Treatment of Nurses Supports Social Conflict Theory

I have a deep rooted respect for nurses. Three of my father's sisters were nurses. They provided frontier (horseback) nursing services in Appalachia, served as military nurses in World War II, and in civilian hospitals for decades after the war. In my generation on my father's side both of my female cousins became nurses.

Nurses form the first line of defense in our health care system. When we visit the doctor's office a nurse is the first health care practitioner we meet, and often the one that interacts with us the most. When we enter the hospital the majority of our care comes from nurses.

The training for nurses is challenging and demanding. I know because I observe it happening in my own college. Not everyone has the intellectual ability or the emotional stamina to become a nurse.

There is a documented shortage of nurses in this country. One that gets worse with each passing year.

So we have an occupation that provides an extremely important, valuable service (function) for society, which also requires extensive training that not just anyone can do, and there is a demonstrable shortage in this valued occupation. Structural-functional theory in sociology (Davis and Moore "Some Principles of Stratification") would suggest that nursing should be a highly rewarded (both in monetary terms and in a wide range of benefits), and highly regarded occupation. If structural-functional theory were correct, nurses should be able to write their own ticket when it came to pay and working conditions.

Not being a big fan of structural-functional theory, it doesn't surprise me that the theory fails to accurately reflect the real world treatment of nurses.

This week, in the Appalachian region, more than 650 registered nurses in the Appalachian Regional Healthcare System are on strike when their contract ended and negotiations failed to produce a new contract. While pay is an issue in the contract dispute (the offered 2% raise would be entirely swallowed up by increased cost of health insurance and decreases in holiday pay), the nurses greater focus is on the issues of benefits and staffing/work schedules.

The new contract ARH put forward, offered the nurses "flexible" scheduling -- it offered the the choice (!!??) of 10 hour shifts or 12 hour shifts. ARH nurses are required to work overtime, every week. Overtime is a mandatory condition of all ARH nursing positions.

The practical result makes it common for the actual nurses shift to be 15 hours, and 24 hour shifts happen all too often. Not only are nurses stretched thin in overly long shifts, but they are covering greater numbers of patients during those shifts. These conditions are not only draining the nurses, but they compromise the levels of care that are provided. A Lexington Herald-Leader article on the strike provided comments from a number of the striking nurses such as:

Lynn Hall, who has been a nurse at McDowell for 16 years, said she is the only person who works in the hospital's four-bed intensive-care unit.
"I don't even have someone to help answer the phone," she said. "It's just the opposite of the way it should be. A hospital should strive to have nurses with high morale, instead of walking out with tears in your eyes because you couldn't do it all."

The ARH response to all this? They aren't even trying to negotiate. They have already started looking for permanent replacements, while in the short run they bus in nurses from temp agencies. Nothing could make it clearer that the occupational realm is one governed by conflict and power, with the hospital administration holding most of the cards. The nurses recognize, but regret the struggle.

"Still, Hall and the other nurses said they would rather be working than striking.
"We don't want to be here," Tanner said. "We tried not to be here. We just want to negotiate the rest of our contract."

The only hope the nurses have is support from the general public. Unfortunately most people in eastern Kentucky have few choices. For those who do, consider taking your medical business else where, to hospitals and clinics where the nursing staff is treated more fairly and with the respect they deserve.

Hijacking the language

David Horowitz, who has made it his life's mission to root out all vestiges of liberalism from American universities, posted an article in FrontPageMagazine.com today. His attack is focused on the University of California at Santa Cruz, for vioilating the “Standing Orders of the Regents,” (passed in September 2005) which states that "political indoctrination and partisan interest" are outside the purview of college curriculum. Horowitz primary evidence that UC Santa Cruz is in violation of this policy is the following statement: “The UCSC faculty offers courses related to social justice -- including broad structural and social changes and community based organizing...”

Silly me, I thought that "social justice" was one of the most broadly based American concept imaginable, with roots in the Declaration of Independence ["all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. — That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, — That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness"] and the Constitution of the United States ["We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity,"]. Seems to me that both of these documents (specifically the passages above) indicate that the concern of our founding fathers was in justice within our social life, or social justice.

