By Esther Kaplan - The Nation, November 2, 2014
Disclaimer: The views expressed here are not the official position of the IWW (or even the IWW’s EUC) and do not necessarily represent the views of anyone but the author’s.
Jessica Wheeler works the night shift as an oncology nurse at Wilkes-Barre General Hospital in northeastern Pennsylvania—but her patients are usually wide awake. “When they have a new cancer diagnosis or they’re going to have a biopsy in the morning, they don’t sleep,” says the 25-year-old Wheeler (which is not her real name). “They’re scared.” Other patients are in their final hours of life, surrounded by grieving family. What she wants is to be there to comfort them, to talk them through those difficult hours, to hold their hands and attend to their pain. But, mostly, she can’t.
According to hospital policy, night nurses on her floor should care for no more than six and a half patients, but they typically have ten. When things go bad with one or two, the floor quickly tips into chaos.
Wheeler recalls one night when she had a patient who couldn’t breathe and several others under her care. “I called the supervisor to ask for anybody—a nursing assistant, anybody! And I didn’t get it, and my patient ended up coding.” Another night, Wheeler had a post-op patient who required constant attention; the patient was confused and sick, and she soon escaped her restraints and pulled out her drains, spraying fecal matter all over the wall. Early the next morning, her heartbeat became irregular just as another patient was dying. “Those nights are scary,” Wheeler says. “I think I’ve seen everybody on our floor cry.”
Another young nurse describes a shift when she had only been on the job a few months and was saddled with ten patients, including one whose incision was leaking badly, requiring her to administer blood all night long. “I was drowning,” the nurse says. She called for help multiple times, but it never came. At the 7 am shift change, she confused two patients’ blood-sugar numbers and medicated the wrong one.
Wilkes-Barre was not always this out of control. For decades, it was a nonprofit community hospital serving the onetime coal town. It was bought in 2009 by what is now the nation’s largest for-profit healthcare chain, Tennessee-based Community Health Systems, which operates 207 hospitals in twenty-nine states. The Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), the nurses’ union, counts fifty-one fewer nurses since the CHS acquisition, a reduction of more than 10 percent—and that’s on top of the elimination of dozens of nursing aides and secretaries. The nurses are not only juggling more patients, says Fran Prusinski, a critical-care nurse who’s been at the hospital for thirty years, but “they have to change the linens, empty the garbage and answer the phones.”
Some of the job’s intensity is due to broad national trends in healthcare. The rise of HMOs and cost-cutting in the 1990s mean patients who are stable and ambulatory—some nurses call them “walkie-talkies”—are now quickly released, so those left in the hospital tend to be sicker and harder to care for. “The patients we’re taking care of on a general medical floor now were the patients twenty years ago we took care of in an ICU [intensive-care unit] with a 2-to-1 patient-to-nurse ratio,” says Elaine Weale, an ER nurse who’s been at the hospital for thirty-three years. “Now that nurse may have five patients, six patients, seven patients.” And as technology has advanced, gravely ill patients who once would have died are now being kept alive, requiring constant care.
But the crush of work these nurses face also exemplifies a hidden side of the recent economic recovery: in industry after industry, speedups are turning work into a hazard, with increasing numbers of injuries and dangerous levels of stress. While 18.6 million people remain underemployed, millions of others are working more hours, and more intensely, than ever. This is especially true in certain industries, from oil refineries to retail to publishing, where federal data shows labor productivity has risen at double or more the national rate. A 2010 survey of people registered with Monster.com found that 53 percent of respondents had taken on additional duties since the start of the recession because co-workers had been laid off—almost all of them without any additional compensation. A 2010 report from the Center for American Progress and the Hastings Center for WorkLife Law found that overwork was a particular problem among professionals: 14 percent of women and 38 percent of men were working more than fifty hours a week. But it has become common in industrial occupations as well. “When time and a half for overtime was established by federal law, that was really a job-creation measure, so it would cost less to hire a new worker,” says Mike Wright, the United Steelworkers’ director of health and safety. “But starting in the late 1970s, the cost of benefits exceeded that extra pay cost, and it became cheaper to work your existing workers harder.”
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American workers do work longer hours than we did a generation ago, according to some analyses, and hundreds more per year than our counterparts in France or Germany—the equivalent of six to eight extra weeks a year. We top the Eurozone nations in productivity by 18 percentage points. “Every month the BLS [Bureau of Labor Statistics] releases its worker-productivity numbers, which measure output per labor hour worked,” says Celeste Monforton, a former Occupational Safety and Health Administration (OSHA) staffer. Montforton, now at the George Washington University School of Public Health, points out that the numbers “go up every month. And that’s because businesses are not hiring new workers; they’re just expecting the old workers to work more, and spitting them out after they get injured.” Some of these gains come from the adoption of new technologies, but others just come from pushing workers harder.
A 2013 survey of its own union reps by the United Steelworkers, which represents such blue-collar industries as oil and steel, found that production pressures, the increased pace of work and increased workloads topped workplace health concerns—outstripping more obvious risks such as poorly maintained equipment. When the reps were asked to give an example of a health or safety problem that had gotten worse over the past year, understaffing led the list. The jobless recovery, in other words, is sustained in part by aggressively overworking those with jobs.
Take the meatpacking industry. By age 39, Juan Martinez, who worked at a Cargill beef processing plant near Omaha, had hands so disfigured from making repetitive cuts that he could no longer work; he is now surviving on disability. He still experiences pain so intense it feels like nails are being hammered into his fingers. His crew had to slice up 4,600 twenty- to thirty-pound pieces per shift. In the four years he was at the plant, from 2003 to 2006, the number of people at his station dropped from eight to six or seven, while the parts kept coming. Since they couldn’t keep up with the line when someone took a bathroom break, supervisors responded by simply denying break requests. “There are people who would pee in their pants,” he told me, “because they didn’t give them permission to go.”
Another meatpacking worker, whom I’ll call Porfirio, worked on the kill line at XL Four Star Beef (now JBS) in Omaha for twenty-seven years. When he started, he says, they killed 1,000 cattle in a ten-hour shift; now they kill 1,100 in eight and a half hours. At night, when he goes to bed, his hands hurt so much that he has trouble falling asleep; when he wakes up in the morning, he can’t move them at all. Everyone talked about popping enormous doses of Tylenol; some talked about pressure so intense it left them depressed. “The Speed Kills You,” a 2009 report from the nonprofit organization Nebraska Appleseed, was based on a survey of 455 meatpacking workers; it cataloged a range of injuries, from cuts, falls and fractures to musculoskeletal and repetitive-strain injuries, attributed mainly to “uninterrupted line speed.” Three-quarters of respondents said line speed had increased in their plant over the past year.
Line speeds in meatpacking and poultry are federally regulated for food safety only, not worker safety. Last year, the USDA proposed to raise the cap on poultry line speeds from 140 to an almost unimaginable 175 birds a minute, even though hand and wrist injuries were already rampant in the industry. A government study of one poultry plant in March of this year found that 41 percent of the workers already exceed safe limits for hand activity, and 42 percent showed evidence of carpal tunnel syndrome.
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