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Nurses in the U.S. Are Suffering “Moral Injury”

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Kari Lydersen

Minnesota emergency room nurse Cliff Willmeng remembers, during the early days of the pandemic, treating a patient at United Hospital who asked how the nurses were doing. The man was a Vietnam veteran, and Willmeng recalls that he said, “This is your war.”

“I kind of laughed, like what do you mean by that?” said Willmeng, who recalled he didn’t grasp at the time how horrible the pandemic would become. “He said, ‘We dealt with this in Vietnam. You don’t know it yet but none of you are ever going to be the same again.’”

More than two years later, Willmeng, like countless other nurses and frontline workers nationwide, knows all too well how true those words turned out to be. 

“The combination of the lethality of the virus and the seemingly total abandonment of collaboration from the management I was under produced anxiety and fear in me I had never felt, never,” said Willmeng, who had worked in emergency rooms and a trauma intensive care unit in Colorado and Chicago. “I was watching nurses sign their advance directives right there at the nursing station, preparing to be intubated and die. It was terrifying.”

In recent years, academics and frontline workers have used the terms “moral injury” and “moral distress” to describe the debilitating combination of anxiety, fear, guilt, shame, anger and betrayal that results when workers like nurses are thrust into life-or-death situations without the resources and support structures to carry out the mission they’ve committed to. 

The term “moral injury” was coined by former U.S. Department of Veteran Affairs psychiatrist Jon­athan Shay based on his work with Vietnam veterans, as explained in a December 2020 white paper by the National Nurses United (NNU) union. Moral injury involves the “deleteri­ous long-term, emotional, psychological, behavioral, spiritual, and/or social effects” of “perpetrating or failing to prevent acts that trans­gress deeply held moral beliefs and expectations in a high-stakes environment,” the paper notes. 

Nurses describe deep parallels between the experiences of veterans who are thrust into horrifying conflicts, left to fend for themselves and forced to make painful choices by corrupt or absent leadership—then blamed or punished for their actions.

Academic studies explain that moral injury is closely related to post-traumatic stress disorder, and can be a significant factor in veterans, emergency workers and others developing PTSD, as a number of studies have shown. It is not listed in the Diagnostic and Statical Manual related to mental illness, and moral injury is not considered to be a mental illness or to directly cause mental illness. This is in part because there is some ambiguity in defining exactly what moral injury entails, as it involves philosophical, social and ethical, as well as psychological, questions, which an article the British Journal of Psychiatry and other journals have explained. 

That journal notes that relatively few studies have been done on moral injury, yet it is recognized by many as a serious issue that goes beyond the ethical dilemmas that most people face. With many ethical dilemmas, the journal notes, people have the power to make a choice. “In moral injury, individuals commonly feel at the mercy of events, constrained by an overarching strategy or hierarchical rules that govern their actions. For some, it may erode their sense of meaning and place in the world,” says the 2020 journal article, by Edgar Jones. 

In military situations, an individual can experience moral injury when they are forced to harm civilians or take unjustified military actions, and the emotional and mental impacts are worsened in situations like the Vietnam War, where veterans face blame and hostility from the general public, or situations like the Iraq War, where the general public is largely unaware of what the veterans have been through, studies note. Nurses report a dynamic that has some parallels: They don’t have the resources to serve their patients well, but hospital administrators blame them for failings or don’t acknowledge the extreme conditions they are working under. And where patients often treat them with hostility or even violence. 

During the pandemic, experiences causing moral injury ranged from having to choose which patients got ventilators, to not being able to check in on Covid-19 patients regularly in order to minimize risk of transmission.

Elizabeth Lalasz, a registered nurse and NNU steward at Chicago’s public hospital, explains that the burn-out, depression, stress and anxiety that nurses face has typically been framed as an individual experience, rather than a systemic injustice caused by a broken healthcare system driven by the bottom line.

In 2021, the United States ranked last among high-wealth countries in the quality of its healthcare system, despite spending the highest amount of these countries on healthcare. Countries with much better healthcare systems provide universal coverage so that finances don’t prevent people from accessing healthcare, and money was not wasted on administrative burdens or siphoned off to insurance companies and massive profit for private healthcare companies. 

Lalasz noted that the pandemic just exacerbated and laid bare longstanding problems with the healthcare system, including lack of access for poor people, and private—and cash-strapped public—healthcare systems trying to save money or maximize profit by not investing adequately in staffing and resources. 

“We do this with the intention of trying to help and save lives,” said Lalasz, who worked three stints in Covid-19 wards and contracted the disease herself, missing 18 days of work. “If you’re not able to have what you need to be able to do that, it’s systemic. All these things existed prior to the Covid-19 pandemic, but that really brought it to a head.”

She said nurses like herself who contracted Covid-19 felt management was “minimizing” their experiences and their concerns, and “gaslighting” them into thinking they just had to toughen up. 

“There needs to be an acknowledgement that there is a systemic problem with the way the healthcare system is run in this country,” Lalasz said. “This was something that happened called a worldwide pandemic. It’s not my fault that it happened—it’s capitalism’s fault.” 

During the pandemic, healthcare workers faced guilt and anxiety about bringing Covid-19 home to their families, on top of the trauma of being unable to adequately care for patients and fearing for their own lives. Meanwhile, workers had to fight and fundraise just to get the basic PPE that could help protect them and their patients and communities—a recipe for moral injury. 

“We had managers telling us it wasn’t an airborne disease,” Willmeng remembers. “We’re doing the math on it: If I get it, maybe I’ll be ok, maybe I’ll die. Either way, I could also give it to my patients or my wife or my son or my next door neighbor or that nice woman at the grocery store.” 

