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End the Need for Nursing “Short Cuts”

My former student, Sony Georges, has been a nurse in Massachusetts for a decade. He’s become a close friend. (I’m calling him “Sony” here, since, like many nurses, he has expressed fears about retaliation from hospital higher ups if he speaks out publicly in support of ballot Question 1.)

Sony is among the most caring and reflective people I know, the kind of person who looks in your eyes, and you sense depth of human sympathy. Somehow you know this brother has seen some suffering in his life. And it’s true. Born into a small poor country abroad, Sony became an orphan at a young age, before being adopted by a local family. He emigrated to the US at age 13 on his own, settling in Boston to go to school. He was an ‘old soul’ long before I met him in a college classroom, almost a decade ago.

Sony’s desire to become a nurse goes way back to when he was only five or six, when he was forced to watch his own mother die an excruciating death from terminal cancer–without the buffer of modern pain medication. In our first-year writing course, Sony filled pages with the vivid and horrific story of listening at the door, paralyzed by his mother’s pain-blind cries. Peering through the door-crack, he watched helplessly as the sickness tore her apart, even as he was deeply moved by the sight of his grandmother, holding her adult daughter tight, telling her to “Clench your teeth” as she left this world on waves of pain.

Being so young, Sony was mostly kept from that room, but the walls were thin and the screams were loud, and he has never forgotten them. Ever since, he has been driven to aid the sick and the aging, to lessen the suffering of those in need. To provide those in pain with the relief that his mother was denied. (And to send as much of his paycheck as he can back home, where the struggles of poor people are far from confined to the hospital.)

***

Over these past few months, Sony has been filling up my phone with text messages, often searing with irony and outrage, as he has watched the “No on Question One” propaganda campaign unfold, across Massachusetts television sets and radio ads. He has expressed frustration and even desperation that the well-funded scare tactics of those funding the “No” side have caught on, not only with the public, but even with some nurses he knows personally. Held hostage by CEOs threatening program closings and job cuts, even nurses themselves are not immune to this million-dollar mass manipulation.

“They’re brainwashing us to Vote No,” he tells me. “They’re scaring us. All the powerful people. They got more money and louder microphones.”

Late one night after pulling a double shift, Sony writes me: “The MFs always win because they always find aways to fool poor folks, to scare us and divide us.” Then he slips into the pithy poetry I’ve come to expect from him: “Why must it be that if you want shoes then we must chop off your arm?”

Why indeed. But it’s clear that many people fall victim to this way of thinking. We accept that it’s better to suffer a bad system we know rather than to take a chance at changing it, a project that necessarily involves some uncertainty. Too often, working people are convinced that it’s better to hunker down and cling to what you’ve got, rather than speak out and stand up, taking a risk to challenge the powers that rule over you.

But one thing is clear to Sony, however powerful the appeals to fear and the threats of CEOs may be. “Nurse exploitation happens everywhere. We need a law to stop it.”

He has seen the pervasiveness of the crisis first-hand, mainly in nursing homes:

“As a 23-year old LPN [Licensed Practical Nurse] I was put in charge of 24 sick, old people. I had 24 patients by day. 48 at night. With no help. And no one to cover when a nurse called out sick. It was impossible to get all the work done in one shift.”

“I was stressing, I had to find short cuts, risking patient safety and care, delivering mediocre care that looked better on paper but scandalous in actuality. I was sometimes forced to punch out and keep working. To do my paperwork off the clock.”

Sony recalls a female colleague who was regularly assigned as many as 7 elderly patients on ventilators all at the same time. “It’s insane. That should *never* happen.”

He is painfully aware: Nursing home facilities like these will not even be directly impacted by Question 1, but they speak to the depth of the crisis of nurse-understaffing. “Question One doesn’t go far enough, actually,” Sony tells me. “But it’s a needed step.”

Sony hopes that the ballot measure can be a step towards a more comprehensive and system-wide reform.

When he was first hired as an LPN, Sony (now a Registered Nurse) recalls being told by a supervisor that he needed to cut down his time with patients if he was going to survive on this job: “Forget the literature,” he was told. “Forget what you read in the textbook. This is the real world.” And what “reality” meant in the context of massive understaffing was above all: “short cuts.”

“You are taught to do things that could get you barred from the Nursing Board. Every nurse does it. You’re forced to do the bare minimum. And the higher ups know damn well what is going on.”

He recounts a list of unsafe practices that were considered “normal” in nursing homes. Short staffed, nurse tasks–from assessing skin conditions to delivering foot care for diabetic patients– are regularly delegated to less-trained nurses aides (CNAs). Medications are prepared ahead of time, or crushed and pre-mixed for G-tubes, so CNAs can deliver care that should be done by nurses. Meanwhile, with the CNAs so strung out covering nurse tasks, aged patients are regularly put back to bed unwashed. “That shit happens every day.”

And it takes a toll on nurses themselves, not only physically but psychologically:

“Every day you need to numb yourself to the contradiction. You’ve gone into this profession because you want to care for people, to give people real compassion. But you’re forced to be a part of a system that provides so much shoddy care. A system that makes you feel more like a robot, popping pills and giving shots. With no time to really be there for these people.”

***

To the propaganda campaign against Question One, Sony is harsh and dismissive. “They say they can’t afford it. But that’s bullshit. They have the money. They’re buying new buildings, expanding, and renovating. Where did they find the money for those projects? They just don’t want to hire more nurses.”

But WE NEED MORE NURSES, across the entire health care system, in this state and beyond.

Better staffing, Sony tells me, will mean that “patients will have more energetic, rested, happier nurses caring for them, giving better head-to-toe assessments, more accurate and timely recognition of patient needs. And no more dangerous short-cuts.”

His hope now is that the tens of millions of dollars being spent by the “No on One” side is going to backfire. As Sony texts me: “Whenever so many rich and powerful fuckers invest so much money in a campaign to fight something, all of us ‘lil folks should be very suspicious.”

***
Sony was forced to grapple with the reality of human frailty and mortality much earlier than most. And he has devoted his life ever since to studying, training and working to ease the suffering of others. But the system in place now does not let him fully carry forward the mission he inherited by his mother’s death bed. Even the most devoted of healers are hamstrung by this sick system of nurse exploitation.

“The irony is that we have all these resources in this country,” he tells me, “all the machines and fancy buildings, and all this money. But the care we’re giving lacks the humanity that even people in poor counties take for granted as a basic right.”

For my dear friend Sony, the stakes are clear. “This is about the potential well-being of all us. We all end up as patients someday.”

 

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