Patients Over Profits

Nurses are the backbone of healthcare. From tending to patients to dealing with doctors, nurses do all the things. In honor of Labor Day, our favorite producer Marcel Malekebu interviews Tracie Ducksworth, a union chair for the Minnesota Nurses Association.

Transcripts may not appear in their final version and are subject to change.

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I’m Marcel Malekebu, and this is Thanks For Asking. You may know who I am, or you might not, but I’ve been working as a producer on the show for a few years now. When I was a kid, I always preferred co-op video games.

I was fine with playing one-on-one in Mario Kart or Mortal Kombat and games like that, if that’s what my brother wanted to do. But I always preferred to go team up against the bad guys.

It’s the same reason I like the Justice League and the Avengers, the same reason I like to play my guitar or piano with my dad’s bandmates or at the church. For me, I felt that working as a team, everything was better.

Instead of fighting or competing with my loved ones, I could go against the opposition. We could do it together. It only seemed right.

And while nowadays I love a game of one-on-one in any sport, any game against any family member, a friend, any chance I get, I still love when I can unite with a team for a common cause and accomplish something.

Today’s episode is inspired by that same vein of thought. And in honor of Labor Day, I decided to talk to Tracie Ducksworth, one of the MNA Union Chairs in Minneapolis. But what does MNA stand for?

The Minnesota Nurses Association.

The Minnesota Nurses Association encompasses nurses from all over Minnesota and even some parts of Wisconsin.

There is a little caveat there.

State-run and county hospitals cannot strike. So, a lot of people don’t realize that the Hennepin County Medical Center nurses are part of MNA. It’s just that they do have that no strike clause because they’re county.

So, most people think of unions. You kind of always think of like your steelworkers unions, your automotive unions. Our union is pretty much the same basis as those unions as well.

We are a labor union and nurses, we’re labor. We’re not trade labor. We’re not like your blue collar workers, but we provide a service and we are a labor union.

And the premise for any union is safe, equitable work environment. We want to be able to go to work safely, to be able to do our job safely. We need to be able to be equitable.

That’s why most unions, we have like the pay scale. It keeps the nepotism and favoritism at bay. The basic cause of basic kind of premise of any union is just cause.

Everything, it should be fair and just. I can’t say, hey, I don’t like the color of your hair. You’re demoted.

You’re fired. I’m going to write you up until you dye it. It doesn’t work that way, but then here comes Joe Blow with the same hair color or whatever, but you just happen to like them.

Right.

Right?

It kind of helps to prevent that. Labor unions don’t necessarily save your job. I mean, you still need to perform your job.

A lot of times, it’s misconstrued as like you’re protecting poor workers. Just cause you’re bad at your job, you’re saved because you’re in a union. I mean, it’s not necessarily that.

It protects you from the inequities.

I want to stop here for transparency and say that Tracie isn’t just a nurse and the chair of the union. She’s also my sister.

And Tracie didn’t exactly decide to be a part of the union originally because by working for the hospital she’s employed with, all nurses must be a part of the union.

But her decision to actually become a chair for the union and work with the union comes from years of experience in the field, years of dealing personally with the same concerns she now fights for.

So from the beginning I did want to go to medical school to be a medical examiner, but my mom is a nurse and one of my first jobs out of high school was in a hospital as a HUC in a pediatric intensive care unit.

And I saw what the nurses did as opposed to the doctors and I thought, hey, this is kind of what I want to do instead. It’s kind of one of those callings that you get to be a nurse and decided to go to nursing school.

On average over the past few years, how many hours would you say you’ve worked? Like a week?

Well, let’s start. I’m hired as a 0.6, which is, let’s do the math. Oh my gosh, 24 hours a week.

I used to work, have higher percentage of work. But on average, as we speak, I have just gotten to text messages to ask for people to come into work. There have been times that I’ve averaged probably 45 hours a week, if not more.

Those aren’t everyday type things. A lot of times, these are double shifts, so coming in at 7 a.m., leaving at 11:30 p.m., just to go home and turn around and come back at 7 a.m. again.

Yeah, we choose to pick up the shifts, but it’s also that need to make sure that the patients are taken care of, because if you’re not working, then who’s going to be there? And not everybody can cover your unit.

I’m not an ICU nurse, so if the ICU is short, I can’t go work in the ICU. So what happens? One of the nurses that’s working stays and works extra, because there’s not someone with the same qualifications able to go into their unit.

I mean, just like in 2020, people are sick. There is nobody to come in when people are sick. When there’s like a flu uptick or whatever goes through it at what time of year, then you really don’t have a choice.