As the pandemic has evolved and become slightly less of an acute crisis, the behavior of healthcare institution management has accelerated a nursing shortage that has become its own crisis. Hundreds of thousands of healthcare workers have retired or otherwise left the profession during the pandemic. Meanwhile, thousands of nurses have left staff jobs—often unionized—to work as gig-worker “travel nurses” earning much higher hourly pay but without collective bargaining rights or job security. 

A recent report by McKinsey & Company estimates the United States could face a nursing shortage of 200,000 to 450,000 available nurses—10% to 20% fewer than needed by 2025. A November 2021 industry study found that 90% of nurses surveyed are considering leaving the profession, citing burnout, staff shortages and unmanageable workloads as key reasons. 

The nursing shortage makes conditions more stressful and dangerous for those who stay in the profession, creating an intense negative feedback loop rife with the potential for continued moral injury. 

This cycle is also exacerbated when nurses leave unionized staff jobs to become traveling nurses with much higher pay but no job security, collective organizing rights or sense of permanency with their patients and community. In keeping with the cycle of blame and guilt typical of moral injury, traveling nurses have been criticized for taking high pay and abandoning their staff posts, when the underlying problem is hospitals’ failure to create physically and morally sustainable staff jobs. 

“There’s not a shortage of nurses,” said Lalasz. “There’s a shortage of nurses who want to work under these conditions.” She argued that the system takes advantage of the workforce made up largely of women, disproportionately women of color, assuming they will be willing to do the work without adequate protection or compensation. “It’s like, ‘You’re caring, you’ll do this.’ We’re done with that. That’s why people have gone [into] traveling [jobs]. The working conditions are so bad, the staffing is so horrendous, you’re not respecting us, so we’re done.” 

Especially at a “safety net” hospital like Chicago’s John H. Stroger, Jr. Hospital of Cook County where Lalasz works, Lalasz notes, it’s important to have staff nurses who understand the needs and deep vulnerability of their patients—like the people incarcerated in the county jail whom she treated early in the pandemic. 

Ironically, the shift to travel nursing undermines the very organized labor system that is more necessary than ever in a time of crisis. Organizers stress that they want to identify and explain the concept of moral injury so that healthcare workers channel their trauma into organizing rather than turning inward or dropping out. The NNU white paper cites trauma experts saying that:

Those who expe­rience moral injury as a perpetrator of an immoral act or from failing to prevent an immoral act typically respond with internalizing emotions such as guilt and shame, whereas those who experience moral injury as a witness who was unable to prevent an immoral act typically respond with externalizing emotions such as anger and resentment. It is crucial that those involved ascribe the blame to the responsible actor(s) and not inappropriately take responsibility for failing to prevent a transgression, if that was not in their power. Anger and resentment are more likely to lead to the collective action necessary to redress transgressions by authoritative leaders or institutions while emotions such as shame and guilt may lead to withdrawal.

Willmeng is disappointed that healthcare unions didn’t do more to assert their rights and demand changes from the industry during the height of the pandemic. As NNU and other healthcare unions have reiterated, higher levels of unionization and a meaningful role for healthcare workers in making decisions about resource allocation and strategy would go a long way to providing better healthcare for patients and making the profession tolerable for workers. Ultimately, NNU and countless individual healthcare workers and leaders say that universal healthcare would vastly improve patient care, allowing access for people regardless of income and eliminating the profit motive that causes private hospitals and insurance companies to ration care and skimp on resources. A recent study published in the journal Proceedings of the National Academy of Sciences found that universal healthcare would have meant 338,000 fewer people dying of Covid-19. 

Willmeng feels that now unions are better marshaling their forces, with Minnesota nurses threatening a statewide strike as multiple contracts for 15,000 nurses are in negotiations. In early June, nurses picketed at 11 Twin Cities-area hospitals, highlighting stratospheric executive pay even as nurses struggle with debilitating understaffing and Republican legislators killed a bill that would involve nurses in staffing plans and provide loan forgiveness for hospital nurses. 

“U.S. capitalism is calling you essential, and you parlay that into what we failed to rise to a major historical event—we’re trying to put the pieces back together again now,” said Willmeng, who started his current emergency room job hours after the union contract expired. He was fired by a different hospital during the pandemic for wearing hospital-issued scrubs, rather than his own, since he didn’t want the extra contagion risk of bringing scrubs home. He was later reinstated and settled a wrongful termination lawsuit. 

In late June, Chicago hosted the Labor Notes international convention of union members and activists, a gathering of progressive rank-and-file union members and leaders and labor activists from the United States and other countries. Much attention was focused on the need for mental healthcare for frontline workers. 

Elizabeth White, a therapist in Kaiser Permanente’s California system that serves many public union members, described the difficulty of getting crucial mental health appointments for her clients—and the toll that takes on therapists themselves. 

“You’re basically always playing a game of Twister, twisting things to try to make it work for people,” she said. “We want to do the right thing for our patients, and the employers take our good intentions and exploit that. That’s the moral injustice.” 

During one Labor Notes session, nurses and other healthcare workers packed a large ballroom to speak out about their experiences, frequently mentioning moral injury and sharing their tactics for survival and organizing. 

“Nurses who have been through the meat grinder of Covid are now having their benefits taken away, feeling like no one cares if we live or die,” said registered nurse and Michigan Nurses Association former interim president Anne Jackson, after the session. “We’re not able to give the care we used to give, and we’re ashamed, and yet hospitals are making record profits.”

Marty Harrison is a staff registered nurse at Temple University’s hospital in Philadelphia, serving among the country’s poorest zip codes, where patients typically have multiple underlying conditions and complex problems. 

“I feel like I’ve done something evil because I didn’t have the capacity to take care of this person,” she said. “That went from being due to the pandemic to being due to the staffing crisis. The employer doesn’t appreciate the degree to which doing a good job is essential to us. No matter how much money I make, I’m not happy if I can’t take care of my patients. We can’t communicate that to them, because they don’t feel that way about their jobs.” 

