Nurses love hand sanitizer. No, really. We use it to the point where our urine contains traceable amounts of alcohol metabolites. We use it to the point where it causes false positives on breathalyzers. We have even used it to the point where it has set both nurses and patients on fire (with the help of static electricity).
Given our prodigious use of hand sanitizer, it is unsurprising that it is one of the staples of health care swag. So when I saw a bag of promotional materials at a Washington State Nurses’ Association (WSNA) meeting, I thought to myself, “Sweet! I hope they have hand sanitizer.”
During the meeting, the WSNA organizer acknowledged the elephant in the room. “I know some believe that unionization diminishes the status of nursing as a profession.” Nurses have fought persistently for years to be viewed as professionals. The recent history of being treated disrespectfully (not to mention sexually harassed) by other health care workers (let’s be honest, it was mostly doctors) makes this an issue fraught with emotion. As a result of this history, anything perceived to diminish the status of nursing is viewed with concern. Hence, the hesitancy surrounding union representation. The WSNA organizer’s rebuttal to this apprehension was that WSNA isn’t just a trade union like SEIU; it is a professional organization that represents the profession and plays a large part in expanding the scope of practice for nurses. Though I already viewed unions as an effective means of addressing workplace issues that impact patient safety, she made me feel that WSNA was an organization for nurses by nurses. After all, the organizer was also a nurse; she spoke our language (something SEIU somehow still hasn’t figured out is really important). And then we were given our swag…
Again, because we can’t get enough hand sanitizer, every nurse took a bottle of WSNA hand sanitizer as they left the meeting. I sprayed my hands (because why not?) and was assaulted with a smell that made my nose hairs curl. It was something reminiscent of an alcoholic wearing way too much cheap perfume. I turned the bottle around to read the ingredients label. “Ethyl alcohol 62%, water, glycerin, fragrance.” First of all, what kind of ingredient is “fragrance”? Second, nurses are extremely conscious about being scent free. Home health nurses make it a common practice to visit patients who smoke at the end of the day so as not to expose other patients to the smell. For many of my cancer patients, the slightest odor can exacerbate nausea. Many hospitals have even begun to implement fragrance-free policies for these reasons.
So what does this say about WSNA? One, it provides a tangible, symbolic example of the disconnect between the actions and rhetoric of the organization. Sure, it may be the professional organization representing nurses. But can they truly be the voice of nurses if they can’t even get the right type of hand sanitizer? More importantly, will they ever be able to convince nurses’ who feel negatively towards unions to come onboard? As long as WSNA makes decisions that every practicing nurse finds ridiculous (in this case, giving way hand sanitizer no nurse can use in a clinical setting), the answer is no.
What does this mean? Currently, most hospitals are closed shop, meaning all nurses’ must join the union and pay dues. If the disconnect between nurses and “their” organization is allowed to persist, what will happen if right-to-work (for poverty wages) legislation is passed in this state as it has been in 23 others? Would the 45% of nurses who have no opinion or a negative opinion of unions’ impact on the profession continue to pay upward of $800 a year in dues? Or would they decline union representation and pocket the extra $800? Given the narrow margin of democratic victory in the last gubernatorial election, and the fact that the state senate is now in republican control thanks to two “democrats” choosing to caucus with republicans, this is something to be concerned about.
As the GOP sets its sights on unions, any successful fight against a right-to-work campaign in this state lies in the hands of unionized workers. Will nurse resistance to such legislation be adequate if 45% of nurses have no opinion or a negative opinion of unions? Given the unprecedented attack on unions, WSNA must reflect on how to encourage nurses to more closely identify with the organization. Once nurses identify with an organization, an attack on the organization is perceived to be an attack on nurses, increasing resistance to as of yet hypothetical right to work legislation. Don’t get me wrong; WSNA has done a marvelous job representing nurses by hiring organizers who are also nurses and advocating for patient safety. But as nurses tirelessly work to improve the quality of care they provide, so should WSNA work to truly be an organization of nurses, by nurses, and for nurses. As we’ve seen in Wisconsin and elsewhere, their survival depends on it.
So the big question. How to get more nurses to identify with the organization? Hand sanitizer is a good place to start.