Time Mag: Nursing a Grudge (Arnold/CA nurses head to court)

[rainbow4321]

http://www.time.com/time/magazine/article/0,9171,1032330,00.html

Perhaps someone should have warned Arnold Schwarzenegger that nurses are no pushovers. For weeks, California's famously tough Governor has been locked in a furious feud with the state's R.N.s over his decision to suspend new state rules that would limit the number of patients a nurse must care for. The tiff took off at a statewide women's conference in Long Beach last December, when the Governor ridiculed a group of nurses who were there to protest. To be sure, the R.N.s were provocative, unfurling a banner that read HANDS OFF OUR RATIOS--a not-so-subtle reference to allegations of female groping by Schwarzenegger that had dogged his gubernatorial campaign. But his response set a combative tone. "Pay no attention," the Governor told the 10,000 women in attendance. "They are the special interests ... I am always kicking their butts."

The nurses took that as an invitation to keep Schwarzenegger's derriere pinned to the hot seat. As they see it, the Governor is just bowing to another set of special interests--hospital and insurance companies--that want to keep profits up by employing fewer nurses than California law requires. And so the nurses have produced a Hollywood caper of a showdown, putting unrelenting public pressure on Schwarzenegger to back down. In two protests, thousands of uniformed R.N.s stormed the steps of the capitol in Sacramento, shouting, "Arnold, Arnold, you can't hide--we can see your corporate side!" Nurses have buzzed his fund raisers with "Air Arnold" planes that drag banners reading DON'T BE BIG BUSINESS'S BULLY! They picketed a celebrity-studded party the Governor threw at his Brentwood home for retired NBC anchor Tom Brokaw. When the A&E channel ran a biopic called See Arnold Run, the California Nurses Association punctuated it with commercials of R.N.s denouncing him as "driven by greed and profits," part of a $100,000 TV campaign. Their full-page ads in Washington and California newspapers accused him of kowtowing to the hospital lobby to "put vital health policy up for sale." The headline: KICKING BUTT OR KISSING UP? Wherever Schwarzenegger turns up these days, nurses are sure to follow.

Whatever happens in court this week, Schwarzenegger's butt kicking has hardly improved his image. According to a recent Gallup poll, nurses are more popular than he is. "The nurses care about patient safety," says state senator Sheila Kuehl, author of the ratio law. "The Governor insulted them. It was a big misstep

[PROGRESSIVE1]

1. 1 Nurse will ALWAYS be greater than 1 million Arnolds!

Arnold is a septic tank! His wife is a leaching field!

Arnold is crap!

:argh:

Go Nurses!!!

Nurses of America: the REAL AMERICANS!

[rainbow4321]

6. Unlike Ahnold...

Nurses don't use performance enhancers to get THEIR job done....I don't think there are enough steroids on this planet that would enable him to do a nurse's job even for a single day.

[Hobarticus]

2. "Kicking their butts"? What are we, TWELVE?

I'm so fucking tired of his disrespectful discourse. And I'm not even in CA.

[Tempest]

3. Just like Ronnie Raygun

The Gropinator thinks he's in a movie.

[sasquatch]

4. Nurses are some TOUGH women

They put up with the diseased and dieing and pull some screaming, excrementing, human out of another.

[Rose Siding]

7. And men.

[Cha]

5. arnie and his many "misteps"..

I can't wait until that over-inflated ego of his is tossed out of the Gov's seat ..so he can go back to making really bad movies.

Everytime I see his face at the video store I turned away fast so I don't regurgitate all over the DVDs.

I'm so happy the California nurses are at the hub of this fight..who better and stronger than them to knock the gropenator OUT!

[mac56]

8. Interesting side about Sen. Sheila Kuehl

As Sheila James, she was Zelda Gilroy on the Dobie Gillis show.

Went on to become an attorney, and the first openly gay member of the California legislature.

Very cool.

[Cha]

9. I had read about her before...long before..

thanks for reminding us who she is.

[MichiganVote]

10. Great place California, no lunch, no education and no good nurses

Boy, can't wait to move there.

[BleedingHeartPatriot]

13. As a nurse, gotta say...the nurses don't want more money they want

their patients to have safe care. Soooo, this makes a bad nurse because???? MKJ

[MichiganVote]

14. Sorry-I was being sarcastic at the expense of the gropenator

I can only imagine how many good nurses are going to want to work in that state. I think nurses deserve the best of the best. Too bad the Calif. nurses are stuck with such a jerk governor.