She and others said that the hemorrhaging of staff nurses has obliterated the mentoring and organizing networks that used to exist for young nurses. “They’re not letting new nurses even know what quality care would be,” she said.

New nurses often leave the field or move to traveling jobs quickly, she and others said, overwhelmed by the lack of support and depth of dysfunction. While healthcare workers at Labor Notes said they understand that reaction, they hope their colleagues will turn their feelings of moral injury and distress into organizing. 

“What I do is fight back,” said Harrison. “For me that’s an essential mechanism.” 

This blog is printed with permission.

About the Author: Author’s name is Kari Lydersen. Kari is a Chicago-based reporter, author and journalism instructor, leading the Social Justice & Investigative specialization in the graduate program at Northwestern University. She is the author of Mayor 1%: Rahm Emanuel and the Rise of Chicago’s 99%.


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Joe Biden Says He Stands With Unions. This Is His Moment to Prove It.

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Mark Dudzic on Single Payer

The longest national nurses strike in over a decade could also be a “watershed moment” for Medicare for All.

Speaking on the recent National Solidarity Call in support of striking nurses at St. Vincent’s Hospital in Worcester, Massachusetts, Our Revolution leader Joseph Geevarghese characterized the situation as ?“Biden’s PATCO Moment.” The call was convened by the Labor Campaign for Single Payer to help mobilize national support for the 800 nurses at the Tenet Healthcare-owned hospital who are now engaged in the longest nurses strike nationally in over a decade. Tenet has spent more than $75 million to date to prolong the strike. A fraction of those funds could have easily met the nurses demands for the staffing improvements that are the sole issue driving the strike.

Now Tenet is threatening to permanently replace the striking nurses who are represented by the Massachusetts Nurses Association (MNA). This action, by a notorious healthcare profiteer (Tenet leveraged federal bailout funds intended to provide urgent relief to employees and patients to triple its profits at the height of the pandemic last summer), has transformed a hard fought strike battle into a red line issue for the entire labor movement.

For those of us old enough to remember, it evokes the rampage of union busting that followed the Reagan Administration’s mass firing of striking air traffic controllers in the notorious PATCO strike of 1981.

Busting the air traffic controllers’ union sent a signal to employers everywhere that it was acceptable for management to break strikes and bust unions. In quick order, striking workers from copper miners in Arizona to newspaper workers in Detroit found themselves permanently replaced. Even more significantly, it changed the balance of power in labor/?management relations as labor’s most powerful weapon was neutralized. This ushered in a devastating period of concessionary bargaining whose consequences are still being felt today.

Reagan’s decision to fire the striking PATCO members was not some isolated act of pique by an outraged president. In fact, his administration jumped at the opportunity to give teeth to its explicit policy to weaken and undermine the considerable power of the U.S. labor movement. And it was very successful.

The U.S. labor movement was slow to respond to this provocation. Both of us can remember standing on the National Mall on Solidarity Day in 1981 with half a million other union workers. It had taken the AFL-CIO more than six weeks after the initial firings to call the rally and they chose to hold it on a Saturday when Washington was shut down tight for the weekend. As we dozed in the sun listening to endless speeches, we could see the planes taking off and landing unimpeded just across the Potomac at National Airport. What should have been a forceful exhibition of labor power had been turned into a demonstration of our impotence. Like many others who were there that day, we vowed to never let another PATCO moment go unchallenged.

Tenet is a key player in a major strategic sector of the economy. If it is able to make the threat of permanent replacement an acceptable management tool in healthcare bargaining, it will weaken the entire labor movement for decades to come.

That’s why the Labor Campaign for Single Payer and other labor groups are stepping up to support the nurses and their union. They will be joining the MNA at a rally on July 7 in front of Tenet Headquarters in Dallas. They are also circulating a petition urging members of Congress to join Reps. Katie Porter (D?—?Calif.) and Rosa DeLaura (D?—?Conn.) in requesting an investigation into the use of taxpayer-financed Covid-19 relief funds by Tenet and other large hospital systems.

This strike could be a watershed moment for the Medicare for All movement by exposing the corrupt and anti-worker underpinnings of our for-profit healthcare system. ?“The simple fact is that, if we had Medicare for All, we wouldn’t even be in this fight,” said LCSP National Coordinator Rhiannon Duryea. ?“Nurse-to-patient ratios would be set by law, ensuring safe and effective staffing ratios across the country that protect nurses, patients, and the community. Hospitals would not be able to exploit nurses and patients to line shareholder pockets.”

This strike could also be a watershed moment for the Biden administration. Ronald Reagan reversed a 40-year policy to promote the right of workers to organize and to bargain collectively. Before Reagan, corporations feared using the permanent replacement option because the federal government had made it clear that it would not tolerate such brutal behavior in the course of labor relations. After Reagan, it was open season on workers and their unions. Inequality skyrocketed as wealth was massively redistributed upward.

President Biden, to his credit, has vowed to reverse these trends. He has made a number of statements explicitly supporting worker rights and has appointed a number of pro-union advocates to key policy positions.

This is his chance to send a message to Tenet and corporate America that there’s a new sheriff in town. We need to challenge the Biden administration to put its money where its mouth is and to intervene forcefully in this conflict. The president must make it clear that permanently replacing lawful strikers is contrary to the policy of the U.S. government.

Tenet is not alone in trying to pull the rug out from under an upsurge in labor militancy. There are a number of current and pending labor battles where management is engaging in overt union busting, including months-long strikes by coal miners in Alabama and steelworkers employed by Allegheny Industries as well as a nasty lockout of refinery workers at a giant Exxon/?Mobil facility in Beaumont, Texas.

