Prizing the Frontline, Not the Bottom Line, in Wisconsin

The goal of the Wisconsin Federation of Nurses and Health Professionals (WFNHP) Code Red campaign is to engage healthcare workers in healing our healthcare system and making it sustainable again—which our members and our patients desperately need. The corporate model of healthcare prizes the bottom line over the frontlines and over patient safety. It has driven healthcare workers to the breaking point. The pandemic lit healthcare on fire, laying bare its structural issues and demonstrating just how unsafe and unsustainable corporate healthcare’s “do more with less” approach is.

For years, our members have worked under grueling conditions, increasingly unable to care for their patients in the way they signed up to do. We’ve heard stories of those who left the bedside because workplace stress threatened their health. Commonly, members work 12-hour shifts without being able to take bathroom or meal breaks. And some have been unable to refuse unsafe assignments for fear of discipline or termination. The extent to which healthcare workers, and nurses specifically, are asked to absorb more responsibilities and forgo a personal life or work-life balance is frightening. Administrators claim it’s necessary because of a pandemic-driven staffing shortage—but in truth, the shortage is a direct result of years of corporate decisions made to increase profit.

In December 2022, the New York Times investigated one of our employers, Ascension, which operates St. Francis Hospital in Milwaukee.* Ascension has been cutting staff since taking over the hospital in 2017—cutting our bargaining unit in half by 2020 and closing labor and delivery services in late 2022—and awarding millions in executive bonuses for keeping labor costs low. St. Francis serves primarily Black and Latinx communities, and these decisions just worsen the acute inequities that exist in Milwaukee, where segregation and inequality are rampant.

Now that the worst of the pandemic is past, healthcare workers also have a decision to make. Do we normalize the deterioration of our working conditions? Or do we fight to make healthcare the way it ought to be?

WFNHP decided to fight.

Wisconsin has no meaningful staffing regulations in place to keep healthcare workers safe. So this fall, we introduced legislation that establishes enforceable staffing ratios created by nurses and direct care staff. It includes a penalty for employers that violate their staffing plans, which will be established in accordance with a committee of direct care providers who work in the hospitals. And it doesn’t allow employers to use overtime as a tool to avoid staffing ratios—the bill bans mandatory overtime for nurses and asserts nurses’ right to refuse unsafe assignments.

Now, we’re advocating for the bill and persuading legislators to give it a hearing. That decision is controlled by the committee chairs, who generally work along party lines. But we believe this bill deserves bipartisan support. The Senate Health Committee chair, a Republican nurse practitioner, has a clinic outside of the insurance industry and well understands the problems with corporate healthcare. So we hope she’s responsive to the work we’re doing to demonstrate the need for safe staffing legislation.

In addition to this legislative push, we’re fighting to make quality care widely available to all people and to actively involve community members in decisions about the services offered in their areas. We have partnered with local groups in a coalition to restore needed surgical and labor and delivery services to Milwaukee, which Ascension closed in 2018 and 2022, and we’re continuing this coalition building to ensure that our communities can access the care they need.

We’re also taking advantage of organizing opportunities throughout Wisconsin, as more nurses and healthcare workers are looking to seize their power and take back control within their hospitals to be able to do their jobs safely. Our message is really resonating with people because the problems with the healthcare system are now clearer than ever. Instead of just complaining that healthcare is broken, we’re fighting for solutions that center patients’ and healthcare workers’ well-being.

It’s healthcare workers, not administrators, who go home at the end of each day wondering whether we did everything we could for our patients. So we are infinitely more qualified than hospital CEOs to fix what’s wrong at the bedside, on our floors, in our labs, and in the system more broadly. We are in a moment of incredible optimism and opportunity, and we’re making the most of it: we’re pushing forward in hope and leading with a vision of the way healthcare can—and should—be.

Connie Smith is the president of the Wisconsin Federation of Nurses and Health Professionals (WFNHP) and has worked in healthcare for more than 20 years, currently as a charge capture coordinator at St. Francis Hospital in Milwaukee. Jamie Lucas is the executive director of WFNHP.

*To read this investigation, visit go.aft.org/agm. (return to article)

[photo: courtesy of WFNHP]