Otherwise, your coworkers suffer and it’s a big cycle because then you’re coming in to clean up a mess that was left if you hadn’t stayed. So it is a choice, but it’s almost a choice by coercion, so to speak. Under duress.

What does your day-to-day work look like?

I’m a psychiatric mental health nurse, and I do specifically work with kids.

But I mean, every nurse starts their day with report, whether it’s in-person listening to a tape recorder or bedside, but we start getting report from the shift that was before. We have to get our assignments. Some are assigned ahead of time.

Sometimes we pick our assignments, but once you get in there, you got to get in. You’re reading over charts. It depends on if you were there the day before, if you were there, if it’s been a week.

If you go on vacation and you have a patient you’ve never met before, you have to be able to comb through a chart and get the basic idea of what’s going on with the patient and what their needs are within a very short amount of time.

I start work at 7 a.m. Med passes starts at 8. So we get done with report at 7.30.

I have 30 minutes, and I have sometimes, you could have up to five patients, sometimes six. And you have to go through all their charts to see which of all these patients have meds due at 8, which nine times out of ten, all of them do.

What meds to give them? You’ve got to figure out who takes priority, and not only just passing the meds, but are there wound cares to be taken care of? What check-in?

So in the mental health piece, we have to check in with our patients. How was your night? How did you sleep?

You’ve got to kind of check in to see, are they feeling suicidal? Are there self-harm? Sometimes a patient wants to talk to you for 20, 30 minutes, and you still have meds to pass for five other patients.

And check in with those patients, too. So you have to kind of prioritize that based off of what the nurse before told you, but also what you read in a chart in 30 minutes. So it can be very difficult.

There are days that people are escalated and they need other interventions that require a lot of your time.

It is unfortunate, and this is what happens in a lot of nursing, I will say, is that there are going to be, unfortunately, some patients that don’t get your full attention.

I’ve had days where I have to sit and think, did I even talk to this person today?

And you’re running to go kind of at least do a quick check-in with them the last 15, 20 minutes of your shift, because they were not, for lack of a better term, kind of like the problem child of the day, and somebody else took up so much of your

time. If you were to break down six patients between eight hours of a workday, you’re not allotted a lot of time per patient, if you were to break that down equally. 30 minutes of that day is in report.

So from seven to 730, you’ve got your 30 minute break, so now you’re already down to seven hours that you’re spending with a patient. If you are lucky enough to get your two 15 minute breaks, that’s another 30 minutes.

Mental health nurses like Tracie deal with slightly different issues than nurses who deal with physical medical issues.

And some of the issues that she deals with on a day to day basis are what would eventually spawn Tracie’s foray into working directly with the union.

I think it’s the exposure to violence that we have. And all of nursing, especially in the last few years, have seen an increase in violence. And when I talk violence, it’s not just physical violence.

When you go to work, there is a high percentage that you are going to be verbally assaulted, physically assaulted, sexually assaulted, so to speak. It depends if you’re working in it with adults or…

We get our patients’ clientele’s as vast, so you can have your criminal patients with mental health issues, your sexual predators.

So who’s not to say that I’m going to walk by and this man is not going to just grab my butt and say some crude things to me. They threaten you. I mean, they may or may not do anything.

I’ve had objects thrown at me. I’ve been spit at, feces thrown at you. The sad thing is, is a lot of mental health nurses say that, well, that’s part of the job.

That’s what I signed up for. But that’s not what we signed up for. And the medical units, unfortunately, they also have to deal with a lot of violence verbally and physically from the families and visitors of the patients.

You think of a patient, they’re not really awake, and they’re on all kinds of tubes and lines, and I’m not going to even really try to name all those.

I don’t work in medical, but you have family members that are concerned and they’re stressed, and they don’t feel like they’re getting enough attention.

And like I mentioned before, you have X amount of patients, so much time, in addition to your charting. And if the family doesn’t feel like you’re giving them enough attention or the right type of care, then things escalate.

They are calling you name. We’ve had nurses where they’re like, the patients are like, what are you stupid? You were just worthless.

They tell us we don’t do anything. You’re just sitting on your ass out there doing X, Y, Z.

When you’re sitting there charting, or you’re on the phone, or you’re trying to pace a doctor for them, they don’t necessarily see what we are doing behind that computer screen. It’s more of an assumption.

Sorry you saw me when I took a sip of water for the first time in three hours after running up and down the hallway, and you needed something. But I think society somehow has thought that it’s okay for us to take that kind of abuse.