You can be sure that employers everywhere are watching how the Biden Administration reacts to these crises. As Our Revolution’s Geevarghese told the participants on the Solidarity Call, ?“This strike creates the opportunity for President Biden to undo what President Reagan did.” It’s an opportunity that should not be squandered. 

This story was first posted at Common Dreams.

This blog originally appeared at In These Times on July 6, 2021. Reprinted with permission.

About the Author: Mark Dudzic is National Coordinator of the Labor Campaign for Single Payer.


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Chicago Nurses Are Going on Strike—And Management Is Bringing in Scabs Through a Text Blast

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Jeff Schuhrke (@JeffSchuhrke) | Twitter

Nurses and support staff in the Chicago area are joining other militant healthcare workers across the country by walking off the job, despite attempts by their bosses to hire strikebreakers.

On Thursday, over 2,700 Chicago-area nurses and support staff at Cook County Health (CCH) are planning to go on strike, the latest example of rising worker militancy in the healthcare sector. 

The National Nurses Organizing Committee (NNOC) and SEIU Local 73?—?which respectively represent 1,250 nurses and 1,500 medical aides, therapists, technicians, clerks, housekeepers, food service workers and patient transporters at CCH?—?have each been in contract negotiations with the county since last fall. 

Citing dramatic staffing shortages, the two unions are teaming up to demand CCH invest in employee recruitment and retention by improving pay and benefits.

Rather than investing in long-term employees, the unions say CCH has been increasingly relying on temp workers hired through staffing agencies like SnapNurse. With the threat of a walkout looming, management is aggressively trying to bring in even more temps to serve as strikebreakers.

In These Times obtained a text blast sent out by SnapNurse last week seeking prospective scabs. Referencing ?“a pending strike notice in Chicago,” the text message explains that strikebreakers will be paid between $4,620 and $6,468 per week?—?more than regular CCH nurses make. ?“Respond with STRIKE to deploy,” the message says.

CCH and SnapNurse did not immediately respond to a request for comment, but in an email to employees last week, CCH’s recently hired CEO Israel Rocha, Jr. said management was ?“taking all steps necessary to ensure the delivery of safe patient care in the event of a strike.”

“Nurses are at the breaking point throughout the Cook County Health system,” said Consuelo Vargas, an emergency room nurse at Stroger Hospital and a chief representative of NNOC. ?“We need more nurses on staff, and we needed them yesterday.”

Consisting of Chicago’s Stroger and Provident Hospitals, as well as over a dozen clinics in the city and suburbs, CCH is one of the nation’s largest public health systems. Its predominantly Black and Brown patients are often uninsured or under-insured, meaning they delay seeking care and therefore face critical health needs. Stroger Hospital, which has the busiest emergency room in Illinois, treats the highest number of Chicago’s gunshot victims (and was the setting of the hit television show ER in the 1990s).

The nurses and support staff say that instead of valuing their labor and listening to their concerns, the county has been dragging out negotiations, offering paltry raises that wouldn’t keep up with the cost of living and seeking to double the amount employees pay for health insurance.

“We are striking because we are tired of being mistreated, undervalued, underserved, disrespected and cast aside,” said Eugenia Harris, a ward clerk at Stroger Hospital and SEIU Local 73 member. 

The nurses plan to be on strike for 24 hours, but may call more strikes in the near future. The SEIU Local 73 members?—?who already held a one-day work stoppage at CCH in December—intend to hold an open-ended strike.

“Our members are willing to strike for as long as it takes to achieve a fair contract,” SEIU Local 73 President Dian Palmer said. ?“It is time for Cook County to take these negotiations seriously.”

Over the past 15 months, healthcare workers have been on the front lines of the Covid pandemic, organizing and striking in states like IllinoisWashington and New York to secure adequate personal protective equipment and safer staffing levels. In Massachusetts, union nurses at St. Vincent Hospital have been on strike for more than 100 days?—?the longest nurse’s strike in the United States in over a decade. Meanwhile, thousands of previously unorganized nurses in North Carolina and Maine successfully voted to unionize in recent months.

The pandemic has fueled the uptick in healthcare worker militancy because it ?“revealed to a lot of us how little our employers care about our lives, and frankly how little they care about our patients’ lives,” Elizabeth Lalasz, a clinical nurse at Stroger Hospital and NNOC steward, told In These Times.

Throughout the pandemic, Vargas said, ?“hospital management has abused, disrespected and abandoned us. Because management treats nurses as expendable, we were not given adequate personal protective equipment, and over 150 of us tested positive for Covid-19.”

NNOC and SEIU Local 73 are calling on management to tap into some of the $998 million in federal funds Cook County is receiving from the American Rescue Plan to invest in the healthcare workforce. 

“Every day we learn of another experienced nurse who resigned for a better job because Cook County has failed to provide them with the resources they need to provide the best care to their patients,” Vargas explained. ?“With each loss of an experienced nurse, we see years of skills and expertise vanish. In one six-week period, I saw a hundred years of experience walk out of my department.”

CCH CEO Rocha’s salary is $650,000 a year. His predecessor, who was dismissed by the Cook County Board of Commissioners in late 2019, received $542,000 in severance pay.

“It doesn’t make any sense for upper management to be making that kind of money when we desperately need people to be recruited and retained,” Lalasz said. ?“We need money for staff and support on the front lines, not for money to be given upwards, or pocketed.” 

This would be the third time in the past two years that SEIU Local 73 went on strike in conjunction with a fellow union. In 2019, Local 73 workers at Chicago Public Schools hit the picket lines alongside their colleagues in the Chicago Teachers Union. And last year, 4,000 Local 73 workers at the University of Illinois at Chicago went on strike at the same time as hundreds of UIC nurses with the Illinois Nurses Association.

