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On Oct. 1, with the ratification of a new agreement by the University of Michigan Professional Nurses Council, a months-long period in which nurses at Michigan Medicine had been working without a contract came to an end. The extended negotiation period was due to hospital administration and Michigan Medicine nurses’s failure to reach a new contractual agreement that would properly resolve the workplace problems that had permeated throughout the hospital.

The new contract was hailed as an achievement by both staff and administration alike; a majority of nurses voted in favor of the new contract, and Michigan Medicine spokesperson Mary Masson called it “a fair agreement that recognizes the value our nurses bring to our patients and the organization.” While this is a cause for hope, it goes without saying that the current challenges and hardships that nurses face are not few and far between.

The union strike vote was spurred by a combination of factors, including staffing difficulties, wage issues and scheduling complications. Many nurses within Michigan Medicine have faced unfair labor practices such as mandatory overtime, which was detrimental to the work-life balance of Ann Arbor nurses. Also notable are the conditions in which nurses and other health care professionals work. Many health care professionals have had to face various pathogens running rampant while fighting on the front-lines to keep our communities safe.

Despite the importance of the work they do, nurses, both at the University and nationally, still lack the payment and wages they deserve. The strike vote by Michigan Medicine nurses aimed to fight back against these unfair practices, and, while many of these problems have been resolved on a local level with the recent contractual agreement reached, these issues extend far beyond Michigan Medicine.

Additionally, due to the grueling nature and financial burden of nursing school, it is important to note the challenges and sacrifices many nurses have to make to go through the proper education and licensing to practice in general. 

The discontent nurses have had with Michigan Medicine is reflected nationally within the healthcare industry. Various other strikes and protests are taking place throughout the United States because of this national shortage. The effects and reverberations of COVID-19 still resonate within the nursing profession, and it has caused a shortage of available nurses willing to work under these unfair conditions and insufficient wages.

These problems are all indicative of a greater, systemic issue within the healthcare industry in the U.S. With nursing being a predominantly female occupation, issues of systemic sexism and other forms of workplace abuse should be considered.

Despite the severity of the situation, there are still manageable action steps toward an improved working environment for nurses. Certain pragmatic solutions, such as paying nurses more, are still Band-Aid solutions over a gaping wound. A structural problem requires structural solutions, and, with hospitals at the root of this problem, we should look to them for the solution.

The first step is to stop treating nurses as interchangeable. Nurses can have very specialized roles. It’s commonplace for the criticality of the patient to exceed the expertise of a nurse in a unit. This issue is compounded when the nurse has multiple patients. Having a non-ICU nurse overseeing the care of ICU patients is an example of this kind of misallocation of resources. This leads to burnout, which can take a toll on their performance at work.

Hospitals must start prioritizing measures for infection control. For instance, more money should be allocated toward personal protective equipment, or “PPE,” for some of the most front-line workers: nurses. Employers also have a responsibility of ensuring the proper use of PPE, which requires the implementation of a PPE program.

While workplace changes within hospitals are necessary, part of the problem also lies in the education system. As older and more experienced nurses move on to other roles or retire, a large educational apparatus is necessary to keep a steady flow of replacements entering the system. Colleges and universities, however, lack the teaching staff and resources to accept all of the large number of qualified people applying, with nearly 80,000 prospective nursing students being refused admission to schools in 2012.

For a field with a turnover rate as high as 27.1%, these educational limitations spell disaster. Without new nurses, jobs cannot be filled and patients will suffer. In 2021, the number of registered nurses in the U.S. shrank by 3%.

After the COVID-19 pandemic and more recent monkeypox scare, we cannot afford to be caught this understaffed and unprepared. To keep supply in line with skyrocketing demand, state and federal funding is necessary to shore up our nursing education infrastructure. A key first step was taken this year in Michigan when Gov. Gretchen Whitmer and the legislature pushed through $56 million of funding for nursing education. This is an excellent start that needs to be built upon in the future.

With more than half a million nurses projected to leave the field by 2024, the problem will only get worse the longer we wait. In the meantime, while new nurses are educated and trained, we must focus on retention of the current labor force.

As nurse unions here at the University of Michigan and across the country push for better contracts, hospital administration must be receptive. Better working conditions will help relieve much of the burnout and stress these health care workers often suffer from. But monetary compensation and reduced overtime are not the only changes that must be made.

Despite their important role in health care, nurses often complain they feel disrespected at work. A job in nursing must also come with the dignity and gratitude it deserves. An atmosphere of support and appreciation would keep nurses on the job for longer and boost floundering ranks at hospitals nationwide.

Many deep-rooted problems must be addressed, both within the hospital system and the nursing education system. However, Michigan Medicine’s new contract marks a significant first step toward better serving and appreciating our valuable nurses. Laying the groundwork for future progress, the contract is a beacon of hope — not only for nurses within Michigan Medicine but for nurses across the nation.

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