First published at SocialistWorker.org
Photo by Tula Adie
May 22, 2018
A crowd of 600 health-care workers and their supporters came together on May 12 in Burlington, Vermont, to show broad community support for nurses engaged in a contract fight with the University of Vermont (UVM) Medical Center.
The workers’ contract with the UVM hospital system expires in June, and management has yet to offer anything approaching a reasonable offer, despite UVM surpassing patient, revenue and profit targets. In addition to a resolution for chronic short-staffing, nurses are also demanding a $15 an hour minimum wage for all hospital workers, as a means of attracting people for hospital jobs that remain vacant.
In this speech, Tristin Adie, a primary-care nurse practitioner, describes the predicament of nurses who love their patients, but who suffer stress and overwork because of the conditions that management consciously maintains in the interests of the bottom line.
MY NAME is Tristin Adie. I’m a nurse practitioner in a primary-care practice that is part of the UVM Medical Center system.
Like so many nurses and other health-care providers here, I love my job. There are days when I really feel like this is what I was born to do. Working with patients during some of their most difficult moments, celebrating their best moments with them and even just chuckling through their most mundane of issues is a true privilege.
Today’s health care system demands more of us every day — broader knowledge of complex health conditions; ever-changing guidelines and parameters; imaging, labs and other diagnostic tests; communicating directly with our patients through online portals and by phone.
For nurse practitioners, there are never, ever enough hours in the day. Talk to any of us, and you’ll hear about how we work through our lunch hours, work in the evenings and work on weekends, trying to catch up on documentation requirements, test results and questions from patients. Many of us even take vacation days just to try to catch up.
Despite having greater responsibilities placed upon us than ever, we have little time built into our daytime schedules to actually manage them.
You’ll hear how we wake up at 3 o’clock in the morning worrying about the patient we didn’t have time to call back. Or feeling guilty about the patient with a new, terrible diagnosis who we just couldn’t devote adequate time to talk with on the phone.
The outstanding nurses we work with, the people who manage your phone calls, questions and prescription refills, are similarly overstretched, trying to do right by the patients they care deeply about but often can’t spend enough time with because there are too few of them trying to manage hundreds of requests and questions per day.
In other words, we love our jobs, but our employer is making it harder — even impossible — to do our jobs adequately.
I think of a colleague who said recently, “All I want is to feel like I don’t suck most of the time.” It really resonated with me. Think about that — we’re so overstretched that we feel like we’re letting everyone down all the time. Our patients tell us that they’re so grateful for our care, but inside, we feel like we suck most of the time.
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SO WHY is this? Certainly some level of stress and frustration goes along with any job in health care. But there are some barriers here that don’t have to exist.
The first is staffing. Our outpatient clinics are chronically understaffed, because UVM Medical Center has refused for years to pay registered nurses and licensed practical nurses the same as their colleagues in the hospital. What nurse would want to take a pay cut to work in a position that requires deep knowledge, experience and in-the-moment independent clinical judgment?
Moreover, as they even admitted in their opening bargaining statement, UVM Medical Center pays nurse practitioners far below “market value.” Right now, a nurse practitioner in this system would have to work 15 years to reach what was the national median salary for nurse practitioners in 2016.
Nurse practitioners in every state that borders ours make an average of $3,000 to $23,000 more per year. And this isn’t a Vermont problem, it’s a UVM Medical Center problem: Nurse practitioners at institutions in this county, other Vermont counties and Plattsburgh, New York, across Lake Champlain all make $20,000 to $30,000 more per year.
It’s an open secret among nurse practitioners that taking a job at UVM Medical Center means a pay cut, plus more work, compared with just about every site you can think of.
So we have nurse practitioner positions that sit open for months and even years. Which means our patients suffer, because it’s much harder to get timely appointments in many clinics (especially primary care and specialties). And we suffer, because we’re trying to cover the shortfall.
So how did UVM Medical Center propose to bring us up to market value? With a 2 percent raise. Does anyone believe this will make it possible to attract nurse practitioners to these open positions?
And all the other remedies we proposed to make our workdays more sustainable? They chose to not even dignify them with a response.
I’ll be honest. I might be willing to cut UVM Medical Center some slack if they were doing their best to make this all work, but just didn’t have the resources. But I think you all know the situation is the opposite: this organization is flush with cash.
In 2016, 15 UVM Medical Center employees were paid a total of $10.7 million in salaries. CEO John Brumsted received $2.1 million that year. He received a raise of more than $500,000 in 2015, the same year we were told during contract negotiations that UVM Medical Center hadn’t budgeted for raises for nurses.
UVM Medical Center’s actual profit — its surplus — in 2017 was $69 million. They spent $8 million to rebrand themselves as UVM Medical Center in 2014. They spent $189 million on the Miller Building.
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LET’S BE very clear, this surplus and this ability to endlessly expand, gobble up other health-care facilities in the region, to make yet more money, comes directly from the work we all do.
Their greatest source of revenue comes from an increase in the number of patients who come to our facility every year. And because we are the hub of this regional system, we see the most complex and ill patients in our facilities, which equals more reimbursement and more money for UVM Medical Center.
So we’re working harder than ever to take care of these patients — so that executives can receive unbelievable pay increases, so that they can expand yet further and reward themselves still further.
And this is where we’re not so unique here at UVM Medical Center: this is the Great American Scandal. Workers work longer hours, at an ever-increasing pace, for stagnant wages, so that a tiny number of executives can rake in millions.
How dare they!
When UVM Medical Center’s representatives pushed their 2 percent wage increase offer across the table, I missed an opportunity.
I wanted to say, “Do you read the news? Do you know what’s happening in this country? People aren’t taking it anymore. Teachers have been striking — in West Virginia, Oklahoma, Arizona, Colorado, North Carolina and here in Burlington! Health-care workers are striking in Massachusetts and California. Do you really want to pick this fight?”
But I didn’t say that. I instead sat there and seethed with anger, along with 300 of my friends in red behind me.
So I’ll say it now to the decision-makers at UVM now, in case any of them are listening: We’re not taking this treatment anymore. Enough of working through our lunch hours, at night and on weekends. Enough with a workload that is unsustainable and makes us feel like we suck all the time.
Enough of our colleagues working for wages that don’t cover the cost of rent or a mortgage, food, and health insurance. Enough of a labor movement that has been willing to accept stagnation at best, outright attacks and decimation at worst.
Enough of us presenting well-reasoned, well-researched arguments to appeal to your better nature and rational judgment. It’s clearly not working!
Enough of us pouring our hearts and souls into work that enriches you at the top. We deserve better. Our patients sure as hell deserve better.
There’s a chant that the teachers in West Virginia came up with that really sums this up, and it’s what I’ll close with: We are worthy. It’s time for the labor movement to turn this whole corporate model on its head: human needs must come before corporate greed.
Our patients are worthy, our colleagues are worthy, and we are worthy.