Besides its members at CCH, nearly 1,000 SEIU Local 73 members at Cook County Jail and other county offices are also set to strike on Thursday. 

Both Local 73 and NNOC have expressed disappointment in Cook County Board President Toni Preckwinkle, who is the ultimate decision-maker on management’s side. Preckwinkle, who doubles as the chair of the Cook County Democratic Party, unsuccessfully ran for Chicago mayor in 2019 on a pro-union platform with the backing of Chicago’s progressive unions.

“For years I’ve worked in politics, particularly with Toni Preckwinkle, who said she would work with the unions to ensure they had contracts with fair wages. She’s turned her back on us,” said veteran civil rights activist James Phipps, a Local 73 member who works at the county clerk’s office. 

Preckwinkle did not immediately respond to a request for comment, but she issued a statement last week calling the staffing shortage at CCH ?“a mutually shared concern.” Regarding management’s demand to raise health insurance costs for workers, she said it has been six years since the last hike and that a new increase ?“is needed in this round of bargaining.”

“It doesn’t matter, you have a billion dollars in Covid relief money and yet you’re asking us to double our healthcare and only take a minimal increase in pay,” Lalasz said in response to Preckwinkle’s statement. ?“We shouldn’t be the people who are suffering…Without us doing the work we do, this hospital system will not function.”

This blog originally appeared at In These Times on June 23, 2021. Reprinted with permission.

About the Author: Jeff Schuhrke has been Working In These Times contributor since 2013. He has a Ph.D. in History from the University of Illinois at Chicago and a Master’s in Labor Studies from UMass Amherst


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Service + Solidarity Spotlight: National Nurses United Leads Coalition to Urge CDC to Acknowledge COVID-19 Aerosol Transmission

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Working people across the United States have stepped up to help out our friends, neighbors and communities during these trying times. In our regular Service + Solidarity Spotlight series, we’ll showcase one of these stories every day. Here’s today’s story.

National Nurses United (NNU) is leading a group of 44 allied unions and organizations, including the AFL-CIO—representing more than 13 million members and their communities—to urge the Centers for Disease Control and Prevention (CDC) to update its COVID-19 guidance to fully reflect the latest scientific evidence regarding coronavirus transmission through aerosols that infected people emit when they breathe, speak, cough, sneeze or sing. Today, NNU’s coalition delivered a petition with over 10,000 signatures, including scientific experts, urging the CDC to recognize COVID-19 aerosol transmission.

“Since the start of the pandemic, the nation’s nurses have demanded that the CDC’s guidelines be based on scientific evidence,” said Bonnie Castillo, RN, executive director of NNU. “Nurses know that to effectively battle this virus, we all need to get on the same page about how it spreads….We urge the Biden administration to honor its commitment to listen to experts in the battle against COVID-19, which includes having CDC and other federal agencies explicitly recognize aerosol transmission.”

This blog originally appeared at AFL-CIO on February 25, 2021. Reprinted with permission.

About the Author: Kenneth Quinnell  is a long-time blogger, campaign staffer and political activist whose writings have appeared on AFL-CIO, Daily Kos, Alternet, the Guardian Online, Media Matters for America, Think Progress, Campaign for America’s Future and elsewhere.


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Stiffing Corporate Lobbyists; Short-Time Work Salvation; Nurses on the Line

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It’s the permanent government—the corporate lobbyists who have friends in both parties. It is at the heart of why we don’t have Medicare for All, why the Pentagon is rolling in dough and why banks and Wall Street rip us off. Jeff Hauser, the executive director of the Revolving Door Project, talks about what the strategy looks like to limit the influence of the corporate elites in a possible Biden Administration.

The pandemic has ripped through the world, killing and sickening millions. But, if you look at the economic hits people have taken, the pandemic has exposed the complete and utter failure of the system in the U.S. to make sure people can hang on. Both Europe and the U.S. had to shut down their economies and both took hits in output—but why has the unemployment rate been so much lower in Europe in the first half of the year than the U.S.? Maria Figueroa, the Director of Labor and Policy Research at the Industrial and Labor Relations School at Cornell University, explains how “short time work” made the difference.

It’s fairly obvious that Trump has the blood of thousands of Americans on his hands for his absolute narcissistic bungling and incompetent handling of the pandemic. Tens of thousands of people, especially front-line workers like nurses, got sick at work because this administration let corporate shills, who don’t care about workers, run the Occupational Safety and Health Administration.

Which brings me to the Oregon Health and Science University, a massive sprawling operation which in 2019 had $3.2 billion in revenues. OHSU is taking a page from Jeff Bezos when it comes to stiffing nurses who are seeking a fair wage and leaving nurses at great risk by refusing to commit to fully providing for a safe workplace during the pandemic. We get the lowdown from Terri Niles, an ICU Nurse at OHSU and a vice president at the 2,900-member Local 52 of the Oregon Nurses Association.

(If you want my final election analysis and predictions for next week, check out my Working Life website and read it all there).

This blog originally appeared at Working Life on October 28, 2020. Reprinted with Permission.

About the Author: Jonathan Tasini is a political / organizing / economic strategist and the author/editor of Working Life.


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Improving Patient Safety: Worker Wins

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Our latest roundup of worker wins begins with nurses across the country winning new contracts and includes numerous examples of working people organizing, bargaining and mobilizing for a better life.

New Contract for More Than 14,000 California Nurses Includes Improved Protections from Violence and Harassment: Registered nurses at the University of California, members of the California Nurses Association (an affiliate of National Nurses United/NNU) voted overwhelmingly to ratify a new five-year contract. The contract covers more than 14,000 registered nurses at more than a dozen locations. “We are so proud to ratify this historic contract for all registered nurses at UC. Nurses stood together in solidarity and fought back over 60 takeaways that would have directly affected our ability to care for our patients,” said Megan Norman, RN, UC Davis. “We won new language addressing infectious disease and hazardous substances as well as stronger protections around workplace violence and sexual harassment.”