And I do wish nurses thought about the verbal abuse because we do have a lot of mental health issues that stem from being berated and yelled at and called worthless by visitors, families, and patients as well.

I asked Tracie if the doctors at the hospital understood what it was like for the nurses.

They come and they see the doc, the patients, they talk to them for a couple of minutes, and then they leave, they go in their office, or their little space, and then they go chart the information and then put the orders in for the nurses to carry

out. So we are the backbone caretakers of it. I need a glass of water, I need to go to the bathroom. I need a new pillow, can you give me a different blanket?

I’m cold, in addition to here’s your meds, I don’t like these, I dropped this. I had an accident, I gotta change your pants for you.

It varies in so many different ways when the doctor is only there for 30 minutes out of one day, and we are there all day, nonstop. And then the doctor gets to complain and says, why didn’t you get their vital signs? I need them right now.

Well, I am down the hallway dealing with a different patient and I am the only one here.

They don’t understand it as much, and they’re not the ones that are getting assaulted because when the patients escalate and they’re getting assaulted, especially on the mental health units with me, the doctors just step back and they can go back in

there. And we’re the ones that are going hands on and the ones that are getting hit and bit and kicked by the patients. And all they do is they write the order that says, yes, you can restrain them.

Are there a lot of doctors on the front lines of that part of the fight to get compensation, help and resources?

I think a lot of the doctors do support the nurses. You’re going to have your few. There’s always a few bad apples in every profession and I’ll say even nursing too.

But for the more support, they do support us and when we explain that we need more resources, they understand that. But their hands are tied. Unfortunately, health care is not the health care of the past.

I would say over 90s, 2000s, it’s really shifted and it’s very corporate. These are corporations that are passing ideas like Kaizen and Lean model.

The word kaizen in Japanese means improvement, or change for good, change for the better. Tracie’s Hospital doesn’t currently use this model, it instead uses a model called the lean model.

Essentially, both models focus on quote unquote continual improvement. And the core principles of both models are good. Things like defining value, you know, that makes sense.

We need to figure out what customers need. Why are they here? What value do they seek?

And we want to deliver that effectively and efficiently, which is another part of the core principles of these models. But in practicality, we all know that businesses rarely implement their core philosophies in their daily course of action.

Most of the time, that gets in the way of their bottom line.

We’re very top-heavy. A lot of management, very little workers. And so there’s all these lean certifications that you can get that they push for upper management.

Lean Sigma-6 black belt. And the compasses, they sit in their little office and calculate the best way to be more efficient and to make more money and to make more profit through this lean model.

So instead of being the work of the people and helping people, we’re cogs in the machine is how they look at nurses. And that’s how they look at doctors too, you know, somewhat. But we are more those smaller pieces that are like running, right?

One doesn’t work, you just remove it and put in a new one.

And so instead of really looking at what’s best for the patients and what’s safe for the staff and which ultimately is safe for the patients, it’s how can my calculations through this Kaizen and Lean model work? Like we are literally a car factory.

That’s how they’re looking at us now. And so now with that, those calculations, they’ve learned that nurse practitioners are a cheaper form of care than an MD. And I love my nurse practitioner co-workers.

They are the best. And I do think that nurse practitioners are really great people to have. They’re closer to the bedside and their care and their mannerisms.

Excuse me. But when you are hiring nurse practitioners, not because of the care that they give, and you are because they are a financial asset, the meaning kind of gets lost in translation.

When Tracie was telling me all of this, I was sure that the decision makers at the hospital at least try to involve the nurses on the ground in the process of deciding and changing hospital policy.

It seemed like the only logical way someone would run a both successful and healthy business or organization.

They put on a show of involving us.

The people who make those decisions, even if they are nurses, because we have our, you know, chief nursing officers and, you know, nursing directors, unless they are new to the job within the last couple of years, they are very far removed from bedside care, right? If I started getting a job at management, I’m still close to the boots on the ground for the next few years, but after a while, it’s a use it or lose it type of thing.

And a lot of our higher leadership nurses, when they were on the floor doing the work, it was a different time. The patients weren’t as violent. They weren’t as sick.

The technology has changed, and they’re not using what they’re implementing. They have committees that they put together to discuss, quote unquote, discuss these changes or ideas that they have.

But when they make these committees, it’s very apparent by the actions and the implementation that they already decided what they were going to do anyway.

So I came to give you the illusion that you were a part of this, but yeah, I heard what you said, but we’re going to go this way.

