It’s a wonder to me how nurses withstand the abuse that’s heaped on them. Many hospital administrations treat them badly. Many patients treat them badly. And many doctors treat them badly. Too often, and by too many people, nurses are treated as hired help and not with the respect they deserve for being the lifeblood of U.S. healthcare.
Nurses are expected to provide compassionate patient care while functioning in a workplace that doesn’t treat them compassionately. The pressures on nurses are mounting, as hospital cutbacks are forcing them to attend to more patients while saddling them with time-consuming administrative work. There is an increased likelihood of harming, and possibly killing, a patient because nurses are stretched so thin. If nurses complain or go public with their patient safety concerns, they will be fired.
For an alarming percentage, the job pressures have become unbearable.
Nurses are 18 percent more likely to commit suicide compared to individuals in the general population, according to a recent study published by JAMA Psychiatry. The study’s findings are even more alarming given they are based on data spanning from 2007 to 2018. It’s reasonable to assume that nurses experienced dramatically higher pressures in 2020 treating Covid patients and helplessly watching many of them die.
Another alarming finding: The suicide risk of female nurses is 70 percent higher than female physicians.
“The main takeaway is that the risk of suicide among nurses is twice that of the general population and even higher than that among physicians, a population known to be at high risk,” lead author Matthew Davis, an associate professor at the University of Michigan School of Nursing, told the trade publication Medscape Anesthesiology.
Davis’ findings likely explain another nursing trend that so far has attracted little attention. Nurses, particularly from younger generations, are increasingly becoming more militant and looking to organize. Kaiser News recently reported that of the approximately 1,500 petitions for union representation posted on the NLRB’s website in 2020, 16 percent related to the healthcare field, up from 14 percent the previous year. Only about seven percent of healthcare and social services workers are unionized, so the growth potential is significant.
Indeed, the future of unionism in America may rest with the heightening resolve of nurses to organize. According to the Bureau of Labor Statistics, America’s union membership rate declined to 10.8 percent in 2020, from 20.1 percent in 1983. Amazon workers at a giant warehouse in Alabama recently voted overwhelmingly against union representation, despite the public support of President Biden and more than 50 members of Congress led by Michigan Rep. Andy Levin.
Levin, who reportedly was considered a Biden candidate for Labor Secretary, maintains the mostly black warehouse workers were frightened by Amazon’s well- honed union busting activities. I suspect they were turned off by the BLM messaging of union organizers and instinctively understood they were being used for political purposes. Stuart Appelbaum, the president of the retail union that sought to organize the Alabama warehouse workers, serves on the executive committee of the DNC and co-chairs the party’s resolutions committee. Unions with sizable memberships are major contributors to the Democratic party and comprise Levin’s biggest campaign donors.
Notably, Biden and Levin offered no public support for two recently successful nurses’ union drives, one of which was located in Levin’s district. Nurse anesthetists at Beaumont Health’s flagship Royal Oak hospital recently voted overwhelmingly to unionize, despite Beaumont’s vehement opposition to organized labor. Michigan’s biggest hospital network spent nearly $2 million on union busters to combat an earlier attempt by Royal Oak nurses to unionize, incurring more than 30 NRLB violations.
The effort was so fierce that the Michigan Nurses Association vowed it would never again attempt to organize at Beaumont because of management’s “climate of fear.” Neither Levin, nor any other Michigan politician, voiced any objections to Beaumont’s union busting activities. Having been abandoned by the Michigan Nurses Association, Beaumont’s nurse anesthetists formed their own union and got the job done, despite union busting intimidation and perceived management retaliatory measures. Sally Gribben, the president of the newly formed union, was furloughed after voicing safety concerns and later placed on administrative leave leave based on allegations her colleagues said were bogus. Gribben was promptly reinstated after the successful union vote.
Nurses at Maine Medical Center, the state’s largest medical center, on Friday voted to unionize, despite intense management opposition. Unlike in Michigan, Maine’s political leaders rallied in defense of MMC’s nurses and objected to the hospital company’s hiring of union busters. Gov. Janet Mills and Troy Jackson, president of the Maine Senate, both issued congratulatory messages after MMC’s nurses voted to unionize.
