Throughout the world, electing the right people and
passing the right laws make all the difference for decent health care

Nursing organization representatives from Ireland, the United Kingdom, Canada, New Zealand and the U.S. may have all had different accents, but their stories are the same: electing sympathetic legislators and getting politically involved are the only ways to make change in today's difficult health care environment.

Addressing the closing session of the 2000 FNHP professional issues conference in Washington, D.C., Karen Jennings, head of nursing for UNISON (the United Kingdom's largest public sector trade union), explained how 18 years of conservative government policies under Prime Minister Margaret Thatcher were aimed at destroying the public sector. "We have new government now, and it makes a world of difference," said Jennings of the new Labor government, which "talks to us, consults with us and listens to us ... and tries to make change."

The former Tory regime "had washed its hands of standards of care," said Jennings. With the new Labor government, national frameworks are being introduced so that standards of care in the National Health Service will be based on evidence, and treatments will be the same throughout the U.K. The nurses are also able to work with the new government on a recruitment campaign to combat the shortage of nurses, on remedies for violence against nurses and on the regulation of unlicensed practitioners.

In Canada, said Canadian Federation of Nurses Unions president Kathleen Connors, nurses are responding to poor wages, a devastating nurse shortage and the "casualization" of the nursing workforce by electing nurses to government office and through grassroots organizing.

In New Zealand, nurses are more politicized, said Judi Mulholland, who heads the New Zealand Nurses Organisation. New Zealand's public hospitals have an 80 percent unionized workforce, and private facilities are 40 percent unionized.

As in the U.K., a right-wing government had a devastating effect on nursing and hospital care, said Mulholland. Her union developed a health manifesto, got organized and helped defeat the government in elections; now the country has a new employment relations act, and much more, she said.

In Ireland, 35,000 nurses throughout the country went on strike and 10,000 of them participated in a mass demonstration in Dublin to address wage issues. Irish Nurses Organisation leader Cora O'Rourke explained that the day the nurses walked out on strike was the same day that the governor of California signed a bill establishing nurse staffing ratios--a measure created and fought for by unions.



Political action in the U.S.

In the U.S., FNHP members are active on all fronts--realizing, as they do, that political action and public support play a key role in securing both legislative and contract measures that protect patient care.

In fact, political action can take a very direct route: meeting with your representatives in Congress or in state legislatures to tell them about the problems you see in health care and asking them--directly--to write, propose or endorse legislation that will help fix those problems.

On June 1, scores of FNHP members made visits--in most cases to the staffs of their senators and representatives at the U.S. Capitol--to encourage support for a federal patients' bill of rights, a needlestick (safe needle) bill, legislation to safeguard against medical errors and better funding for home health care services. In fact, the delegation from Kansas City, Mo., was able to persuade one of their U.S. representatives to sign on as a co-sponsor of the safe needle bill.

In New York state, members of the Public Employees Federation Statewide Nurses Committee met with their legislators on March 14 to urge passage of bills offering whistleblower protection, safe needle device usage and hospital disclosure of licensed nurse staffing ratios.

And, in Connecticut, FNHP members used the legislative process--and the support of former nurse and current AFT member State Senator Melody Peters--to secure passage of legislation that will result in a public report card on hospital staffing.

Danbury Hospital Professional Nurses Association/FNHP president Carol Flynn, who put the legislation together, said the current bill "is a wonderful model for all of our states to do similar things" on staffing data collection and staffing standards.

The legislation calls for data collection on nurse staffing levels as well as a study "of the relationship between nurse staffing patterns in hospitals and the quality of health care, including patient outcomes." It also calls for a study of the nurse shortage in the state and an examination of its causes.

Representatives of the California Nurses Association (CNA) and Massachusetts Nurses Association (MNA), who addressed the FNHP professional issues conference in June, both emphasized the importance of political action, public support and electing the right legislators.

Jill Furrillo, CNA director of government relations, described the years of political work it took for passage of the California staffing bill, which is the first in the nation to set nurse staffing ratios. And MNA leader Julie Pinkham described the political and community support that was needed to help settle a dispute at St. Vincent Hospital in Worcester, Mass., after nurses there had been in negotiations for two years and on strike for more than a month over management's refusal to limit mandatory overtime.

When Sen. Edward M. Kennedy (D-Mass.) intervened this May in the dispute, both sides were finally able to hammer out a successful agreement, which limits shifts to no more than 12 hours. Furthermore, a nurse can only be asked two times in each quarter to work overtime. "Any nurse can refuse overtime for personal fatigue or personal illness," explained Pinkham. "That was the biggie: Nurses shall define whether they're competent to take care of patients."