A lot of those ones that are coming from the top, and I’m talking the higher, higher ups, the ones that are really running the money, and a lot of that is our board of directors.

Most hospitals are run by a board of directors, which are people who aren’t in the medical field at all. So we’re talking your Piper Jaffrey CEOs, all your Merrill Lynch, all of your banks, US. Bank is involved, Wells Fargo.

They have members, they have corporate people from those companies that are on the board of directors of our hospitals. Those are the people calling the shots for everybody’s healthcare. They’re bankers, they’re money, that’s what they see as money.

Are you in the red or are you in the black? Okay, so you’re in the red. How do we fix this and where do we make these cuts?

And so they do have a big impact on what RCE does, but then he also gets a bonus on how we perform, which is sad because I don’t get a bonus. Like I just saved a patient’s life today. Oh, good for you.

Here’s your next one. When you think of back in the day, your nurses, nurses were almost like nuns way back when. You were married to your job as a nurse.

You lived there back in the day. There was no dietary department. There was no housekeeping.

They did the laundry. They cooked the food. They made the beds, all of that for the patients.

And they pretty much lived there. So it was all encompassing before, oh, let’s have a dietary department that’s solely specific on doing that. Let’s do, you know, we’re going to have somebody in housekeeping.

And healthcare has evolved. It’s so many more people than the nursing department. But what that does cost money, and hospitals shouldn’t be for profit.

I don’t think there ever should be a for-profit hospital. We should all be non-profit. You made a, yes, we have to make money to put back into it, but you’re paying people’s salaries.

You’re paying for the equipment to take care of the patients. And when you try to make a profit off of somebody’s disease, I mean, lack of health, it’s sad.

It’s like, you’re almost hoping, oh my gosh, the units that survive are your cancer units, your cardiac units. You’re trying to profit off of those departments and then letting the other ones suffer.

If you have a nurse that’s making 80, $90,000 a year, one nurse, taking care of this patient, that’s very high profitable because of all the meds and everything that they’re taking.

If I can cut that one by two more nurses and now we’re going to give you three patients to one nurse versus two to one, we’ve just saved a lot of money.

And that’s sad because by taking that extra nurse away, you’re taking time, care, patients, education from those patients.

This definitely isn’t new. The lack of staffing is one of the main issues nurses face every day in hospitals all across the country. I mean, you see it in all of the strikes that go on.

According to the American Hospital Association website, by 2026, there will be a projected 3.2 million health care worker shortage.

And for me, this seems really strange that it’s still an issue when it’s a very obvious one with seemingly obvious solutions.

So even on a good day with a great ratio of patients, so say I have five patients myself, which isn’t unheard of in mental health, okay? Medical is different, but I have five patients. All of us do.

There’s three nurses here. But my peer wants to go on break for 30 minutes. She has five patients.

I have five patients. She went on break. Who’s taking care of her five patients?

Now I have 10 patients. So do you just tell her patients, well, your nurse is on break, sucks to be you? Or now do you spread yourself between 10?

So we need a break nurse. There are some departments that I have worked in in my career. And when I say my career, I mean like fresh out of high school and working as a health unit coordinator, I’ve seen the structures and how things work.

That with a break nurse, that person goes around and gives people their break. So if I am just the break nurse, I don’t have a patient assignment, and you go on break, I have just taken your five, but I still have a one to five.

So why not just hire an additional nurse as well as the break nurse, but like why is the charge nurse having their own caseload, I guess, or whatever?

Because the cost involved is too high, and that’s what we’ve been told, right? I don’t have their financial ledger in front of me, but that’s two FTEs that are not taking care of patients.

Kind of non-productive, so to speak, is like the term they like to use. So, why are we going to pay you when you’re not taking care of patients? And that’s where it goes down to, how small of a staff can we keep to maintain safe patient care?

And when we say safe patient care, the hospital looks at logistics as inpatient falls, infection rates from like lines, IVs and stuff like that. That’s when they’re talking like safely like, oh, you’re doing great.

We don’t have any CLABSIs, which is a type of line infection. The readmission rate is down. There haven’t been any patient falls or anything like that, patient injuries.

They don’t look at, oh, your staff just got beat up. Right? The burnout rate.

All of a sudden you had an uptick in sick, ill calls because of the burnout rate. Like, I just can’t do this. I’m not coming to work today.

So Tracie’s calling it getting beat up, but that’s another legitimate major issue for health care workers.

Basic safety.

We’re talking about workplace safety. I shouldn’t go to work and feel like this might be the last day that I’m able to do my job. Right.

