Saturday, July 3, 2010

The Slippery Slope to a Holy War

I am seeing a few scatter signs that the quest for safe staffing is becoming a "holy war." This concerns me, and it concerns me a lot.

The conditions needed for a holy war is that each side believes something very strongly, and just as strongly believes the position held by the other party is antithetical to their own position. Accepting, at least for now, each side's position is sincere as presented:

  • Nurses believe safe patient care requires mandated staffing ratios, and Management has more than adequate resources to cover the additional cost.
  • Management believes safe patient care requires solvent and financially stable institutions, with a high degree of flexibility to exactly meet demands for nursing services, and mandated ratios are financially unsupportable.

As each side lacks the data to prove their position, they are operating from belief, from faith. Faith is impervious to debate, it is cannot be proved or disproved, and each side holds its "articles of faith" as sacred while holding their opponent's view as profane.
As I follow postings on the MNA Facebook page, I see other complementary and disturbing trends, also consistent with preparations for a "holy war":

  • Those outside the group (in this case, MNA) who do not share the articles of faith (the hospitals) are infidels; they must be vanquished.
  • Those inside the group who do not share the articles of faith are heretics; they must be found and cast out.

Herein lies my problem. As Robert Langdon put it in Angels and Demons, "Faith is a gift I have yet to receive." I occasionally envy the serene confidence that marks people of faith: a Christian with four aces is truly a wonder to behold. That envy is not compelling enough for me to desire this "gift." I claim as my gift the ability to see the grays and notice the nuances. The universe is complex, simple answers do not satisfy, and the search for the complex and nuanced answers is endlessly fascinating. I will not surrender my gift, no matter how inconvenient my vision is for myself or others.

This is unease is compounded by history. Crusades seldom work out well for the crusader: the infidels are well armed and have the home-field advantage. I fear that if MNA decides to embark on this crusade, we won't fare any better and likely will suffer greatly for our efforts.

The importance of patient safety is inarguable; it must be enhanced and assured. Nurses' professional integrity is an obligation of every professional nurse, and a demonstrated component of safe patient care. Required staffing ratios are one of many paths; true believers' assertions to the contrary. There are many others to be investigated and tested, with care and deliberation, lest our "cure" (like so many in our history) creates a new and more dangerous disease.

I profess no faith, only provisional trust. More generous provisions must be earned. Mandated staffing ratios have not earned that even my most provisional trust.

And I will not march into any conflict on the basis of faith.

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