Monday, October 7, 2013

Public Sector Workers , Nurses and "Professionalism"

by Wendy Forrest

I think a lot about health care specifically about public health care.
As a Canadian who enjoys the benefits of a public health care system , a system which is being undermined by the neoliberal project of privatization of all public services and attacks on public sector workers, I have always been both fascinated and disgusted by the US health care system.
As a Registered Nurse I have always worked within a public healthcare system. I have always been a unionized worker because the vast majority of workers in Canadian hospitals are organized in unions.
I am not a passive union member who pays my union dues and then carries on with my life. I think of myself as a both a union and community activist.
Nurses like teachers, are constantly forced to struggle with how we understand ourselves as “professionals” and as “workers.”
I resent this a lot. I resent this because while I know that I am a public sector worker, the concept or idea that I am a professional has been imposed upon me as well as on the society I work within and the public I serve.
The contradictions and tensions that exist between the reality of my existence as a worker and the “idea “of myself as a professional are constantly being exploited by employers and by politicians.
All public sector workers struggle with this on a daily basis whether or not we are conscious of this fact. We work within this tension every day. But it is becomes a heightened reality when we are forced into situations of conflict and sometimes outright confrontation with our employers. Take for instance when public sector workers are forced to consider strike action in order to defend our wages, benefits and pensions. Right now I have in mind the BART workers in the San Francisco area of California.

In situations like this it is the politicians and the employers who force upon us and upon the public the idea that we are in conflict with the public we serve. At times like this it is forgotten that as workers we are also members of the public. The idea that we are making the public suffer when we fight back is a false idea, perpetuated and exploited by the employers and politicians. Suddenly all blame is forced upon the workers.  We are deliberately constructed in the eye of the public as greedy and selfish. Main stream media, owned and operated by the powerful and rich and served by the politicians, perpetuates , bombards and manipulates public opinion to the extent that we have to fight not only our employers and the politicians but struggle to convince our own people, our own “people”, fellow worker who are the majority of the public.

For so called “professional” public sector workers this reality is even more complicated.
The best way for me to explain or talk about this is to share the day to day situations I encounter in my work as a nurse in a public hospital. The majority of nurses in Ontario are belong to unions- either the nurses union or in sister public sector provincial and national unions.

I have always enjoyed the benefits of belonging to a union.

My first encounter and exposure to trade unions happened when I was a student nurse at the age of 20. As the only daughter of working class parents I was idealistic and thrilled to have the chance to go beyond secondary school and become a “professional.” I was very politically na├»eve and unaware. I never thought about the fact that the only reason I was able to become a nurse was that my education was completely funded by the government. My parents would not have been able to afford to send me to university for 4 years as is the case now to become a Registered Nurse. Approximately 50 percent of my education was hands on work experience on the hospital wards. The rest was in the classroom. It was grueling work. We often worked ten days in a row without a day off, had less than 8 hrs rest between shifts sometimes. My feet and back ached as a result of running back and forth from patients rooms.

Still I was a proud and idealistic young woman. I took for granted and was even perversely proud, well prepared by society to take on the mantle of overwork and “martyrdom.” One day one of my instructors came into the classroom and spent 3 hours talking about the newly formed provincial nurses union. She introduced the idea that we were entitled to decent working conditions, better wages when we graduated etc. She began to re-frame our thinking. It was a lively session, the first of several more we would enjoy with this instructor. Many of us resisted as is to be expected.

It was a lot to expect that any one of us would immediately lose our false idealistic notions that we were “special”, that we were future “professionals” and that our main purpose was to serve with no regard for ourselves. Initially I was one of the biggest resisters to this whole new way of thinking. I argued fiercely but my teacher was well prepared and gently re-framed the ideas that had been thrust upon me and that prevailed generally among the public.

I remember challenging her with the question regarding how could she suggest that I not do unpaid overtime. I used the example of what would happen to my patient(s), especially an acutely ill patient, if I just “walked off the job” after my 8 hours of work. She deftly introduced the idea that it was the employers’ responsibility to make sure that staffing levels were sufficient to make sure that I was replaced at all times as my shift ended. She was firm in her conviction that it was the responsibility of the politicians and the employers to ensure the hiring of sufficient nurses so that except in emergencies nurses should not have to work overtime and if this was the case we should be paid overtime pay. She told us that employers were doing the public a disservice as well as us as workers by forcing us to work 10 shifts in a row without time off and that we should be guaranteed 16 hours off between shifts.

Up until then I had no knowledge that nurses across the province were organizing into a union.
I was an easy convert and as it happened my first Job was in a unionized hospital and the rest is history for me.

In a nut shell she introduced me and my fellow students to the new ideas that we were working people as well as “professionals” and that as such we were entitled as “workers” to decent wages and working conditions. As well she gently turned us towards the correct idea that we could only achieve what we are entitled to only if we were organized collectively.

Now 40 years later I am still working as a front line nurse in a public hospital, witnessing and living the realities of sharpened class struggle, watching and living day to day the reality that the gains all public sector workers have made over 4 decades have been literally thrown back and our public services which we as workers in our unions fought for being dismantled.

Alongside this I see the false dichotomy between my reality as a worker and the “idea” of myself as a “professional” sharpening and once again. I see it being used as part of an ideology to undermine my sense of entitlement as a worker and user of hard won public services.

Every day on and off the job I am forced to spend a lot of time talking to friends and neighbours as well as co workers. I am forced to point out again and again that being a “professional “and being a “worker “ with rights and entitlements worker are not mutually exclusive. As a union steward more and more I am forced to educate and “encourage” new graduates and sometimes even older more experienced nurses to fight the exploitation that occurs when they stay overtime to complete their work and do not claim their overtime pay. I have to tear apart the employers “talk” that as professionals we should understand that we are responsible for “professional development “, even if it means donating our unpaid labor. We are discouraged from claiming paid educational days, negotiated into our collective agreement. The message in one form or another is that as professionals we are not “clock watchers.”

I am challenged constantly to find new and creative ways to talk about work and “labour.” I struggle to show them how the undermining of our public health care system originates from the same source as the disrespect for our work and the attacks on our wages , benefits and soon to happen attacks on our pensions. I try to help them see that the most “professional “ thing they can possibly do is to fight for their rights and entitlements as public sector workers because this in integrally connected to a fight for public health care and the rights of our patients to free universally accessible publicly administered health care.

I tell them that “union talk” is often more professional than when it comes to the present and future welfare of our patients in a public health care system under attack.
I tell them about the rise of poverty and the destruction of the welfare system- many of our patients receive social assistance in the form of welfare and disability, to make the abstract and soft pedaled notion of ‘the social determinants of health” that they learn in the classroom become concrete and alive in reflective practice” meaning their everyday practice on the job. I even try to make connections between their right to a safe workplace implies a right to as safer environment for patients.
In short I push the idea of entitlement hard. Too many workers in so many ways  merely accept  that the rich and powerful are entitled and are ok with that. We are lulled into thinking that this is the nature of things and that the capitalist system that rewards and privileges the very few is the only way and that there are no alternatives. We are bombarded with the idea that we must sacrifice to save and maintain the very system that ensures we will not collectively feel and know our value and our worth and demand our entitlements.

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