DULUTH — Students at the University of Minnesota School of Medicine, Duluth Campus are taking initiative to build relationships with the local members of the Minnesota Nurses Association.
The student organization White Coats for Black Lives hosted a community panel Tuesday with local MNA representatives to talk about the staffing shortage in the health care field, the nurses' fight for new contracts last fall and the corporate structure of health care.
Student organizer Jamey Sharp said he was impressed to see more than a dozen of his fellow medical students in attendance, plus students in other studies and Duluth residents. The event, Sharp said, was inspired by a recent New York Times opinion article stating 1 in 5 doctors plan to leave the practice because of feelings of burnout and demoralization in the field.
“A big portion of my medical school class was in the room tonight, not because they were forced to go but because they recognize this is a problem," Sharp said. "They worked as EMTs, nursing assistants, they worked in the hospitals, and they know that these are the problems that will keep them from doing their job well as a physician.”
The three MNA panelists went into detail about how the staffing crisis has impacted them during their jobs at Essentia Health and St. Luke's in Duluth. Steve Strand, who has been an ICU nurse at Essentia for 40 years, said the shortage is a perpetuating cycle.
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"If you don't have enough people, you don't feel good about the work you do, so you leave. And then there's not enough, and it just keeps getting worse," Strand said.
Chris Rubesch, an Essentia RN and MNA first vice president, said a problem he sees is complexity compression, where tasks that used to fall on other employees are now falling to nurses, on top of their patient care demands.
Larissa Hubbartt, a registered nurse at St. Luke's, said other impacts of short-staffing include patients not getting medications or taken to the restroom until it's too late; patients not getting the monitoring they need to prevent their health from declining; and patients being held on other floors for several extra days because there isn't anywhere else for them to go.
The panelists discussed ways the future physicians in the room can be mindful when they work with nurses. Strand said he is often asked his opinion about what level of care a patient needs and whether they should be admitted to the ICU, which is usually full or near capacity.
"I don't feel that that's my place. I haven't even assessed the patient; I've just seen them on paper," Strand said. "If that's where you want them to go, I shouldn't be intervening in what your decision is."
The nurses said having doctors who listen to the nurses they work with and report to administration when they see situations like unsafe staffing goes a long way.
"We have to work together," Hubbartt said. "There's no way that we can work apart. We do totally separate jobs, but we're completely commingled and we have to work together."
Dakota MacColl, a first-year medical student in Duluth, said during her time training at health centers, she's observed that the nurses are the ones doing all the work with patients, yet they're still taking the time to ask what they can do to help her.
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“They’re teaching me everything they know. They’re some of my greatest teachers," MacColl said. "I think when we’re looking at the future of physician-nurse relationships and interdependent teamwork between physicians, ancillary teams and even the public, they’re not teaching us that here.”
MacColl said she wants to build these relationships to show a sense of solidarity between health care workers, regardless of title. She said supporting the nurses on the picket lines during their historic strike in September was a way of showing nurses that the people entering the medical field will have their backs.
“I think there is also, unfortunately, this kind of power differential between physicians and nurses, and I think when we show up at rallies, at pickets, in our white coats, it really speaks volumes, especially to the people who are in charge of bargaining on the company’s side or the corporate health care side,” MacColl said.
The three MNA nurses were joined by MNA labor relations specialist Chad McKenna, who worked with Essentia nurses during last year's contract negotiations and helped lead the discussion about union goals for the common good. The panelists discussed their requests at the bargaining table, including their desire to be able to refuse a job they feel is unsafe and nurses having more of a say in company decisions, including base staffing levels.
If you don't have enough people, you don't feel good about the work you do, so you leave. And then there's not enough, and it just keeps getting worse.
They also gave a plug for the Keeping Nurses at the Bedside Act , which was heard Wednesday morning in its first Senate committee hearing of the year. The act would establish committees of direct care workers and management to create staffing plans for each unit at each hospital in the state, aiming to solve the staffing and retention shortages. The bill is asking for a maximum number of patients nurses could care for at a time and require hospitals to be transparent about emergency department wait times and inform patients of staffing levels.
The MNA members discussed their position on corporate health care, stating the union is against the in-the-works mergers between Sanford and Fairview health services and Essentia and Marshfield Clinic systems. The nurses are concerned that monopolized health care is profit-centered, not patient-centered.
According to the New York Times piece, American physicians have a sense of helplessness and loss of purpose not just because of short staffing, but because the for-profit medicine system is failing patients, causing preventable deaths because care is so expensive.
"Regardless of whether we act through unions or other means, the fact remains that until doctors join together to call for a fundamental reorganization of our medical system, our work won’t do what we were promised it would do, nor will it prioritize the people we claim to prioritize," Eric Reinhart wrote in the New York Times op-ed. "To be able to build the systems we need, we must face an unpleasant truth: Our health care institutions as they exist today are part of the problem rather than the solution."
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Despite hearing about negative aspects of the health industry, MacColl and Sharp said they're more motivated than ever to become physicians.
“When I am held in fear in rooms like this, it makes it a lot less scary,” MacColl said. “I wouldn’t keep coming to work if I didn’t think it mattered.”
Sharp said he wants to make sure there's a place for his patients to receive the cutting-edge medical technologies being developed today, but he's aware the system causes huge disparities, especially because of biases in race, gender and socioeconomic class. He doesn't want the local hospitals to see the critique of corporate health care as a threat, but rather as an opportunity to create change and take initiative toward improving the system.
“It’s more surprising and troubling when we’re not talking about it," Sharp said of the problems in today's health care field. "It’s like the elephant in the room, so if we’re in classrooms and just learning about proteins and the mechanisms of Parkinson’s disease, and pretending that everything we’re learning is just going to work in the system we are told doesn’t work, that is way more anxiety-producing for me.”
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