I have had to run from 300 pounds, six feet men that unfortunately happen to be children. But when you’re six, three and 300 and some pounds, you’re a man. I’m sorry.

I’ve been hit with chairs. I’ve been punched. I’ve been kicked, hair ripped out of my head, spit on during COVID.

Patients would purposely try to grab your mask off of your face and spit on you. Those are poor working conditions.

I look at nursing and when I first started, I was like, I never thought in what world did I have a job where you could be sexually and physically, you know, and verbally harassed. And that’s okay.

The American Hospital Association did a study back in 2022. That study showed that in that year, an estimated 16,990 workers in hospitals had a violence related non-fatal occupational injury or illness that involved days away from work.

And another 8,740 hospital workers had days of restricted work activity or job transfer due to violence related occupational injury or illness.

That same study showed that frequent exposure to workplace violence has been found to increase levels of burnout among healthcare workers. It’s also found to lead to compassion fatigue.

Healthcare workers can experience a decreased desire to interact with patients and their families after experiencing workplace violence. Do you guys have like panic buttons?

So we do have panic buttons in certain units. One of the biggest things during our negotiations just recently was panic buttons. That was a big topic.

During negotiations in 2022, we got what’s called a letter of understanding. So it’s not more a letter of understanding. It’s just like, hey, we understand that we’re working on this and we’re going to do this.

And we’ve put this into our contract. Was to get panic buttons for all units. That’s what we want is every unit.

So in the behavioral health departments, I have one personally that I wear on my person. It’s assigned to me.

When I push it, there is it makes a little sound on my unit and on a couple other units in my building, and it says, Tracie Ducksworth needs help. And it says where I am.

So if I got transferred to the unit across on the other side, if I’m still wearing my button, it’s going to tell me I’m on that unit. If you’re wearing it on your person, that is something that you can press immediately.

It’s not going to solve all problems. No, if I got hit and I got knocked out, obviously I couldn’t hit it.

But when you’re in a room and somebody doesn’t know where you are and they know that you’re assigned to five different patients and one can be down one hall and one down the other, they don’t know where you are.

And Tracie’s mental health unit does have those panic buttons and she says that they’re helpful. But to date, that hospital does not have these panic buttons available for every nurse on every unit.

So we are asking that all units have these buttons available to the nurses to use. Because people with mental health have medical issues.

And what we’re seeing now is that our mental health patients sometime are aggressive and violent patients and are getting admitted to our medical units. And these nurses, they’re not equipped to handle these patients.

They weren’t, in the past, they weren’t trained to restrain patients. They didn’t know what medications to get. They didn’t know what to ask for.

They weren’t trained in de-escalation. So at least having that button to say, hey, I need help, and having that button go to security.

I asked Tracie if she felt like she and the other nurses were overworked or if she had seen lots of turnover due to all these issues. This is what she said.

Right now at our hospital, 60% of our hospital staff have five years or less of nursing experience. And that says a lot.

Wow.

And…

60%?

60% have five years or less of nursing experience. So when you walk in that hospital, you have somebody that has been a nurse for less than five years. It’s crazy.

And the significance of that number when you say about turnover rate is because essentially you almost have the blind leading the blind. Out of 100 nurses on a unit, 60 of them have five years or less.

If you hire somebody new, that means you have a 60% chance of being oriented by somebody who has… Exactly. And that’s a problem.

So how do you keep that when you’re not learned… The seasoned nurses aren’t there. They’re tired.

We’re, you know, we’re tired. It’s no fault of their own. We’ve got the COVID nurses now.

So this new year batch are the COVID nurses that didn’t have clinicals. All their nursing school was online. There was no human interaction, you know, computer simulations and dummies.

Those are the ones that just graduated in 2024. If you think about 2024, even now that started 19, 2021, they’re going to need a little bit more attention.

They’re going to need a little bit more, but then also they don’t know what they’re getting themselves into because you do see a lot when you go into the hospital on your clinical rotation.

You can decide, oh, this is not for me or this, yeah, when you’re in that setting. So it’s a wake up call. A lot of them are just going on.

They’re going on to management. They’re going into work at home fields now, consulting, nurse practitioner. So they’re not staying anymore.

The younger generation just isn’t staying like they used to, but gone are the benefits of being a nurse long term.

I’ve done my eight years. I’m up there in seniority now. Now I’m at a place where I’m not worried every time I want to go on vacation.

But nobody sees it because our society has changed and the views on work has changed. Part of M&A and as a union is trying to maintain the nurses at the hospitals that we have and to show them the benefits of being part of a union.