The driving force of the Beaumont nurse anesthetists’ and MMC nurses’ union drives was a concern for patient safety. Beaumont Royal Oak, one of the busiest surgical centers in the country, in January outsourced its anesthesiology function to a controversial company called NorthStar Anesthesia. The co-heads of Royal Oak’s cardiology department warned Beaumont’s chairman they had “serious concerns” about NorthStar’s capabilities, but they were ignored. Within three weeks of NorthStar taking over, a patient undergoing a routine colonoscopy died from an intubation gone awry and another landed in the ICU because of a pain medication overdose.
There is evidence that Beaumont’s management was looking to sabotage efforts by nurse anesthetists to register written concerns about faulty Alaris drug infusion pumps linked to more than 40 deaths and more than 325 patient injuries at hospitals across the country. A survey of Beaumont doctors last year revealed that a majority of them didn’t have faith in Beaumont CEO John Fox and his management team. The once nationally ranked Royal Oak hospital last year lost more than a dozen prominent surgeons, more than 50 physicians, half its fellowship trained anesthesiology staff, 50 nurse anesthetists, and dozens of nurses.
Among the publicly cited concerns of nurses at Maine Medical Center were insufficient staffing, mandatory scheduling that requires them to rotate day and night shifts causing burnout and fatigue, lack of meal and break relief, being assigned to work in units where they have inadequate clinical experience, and other workplace issues.
A 2016 study published by Cornell’s ILR (Industrial Labor Relations) Review found that hospitals with a successful union election outperformed hospitals with a failed election in 12 of 13 potentially nurse-sensitive patient outcomes. The study also found that hospitals were more likely to have a unionization attempt if they were of declining quality, as measured by patient outcomes. University of Michigan’s teaching hospital, ranked by U.S. News & World Report as the 11th best hospital in the country, is unionized.
One has to be awfully naïve to believe that patient safety is driving the concern of many U.S. hospital managements. Increasingly supposedly nonprofit hospitals are being run by richly paid executives with MBA and accounting degrees like Beaumont’s John Fox, who earns about $6 million a year in compensation. Despite the pandemic and Fox’s dire warnings that it would cripple U.S. hospitals, Beaumont in 2020 had a pretty good year and was able to stash away an additional $1 billion to its already significant $2.5 billion cash reserves. Fox achieved his impressive financial results by firing 450 employees and accepting $387 million in CARES Act taxpayer funding Beaumont could have managed without.
A unionized nursing staff will also result in higher wages, which hospital managements resist at all costs because it means less money for themselves. A booming cottage industry of healthcare union busters has emerged, and hospital managements will spare no expense to employ them to intimidate nurses seeking to organize. The American Hospital Association is a powerful lobbying force in Washington, generously greasing both sides of the aisle. NorthStar Anesthesia, the controversial outsourcing firm that Beaumont uses, is controlled by a holding company whose previous CEO, Jeffrey Dunston Zients, resigned in December to co-head Biden’s transition team and now oversees the administration’s Covid response.
Given the successful union drives of Beaumont’s nurse anesthetists and the nurses at Maine Medical Center, rest assured hospital managements are going to wage even more aggressive campaigns to frighten nurses against organizing. But the nursing union train may already have left the station and gathered too much speed. Nurses increasingly have come to appreciate that unionizing might not only save patient lives, it also could save their own.
That’s a pretty powerful union rallying cry, one that’s already garnered meaningful support without a peep from President Biden, Andy Levin, and other Democrats who feign support for the rights of all American workers to organize.
FYI: Much of the information contained in this story is based on reporting I’ve previously done about the implosion of Beaumont Health for Deadline Detroit, an independent online publication focused on southeastern Michigan. My most recent story can be found here, and at the bottom are headlines and links to previous Beaumont stories I’ve written.
In reporting about Beaumont, I’ve come to appreciate American healthcare is badly broken, riddled with grossly overpaid managements, conflicted group purchasing organizations, and the growing influence of private equity firms looking to squeeze more profits by replacing doctors with less well-trained professionals and other measures that harm patient safety.
I’m looking to raise funding to start a website focused on the compromising of U.S. healthcare and providing a voice for the brave medical professionals willing to risk their jobs and livelihoods to voice concerns about growing patient safety issues at even the top-ranked hospitals. If you, or someone you know, might be willing to assist in this effort please contact me privately at [email protected].