Sometimes Striking Is the Only Way Nurses Can Protect Patient Safety, Expert Says

In the past few months, nurses across the country have been going on strike (or threatening to) as a measure of last resort to address dangerous understaffing at hospitals. In fact, two key examples of this came on Thursday.

The first was the end of a nurses strike in New York City — about 7,000 nurses stopped striking after they reached tentative contract agreements to improve staffing levels. They went on strike for three days at Mount Sinai Medical Center and Montefiore Medical Center, both located in the city.

The second event that occurred on Thursday was a rally at a HCA Healthcare-owned hospital West Hills, California. Employees traveled from multiple states to draw attention to the dire staffing levels at the health system’s more than 150 hospitals across 19 states. The goal of the rally was to show HCA that its workers know how profitable the company is and that they won’t be able to tolerate their working conditions for much longer. 

If HCA doesn’t demonstrate that it’s taking action to address its workers’ concerns after the rally, workers are likely to go on strike, Rosanna Mendez, the executive director of a nurses union connected to the rally, told MedCity News.

To understand more about the recent wave of nurse strikes, I spoke to Theresa Brown. She is a nurse and New York Times bestselling author who often writes about nurses’ underappreciated role in the U.S. healthcare system.

“I have never met a nurse who happily embraces striking — people don’t just love to strike. A nurse who strikes does that out of a sense of necessity,” she said.

Nurses strike only when they believe it is the only option left to protect patients and deliver quality care. This occurs after hospital management fails to adequately respond to repeated requests to address staffing concerns, Brown pointed out.

Understaffing obviously causes burnout and harms nurses’ mental health and wellbeing, but those problems aren’t really what drives nurses to go on strike, she said. It’s the well-researched fact that understaffing has a dangerous and sometimes fatal effect on patient care.

When nurses are assigned more patients than they can handle, patients die who wouldn’t have otherwise, Brown pointed out, adding that this fact has been verified by multiple academic studies. Patients also tend to also suffer more adverse events, such as urinary tract infections and central line infections, when units are understaffed, she said.

“That sounds very dramatic, and I think it’s hard for people to understand exactly how that could  be. They might think that all nurses are doing is running around giving medicines and emptying bedpans, but that’s a misunderstanding of the job. The nurse is the canary in the coal mine for every patient,” Brown declared.

Nurses are unable to keep a close eye on patients when they’re overworked. This is problematic because most people who are in the hospital are quite sick. As Brown put it, hospitals “try to get rid of people as quickly as possible,” so the patients who are occupying rooms are often in an acute condition that could take a turn for the worse at any moment.

Hospitals need adequate staffing levels so that nurses can be there to check in on their patients and notice when something goes wrong — which is impossible if a nurse is juggling a dozen patients. Brown thinks hospitals are failing to recognize how vital this is.

“I think there’s not an appreciation of the importance of staffing — which is at this point just willful blindness. The data is out there. It’s very clear. And unfortunately, we’ve seen this incredible focus over the past two decades on having healthcare systems be like any other business — with an extreme focus on profitability,” she said.

When nurses talk to their employers about understaffing and its negative impact on patient care, they are often told that budget constraints are preventing the hospital from addressing the issue, Brown pointed out. This puts nurses in an incredibly tough mental and emotional place — they see that their patients are not getting quality care, but they have been told there’s no way to fix it. 

This is what causes nurses to go on strike — they feel like it is the only way to get their employer to take action, Brown said.

“My hat is off to the strikers, and my heart goes out to them because it must have been incredibly hard to do what they’re doing. They would only do it because they thought it was the last resort option to get patients the care they need. Nurses are not in the job for the money or the glory — they do it because they’re committed and they care,” she said.

Photo: FilippoBacci, Getty Images