Tracie told me that the union provides a number of assurances to nurses. There’s a great pension. There’s protection.

The union will provide representation to sit with you in meetings with a manager. There are clear rules about rights involving sick calls and maternity leave and a host of other things. It’s like the Justice League for nurses.

I asked Tracie to explain to me more about the process of union negotiations with the hospitals.

We have written into our contract that the hospital will pay a certain percentage of the insurance premium. So it’s a higher percentage payout by the hospital than the regular plan that all the other employees have.

But that’s written into our contract. That’s like one of the great things of the union. You get this put in a contract, it’s legally binding.

Right? This year, they wanted to get rid of our M&A plans, which would raise the cost of insurance significantly for a big majority of our nurses.

I would not be able to afford the insurance that I have if they had taken away the insurance plan that they were trying to take away. So, you know, you look at them and you’re like, okay, this is a proposal that is an absolute no.

There’s really nothing to negotiate, right? Like just no, we’re willing to bargain this. Like, so you have things that are in there and they do put a lot of things in their proposals just like us.

They’re like, it would be nice to have this, but we don’t have to have it because now I can say, I’ll take this off the table if you keep this and vice versa. It’s like haggling a car almost.

So what the employer, I’ve noticed, likes to do is play the public opinion game. Oh, look, they don’t care about the patients. They’re all about their money.

They only want X, Y, Z.

This is during negotiations.

During negotiations, right? Well, I mean, you have to realize during 2022, we were heroes until we were negotiating a contract. Then we were just greedy and didn’t care about our patients.

We were just healthcare heroes up until you want a pay raise, a livable pay raise, right? When you go in for your thing, you’re going to go high. You’re haggling a car.

A car salesman is not going to come in there and be like, this is MSRP price and that’s what I got for you. They’re going to say, this car is $40,000 and you’re like, I’ll give you 35. Do you know what?

Oh, I’ll give you 20. You know, you drop it down, right?

Let me get it for this, but you know you’re going to have to pay more or vice versa. It’s going to be, you’re going to get less.

Right. So no, it’s not about, oh, I’m so greedy. I did not want a 45% raise in 2022, but I knew the only way that I’m only going to get close to anything that I need is to ask.

You got to shoot for the stars to reach the moon.

It’s funny to me how hospitals haggle with nurses over 3% increases, when from 2014 to 2022, private insurance saw a 61% increase per enrollee. And from 2009 to 2024, the Consumer Price Index for Medical Services went up by 54.5%.

That’s over 3.5% per year. So with 3 and 4% increases each year, the nurses are literally just asking for their rightful share. Also, there’s inflation, but I digress.

What were the asks this time around?

From our standpoint, a big sticking point was staffing ratios, panic buttons, and safety. The biggest thing is that when you’re talking about the staff safety, nurse safety, duress pagers, everything, that actually goes hand in hand with staffing.

If you are understaffed and not giving the attention and meeting the needs of your patients, they’re gonna get agitated. They’re already in a very difficult situation. They’re gonna get agitated.

They’re gonna be upset, and they’re gonna take it out on you. And that’s less likely to happen if there’s enough staff to take care of these patients.

You know, if you’re not sitting in a waiting room for five hours in severe pain waiting to be seen, you’re not gonna yell at people. So they go hand in hand. On the personal panic button specifically, we’re one that was a big topic of interest.

We did have AI was in there. Just want to make sure that, you know, AI is a big thing and it’s moving fast right now, but we don’t want it taking the place of people’s jobs. You’ve seen those hospitals.

Well, the hospitals have like, I don’t know if you’ve been to the sushi restaurant or that little, you know, the robot cat that comes to your table with your food.

There’s actually certain hospital systems in the country that actually have those robots that like go deliver meds and stuff to the rooms.

You’re replacing workers with, I mean, okay, I don’t think it’s a robot cat in the hospital, but, yes, with those kind of things. So there’s a lot going on, because telemedicine is a new avenue.

So there’s a lot that we were looking at that will be brand new to our country. I’m not going to say changing, but AI is new. It’s ever changing.

We don’t know what’s going to happen. That was another hot butt topic as well. Our wages weren’t that big a deal.

The hospital really wanted to crucify us because we just wanted to wait to talk about wages. And part of it was the staffing ratio piece. We understood the financial implications of that.

Now, if you’re going to agree to these staffing ratios, we’re not going to be like, hey, I want a 20% raise over three years. I’m going to understand. I’m getting help.

We’ve got, there’s a give and take there. So they wanted to crucify us with the whole, well, how do they say it? Your union won’t discuss X, Y, Z.

