What does reclaiming the promise mean to you? That was the question posed to the 275 nurses and health professionals who gathered in Baltimore in May for the first-ever joint AFT Healthcare Professional Issues Conference and National Federation of Nurses Annual Labor Academy. The conference introduced the AFT's national effort to reclaim the promise of high-quality healthcare.
"When I think of reclaiming the promise, I think about taking our healthcare system back to a focus of public good and service rather than profits," Candice Owley, president of the Wisconsin Federation of Nurses and Health Professionals and an AFT vice president, said during the opening session. "Healthcare is viewed as a commodity today, and for many nurses, this is the only system they know. But there was a time when quality of care was what we believed in."
We can change the focus in healthcare, and we are committed to change the culture, AFT President Randi Weingarten told attendees during the opening session. "Our history has been to find a way to create a voice as members that can be heard to preserve the respect and dignity of work. That's the theory behind 'reclaim the promise': ensuring the view you have of wanting to make a difference is aligned with the tools you have to get things done."
The union's goal is to work on a national, state and local level to transform the American healthcare system once and for all to deliver the high-quality care that patients deserve, and to ensure that our members have the tools and resources they need to thrive and succeed, Weingarten said. "Now is the time to reclaim the promise of our healthcare system, end the deprofessionalization of healthcare workers, and put patients above profits."
But we can't do it alone, said Weingarten. "We have to get the community on our side, and our members have to be engaged. When they are, they feel empowered—and no one can divide us. We have to be solution driven, community engaged and member mobilized."
The AFT's healthcare division used the pre-conference workshop to help participants connect with the community. "We have a stake in getting our community involved in our fight," said AFT staffer Bill Shiebler, who led the workshop. "By engaging the community, we give them a chance to hear our side, and we can own our issues beyond our members."
The daylong workshop helped members like Michelle Silvio discuss and create a plan to engage with the community by building partnerships with community organizations. "I want to use community engagement to get my members more involved too," said Silvio, who is the president of Health Professionals and Allied Employees Local 5131 in New Jersey.
"We can make a difference by holding hospitals accountable for decisions that impact the community and by working with community organizations to build strength," Shiebler told the attendees.
In another session, nurse researcher Sean Clarke discussed the latest staffing research and trends in addressing staffing issues effectively. Clarke, the department chair for nursing research and innovative practice at McGill University, noted that until recently, there was no evidence to say that staffing had an impact on hospital outcomes. It wasn't until the U.S. Institute of Medicine released its 1999 report "To Err Is Human," which said that medical errors were one of the top 10 preventable causes of death, that people began looking at staffing, said Clarke. "It was a watershed event that led to change in the research."
However, there is still remarkably little information about what happens on hospital units, said Clarke. "Nursing is a big part of healthcare, but it's largely invisible to outsiders. Research in this area is so difficult because outcomes are influenced by many different factors."
But that doesn't mean that staffing doesn't matter, said Clarke. "Staffing is almost definitely one factor involved in patient outcomes—but these variables are likely to be associated with other factors." He also cautioned about focusing on staffing alone because facility location and patient factors also influence outcomes.
To impact care, he said, it's important to know where your hospital stands on staffing, and nurses need to advocate for the necessary support and structures to help them provide high-quality care, such as communication, leadership, professional development systems and proper equipment.
In a session titled "Money, Politics and Right to Work," Gordon Lafer, associate professor at the Labor Education and Research Center at the University of Oregon, discussed the unprecedented wave of legislation aimed at reducing healthcare wages, safety measures and workers' ability to bargain, as well as attacks on nonunion workers.
"Right to work succeeds in lowering wages and benefits—like healthcare and pensions—for everyone, but does nothing to increase job growth," said Lafer. "This is not an issue of partisanship. It's about carrying out an agenda that will make the rich richer. When this legislation comes to states, it seems local, but the truth is that these are cookie-cutter bills that come from national corporate lobbies who write model legislation."
The legislation targets union and nonunion workers by going after the right to paid sick leave, trying to suppress the minimum wage, using single employer visas, increasing the use of child labor and restricting union dues through "paycheck protection," said Lafer. "It's important to know who is behind it and how it fits into an agenda."
Lafer said the goal of these corporations is to stifle the voice of organized unions, but he offered a way to fight back: "Take the information back home and make sure your friends and family understand where all of this is coming from and the true agenda."
The three-day conference featured more than a dozen workshops, with topics ranging from intergenerational communications to nursing malpractice to social media, as well as a movie night and a health fair.
[Adrienne Coles/photos by Michael Campbell]
May 23, 2014