As nurses at a Washington DC ‘non-profit’ hospital, my co-workers and I are watching with pits in our stomach as a nightmare scenario unfolds across wards in New York City. We hear devastating accounts of nurses, patient care technicians and other frontline workers falling out of work rotations, only to return as COVID-19 patients in hospital beds. Retired nurses, who are themselves in a high-risk group, are being asked to come back to the bedside. Two-hundred miles south, in DC, COVID-19 cases requiring hospitalization are starting their relentless rise, and an increasing number of floors are flipping “blue”, dedicated to the care of patients battling this devastating virus. Anxiety increases as we see what is coming.
Why then, in the middle of an extraordinary public health crisis, are hospital workers getting hours cut or cancelled from working their shifts?
Hospital administrations, adhering to the corporate ethos of profit over everything, are fretting over “lost revenue” as they have been forced to cancel more lucrative elective procedures. Added to this, social distancing and fear of exposure has led to a temporary slow down in non-COVID-19 patients coming to the emergency room. Unlike the ongoing lags and delays in securing PPE for frontline workers, administrators have responded to the drop in projected revenue with crisis-response swiftness. Which means that healthcare workers, who are the most essential to caring for patients and making the hospital run, are simultaneously treated as the most expendable – and will in fact be squeezed to pay for the loss of revenue.
In a corporate practice designed to cut labor costs at any opportunity, temporary contracted workers have been terminated and waged workers are ‘cancelled’ from working their shifts if the number of patients or patient census is low. These cold calculations to maximize profits leave workers with severely reduced hours, snipped wages and uncertainty as most live paycheck to paycheck. Rather than “over”-staffing to have additional help and vital skills on standby, “low census” gives corporate executives an excuse to provide the least number of staff at lowest cost to the company. With the bare-minimum staffing numbers in place, healthcare workers are then left to provide essential services in a constant state of manufactured scarcity. For no reason other than protecting corporate profits, workers provide essential services in conditions that leave nurses burned out and overworked. Missed breaks, long hours, higher patient loads and moral distress from having to prioritize emergency patient care while leaving other patients neglected are taken for granted as parts of the job. In the meantime, the profits squeezed from these practices are used to garnish top-earning executive paychecks and bonuses.
Nurses are caring for an increased number of COVID-19 patients at great risk to their personal and family’s health — which is exacerbated by lack of PPE and inadequate staffing. While hospitals reduce pay and cancel critical and essential staff such as environmental and janitorial workers, who are already underpaid and undervalued, nurses are left to pick up the remaining slack. Nurses are yanked from bedside care to additionally take on the work of sanitizing and cleaning equipment, turning over rooms, taking out trash, delivering food trays, filling in for unit clerks and transporting patients. These are the “solutions” that have been mandated by management to navigate the crisis.
For those of us who have spent years working in this hospital system, we know deep in our guts that this system is illogical and cruel. Profit, rather than patients or workers, has always been the most cared for and protected. This profit has been amassed off the backs of largely Black, immigrant and female workers who make up a large portion of the healthcare labor sector in Washington DC. They are also the most exploited, precarious and least protected in this crisis. These dangerous practices, which have already been normalized in our corporate health care system, are outright criminal in the face of this global crisis. In a pandemic where nurses and other frontline workers risk dying in one part of the country, clinical nurses in other states are being cancelled. There is no coordinated national system to compensate and safely redeploy these workers to the areas of most critical need. With a life-threatening shortage of PPE, hospitals compete with each other to bid on equipment rather than pooling resources to provide for all. The decision-makers for health institutions are business capitalists whose logic of scarcity for the worker has left nurses in the impossible position of being considered both most essential and most expendable in this epidemic.
Rather than exploited labor used at whim by bosses, we are in fact a powerful force for visioning a worker and patient-run public healthcare system that can meet the needs of all. We both acutely feel and see the failure of the current system while also having the wisdom and experience to treat patients. We understand intuitively that investing in PPE, increased staff, training, and public infrastructure for more beds will prevent needless death and the hospitals from collapsing. We don’t need the bloated hospital administration teeming with MBAs to dictate the course of our collective health. The solution to corporate healthcare doesn’t lie with small reforms — token CEO pay cuts and flashy donations to employee assistant funds (tax-deductible) or petty incremental raises dribbled down to wage workers. We won’t be appeased with meaningless reforms when patient and workers lives are literally on the line.
In New York City, organic frontline worker groups that have formed in response to the crisis provide us a model for a first step in organizing across different healthcare disciplines and beyond the silos enforced at the workplace. Coordinated protests and testimonials by these groups have captured public and media attention and forced CEOs to reckon with realities on the ground and the power of their workers. Calls for nationalizing healthcare and worker-control of hospitals begin with us organizing ourselves independently.
It is time for us to take over and run our own floors. As nurses we must join the growing demand for healthcare workers to assume control of the hospitals and dismantle this corporate health hell once and for all. Our voices, our perspectives and our experience is invaluable. At no time is this more clear than now. We run the floors.
