Last month, President Obama invited people from across the country to a “White House Summit on Worker Voice,” advertised as an occasion “to highlight the relationship between worker voice and a thriving middle class.” Essentially, it was a fete for organized labor. Among them was Gawker writer Hamilton Nolan; another was Allysha Almada, a nurse from Pasadena, California.
Until recently, Almada worked at Huntington Memorial Hospital. When nurses at the facility started trying to unionize their workplace, Almada took a leading role. That is, until, she was fired. She told The Pasadena Weekly that she was informed she’d broken hospital protocol by sharing a computer password with another nurse, but said they’re required to remember so many it’s essentially impossible to without writing them down. The hospital gave some boilerplate about the matter to the Pasadena Star News:
“As any responsible employers would do, we respectfully declined to comment on the specifics of a personnel issue, however we can say our guiding principles in decision making are based on ensuring patient safety — and providing the quality care we have consistently delivered as a trusted community resource,” said Jim Noble, executive vice president and chief operating officer, in a statement.
Almada alleges it was a clear-cut case of retaliation for her dedicated participation in the union drive. (We reached out to Huntington for comment and will update if we hear anything.) And rather than go quietly, she’s speaking up. Not only did she appear at the White House, handing Obama a stethoscope, but she also made the rounds on Capitol Hill, appearing at a press conference with Bernie Sanders, meeting with Congresswoman Judy Chu and Secretary of Labor Tom Perez, encouraging support for bills that would aim to strengthen workplace protections.
“Overall, everyone’s been very supportive,” she said. “It’s just they’re gonna have a huge fight on trying to pass labor laws that are going to be stronger for us.”
I got a chance to chat with Almada about nursing, stereotypes, how she got into the profession and why she’s fighting for the union. This interview has been trimmed and lightly edited.
Tell me about why you originally got into nursing as a profession.
My mom’s a nurse at Huntington Hospital. She’s been working there for 30 years now, and I got into nursing because of her. I was able to be a volunteer at Huntington and actually volunteered on the same unit that my mom was working on, and growing up I got to see how she was with patients and her coworkers, and i just got to see that it really brought her a lot of joy. I got to see her make a difference with [her] patients. I definitely wanted to have that same type of impact on people’s lives as my mom did.
For our readers who aren’t familiar with the profession—with the understanding that there’s a lot of difference between various nursing jobs—I was wondering if you could explain a little bit about what’s involved in the job. Because I’m not entirely sure that people who don’t work in the field or haven’t spent time in hospitals really understand how much nurses are responsible for. For instance, the recent controversy about The View and people not understanding, say, that nurses use stethoscopes.
Well, nurses are the eyes and ears. Our shifts are 12-hour shifts, and we’re going to spend all that time at the bedside, caring for patients. So when I start a shift at work, I usually do a quick look over at the patient’s chart. I look at their labs, I look over some of their bio signs for the past couple of days and ask about any trends that the other nurse is talking about, if they’ve noticed anything. And definitely key in on how’s this person doing, is there any family issues that I need to be aware of, is there another stressor in the family, a death in the family, that could be putting a lot of stress on this patient and their caregivers.
A lot of the time the doctors rely on nurses and their assessments to help guide the decisions they make. The first thing that a lot of the doctors will come in and do is ask the nurse, “How did this patient do? What’s going on?” They really rely on nurses to be almost their eyes and ears. Because I work in the intensive care unit, a lot of my patients can’t speak for themselves. So as the nurse, I have to be the one that has to be like, “Hey, you know what? We haven’t started any feeding or nutrition for this person, we really need to start thinking about giving them some form of nutrition. When can we start that process?” Or, “I think that this option would be a good idea for this patient.”
I’m not going to try and talk trash about the doctors, because we do have really wonderful doctors out there. But nurses, our focus is not just on the one type of body system or their illness. We’re very concerned about the whole person in general. We’re not only treating their illness, but we want to make sure they’re supported mentally, we want to make sure they’re supported physically, we want to make sure they’re supported spiritually. Some of the questions we ask are, “Do you have somebody you need us to call? Do you need us to call a priest or a pastor or anybody special in your life to hug you in this moment?” And I feel like the special thing about nursing is it’s not just the physical, science aspects of it. We also really want to look at the person as just that—a person.
What did you make of the response to those comments? It feels like it got people thinking about nurses, thinking about the job you do. How did you feel about it?
I definitely was not surprised about the comment. I was very disappointed about that comment about it being a “doctor’s” stethoscope, but I wasn’t surprised. A lot of people have this misconception that nurses are just waitresses at the hospital. That all they’re there to do is pass pills and pass trays. But we really do so much more, and a lot of it is behind the scenes, that patients won’t ever realize, and nurses aren’t going to be the type to tell you, “Hey, I did X, Y, and Z,” or list every single thing that they’ve done. That’s not in them to do that. And it is a little frustrating, because as a nurse, there are moments where you are trying, you’re doing everything that you can for them, and then sometimes it does go unnoticed. But for the majority of our patients that we’ve come across and we’ve dealt with, they are very grateful and we have good, meaningful connections with not only the patients, but with their family as well.
