NEWS & LETTERS, May-June 2012
Workshop Talks
Spy on workers, but overlook patients
by Htun Lin
If time is money, hi-tech forces us to count time down to the millisecond. The stock exchange on Wall Street is now controlled by super-fast computers making automated billion-dollar trades in a split second by counting differences of fractions of a penny in the price per share. We're constantly counting so much that our world has lost sight of what really counts.
At the HMO where I work, our company has invested billions of dollars in a super computer system which is able to count everything, from how many pieces of gauze are used on a patient to how much nurse-time each patient expends. Everything is tracked for cost control, up to the minute and down to the penny. An obsession with quantitative measures predominates, but because of state regulations the company pretends to monitor "quality" of healthcare.
Originally, it was consumers and labor unions like the California Nurses Association and service workers' unions who successfully lobbied our state legislature to enact quality care monitoring. But management always found ways to turn those watershed laws on their head.
Take, for example, the state mandate for a minimum nurse-patient ratio. When that became law, management started to reduce support staff around nurses. They successfully trimmed the workforce in housekeeping, unit assistants, nurses aides, LVNs, and transportation aides. Frontline RNs now have to fill in those gaps. They have suffered an increase in back and other injuries from this extra workload.
Due to this speedup, there has been an increase in error rates. Whenever one of us makes an honest error in our daily routine, either with a patient's medical number, or other medical data, management will turn a simple error into a federal case. The shop floor now feels like a police state.
HI-TECH SNOOPING
Technology is used not to enhance care, but is deployed as hi-tech snooping on employees. What do they police? Mostly the money, but also to catch employees in "gotchas" to discipline and trim staff.
They install surveillance systems under the pretense of quality care monitoring, but we workers know it's really about how to apportion blame when things go wrong. For example, state-of-the-art electronic devices detect whether a nurse has washed her hands and how many times, or whether a patient has been placed in a room within a specified amount of time.
Never mind that the room doesn't have adequate facilities, or that the nurse is spread out to many rooms in separate wings on the floor with insufficient support staff. Never mind that the nurse is unable to tend to the new patient, because she is busy tending to requisite data-entry for the last recent admission, or that there are no instructions from the doctor either, because the doctor too is hampered by computer protocol.
When some mishap in care or breach of patient data occurs, or when these tracking and monitoring systems register a failure, administration will blame individual workers and not take responsibility for system failures. Their system compromises both patients' safety and workers' safety on a daily basis.
DESIGNED TO FAIL
We workers don't oppose monitoring of quality of care. In fact, it was workers' initiatives which first brought landmark contractual language on quality care. But don't just lecture to us, or police us, under a system designed to set us up for failure, indeed, expecting failure in order to assign blame.
What we have is a healthcare shop floor turned into a factory where patients are treated like commodities on an assembly line, and employees are treated like appendages to the information super-machine.
We sorely need healthcare reform in this country, but that's not what politicians are fighting about. They're only fighting over what they call cost control. Tens of thousands of people continue to die every year unnecessarily from HMO errors and negligence. Hundreds of thousands more are injured because frontline healthcare workers are so hurried, harried, and harassed. Frustration on the job is rampant. Only workers' own initiatives can shift the ground back to real healthcare.
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