11,000 VA Nurses Ratify New Contract: More than 11,000 registered nurses at 23 hospitals run by the Department of Veterans Affairs, who are represented by the National Nurses Organizing Committee/NNU, voted to ratify a new three-year contract that features workplace violence protections, infectious disease training and emergency preparedness information. “I am very excited about the workplace safety provisions that will improve the safety of our nurses and protect them from violence and injury,” said Irma Westmoreland, registered nurse and National Nurses United board member.

Maine Nurses Win Increased Workplace Safety in New Contract: Neatly 900 members of the Maine State Nurses Association (part of the NNOC/NNU) who work at the Eastern Maine Medical Center (EMMC) ratified a new contract. “This new agreement sets a new bar for quality care and patient safety at our hospital,” said Dawn Caron, bargaining team member and chief union steward for the nurses at EMMC. “When we began this process back in February, we set out to protect the role of our charge nurses and all of the other safe patient care provisions of our contract. The nurses at EMMC are proud to announce that today, we have done exactly that.”

Disneyland Resort Workers Approve Contract with Wage Raise and Bonus: After more than a year and a half of negotiations, Disneyland Resort hotel workers approved a new contract that includes nearly $2 an hour in higher wages and the payment of $1,000 employee bonuses originally announced in January. UNITE HERE Local 11 represents the more than 2,700 hotel workers at Disney covered by the new contract.

UFCW Members at Four Roses Distillery Reach Agreement to End Strike: In September, members of United Food and Commercial Workers (UFCW) Local 10D who work at the Four Roses distillery in Lawrenceburg, Kentucky, won a new agreement after a strike that lasted nearly two weeks. “We’re one big, happy, dysfunctional family around here,” Local 10D President Jeff Royalty said. “You know, just like brothers and sisters, you’ll have some hard feelings from time to time, but they’re short-lived.”

Columbia Postdoctoral Researchers Win Right to Form Union: The National Labor Relations Board ruled that postdoctoral researchers at Columbia can form a union. Official elections are being held this week to determine whether or not the Columbia Postdoctoral Workers become members of the UAW. “We are very excited that the NLRB finally issued the decision that Columbia’s postdoctoral workers can unionize despite the university’s efforts to undermine us,” said Alvaro Cuesta-Dominguez, a member of the postdoctoral worker organizing committee and a second-year postdoc researcher. “We look forward to the opportunity to really have our voices heard.”

Federal Judge Sides with FLOC, Rejects Anti-Union North Carolina Law: U.S. District Judge Loretta Biggs ruled that a North Carolina law limiting union organizing for farmworkers was unconstitutional. “North Carolina’s law is clearly designed to make it harder, if not impossible, for the state’s only farmworkers union to advocate for sorely needed protections against exploitation and bad working conditions,” said Brian Hauss, a staff attorney with the American Civil Liberties Union.

New York Port Authority Workers Win Wage Increase: After a long fight, working people at the New York Port Authority represented by the Retail, Wholesale and Department Store Union/UFCW (RWDSU/UFCW) and UNITE HERE won an increase to a minimum wage of $19 per hour by 2023. The new agreement includes nearly 5,000 catering workers that were excluded from the previous policy. The proposal could impact tens of thousands of workers at other area airports, as well.

ExpressJet Pilots Overwhelmingly Approve New Contract: United Express pilots at ExpressJet Airlines, represented by the Air Line Pilots Association (ALPA), have won a new contract that increases pilot pay. More than 90% of those who voted supported the new three-year deal.

This blog was originally published by the AFL-CIO on October 3, 2018. Reprinted with permission. 


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Immigrant Nurses Demand Equal Pay—And Win

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 It started when a few nurses at Temple University Hospital told stewards that they weren’t being paid for their experience.

One of the first to speak up was Jessy Palathinkal, who had become a nurse in India in 1990. She got her U.S. nursing license when she moved here in 1995. But when she started working at Temple, her placement on the pay scale was as though those five years of nursing never happened.

She asked why. Human Resources told her the hospital didn’t count years of experience in foreign countries.

“I was feeling a little bit upset. I had all the certification,” Palathinkal said. “I thought, ‘Well, that’s not right, but what can I do?’”

What Palathinkal did was tell her shop steward. The steward told officers of their union, the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP). And the officers started asking around to see whether anyone else was affected.

They put out a call in their monthly newsletter—did anyone else think that their pay was incorrect for their level of experience? Three more nurses had the same complaint.

Four nurses joined a class-action grievance. Management denied it. That’s when union officers decided this was a hospital-wide issue.

Double standard

Management’s argument was that foreign experience was not comparable to U.S. experience. But the underpaid nurses coming forward had something else in common: they were primarily people of color, mainly from India.

That struck nurse Mary Adamson as unfair. After all, everyone had met the requirements to become a registered nurse in the U.S. “All these people had to take the test, and they passed it,” said Adamson, the union’s membership secretary. “They had the knowledge.”

“Maybe in H.R. they were thinking, because India is a third-world country, maybe they don’t want to take my experience,” Palathinkal said. “I can prove my knowledge and skills here, based on my work in India.”

“They were chipping away at contract language, doing it covertly, and targeting people that they knew would be afraid to speak up,” Adamson said.

An attack on the contract

She and other union officers at Temple saw this pattern of underpayment as an attack on the contract. If members aren’t vigilant, management can underpay nurses in many ways—overtime, shift differential, holiday pay. This was no different.

“Truthfully, their experience is just as valuable as working down the street,” Adamson said. “Health care is health care.”