[BleedingHeartPatriot]

15. Ohhh, sorry right back atcha...I get it now...

Our CA nurse sisters/brothers have fought the good fight for all of us in nursing, so I get all "Norma Rae" about them, sometimes resulting in a humor deficit. Thanks for the words of encouragement. MKJ

[MichiganVote]

16. That's ok. I knew after I had posted it, it might sound wrong

So I've been watching the post to correct a bad impression. Viva le nurses!

[rainbow4321]

26. The hospitals will lose more $$ with these crappy nurse/pt ratio numbers

Between potential lawsuits that will happen when patient safety suffers AND when nurses have to stay after their shift to chart....patient overload during a shift means no charting gets done til the end of the shift so we end up staying late. Figure if, say, 3 nurses end up staying after, usually it is for a couple hours each, that is 6 hours of nurse pay right there.
Why not just bring an extra nurse for an 8 hr shift, let everyone have a safe nurse/pt ratio and send everyone HOME on time. The "staying after" hours add up..the damn hospitals are NOT saving themselves any money by cutting back on their nursing staff numbers each shift.
And what happens when people start to get backlogged in the ER's? Are the hospitals going to start diverting ambulances to other facilities? If so, there goes more $$ out the door. No nurses=no bed=no patients = no $$$

My facilty already have had pts w/ 12 hour waits in the ER in this week...12 HOURS just waiting to get a bed. Is that supposed to make them WANT to come back to our facility the next time they need to go into the hospital?? And my place will NOT do diversion..they allowed it for ONE hour last week but that is it. Screw the fact that patients will have to wait, all the hospitals see is dollar signs instead of sick ER patients!

[CaliforniaPeggy]

23. Now just a doggone minute, MV

It's true we underfund education shamefully here; I don't know about lunches. Do you mean school lunches? BUT no good nurses?! That's just not true. And I speak from my own personal experience as both an RN, and as a patient.

The VAST majority of nurses in this state are outstanding ones. They work very hard, under conditions that are far from optimal. And they have fought hard for implementing SAFE patient/nurse ratios. The gropenator has made a big mistake in taking them on.

[jody]

11. Many hospitals are bringing in part time nurses from other states and

paying them twice as much to avoid dealing with organized nurses in California. A friend of mine is just starting a short term contract with a California hospital for hourly rates at least twice her normal rate.

I wonder if California hospitals are recruiting nurses from foreign countries, e.g Philippines?

[Helga Scow Stern]

20. Yes, I saw that when my dad was sick last summer.

The nurses told us they'd been recruited from other states for very high pay. And there was little coordination between them and staff.

[burythehatchet]

24. Every provider is recruiting from overseas

there is a shortage of nurses.

[BleedingHeartPatriot]

12. I'm a nurse, I manage an incredibly busy clinic, our patients are

shortchanged from so many sides....we as nurses try and try to advocate for the patients and their families....CA is one of only a handful of states where the nurses are pushing back.

Notice that they are not demanding more pay or benefits...they want better care for their patients.

Ahnold is messing with the wrong group. MKJ

[BleedingHeartPatriot]

17. BTW, recommending for "greatest", love to see my fellow nurses take it to

Ahnold. MKJ

[BleedingHeartPatriot]

18. kicking for nurses...is everyone working swing shift tonight?

MKJ

[Disturbed]

19. Yes, Hospitals are recruiting nurses from the Philipines.

Many are being recruited because they won't side with the unions and will accept much lower pay and higher patient ratio. CA hospitals are in dire staits because the Corps. will not lwoer their profit margins and expect nurses to work in dangerous conditions for both nurses and patients. The Gropenator is a disgrace and should be voted out of office. Hell, he should never have been voted in but many voters were duped by the GOP machine and his star power. The Gropenator is a Nazi Capitalist Scumbag.

[mopinko]

22. this makes me so sick

we have no business sucking nurses out of countries where they need them so much more than we do.
decent wages, decent working condiditions, decent training programs, we could have enough nurses to have one to a bed. we could SEND them all over the world, like we should.
assholes. short sighted greedy assholes.

