Nurses in the Real World of For-Profit Medicine


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Source: Counterpunch

Photo by Steve Sanchez Photos/Shutterstock

 

Since 1990, when the American Nurses Association declared that an entire week – from May 6-12th (the birthday of Florence Nightingale) — would be dedicated to celebrating the nation’s nurses, hospitals and other institutions that employ nurses use Nurses’ Week as a once- a- year opportunity to make up for any neglect, poor working conditions, or managerial mistreatment that nurses routinely experience in their workplaces.  The media also occasionally joins in, hoping that nurses will overlook the fact that reporters consistently neglect the significant role nurses play in healthcare, highlighting instead the accomplishments of those they consider to be more prestigious  — physicians and bio-medical researchers.  Even corporate America tries to burnish its altruistic image by promoting their products and offering freebies to RNs.

For years Nurses’ Week celebrations have managed to celebrate nurses while trivializing their work.  The images mobilized during Nurses’ Week reinforce the most highly gendered and demeaning stereotypes of the profession, with nurses lauded not for their using their brains and mobilizing the knowledge and skill they master during nursing school and the expertise they acquire on the job, but for their selflessness and self-sacrifice, kindness, caring, and compassion.  Comparisons to saints and angels abound.  This year, another metaphor has been added to the list.  Nurses are heroes, extolled not for doing a job that has always been arduous and risky, but for their bravery, for going above and beyond.

As the nation once again encourages nurses to soldier on at their posts, the gap between the saccharine rhetoric of Nurses’ Week and the grim reality of nurses’ work during the pandemic is even more glaring – and galling – than ever.  For the past nineteen months, nurses have experienced the consequences of hospitals’ short- term pursuit of profit and our nation’s failure to attend to even the barest necessities of preparedness for a predictable public health emergency.   In hospitals across the country, nurses have begged and pleaded for the kind of personal protective equipment (PPE) that would make them safe on the job.  In response, hospitals have fired or disciplined nurses who dared to speak out to the media, or even to their own hospital administration.  Since the pandemic began, nurses have begged for more staff to help them on wards and ICUs bursting with desperately ill and dying patients.  Instead of responding positively, even some hospitals who received federal bailout funds have furloughed nurses to save money.  While hospitals have lauded nurses for their heroism, some have even denied them sick pay or time off to recover from side effects of Covid-19 vaccines.  Perhaps the only good thing to come out of this pandemic is that the media has suddenly recognized that, oh my goodness, nurses actually do something useful in our healthcare system and have included nurses in the coverage of the Covid-19 pandemic.  All one can say is better late than never.

And here we are, during another Nurses’ Week and most of the players – including those in the media, have reverted to the default position of ignoring what nurses really do and the conditions that make it so difficult to do their job so the public can finally act to support nurses in a way that moves beyond platitudes to political activism to support a legislative agenda that would help them protect their patients and themselves.

Consider for example, the way hospitals have recognized nurses this Nurses’ Week.  The Mass General, one of the most prestigious hospitals in the country, put up a webpage titled “Say Thanks to Our Nurses.  “Nurses are,” the website tells us,  “a vital part of our mission to provide the very best healthcare in a safe, compassionate environment.”

How are nurses to be thanked for helping the hospital perform its mission?  Nurses and other staff are asked to donate to an MGH Fund +United Way Employee campaign and send a personalized message to other nurses.  Interestingly, when one turns to the hospital’s main website, there is nary a mention of either Nurses’ Week or even nurses’ contribution to the hospital’s mission.  The website, like those of most other hospitals, focuses only on the accomplishments of the MDs and PhDs who have made MGH Number 1 in research.  Nurses apparently have made no contributions to any of the hospitals’ research endeavors.

In a classic exercise of chutzpah (the Yiddish term for outrageous hypocrisy), one of the nation’s largest for-profit hospital companies as well as one of the largest employers of nurses, HCA Healthcare, thanked nurses for “displaying courage, care, and commitment to their patients everyday.”  Working for HCA certainly requires courage since, as the New York Times reported, the company which received over $1 billion in bailout money, did not provide employees with adequate Personal Protective Equipment and warned that it would lay off thousands of workers during the pandemic.

The media has also reverted to the usual trivializing stereotypes to thank nurses for their service. On May 6th, for example, the Today show reminded its viewers that, “This is always an incredibly important time to appreciate nurses and other healthcare workers, but it is now true on a whole other level.”  The show features four frontline nurse talking about the incredible risks they took and challenges they face working during the pandemic.  What is the reward for their courage?  Tips on how to score “free coffee, tacos, and cookies,” from companies like  Chipotle, Dunkin, and Outback Steakhouse.

Another company that is trying to promote its image and products by connecting to the saintly reputation of nurses is CeraVE, a skin care company started by dermatologists.  In a series of full page ads that ran in newspapers like the New York Times before and during Nurses’ Week the company applauded  nurses as, “The Heroes Behind the Mask,”  who “put others before themselves everyday.” These “heroes” are the subjects of several videos that emphasize nurses’ fears and tears, and the hands they’ve held at the bedside.  One video follows an African American Nurse who explains that “as nurses we sacrifice ourselves a lot,” because “we love what we do.”  We don’t, however, learn much about what this labor and delivery does on the job because the video instead follows her as she donates a bag of food to a local church.

Meanwhile, in the real world, not all nurses are content to be self-sacrificing angels of mercies or heroes willing to be healthcare martyrs.  All over the country nurses are fighting to make sure hospital staff get needed personal protective equipment and safe staffing.

In Portland, Maine the Maine State Nurses Association/ National Nurses United (NNU) scored a huge win in union elections at the Maine Medical Center.  In Asheville, North Carolina, the NNU won another major victory at the for-profit HCA Mission Hospital.  In Washington State, the Washington State Nurses Association (WSNA), along with SEIU Healthcare 1199 and UFCW 21 won landmark legislation to assure that nurses have guaranteed breaks on the job and are not forced to do mandatory overtime.  The WSNA has also fought for   adequate staffing and personal protective equipment. And in Massachusetts, the Massachusetts Nurses Association (MNA) is using Nurses’ Week as a platform to protest worsening conditions in the Bay State’s hospitals.

These examples of collective action are far more worthy of celebration and emulation during Nurses’ Week – and every week – than hollow exercises in nurse hagiography.

Suzanne Gordon is the author of many books about health care work and policy. She edits of the Culture and Politics of Healthcare Work Series at Cornell University Press.  She is currently working on a book about the Veterans Health Administration. Gordon can be reached at sg.@suzannegordon.com

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