posts, venting, (some call it whining) and distractions from what really matters ... you, patients and your practice.
We have to promote a single payer form of health insurance that is an extended form of Medicare. Thebusiness/competitive/capitalistic system we have in place is pathetic and inhumane. Particularly, since we are one of the richest countries in the world. If we can spend 10 billion of our tax dollars on Iraq each month, then we can afford to insure every American. If we can pass a law to bail out people who are being foreclosed on their homes (some McMansions) then we as a humane & humanistic society can provide healthcare insurance to all. The United States has a third-world infant mortality rate. Actually, some parts of the third-world may be doing better! The weight of the uninsured, the underinsured, and those without are and will become the burdens of our children and their children!
The arguments against having a single payer system pale in comparison to people losing their homes, their life savings, becoming homeless and living on the streets, and actually dying because insurance companies deny coverage, or will not pay, or the premiums are too high, or they simply will not cover individuals.
Universal healthcare and the single payer system surprisingly have been ongoing dicussions in the healthcare reform zeitgeist since the 1900's.
A single payer system of Universal Healthcare is not socialized medicine. Many people erroneously equate universal health care, the single payer system with socialized medicine. If it were socialized medicine the hospitals and clinics would be owned by the government.
"The AMA used it to mean any kind of proposal that involved an increased role for the government in the health care system," he says. "They also used it to mean things in the private system that they didn't like. So, at one point, HMOs were a form of socialized medicine."
In terms of government programs, Oberlander says it was used against Medicare in the 1960s, and prenatal care in the 1920s and 1930s. "It really is a term that is very flexible, and because it means nothing precisely, you can define everything by it."
These days, there is one potentially accurate use of the phrase, Oberlander says. It can be used to make the distinction between a so-called single-payer health care system — where the government pays all the health care bills — and a truly government-operated health system, he says.
Term's Definition
"When you talk about Europe, and you talk about a British system where the hospitals are owned by the government and the doctors are directly employed by the government, then you might say that's socialized medicine," Oberlander says.
But that is different from what most single-payer proposals would do. "There, you would essentially have government financing, just like you do with Medicare, but you would continue to have private practicing physicians and private hospitals, Jonathan Oberlander, professor of health policy says."
(http://www.npr.org/templates/story/story.php?storyId=16962482)
With an extended form of Medicare, the single payer system, everyone would be included with no one left out. Many private insurance companies and some hospitals in adopting a business model of healthcare delivery and services, have commodified disease and thus have made the patient (and the patients families) proxies in our present healthcare system.
As nurses, we are part of this collusion upon patients, the public and each other because the public trusts us. As stated above 'nurses are the most trusted healthcare professionals.' Yet, this public trust and integrity is being exploited by hospitals and private insurance companies The public trusts us and right now, I do not know if they really should. We act impotent. We do too much talking and not enough action.
Nurses need to unionize! Doctors have a union, although they do not use the language/word -union. For doctors it is the American Medical Association. The AMA, among it's many strengths, is it's political clout and lobbying connections The AMA does in fact serve the holistic interests of it's membership - the medical profession. If you think doctors do not negotiate or argue about their pay, healthcare coverage, hours, etc, ... think again.
Every medical student/doctor within and upon exiting medical school is encouraged to join and support the AMA. As a matter of fact, most medical students/doctors consider joining the AMA as a rite of passage within their profession.
The same drive and enthusiasm to membership within a professional nursing union should be evident in every nursing school. Yet, name one union that you heard of upon graduation ... or even now? Most nurses are groomed and institutionalized to believe that unions are bad and unprofessional (anytime a nurse hears the term unprofessional, it is usually from management in an attempt to control behavior). Nurses hear much of that propaganda from hospitals and those within hospital administration, nursing management, and other nurses that are institutionalized within the hospital system!
Actors have a union. Actor's Equity (AEA), serves the holistic interests (pay, health insurance, collective bargaining, etc.) of actors.
Taken from the AEA site: "... founded in 1913, is the labor union that represents more than 45,000 Actors and Stage Managers in the United States. Equity seeks to advance, promote and foster the art of live theatre as an essential component of our society. Equity negotiates wages and working conditions and provides a wide range of benefits, including health and pension plans, for its members. Actors' Equity is a member of the AFL-CIO, and is affiliated with FIA, an international organization of performing arts unions." (http://www.actorsequity.org)
Did you see an actor of note crossing the picket line when the Writer's Guild went on strike in 2007? Many actors, Jay Leno, Susan Sarandon, Robin Williams, Ben Stiller, Kathy Griffin, Neil Patrick Harris, Calista Flockhart, Sarah Silverman, T.R. Knight, James Denton, Sally Field, and others supported the efforts of their fellow union members! I mentioned some of these actors to demonstrate that we as nurses in our activism efforts ... are not alone! The movie industry is an industry that circles the globe. Hollywood is a union town:
"Even the Teamsters were impressed. “Wow,” said Leo Reed, the gruff secretary-treasurer of Teamsters Local 399 and director of its motion picture division. “You are acting like a militant union.” (http://www.nytimes.com/2007/11/26/business/media/26strike.html?fta=y).
Nurses need a professional collective bargaining, nurse advocacy, ratio mandate/mandating progressive union that is Nurses Only. We should not be aligned with service workers (janitors, custodians, food service, with the SEIU, etc.) as we do not work within those industries. Can you imagine the AMA or Actor's Equity being part of any other union that does not serve their distinct and unique needs?
We require our own professional organization that champions, promotes, negotiates for and educates our membership and the public.
The National Nurses Organizing Committee (NNOC) answers that need and collective call. Please, go to the site. Read and empower yourselves about this union, the single payer system, and how you and others can work to change the system ... not just for you, but for the betterment of those who will come after you.
The website is http://calnurses.org
Adrienne Zurub
Author, 'Notes From the Mothership The Naked Invisibles'
Adrienne Zurub's Amazon Blog - http://www.amazon.com/gp/blog/A3DXVTX2C4WOPO