[Enraged_Ape]

21. Arnold is trying to bully his state into providing shitty health care

I can't believe the people of California are going, "YEAH!!! We want to go to the hospital and have as few nurses as possible! GO, ARNOLD!!!"

If Arnold wants to fight a battle with nurses over patient safety issues, he's going to get his steroid-basted butt kicked.

[earth mom]

25. Arnold is an idiot

Good luck to him the next time he gets sick...and I mean anywhere...not just California. His disrespect will be paid back tenfold. What a dumbass! :eyes:

[Sequoia]

28. Say, where's my voodoo doll, that bobble head will do.

[yellowcanine]

27. Woo hoo! Arnie is going to wish he hadn't touched this. The nurses are

are going to bust his chops.

[depakid]

29. Why Arnold is WRONG- and why he's hitting tarbaby

I wrote this for another board- but I thought some of you all might enjoy it too:

For anyone who's interested, part of what's going on here is described in this economics paper:

Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts

Here's Depa's analysis-

Basically, during the 80's and 90's, there was a consolodation trend in the American healthcare industry. A lot of non-profits were scooped up by for-profit firms, who of course wanted to increase their marginal revenue.

Sometimes you can do that- increase marginal revenue, without a corresponding drop in quality of care or wages, due to what's called "economies of scale." But only sometimes, under certain conditions and only if you're not too greedy.

And of course, these corporations promised regulators that they wouldn't be too greedy if they were allowed to buy up lots of non-profit hospitals and convert them into for-profits all under common ownership and management.

I wish could draw you all a nice 'lil graph, to show you how that works- and where the point of peak efficiency is- and how after that, getting larger decreases efficiency. It's pretty easy to understand.

One of the things that the paper notes is that peak efficiencies have already been pretty well met in most cases, so the takeovers aren't going to generate a lot of savings- via economies of scale.

What happens is that they force wages down among contract workers by creating what's called monopsony conditions. This is kind of like a monopoly- except from the buyer's side. With large hospital mergers- especially in smaller cities- there are maybe only one or two "buyers" of healthcare sevices that workers "sell."

Now, if you're just a contract worker- you're out of luck. Your wages or benefits will be forced down.

With nurses- who have the power of collective bargaining- their wages and benefits are protected by union contracts.

So what happens is that the large for-profit hospital chains is that they still want to increase their marginal revenue- designated in the paper as αR. To do that they either need to raise prices (which they do for the uninsured- but can't do with large third party payers or Medicare/Medicaid)

Since you can't raise prices, and you can't force down nurses' wages (w), to increase αR under the equations you make the nurses work harder.

You make them handle more patients. You mess with q (which represents "work intensity" in the models).

Am I losing you yet? I hope not, because here's the coup de grâce.

Studies show that the number of nurses per patient (the ratio) has a substantial impact on hospital mortality rates and the number of adverse events (avoidable bad results) .

The California legislature recognized this, took a look at the science and fixed the nursing ratios at a level that the studies indicated would be both affordable and protect the quality of care.

In other words, they kept the bean counters from messing with q to increase their profits!

Now, rather than deal honestly with the underlying issues as to why hospitals are closing- and there are many- Arnold simply suspended the law- which (and there's no getting around this) WILL KILL AND MAIM people. And burn the nurses out in the process.

It's Arnold who's protecting the special interests here- The Tenet healthcare corporations of the world (from accountability for their own bad business decisions)

It's the nurses- not Arnold and his crony's, who are "with the people" here-

And as he's finding out- even though we may not always like them when we're in the hospital feeling cranky-

People recognize that the nurses are looking out for oall of us and that they work hard and often thanklessly helping us heal-

[Bugaboo]

30. "special interests" grrrrrrrr

Nurses ROCK! They are strong and caring men and women who have chosen a career that (theoretically) puts PEOPLE, not profit first. Arnold might as well go kick a puppy now because it will give him better PR than dissing nurses.

I'm a nursing student with one quarter to go and will be a practicing RN this summer. Not in CA, but will pay attention to what happens. Go California nurses!

[Andromeda]

31. What's going to happen if...

the Boobengrabber has to go to the hospital for something?

He'll have to have a nurse take care of him. How ironic.

[BleedingHeartPatriot]

32. My heart goes out to any nurse who would have to care for him....

but we always put the patients first, so Ahnold will probably get great care, regardless. MKJ