I think David Horowitz's article says far more about the partisan, conservative political agenda that he wishes to promote, than it does about partisan politics as USSC.

Education and Economic Justice

My first reaction to Thursday (June 28, 2007) Supreme Court decision on race and education was dismay. It seemed, to a life long leftie like me, to be a horrendous step backward. But over the past few days, as I read articles from various papers around the nation, it occurs to me that this is instead a tremendous opportunity to turn the focus where it really should be -- on issues of social class.

The Christian Science Monitor today noted that many of those concerned about issues of equity in education feel "it would be more practical for districts to shift toward balancing school populations on the basis of factors such as income level."

Cited in the CS Monitor article:

"The socioeconomic approach offers two advantages," says Richard Kahlenberg, author of a new report detailing such plans and a senior fellow at The Century Foundation, a progressive policy group in Washington. First, districts that have done it most successfully give families a choice of magnet schools with special programs, "so there are incentives for middle-class people to buy into socioeconomic integration," says Mr. Kahlenberg. Second, "as a legal matter, it's clearly fine to use income to distinguish people."

If we are honest about it, the only reason for anyone to be concerned about inequities in education is because education has consequences for the material and economic conditions in which people live. Concerns about racial segregation were never about an abstract access to "knowledge," but rather about practical access to power (political and economic) and the pathways to full economic opportunity.

It is time now to focus on making sure that our schools are integrated by social class, and use things like income, home value, and neighborhood residence to create diversity in the schools. If we have social class diversity, then racial and ethnic diversity will happen as a matter of course.

Perusing the Web

During the school year, I spend hours a day at the computer, responding to e-mails from students, colleagues and organizations, reading and responding to student forum posts in my on-line classes, and grading papers. I also use Google, every day, to find ideas and materials for my courses.

Now I'm on vacation, but I'm still spending hours a day at the computer, because there is just so much to read, see and hear on the Web.

I decided that I needed to get more systematic in reading the news on-line. [Although I still spend a couple of hours a day skimming news on television and cable, the quality of "news" available on the tube has severely deteriorated]. So I created a Google home page, and pulled in lots of news feeds.

And I learned, once again, why it is that I don't keep up with the news on the Internet all the time -- every time I read one news story, I end up following a link to something else, which links to something else, which reminds me of something that I want to Google, which leads to new pages that have links that cry out to be followed. Three hours later, I am still sitting in my nightgown with cold coffee, and have not yet read all the news I wanted to read because I fell down a rabbit hole into Wonderland.

On this particular trip down the rabbit hole, I discovered something called City Journal (the city in question being New York of course). What led me there was an article by Sol Stern
"Radical Math at the DOE" -- which refers to the Department of Education (in NY), not the Department of Defense, which had been my first thought.

Stern was decrying a conference which provided opportunities for math instructors (from elementary through high school) to learn ways of incorporating social justice issues in math lessons. Aside from the fact that I heartily approve of inserting lessons on social justice where ever one can, as someone who teaches statistics to unprepared and math phobic students in college, I consider any approach to teaching math in public schools that might actually engage students interest in the subject and make them desire to learn math all to the good.

What I was particularly intrigued about in Stern's article was the following:

Mayor Michael Bloomberg has won plaudits from business leaders for his corporate-style reorganization of the school system, and for supporting market-oriented education initiatives such as charter schools and merit pay for teachers. But the mayor’s supporters have been reluctant to acknowledge the downside of this new approach. Bloomberg and his schools chancellor have also taken a laissez-faire stance about what gets taught in the city’s classrooms....It’s ironic that while Bloomberg extols the benefits of the market in education, his schools are becoming rife with radical teachers using the classroom to trash the American system.

First, I thought that "laissez-faire" was the absolute essence of market capitalism. If laissez-faire is appropriate for business, and one wishes education to emulate business, then it would seem appropriate for education. [Note I say "if" one wishes education to emulate business. Be assured that I, as a left wing radical certainly do not wish that, but Stern seems to heartily approve a market approach to education.] Secondly, if in fact one does wish education to emulate the capitalist market, then it would be for the consumers of education to determine the appropriateness and/or desirability of what happens in the classroom. Has it occurred to Stern, that perhaps social justice is what the people want?