Tell me how you got involved in the union drive at Huntington.
It all started because as a nurse, I wanted to be able to provide the best care that I possibly can for my patient. And I was noticing that there some cuts and there were some changes that were happening in the hospital that I felt were affecting my ability to care for my patients. We noticed we were short on supplies, like for example we were short on clean patient gowns or wash clothes, towels, and clean bed linens. And to me, those are some basic things that you need to care for a patient. In ICU we have a lot of patients who are constantly soiling themselves and soiling the bed, and all of that gets on their skin and they may have skin breakdowns and that puts them at risk of infection and more problems and bedsores.
And to me—this is a person. This is a human being we’re dealing with. You need to respect their dignity and their privacy. And to not to be able to keep them clean, I just feel is a violation of their human rights. So nurses like myself were very frustrated that we were short on, just, clean linens. And it wasn’t just nurses in my unit. It was nurses throughout the hospital that were noticing there were changes that administration was making without the input of the nurses and the nurses were feeling like that was starting to affect how they were able to care for their patients.
The nurses ended up calling the California Nurses’ Association, because we were just like, enough is enough. We tried talking with administration, we tried talking with our managers and trying to raise our voices and to find solutions to these problems, but the nurses just felt like they weren’t being heard. We felt like we were being put off and that there really was no effective change happening within the hospital.
I ended up getting into it almost early on. It was my mom who encouraged me to go to the informational meeting. And I asked them some questions, because at first I was pretty skeptical about how a union would be effective in helping with nurses and caring for patients. But I definitely did some of my homework and did my research and I felt like, you know what, this is what nurses need. We need to have a collective voice. We need to have a strong voice within the hospital.
I was going to ask—in a previous interview you’d mentioned you were skeptical initially, and I was curious what brought you around to the idea that a union would be the answer to this particular set of problems.
Well, I talked to a lot of my other friends in other hospitals that had a union and were organized, and I got to pick their brains a little bit. And the nurses they worked with and even they themselves felt empowered in their workplace. They felt that if there’s something that’s going on that they’re having a problem with or it’s affecting their patients, they have a voice in their workplace and they could actually have real change. For our nurses at Huntington, I know it’s been really frustrating in that we have these councils or committees for nurses, but any time we try to enact some kind of change, it feels like it just takes so long.
One of the things I was really impressed with as far as the California Nurses’ Association and understanding the importance of having a union, is that the California Nurses’ Association was responsible for establishing nurse-to-patient ratios in the state of California. And when I found that out, I was just blown away. Being naive, I thought that it just happened that somebody had figured out and that overall hospitals thought it was a good idea to have ratios. But really, it was the nurses who came together through the California Nurses’ Association and pushed to have patient ratios. So to me, it was a good signal that this is what we at Huntington Hospital need as nurses to have real, lasting change.
Are there reasons that nurses would be especially prone to unfair or inequitable working conditions or would face particular challenges that would require that collective voice?
Let’s take a look at how many nurses are affected by back injuries each year because of trying to lift and turn patients and get them out of bed. In the ICU, our patients are completely dependent upon us to move them in bed so we can prevent them having a bedsore, to keep their muscles from wasting away. We need to have better patient handling policies, which allow us to turn and move patients in a way that’s safe not only for the patient, but also for nurses.
And then, let’s take a look at the ebola outbreak that happened in Texas. Nurses were directly affected by that. They didn’t have the training or the equipment to protect them from getting sick. And that is a real fear. We need to have some protective equipment that protects us from getting sick. That way we can continue to care for our patients, but also so that we don’t go home and get our family members sick and we ourselves don’t get sick.
Being at the front line of patient care definitely puts us at risk for things like back injuries, as well as infectious disease.
Almada speaks alongside Senator Bernie Sanders at a October 6 rally to introduce the Workplace Democracy Act in Washington, D.C. Photo via NNOC.
Do you think that part of what the dynamic is here is that there’s an assumption that nurses are women and doctors are men?
I definitely think so. Nursing is still predominantly women. It’s a women-associated profession. We do have quite a few male nurses that are still coming into the profession. But I remember very clearly that at work I would come into the room and have a male nurse with me, and some of the patients would just talk to the male, my coworker, who was also the nurse, and say, “Hi doctor,” and automatically dismiss me.
I still think that there is an overall cultural perception about nurses, and I know that nurses have been working really hard to change that perception that nurses are just a helpmate.
Yeah, it seems like that stereotype is one you guys struggle with.
