Leading together for high-quality healthcare

The last time AFT's nurses and health professionals got together, they resolved to focus their efforts on reshaping the U.S. healthcare system to meet the needs of their communities and to put patients first. In May, they took a step toward that goal at the AFT Nurses and Health Professionals annual professional issues conference and labor academy. The conference, held in Chicago, May 20-22, was filled with opportunities for participants to learn how to use their voice and workplace power to build the strength necessary to protect patients.

"Hospitals and healthcare facilities are changing," AFT President Randi Weingarten told attendees in her keynote address on the first day. "They are aggregating their power, and they no longer care about the communities in which they operate." The result has been that those in charge have tried to exploit the goodness of your collective hearts" and those of the people you care for, she said.

"You went into healthcare because you wanted to make a difference in the lives of patients, and we don't want to lose that reasoning. So we have to make sure that your patients have the best medical care possible and, at the same time, that you are respected, have conditions to do the work, and have work-life balance."

"That's what we're fighting for," said Weingarten. "I remember when my grandparents talked about the promise of America—having a place where they could raise a family and be successful. Today, we think about being able to send our kids to great neighborhood public schools, giving our kids the advantage of higher education without going broke, having access to great healthcare. These are not radical notions. It's what we are fighting for."

The only way to have a voice in this fight is by using collective power, she said.

"The people who hate us are going after our infrastructure; they want to break us. They have tried to make union leaders look bad and divide us from members. But it's not working, so now they are trying to starve the union by pushing for an end to payroll deduction and fair share agreements."

"We have got to fight back," she urged. "This next election will be about wealth inequity, income inequality and reclaiming the promise of America so that everyone can have a decent life."

To do that, the focus has to be on connecting with community, engaging members and providing solution-driven unionism, Weingarten said. "I'm not asking for everyone to be an activist, but to be engaged in the work of the union, because when you have thousands at a rally, or signing petitions or sitting at the bargaining table, it changes behavior. When they see us working together, that's when we start winning this war. If we work collectively, we will regain and reclaim the promise of America."

Finding solutions
How to address the challenge of keeping patient care and quality the priority in our healthcare system was at the heart of a panel discussion featuring healthcare advocates and providers. The thoughtful and free-flowing exchange of ideas prompted questions from audience members who wanted to know what they could do to challenge the system.

Meg Gaines, director of the Center for Patient Partnerships, encouraged the nurses and health professionals to engage patients in their work. "Nurses, like all professionals, need to learn how to empower their patients. Leave people with the ability to advocate for themselves." Gaines said her own experience with the healthcare system led her to train others on how to advocate for patients.

"You have been incredibly helpful to patients. Those are the people you must tap to help you."

Fred Hyde, a healthcare consultant and professor at Columbia University's Mailman School of Public Health, said the union's campaign to put patients before profits is a worthy one. "The moral standard sets the right tone for your efforts because putting the personal in front of the professional in healthcare has become an epidemic."

Hyde offered a number of recommendations to address the problem, including calling on the Internal Revenue Service to require hospitals to limit the total compensation for a CEO to no more than 25 times the pay of the lowest-paid full-time employees, and working with a consumer organization to enforce transparency in medical billing.

"People look at how professional we are by the actions we take," said Barry Egener, medical director of the Foundation for Medical Excellence. The union's focus on putting patients first, providing access to all, ensuring staff are well-prepared, and the collective moral responsibility are an important part of advocating for your profession, he said. "The public will endorse you as long as you frame your goals around professionalism."

Closing out the session, Gaines again encouraged participants: "If nurses stood up and said ‘we have had enough, we will not do this anymore,’ it will change!"

Spreading the word
At the end of the session, nurses and health professionals took the day's message out to the streets of Chicago. The nurses converged briefly on Millennium Park, chanting "Patients not profits, we need time to care! Patients not profits, we need staffing that's fair!"

Dawnette McCloud, a member of the Oregon Federation of Nurses and Health Professionals, who organized the action, noted that staffing and hospital profits are linked; that's why the local pushed back when staffing changed at one of OFNHP's hospitals. The members made a public show of the problem, and the hospital backed down. "Short staffing and doing more with less is a shortsighted way of dealing with costs, but it is our reality. We needed a positive message to let our community know that 'we care about your care.'"

The conference was packed with workshops, including a pre-conference session that taught members how to protect themselves from measles, Ebola and other infectious diseases. The second day of the conference featured Nancy Hoyt of Compassion & Choices, who spoke about educating patients on end-of-life decisions. Author Suzanne Gordon shared her experience in the healthcare system as a way to spark discussion about how members can tell their stories to describe problems they see in the system and to offer their own solutions. Richard Kirsch, a senior fellow at the Roosevelt Institute, closed the conference with a presentation about healthcare that works for us all.

[Adrienne Coles/photos by Michael Campbell/video by Matthew Jones]