That’s how they represent it to the nurses. They try to separate us saying their union because they fail to realize the nurses are the union.

But when it comes to dealing with union matters, it’s always your union won’t let us do what we want to do to help you to separate the nurse from the union.

We had a bill, the Keeping Nurses at the Bedside Bill, which had a lot of nurse safety things.

It was staffing ratios was part of it, made it all the way through, and was vetoed by the governor because the mail threatened to pull out of the state if it went through.

They either wanted to, they didn’t want it to go through, or they wanted to be exempt from it, and they threatened to pull out of Minnesota if it went through, so it got vetoed. But we made it all the way through legislature with that.

Do you know what their hang up was about that particular bill?

Well, one, mail is an anti-union hospital. Let’s start with that. Two, they don’t want to be told what to do.

The hospitals don’t want to be. Like I said, if I tell you that if your ICU has to have one nurse to every two patients, you have to pay for that many nurses, or you’re going to get a penalty, that’s going to mess up your bottom line.

What if I find out that I can be in the black by three patients to one nurse? They don’t want that line. We’re not allowing flexibility is what they say.

We’re not allowing you to make cuts for your profit.

You guys reached a settlement basically on this contract, and how did that get done?

A lot of crying. The last three days of the contract negotiations were horrible. I think we probably did 18-hour days for the first two days.

The last day of the negotiations, we negotiated I want to say for 22 hours straight.

In this year’s negotiations, Tracie told me that the hospital wanted to cut down accrued sick time hours from over 700 hours of accruals to 80 hours.

The logic is that it’s easier for the hospital if short-term disability kicks in faster, so they only have to pay 60% of the employees’ salaries for the extended period where nurses are out on leave.

In this negotiation, the nurses got some of their ass fulfilled, and others had to go. For example, they kept the sick time accrual, but they have something called mandatory low need days.

This is where nurses basically get told, hey, we don’t need you, don’t come in today. And they just don’t get paid for that day. But this rule only applied to nurses who were 0.6 or under.

But in order to keep the sick time accruals, they had to give up the exemption for 0.8 nurses from low need days. The hospital also wanted to increase the amount of mandatory low need hours from 16 hours to 72 hours.

That’s nearly an entire full-time pay period. Luckily, that ask from the hospital did not go through.

When you think about like what your CEO makes and what some of the higher ups make and some of the asks that you have, like how do you feel about it?

I think it’s sad. It’s, I think I’ve met this man in eight years once. And I would say that if it wasn’t for me being so vocal in front of cameras, he wouldn’t know who I was.

And I don’t think he needs to know every nurse and who they are, but I need him to be in our hospital. Like, make yourself present.

He’s hiding behind locked doors in their corporate building, making decisions on things he knows nothing about, to be honest with you. Our CEO at our hospital was a teacher. He was part of a union and he was up there.

I mean, I want to say one of the lead negotiators in our bargaining team for the teacher’s union. That’s sad to come and dispute all the things that you say about a union and all about your money with your multiple houses.

And you’re talking about, we, you know, especially in 22, like, oh, we’re all about the money. We’re not about the patient care. But nobody went to work during COVID.

The managers, actually, even the nurse managers on the units, got to stay home. And we went to work every day and put our lives at risk. And you got a bonus.

Like, we isolated ourselves. Had family members who, you know, with health issues, cancer, all of that, right, who had to not even stay in the same home as their family members so that they could go to work.

And that wasn’t necessarily about the money, per se. It’s all, it’s going to be about the money, right? We have bills to pay.

We have families that we’re taking care of. We didn’t do that during COVID because we’re like, oh, we’re going to get banked at the end. But at the same time, when we do ask for a raise, we’re greedy and we don’t care.

But where were you when the patients needed you?

When all the staff was calling out sick, and I mean, when I say all the staff, not just the nurses, but everything that affects us, dietary, short staff, that affects our patients’ nutrition, housekeeping.

We ended up mopping floors because they’re stretched so thin, we couldn’t even get the rooms clean. Why didn’t you come in and help? Let me wipe down a counter or two.

You don’t have to do the nursing care, but you could have, oh, I can push this tray up to unit eight while you go push this one to this one, something, right? No, you got to sit at home and watch the cameras to tell me what I am and I’m not doing.

You’re calling staff like, oh, you shouldn’t be on your phone.

What? Right.

But you’re sitting at home. So why do you get a bonus for that? Running a company is your job.

Making sure your company is in the black is your job, but reinvesting in your company that you’re running as a nonprofit is also your job.

