Hundreds of CA Nurses Strike Over Unsafe Staffing During a Pandemic
As nurses across the country are dealing with the uncertainty of the ongoing COVID-19 pandemic, nurses at Riverside Community Hospital are dealing with a very different type of uncertainty. For decades, nurses throughout California have been a part of one of the strong nursing unions in the country. They have fought for safe staffing ratios, supplies, time off, and more essential personnel. Despite the strength of the nursing union, nurses at Riverside are fighting for their rights.
Monique Hernandez, a full-time charge nurse on the telemetry unit at Riverside Community Hospital, spoke to Nurse.Org regarding the ongoing nursing strike regarding safe working conditions. It’s important to note that the hospital and nurses are not striking over COVID-19 working conditions, but rather conditions that needed to be addressed prior to the pandemic.
Kathleen Gaines (KG): What is your nursing background?
Monique Hernandez (MH): I am a graduate of California State University, San Bernardino. I began my nursing career at the staff level in the "South 4" telemetry unit at Riverside Community Hospital in 2009. It is the cardiac telemetry at my facility and we cared for postoperative open-heart patients and ACS. After feeling a reasonable amount of comfort in that setting, about six years, I set out to tackle a higher acuity: surgical intensive care. I made this decision because I aspired to someday return to telemetry as a charge RN and be capable of providing perspective and expertise to my colleagues when it came to cardiac care. I hit a steep learning curve in intensive care and sharpened my tools and skills in nursing; I also began to engage in conversation, action and thought towards resuscitating and invigorating our hospital chapter of SEIU 121RN. There were other motivated and spirited supporters of taking back some control from our administrators within the hospital. After four years in intensive care, with a new perspective on both my professional and activist potential, I returned to my home telemetry unit to be a full-time charge RN.
KG: What made you decide to become a nurse?
MH: When I was five years old my aunt was diagnosed with leukemia. This is where the idea of becoming a nurse first entered my brain. At that tender and naive age, I believed that I could somehow quickly become a nurse, help to treat my auntie, and this devastating disease would not take her away from me. Unfortunately, I lost my auntie when I was seven, but the aspiration continues to motivate me. These thirty-some years later, I still look at her photo and reflect on my loss, and I weigh this loss against the lives I may have changed or saved in the course of a shift. I see her and my vulnerable five-year-old self when I look at my patients and their families, and I labor to maintain, restore, and preserve the lives I am lucky enough to be allowed to touch.
KG: How long have you been a nurse?
MH: Eleven years.
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KG: Why are nurses at Riverside Community Hospital striking?
MH: We are striking in an effort to protect our patients and our staff. Riverside Community Hospital and Hospital Corporation of America, its parent company, have worked hard to parse down our staff, nursing, and non-nursing, and have made it incredibly challenging to do our jobs.
- The hospital is understaffed: there are too few pharmacists, pharmacy techs, phlebotomists, clinical lab scientists, environmental service workers, food and nutritional service workers, aides, secretaries, public safety officers, and so on. Anywhere they could find or imagine, some inefficiency, staff, and resources would be reduced.
- Many of our nursing and executive leaders subscribed to the Lean Six Sigma doctrine, wherein a process (originally this doctrine was applied to car manufacturing) is stripped down of any waste or excess until the "product" begins to suffer. Unfortunately, the product of a hospital is not hatchbacks, it is human health and the avoidance of human suffering.
- This approach has created a strict and cruel "staff to the numbers" approach.
- Insufficient meal relief staff, inconsistent charge nurse staffing, out of ratio assignments, daily use of 18 or 20 or 22-hour shifts to cover care, and a total lack of preparedness for even the most predictable challenges (eg a code blue that must be moved to the ICU) are standard operating procedures at Riverside Community Hospital.
- Our nurses are exhausted, and we are saying "no". No to missed meals and breaks, no to subpar patient care as a direct result of reducing resources and staff, no to a lack of preparedness, no to being the heroes working in our sweatshop.
KG: How many nurses are projected to strike?
MH: On our first day over six hundred nurses walked the picket line, shared stories, chanted, and drummed up community support. That is around half of the hospital's total nursing workforce. It is difficult to know who has crossed our picket, but I think it is fair to assume that not every nurse that was not picketing was working. When we took our initial strike vote we had over 90% approval, I think that this number represents the enthusiasm and determination of our staff. People are tired of being treated poorly while working extremely hard, especially with the hospital taking deliberate actions that reduce our staff by canceling travelers, registry, and per diems due to our relatively low census.
KG: What are nurses at your hospital hoping to achieve?
MH: We hope that the hospital will cease its irresponsible and unsafe staffing habits. It endangers our patients, our licenses, and our individual safety. We hope that we can create lasting change so that our hospital will cease to be a turnstile for young nurses (one of my colleagues cruelly, but accurately, refers to Riverside Community Hospital as "Kaiser's extended orientation program" due to us frequently losing staff to this more worker-friendly employer) and evolve into a place that we can have pride and dignity.
KG: Are other hospitals in the system striking too?
MH: While we have the support of our sister facilities within SEIU 121RN, and most if not all of our neighboring hospitals, we are striking alone.
KG: What would you like the public to know about the conditions you have been working in?
MH: I want people to imagine what it is like to wear an air-tight, N95 respirator for twelve hours and not get a meal break, not get even ten minutes to allow your face to relax and quench your thirst or slake your appetite. Now add to that anguish that there are nurses, your colleagues, who are being told they cannot come into work to serve as the break nurse because the hospital census is too low. That is your hospital administration telling you you cannot be relieved to meet your human needs and protect your mental wellbeing because they are not turning enough of a profit. On top of all this, imagine the pain a nurse feels when they know that they are not the best version of themselves when they are caring for you or for someone you love; that they are tired and thirsty, and hungry and trying so hard to still make the best decision because they feel responsible for your wellbeing and put it before their own.
KG: Is the strike a result of COVID and hospital conditions?
MH: We are not striking over protective equipment, though the fear and anxiety of working in sweatshop conditions during a pandemic certainly have not helped matters. Universal masking, poor administrative and engineering controls, incoherent and inconsistent procedures for testing, and caring for patients made the already poor staffing conditions more difficult to tolerate. Beyond that, the hospital did an abysmal job at preparing staff, my dear colleagues from the ICU were flatly shut down when they asked if they could go out and give education and simulation for caring for critical COVID patients. Many nurses sat at home that could have been at work helping to prepare for the complex care that these patients require. The strike is about staffing, the hospital's poor preparation, implementation, and action around COVID are part and parcel to their historic behavior.