by AFT President Sandra Feldman
April, 2002

Understaffing
and mandatory
overtime pose a
danger to patients.

What do teachers and education have to offer in a war with the shadowy, well-funded network of terrorists who attack our country and its values? The answer: plenty. Education goes right to the heart of this conflict, which is a battle of ideas about values: Who governs? By what right do they claim power? Are there free elections? Are free speech, a free press, independent trade unions, and free enterprise protected? Are people free to worship--or not--as they wish? Do women and other groups enjoy basic human rights?

A few weeks ago, a healthy young man who was donating a part of his liver to save his brother’s life, died in one of the country’s most prestigious teaching hospitals--a world-class organ transplant facility. How could this happen? Too few health professionals caring for too many patients.

This kind of tragedy is becoming all too commonplace in healthcare institutions whose purpose is to heal but whose policies too often cause harm.

A frenzy of mergers, acquisitions and consolidations, a lack of oversight and regulation, a focus on competition and profits rather than on patients and quality care, have resulted in the sad state of affairs where families fear the hospital. We suffer more than the usual anxiety when we take our loved ones to what should be--and once was--a zone of comfort and relief.

Anyone who has spent time in a hospital these days can tell you: Nurses and other health professionals are overworked and overtired. Dangerously low staffing levels at many hospitals lead to mandatory overtime and exhausted workers. In addition, many procedures once performed by nurses are now being turned over to staff never trained to assume such roles.

It’s no wonder that medical errors are on the rise. Dedicated healthcare workers feel beaten down, and many are fleeing the profession in droves. Those remaining are left with even heavier workloads and unsafe working conditions. It’s a vicious cycle. Hospitals and medical facilities have set the staffing levels so low and made the working conditions so intolerable that trained and talented professionals are seeking other careers--just as teachers and prospective teachers are leaving or deciding not to pursue their chosen profession. Serious shortages in both fields pose a grave national crisis. 

Exhausted nurses

Americans can be proud of our many talented healthcare workers. Nurses, technicians and aides, who work closely with patients, are an integral part of a quality healthcare system. They can help reduce medical errors in hospitals, which, according to an authoritative report from the National Academy of Sciences’ Institute of Medicine, lead to at least 98,000 preventable deaths a year. But despite their hard work and commitment, too many healthcare professionals are overburdened, and too many patients are increasingly at risk.

Mandatory overtime is a particularly dangerous practice because it sends exhausted nurses back onto the floor and undermines hospitals’ efforts to deliver high-quality patient care. As one RN puts it: "When I’ve been up for 24 hours, my judgment gets a little shaky--and so do my hands."

There is some new hope for ending forced overtime for nurses and other healthcare workers. New Jersey recently enacted a law banning the practice, and several other states are considering similar legislation. But the crisis in our healthcare industry is a national problem requiring a national solution. That’s why hundreds of dedicated healthcare workers will come to Washington, D.C., this month to urge their elected representatives to enact a federal law banning mandatory overtime.

Too many children still uninsured

But quality is not the only problem in our healthcare system. It is unconscionable that in this great nation we continue to see an increase in uninsured people, including millions of children. What is more, states facing budget shortfalls increasingly are unable to respond to the challenge. It is estimated that as many as 44 million Americans are without health insurance. Although the State Children’s Health Insurance Program (SCHIP)--a federal-state partnership created in 1997 to provide health coverage to previously uninsured children--has helped lower the number of uninsured children in recent years, there are still nearly nine million young people who are at constant risk because they lack insurance. We must support and try to expand this valuable program.

For nearly a decade, the United States has ranked near the bottom of industrialized nations in healthcare. We are among the nations having the highest death rates for young children and young adults. Lives could be saved if the richest nation in the world made high-quality, affordable healthcare available to all.

We can avoid a healthcare catastrophe if we act now. We owe it to the healthcare workers coming to Washington this month to support solutions to a problem that politicians have avoided for too long. And we owe it to our nation’s children and to the Americans who have lost their jobs and lack the security of quality health benefits. One nurse’s comment says it all: "By the end of my 16th hour on shift, my caring and sympathy have drained away. I’m too tired. Patients deserve better, and so do nurses."