It’s a little bit understandable, because women today are still expected to be part of that caring, nurturing role, and I think a lot of people look to that. You think of your mom and you think of how she cared for you when you were sick. You think of nurses, and you think of your mom caring for you when you were sick. You don’t think of a man walking into your room, caring for you the way your mom did. It’s a little different, and it’s been a challenge for nurses to not only break out of that stereotype, that nurses are only women and men are supposed to be doctors, but also that nurses make important decisions regarding patient care. A lot of patients think, “Oh, I can only get information about my health care from a doctor,” or, “The nurses don’t understand what they’re doing. I should really only be talking to my doctor.” .
There’s signing the union card, which is a big step for a lot of people. But becoming an activist in the workplace and more broadly—that’s a big decision. What encouraged you to take that step?
I definitely felt that if I wasn’t gonna do it, no one else would. And this whole issue really mattered to me. And I felt like this is the direction we needed to go, and I just felt like, again, if no one else was going to step up into that role, nothing would change. We would still have the same problems—care would decline, and I would just become more and more frustrated.
My parents have had a huge impact in how active I’ve become with the organizing effort. It’s kind of funny, because they are very conservative politically, but they were always very supportive of me speaking up and being independent and fighting for what i believed was right. My mom has always told me if you’re not happy, and there’s something wrong, there’s only really two things you can do about it. You can either, one, leave it alone and do nothing, or you can work to change it and fix it. I was like, well, I’m not gonna just walk away from this problem because Huntington is my second home. I was born there, my mom works there, I volunteered there, this is my first nursing job right out of nursing school. I didn’t want to give up on Huntington, and I definitely wanted to fight for change. To me, that was my major motivation for sticking it out and becoming more and more active.
You seem to feel a very strong connection to this particular facility.
My mom still works there. She’s an employee there. So i’m not just fighting for myself and for my patients. I’m fighting for my mom as well. I want to make sure that she is going to be taken care of, that she’s going to have a voice and that she’s still going to be able to provide the care that she’s been doing for over thirty years. To me, that is really important.
Have you come to a pass where friends or family have said, have you thought about dialing it back and looking for another job? Or have you reached a point where you got frustrated and said maybe I should do something different?
There definitely was that point, especially right after I was fired. Because that whole termination was just a roller coaster ride of emotions. From being pulled off the floor in front of everybody, in front of my peers, to being put on suspension and being cleared to come back to work, and then working a shift and then resuspended and then terminated—I definitely felt like I was a terrible nurse. And I definitely questioned myself.
But then the pity party ended, and I was like, “You know what? I need to get back up, and I need to fight again, because this whole thing was just meant to scare the other nurses, was meant to make me feel terrible about myself and to put me down, and was meant to stop nurses from organizing.” And I just felt that was wrong. They essentially were playing with my career, and I was like, that’s wrong. And they’re free to do that to the other nurses there, just because they spoke up and called attention to something that was going on in the hospital that they felt was endangering patients. I think that’s irresponsible of Huntington as a community-based hospital.
Part of it was, Huntington always tried to put itself out there as, we’re a family, we’re a community-based hospital, we all are working together for a common goal. But then push comes to shove, as soon as you try to advocate for change and even potentially prevent something from happening and if it’s going to interfere with the hospital’s bottom line, hospitals have no qualms in getting rid of you in order to keep you quiet.
Tell me about the White House. Tell me about how that went.
The White House was an amazing experience. I was just telling my fiance the other day that I had to rewatch some of the footage from the livestreaming, because I remember President Obama coming down and shaking my hand, and I actually gave him a stethoscope, and I remember words coming out of my mouth, and I remember him turning and we took a picture or something, and then him walking away. I literally had to rewatch the footage to be like, “That actually did happen.” I kind of blacked out for a little bit out of sheer excitement this was happening.
The White House was a once-in-a-lifetime experience and an opportunity. I got to meet a lot of great people at the White House Summit, a lot of inspirational workers who like me are just trying to fight for a better workplace, and they’re trying to fight to have a voice in their workplace and to organize their fellow coworkers to have a union and to have better benefits.
What was your goal? What did you want to say to Obama?
I definitely wanted to say to him, “Hey, you know what? Workers need better, stronger protections. We have a good basis right now in labor law, but it’s not enough. Nurses are still being retaliated against. Other workers are still being retaliated against in their workplace.” I was just talking with a woman who is a steelworker, and she was sexually harassed in her workplace for trying to organize and for trying to have a stronger voice in her workplace. And she was literally told by her employers, you’re a black woman, you should be glad you have a job. To me, this is the perfect example of legislators need to step up and pass labor laws that strengthen worker rights and protect us.
Contact the author at firstname.lastname@example.org.
Photo via National Nurses United/flickr.