The officers brought the grievance to the bargaining team, already in contract talks. This wasn’t a question of the difference between nurses trained abroad and those trained in the U.S., they argued—the problem was management not respecting the contract. The union’s 20-member bargaining team agreed to raise the issue in negotiations.

Although it was nothing like 2010, when Temple nurses struck for 28 days, the 2016 contract campaign was vigorous. A hundred nurses packed into bargaining sessions; 1,000 signed petitions for better staffing. The union threatened an informational picket before winning a final contract agreement that included a provision spelling out that foreign nurses’ experience should be treated equally.

Meanwhile the original grievance was headed to arbitration, but at the last minute, management caved and agreed to grant back pay to the original four nurses, in addition to bumping them up to the right place on the wage scale.

Winning clear contract language was a breakthrough, but the fight wasn’t over yet. “That expanded the universe” of nurses who might be affected, Adamson said. At membership meetings the union found more underpaid nurses. Ultimately a dozen were brought up to their correct places on the scale.

Raising consciousness

The whole saga was a new experience for Palathinkal, who had never worked at a union hospital before. At the start, “I didn’t have any knowledge of what I was supposed to do or who was I supposed to talk to,” she said. “I was thinking, ‘This is not going to work.’”

But it did. “The union stood up for me,” she said.

This grievance fight gave union activists a way to get recent hires involved and show them what the union is about. “Not everyone has been through a strike,” Adamson said. “We are constantly trying to raise the consciousness of new people who are coming in.”

Many of the affected nurses have stayed engaged, signing petitions and coming to meetings. “People become more aware of, ‘The boss might be cheating me,’” Adamson said. “Any time we get a win, people are happy about it. It reinforces among the workers that we’re watching.”

This article originally appeared at Inthesetimes.com on May 10, 2017. Reprinted with permission. 

About the Author: Samantha Winslow is a staff writer and organizer with Labor Notes.


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An Outrageous Number Of People Are Hurt And Killed At Work

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Bryce CovertOn Tuesday night, a psychiatric patient under Kay’s care told her she was going to beat her because Kay couldn’t give her any more phone call privileges.

Kay, a registered nurse who withheld her last name, had some good reason to believe the patient and fear for her own safety. Not too long ago, a different patient charged at her from 30 feet away, crushing her shoulder. The injury required months of physical therapy and she was in constant pain. She had to be removed from her normal job for a time. “My livelihood was robbed,” she said on a call with media on Wednesday morning.

Even today she still has flareups of pain, numbness, or burning in the injured shoulder. The incident also left mental scars. “I find I respond differently to stressful or perceived stressful situations,” she said. Her fight or flight instinct is more easily triggered, and she struggles with anxiety.

She’s not the only one in her workplace, either. One particular patient, weighing 285 pounds, has repeatedly assaulted both nurses and patients at the facility. Kay herself had to intervene in one incident where the patient grabbed a coworker’s head, hitting it against a window several times. There were just three other people around to restrain the patient. The incident left Kay’s coworker, a woman in her early 40s, with head and neck injuries, the loss of a tooth, and permanent hearing loss.

“People may assume that getting punched, kicked, or stepped on, or threatened and verbally abused, is part of working in a psychiatric facility,” Kay said. But “it’s unacceptable and preventable.”

It may be preventable, but the violence Kay experiences on a regular basis in her workplace is widespread — and getting worse. According to a report released Wednesday by the AFL-CIO, there were officially about 3.8 million work-related injuries and illnesses reported in 2014, although because underreporting is so widespread, the real number is likely somewhere between 7.6 and 11.4 million. That’s more than 10,000 people hurt or sickened at work every day.

And women like Kay and her coworker are on the front lines of the problem. The health care and social assistance industry made up the greatest share of nonfatal work injuries and illnesses, at more than 20 percent. Nursing and residential care facilities in particular have a high rate of 12.6 workers injured for every 100.

Violence generally is a growing workplace threat. It was responsible for 26,540 injuries that resulted in lost work time in 2014 across the country and across industries. “While the overall injury and illness rate in the U.S. has gone down over the last 25 years, the workplace violence rate was decreasing in the 90s and now it’s getting worse,” said Rebecca Reindel, the AFL-CIO’s senior safety and health specialist on the call with media. It’s increased more than 100 percent, for example, in private hospitals and psychiatric hospitals. And women are bearing the brunt, suffering two-thirds of these incidents.

Those findings line up with a recent report from the Government Accountability Office. It found that health care workers experience injuries from workplace violence at “substantially higher” rates than the rest of the workforce, ranging from five to 12 times the rate of the overall workforce depending on the type of facility. For example, nursing and residential care workers had a rate of 35.2 per 10,000 workers, compared to 2.8 for the workforce as a whole. Patients are the most common perpetrators, and workers most frequently report being hit, kicked, or beaten. The GAO also found that rates are getting worse, not better. But the full extent of the problem still isn’t known because health care workers are so unlikely to report incidents.

Perhaps even worse than injury and illness are the high rates of deaths on the job. In 2014, 4,821 workers were killed at work, an increase from the year before, the AFL-CIO reports. More troubling, the rate of death inched up, from 3.3 workers killed per 100,000 in 2013 to 3.4, showing that even if raw numbers went up because more people were at work, the share being killed is also increasing. On top of that, an estimated 50,000 people died from diseases they picked up from their jobs. That all works out to 150 workers dying every day from dangerous work conditions.

Violence is again a big problem when it comes to fatalities, accounting for 16 percent of all traumatic workplace deaths, or 765 total, in 2014. But other causes in industries beyond health care also had disturbingly high numbers. The highest was in transportation and material moving, with 1,346 deaths on the job in 2014, followed by 902 in construction and extraction. The oil and gas industry notched the highest number of fatalities it ever recorded at 144 and had a rate nearly five times the national average. And the leading cause of death at work is transportation incidents, particularly roadway crashes.

