Debbie Cuaresma has been a registered nurse for the past 22 years, witnessing first hand the changes that have roiled the health care system in Southern California and the state, especially over the past decade.
She has had to care for ever needier patients, as managed care gatekeepers have kept all but the sickest out of hospital beds. She has found herself floated to wards where she has felt unskilled because of a shortage of co-workers. She has worked 12-hour plus shifts dead tired.
It's not the same as when she started.
"I used to go home feeling, "I made a difference today," said Cuaresma, now a cardiac unit nurse at St. Vincent Medical Center in Los Angeles.
"Now, I wonder, "What did I miss? Could I have done any better?"
Unlike many of her colleagues who have left the hospital setting for seemingly greener pastures elsewhere, Cuaresma has stayed. But now she is a member of the California Nurses Association, which organized the hospital's registered nurses in 1998 capitalizing on such discontent.
That campaign was among the first for the association in Southern California since the early 1990s. And it turned out to be more than a hint of what was to come.
Over the past two years, the CNA, and its rival, the Service Employees International Union, have organized seven Los Angeles County hospitals, and others regionwide. The CNA only represents registered nurses while the SEIU largely represents lower skilled workers, but also RNs.Elections scheduled
Indeed, within the next few weeks, SEIU elections are planned at three Los Angeles area hospitals, including one for RNs at Northridge Hospital Medical Center and technical, service and maintenance workers at California Hospital Medical Center in downtown Los Angeles.
The industry maintains that the nurses are mistaken if they think the unions are going to quickly improve conditions that it acknowledges are difficult.
"I think the world of nursing is often very, very demanding and exhausting," said Mary Dee Hacker, chief nursing officer at Childrens Hospital Los Angeles, which remains non-union. "Many nurses are trying to find an answer. But the answer is not found in a quick fix."
While the nurses have various specific gripes with individual hospitals, the underlying complaints by the unions are consistent against all of them: They contend that fewer nurses are being forced to work longer hours to take care of greater numbers of patients who are sicker than ever.
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