Nurses and healthcare professionals around the country were outraged at Washington state senator Maureen Walsh’s comments last week, addressing how nurses spend our time: “I understand… making sure that we have ‘rest breaks’ and things like that. But I also understand that we need to care for patients first and foremost…I would submit to you that those [critical access hospital] nurses probably do get breaks. They probably play cards for a considerable amount of the day.”
Walsh was speaking in favor of an amendment to a bill ending mandatory overtime and mandating rest breaks in hospitals that would exclude small, rural hospitals from the legislation.
Her statement struck a nerve. Besides wide frustration from the 8,500 nurses and healthcare professionals in my union, the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), and at Temple University Hospital where I work, over 700,000 people have signed a petition on Change.org asking state Senator Walsh to shadow a nurse for a shift.
The senator’s comments reveal a deep misunderstanding of how nurses and healthcare professionals actually work. We rarely if ever get real breaks on the job. In 35 years of nursing, I have never seen nurses on the clock playing cards. Saving lives takes work, and we do it.
PASNAP has spent two decades fighting for the rights of healthcare workers to have bona fide rest breaks. Thanks to the leadership of legislators like Rep. Gene DiGirolamo (R-Bensalem), and a broad coalition of nurses and healthcare workers led by PASNAP and SEIU Healthcare PA, we were in 2008 able to get a ban on mandatory overtime passed in Pennsylvania — a right nurses and healthcare professionals in Washington state are seeking to expand.
Senator Walsh’s remarks were disgraceful. But hidden under more sophisticated language, we hear this pathology all the time from administrators that make the crucial staffing decisions in our community hospitals.
One of the most common rejoinders to Senator Walsh shared by nurses and healthcare professionals on Facebook is a picture of a hospital room after a critically ill patient has left. Blood and mess are everywhere. This is the definition of an “emergency.” Hospitals exist to care for patients in emergency situations, and nobody can predict when a 9-car pileup will happen. Or a school bus crash. Or a mass shooting. Or a terrorist attack. Or a train derailment, which happened in May 2015. If hospitals aren’t staffed with enough nurses and healthcare professionals, people will die.
California is the only state that has recognized this by mandating minimum nurse staffing levels for hospitals. Researchers from the University of Pennsylvania have found that those standards, if implemented in Pennsylvania, would save over 250 lives per year.
On March 20, safe staffing legislation was re-introduced in Harrisburg by Senator Maria Collett (D-District 12) and Rep. DiGirolamo. With 20 sponsors in the Senate and over 60 in the House, the legislation is closer to passage than ever before. Because the fact is that nurses rarely if ever get any down time, and hospitals need to staff adequately for patients to receive the care they need.
Our biggest opponent, unfortunately, is the Hospital and Healthsystems Association of Pennsylvania, which with resources and influence at its disposal has consistently opposed staffing legislation.
Some hospital leaders claim that safe staffing laws would hurt their bottom line — but the research doesn’t support that. A 2013 study from Health Care Management Review found that in competitive hospital markets like Pittsburgh and Philadelphia, safe staffing levels are associated with positive financial indicators for hospitals. In less competitive markets, lowered nurse staffing levels do not generate financial gains.
Despite the intransigence of hospital executives, the outrage over Senator Walsh’s comments shows how fed-up nurses and healthcare professionals are with policymakers who do not understand the work we do. There’s a rising sense in our professions that we need to take matters into our own hands. That’s exactly what we’re going to do, and it starts with ironclad safe staffing standards, written into law.
Maureen May, RN, is president of the Pennsylvania Association of Staff Nurses and Allied Professionals.