Beyond the cost of life and safety, the economic cost of injury and illness at work is also huge, estimated to be somewhere between $250 and $370 billion each year.

That cost could be alleviated by investing more in the agency meant to police workplaces to ensure workers’ safety. The Occupational Safety and Health Administration (OSHA), created in 1970, has saved more than 532,000 people since then, according to the AFL-CIO report. But it could be doing far more. There are just 1,840 inspectors tasked with monitoring the country’s 8 million workplaces under its jurisdiction, working out to one inspector for every 74,760 workers. That means a workplace will see a state OSHA inspector once every 97 years, on average, and a federal one just once every 145 years. Over the last quarter century, “the capacity of the government to oversee and enforce safety and health has gotten a lot worse,” said Peg Seminario, Director of Health and Safety at the AFL-CIO.

But even when OSHA does inspect and uncover dangerous conditions, the fines it levies are a drop in the bucket. The average penalty for a serious violation of safety regulations was $2,148 from the federal agency and $1,317 for a state one. Even killing a worker doesn’t cost much: The median penalty was $7,000 at the federal level and just $3,500 in states. “This clearly isn’t enough to deter,” Seminario said, “to cause employers to change their practices.”

Kay wants to see much more done to ensure her safety at work. “I love my job and I love the work that I do,” she said. “I want to continue to help patients who are suffering.” But to do that without fearing for her health, she thinks it’ll take increased security measures, better policies, more training for staff, and better reporting of incidents.

And she wants to see OSHA do something about it. There is no federal standard when it comes to workplace violence. “We need a standard,” she said.

This blog originally appeared at ThinkProgress.org on April 27,  2016. Reprinted with permission.

Bryce Covert Bryce Covert is the Economic Policy Editor for ThinkProgress. Her writing has appeared in the New York Times, The New York Daily News, New York Magazine, Slate, The New Republic, and others. She has appeared on ABC, CBS, MSNBC, and other outlets.


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Nurse’s Role Protecting Healthcare Law More Critical than Ever

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Dian PalmerIt’s already October and we are in full swing organizing, educating and mobilizing for Election Day. I am sure many of you are too with so much hanging in the balance!

Again, nurses find themselves in the familiar role of protecting and defending the ?Affordable Care Act. More and more evidence backs up what nurses already know–the healthcare law works. Thanks to the law, the number of uninsured Americans is expected to decline by nearly half from 45 million in 2012 to 23 million by 2023, according to a recent report from CMS actuaries. A new report from the Kaiser Family Foundation further shows the healthcare law is not only working for the millions who have coverage now, especially parents, but it is also working for the nation by slowing down spending on healthcare costs.

Nonetheless, the successes of the healthcare law does not mean the “Party of No” has given up on making Obamacare a polarizing issue in the midterm elections. Make sure you check out the 2014 Healthcare Law SEIU Member GOTV Toolkit to use for member outreach and education in advance of the election.

This blog originally appeared in SEIU.org on October 9, 2014. Reprinted with permission. http://www.seiu.org/2014/10/nurses-role-protecting-healthcare-law-more-critica.php

About the author: Dian Palmer has been a nurse for 25 years, and a member of SEIU for 17 years. “Before I joined SEIU, I was disgusted by the numerous abuses suffered as healthcare providers. We were forced to work for seven days in a row, required to do double-shifts, and had no voice in the workplace. I organized my workplace not for better wages, but because as a way to counter the abuses. Before SEIU, I thought we just had to deal with the hand we were dealt, joining a union gave us a voice and a platform to stand up for ourselves.”

Palmer is actively involved in improving working conditions and patient care. Currently, she is President of SEIU Healthcare Wisconsin and an Executive Board Member of SEIU. She is a member of the Milwaukee Chapter Black Nurses Association, and a Governor’s Appointee to the State of Wisconsin Minimum Wage Task Force. In addition, she serves as a member of the Democratic Party of Wisconsin Board, the UWHCA Public Authority Board of Directors and the Wisconsin Citizen Action Board of Directors.

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Altoona Nurses Strike As UPMC Continues to Put Profits Before Patients

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seiu-org-logoSEIU Healthcare Pennsylvania‘s registered nurses at University of Pittsburgh Medical Center (UPMC) Altoona are on a one-day strike today. UPMC rejected proposals for better staffing ratios, which is shown to improve patient outcomes, decrease the length of hospital stays, and increase patient satisfaction scores, among other issues.

“It comes down to patient care and safety,” explains Kim Heverly, who has been an RN at the hospital for 22 years. “If we don’t have good ratios, nursing becomes just a series of tasks, and you may miss subtle changes in a patient’s condition that could be an early indicator of complications. You also lose those one-on-one moments of caring and compassion, which is so important in nursing.”

Today’s strike is a part of a larger campaign effort by Make It Our UPMC, a coalition of UPMC employees, faith and community leaders, elected officials, healthcare providers and activists, parents and teachers, bus-riders and people across the region whose goal is to ensure that UPMC plays by the rules, partners with the community to build great neighborhoods, and makes every job a family sustaining job. UPMC, the $10 billion global health enterprise based in Pittsburgh, acquired Altoona Regional Health System on July 1.

Nurses, joined by community members, hosted a candle light vigil in December, launched a petition calling on the Board at UPMC to address community concerns, and are planning a Valentine’s Day Action where nurses from across the country will send Valentine’s Day cards to management asking them to “have a heart” and put patients before profits.

Share this on Facebook to show you’re standing with these nurses.

Stand up for SEIU Healthcare PA nurses on strike against UMPC

This article was originally printed on SEIU on February 11, 2014.  Reprinted with permission.

Author: SEIU Communications


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