And you’re routing those funds, $1.4 million bonus could be put, that bonus could be put back into the hospital to renovate the, or expand your emergency department that people don’t have enough rooms for, or get duress buttons for your staff to be

safe. Instead of remodeling one of your multiple homes, because it’s apparent if you have two homes that you can pay mortgages on, then I think you’re okay.

When all the people that work under you are barely able to pay their mortgages and you want to call us greedy because we asked for a 5% raise, or whatever raise we asked for, that’s sad.

What percentage of people are ever going to be in that position? You’re always going to be the working class. Your honor is going to be replaceable and you’re always going to be a cog in the machine until you realize that you are more than that.

And we need to find a way to hit them where they can and that’s why we’re more vocal and the union is fighting that because you shouldn’t get a bonus for doing what you’re supposed to do.

And I just think that, you know, in itself he should be ashamed of himself because he could always turn it down.

What would you say to them to try to get them to be more educated or on board with this type of work and perspective?

I would say you don’t have to be in, jump in and be involved, but be educated. Know your worth. That’s, we got to start with that.

First and foremost, that’s in any relationship. Know your worth. Stand up to them.

Let them know that it’s not tolerated, because when you have enough people who allow things to happen, it’s going to continue to happen. Not to quote my mother. You promote what you permit.

It is when you get scared, when you do see the people who speak up that kind of gets retaliated against, so to speak, the reason that they retaliate against those people is because they’re trying to intimidate you.

If the entire department spoke up and were upset, and that’s why strikes are so important, right? One or two nurses like, this isn’t fair, doesn’t work. 2,000 nurses walking off the job says, oh shit, they’re not playing.

So, that was, when we went on strike, that was 2,000 nurses saying, we know our worth and you can’t replace all of us. And that is the biggest thing I could say.

Anything else I didn’t ask you about that, maybe you feel like people should understand about what you do and the task at hand?

I mean, check on your nurse friends. Guys, we’re not okay. And I don’t say it in that respect.

I think that we are caregivers by nature. And when you take so much time taking care of everybody, you forget to take care of yourself. It’s very taxing.

It’s very stressful. I am not a doctor, so I cannot technically diagnose, but I will say that there are a lot of nurses out there walking around with PTSD. We’re in a different war.

You know, you think of PTSD as significant traumas, but nurses work through COVID, and we watched people die day after day, and there was nothing we could do about it.

Mental health nurses, ED nurses, were getting assaulted on a bed, and hypervigilance really leads to burnout when you’re looking over your shoulder and every single clink and clack.

And that affects our home life, and that understanding and knowledge, and what can I do for you, and just giving that five minutes when they come home to let them decompress. You know, if they want to talk about it, just listen.

If they don’t, leave it alone. But we need to take care of ourselves because nobody else is taking care of us. And we can only be Florence Nightingale for so long when we have to take that hat off and be human beings.

And our quality of work and our working conditions also include safe patient care. So when we’re talking about safety, we’re not just talking about the safety of the nurses.

We’re also talking about the safety of the patients because patient care is our working condition. So that is the main goal of the nursing union. We want affordable care for our patients.

We want safe care for our patients, as well as safe working conditions for ourselves.

Tracie Ducksworth, thank you so much. Appreciate it.

Oh, thank you.

All right, so maybe it’s not exactly like the Avengers. The Avengers don’t sit in a room for 22 hours finishing negotiations with Dr. Doom.

They just get to throwing hands and hoping that they can stop him in time to prevent global destruction. But real life requires real work, like that of all the MNA and all the other individuals working in healthcare.

Sometimes it’s our job to change a bed over where the patient is heavy and you don’t have help. Sometimes it’s our job to feed someone who is cussing you out or throwing shit at you.

Sometimes it’s even our job to calm down the brother or aunt of someone who’s had a heart attack, where they don’t understand why things aren’t improving, or when our coworkers haven’t treated them properly.

But sometimes it’s our job to speak out and act against the unethical decisions made by a more than $4 billion a year company, when the impact lands on its employees, its clients and its community. This has been Thanks For Asking.

I’m Marcel Malekebu. Our team is Nora McInerny, Grace Berry, and myself. Our theme music is by Geoffrey Lamar Wilson, and our ending theme is by Q.

This show would not work at all without support from you guys, so thanks for everyone who listens or subscribes. You can find us on Substack at at Nora Borealis. The highest tier of support on Substack is that of supporting producers.

Those are the people who have supported at a certain level where we read their names and the credits. So here we go.

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