Finger pointing is easy. Figuring out what to do about labour relations in healthcare is harder.
See this recent story: Patient Dies During Hospital Labor Dispute
California authorities are investigating the death of a patient at an Oakland hospital that police and hospital and union officials said resulted from a medication error made during a labor dispute between nurses and the health system that runs the hospital.
Police and officials at Alta Bates Summit Medical Center told the local media the woman died after she received an incorrect dose of medication administered by a replacement nurse. At the time, regular staff nurses employed by Sutter Health System were locked out following a one-day strike by 23,000 nurses across the state….
A couple of things differentiate labour disputes in healthcare from labour disputes in, say, the auto industry. One is that in healthcare, the “labourers” tend to be licensed professionals, subject to a code of ethics, etc.
The other difference is that, in healthcare, there’s always a shared focal point for ethical argumentation, namely the patient. Both sides in a healthcare labour dispute have to put some of their most central arguments in terms of patient wellbeing. In the auto industry, by comparison, there’s much less common ground. Sure, both GM and the UAW have an interest in making sure the company stays in business. But beyond that, it’s “us vs. them.” Every dollar gained by the workers is a dollar lost by someone else (managers, shareholders, etc.) In healthcare everyone has to bow to patient interests. You can be as cynical as you want about the other side, but you still know that, in public at least, the arguments they give must give priority to patient wellbeing.
One final note: an ethicist quoted in the story above blames inadequate compensation for troubles like this. I’m skeptical about that. I don’t doubt that wages are an issue. But higher wages wouldn’t necessarily mean fewer labour disputes. You would likely still see the regular cycle of negotiation, strike, contract, period of calm, and then renewed negotiations. And so on. And after all, wages aren’t the key issue in the eyes of nurses, are they? What do you think?
The Nursing Ethics Blog 
This is a sad situation and the fault could be shared. I do believe that wages were a contributing factor here however, higher wages does not eliminate the fact that higher wages could lead to fewer nurses and labor disputes will probably continue. I would also assign blame to the hospital and the nurse that administered the medication. Patient care and patient safety should be the overriding factor and should not be compromised. Although the hospital brought in replacement nurses, what standard of care was in place, did the nurses receive orientation, what were their qualifications?
Carol:
Thanks for your comment.
It’s also worth pointing out that medication errors are relatively (and regrettably!) common to start with. So the fact that an adverse event happened during a lockout doesn’t mean that it happened because of the lockout.
Chris.