Vital Signs

Nurses' Rights Equal Quality Care

We need to take our message about the value of nurses to the public--as the nurses at my hospital did in the 1970s.

by Wilma Jones, RN

As we all celebrate our achievements during National Nurses Week, I find myself recalling June 1976, when my career as a registered nurse began at the Hazard Appalachian Regional Hospital in Hazard, Kentucky. Anxious yet eager to care for my patients, I began my journey in nursing. I soon found, though, that the reality of caring for those who were ill and impaired was not what my vision had been. It wasn't just the patients who had problems--so did the registered nurses! We constantly ran into roadblocks--lack of supplies, inadequate staffing, and even discord among ourselves--in our quest to provide the best patient care possible.

The opportunity to surmount these obstacles came on September 20, 1976, when the 40 or so RNs at the Hazard Appalachian Regional Hospital and Home Health Care Unit formed a bargaining unit, represented by the Kentucky Nurses Association (KNA). While our first few years as a unified workforce were rocky, they formed a solid foundation for the activism I have embraced throughout my career. In 1977, after many futile attempts to obtain necessary supplies, functional working equipment, and adequate staff, we called an emergency meeting of local unit members. We voted to send a letter to the local newspaper to let the public know that a lack of supplies, equipment, and adequate staff were impeding our ability to provide safe, quality care. As unit secretary, I wrote the letter and hand-delivered it to the newspaper office and director of nursing.

This action ultimately resulted in a commitment from management to obtain the supplies, equipment, and staff that were needed at that time. As evidence of the impact of our public-relations efforts, the hospital followed up with a policy that required any public information involving the hospital to be approved by management. The local unit members had learned what collective action can do. A year later, we learned again of this power, when we faced unsafe working conditions that mandated emergency action. We planned a "wildcat strike," June 23, 1978, as an attempt to make our "professional collective voice" heard. Since our KNA representatives were attending the ANA's biennial convention at the time, the ANA promptly sent a field representative to support our cause. As a result of our action and the ANA's intervention, we were able to develop a task force for safe patient care and meet with management to resolve the problems, thus avoiding a strike. Our success ultimately spurred many of us to solidify our commitment to the profession on another level--by serving on committees and running for office in the KNA. In October 1978, I was elected chairperson of the KNA's Economic and General Welfare Commission.

With the support and guidance from KNA board members and many mentors, I remain committed and actively involved in my professional association to this day, a time when such involvement is more crucial than ever for practicing nurses. As it was when I first joined the KNA 20 years ago, inadequate staffing is threatening our patients.

Where have all the nurses gone? This is a question that patients and visitors are asking today. Once again, nursing is being undervalued in the health care industry, as managed care and hospital restructuring result in the replacement of RNs by unlicensed personnel, as well as outright cuts in nurse staffing. The ANA and the state nurses associations (SNAs) have long understood the link between quality care and positive patient-care outcomes. A decade of research shows that with more RNs, patients experience fewer complications, lower readmission rates, and fewer deaths, resulting in overall lower costs.

We need to come together now and take our message about the value of nurses to the public--as the nurses at my hospital did in the 1970s. We need to tell the media, policy makers, and consumers that RNs are essential care providers in all health care settings. At the same time, the ANA and the SNAs must be supported in their endeavors to ensure our place in health care through education, research, collective bargaining, workplace advocacy, legislation, and regulation.

The most important lesson of our profession's past successes is the power of unity. Throughout my 21 years of practice as an RN, I've been committed to my professional organization and what it represents for all nurses and the patients for whom we care. I have seen firsthand how protection of nurses translates into better care for patients. I remain committed to representing nurses and getting the message to them that "unless nurses know what their rights are, they can't protect their patients' rights." I invite you to join me.

Wilma Jones is a staff nurse at the Hazard Appalachian Regional Hospital, in Hazard, KY, w here she has a long tenure of leadership with her bargaining unit. She will receive the Mary Ellen Patton Award, recognizing her contributions to the advancement of staff nurses, at the ANA Convention, June 26-July 1, in San Diego, CA.