Saturday, April 14, 2012

Nursing a Grievance

This is a video of 500 nurses holding a meeting to complain about conditions at Taipei's Rungzung Hospital, a situation replicated all over Taiwan. The hospital was successful in keeping the media out of the meeting so this video comes from the cellphone of a participant.

According to the video, the hospital is short 171 nurses, and thus each of its nurses care for too many patients. Rungzung is famous; it has a 95% occupancy rate. The nursing shortage is paradoxical -- there are more nursing students then places for them, but then they leave the profession at greater rates than they enter when they realize how awful it is. At some hospitals the nurses clock out at the end of the shift as required by law but then work unpaid and unrecorded overtime, exploitative, illegal, and dangerous.

This is not a health industry problem but is par for the course in all sorts of production situations in Taiwan, especially where there is a moral or public service element involved (the police also have brutal schedules) but in general workers in offices and factories who work overtime without pay don't kill people when they make inevitable errors. These problems are only the tip of the iceberg, I hope to do some interviews of nurses before the summer and expand the list of issues. What I've already heard will make your hair turn white.

The first nurse to rise complains that they make $30,000 month as a nurse; on her recent trip to a Taichung night market she encountered a student worker making $33,000 a month selling fried octopus meatballs in the night market. "Shouldn't I go sell octopus balls in the night market?" she says, to everyone's laughter and resounding "yes!" Then she goes on: "those of you who have been here three years, four years, have you been promoted?" "No!" The next woman who stands up complains that the money the hospital has been spending on purchasing flowers to beautify the place should be going to paying the nurses.

Because it is doctors who generate income for the hospital by taking on patients, hospitals seek to maximize doctors and minimize nurses, who represent a cost to the institution, which are often privately owned and like so many large corporations in Taiwan, farming Taiwan's subsidy regime. At the bottom of the institutional pecking order, often from working class families, nurses are the target of the System's attempt to reduce costs by exploiting labor. The job is so awful that even nursing positions that pay as much as college professor positions go unfilled.....

Clearly reforming the NHI is going to involve much more than simply adjusting the billing and payment regimes. The whole approach to the use of labor is going to have to be rethought.
Don't miss the comments below! And check out my blog and its sidebars for events, links to previous posts and picture posts, and scores of links to other Taiwan blogs and forums! Delenda est, baby.


Anonymous said...

Every nurse I've spoken with in Taiwan has complained about how little they are paid, but they have mostly been dedicated and professional. It is a shame that hard working people like this are being taken advantage of for their virtues. This is precisely why a labor union is needed.
Could you do an article on the general abuse of workers in Taiwan by managers and owners?

Tommy said...

Can the US promote immigration of Taiwanese nurses? We need their skills here, they would be hardworking contributors to society, and they would be paid much better. :)

Feiren said...

Isn't this hospital usually known in English as Taipei Veterans General Hospital?
This is where LTH had his recent surgery. It may be Taiwan's best hospital.

I think it's great that this video has been leaked.

The nursing profession is a great example of the problems in Taiwan's labor markets. Taiwan produces well trained professionals and then doesn't pay the properly. Of course the US and Australia love to snap up Taiwanese nurses.

vin said...

Excellent piece, Michael. I'll be using it for discussion in some of my higher-level English classes -- which include some nurses.

Anonymous said...

Of course the US and Australia love to snap up Taiwanese nurses

And ironically, Australia is snapping them up because Australia is in basically the same situation as Taiwan when it comes to nursing. Long hours and low pay meaning that the Australian nurses who can go to the UK and Europe, and the others go into other fields.

Ben Goren said...

My personal experience of one sector of Taiwan's health care business is that it is one of the biggest black gold rackets run in the country. The health and welfare of patients and customers is definitely NOT the first priority. I mean, why hold to a standard of ethics when another doctor is making more money than you and flashing it in your face at the gold club?

Anonymous said...

Study: California's Nursing-Ratio Law Saves Patients' Lives

News outlets report on a study suggesting that California's mandatory nursing-ratio law saves patient lives.

"If similar laws were enacted in such states as Pennsylvania and New Jersey, the number of patient deaths in those states could be reduced by as much as 14 percent, according to the study conducted by researchers at the University of Pennsylvania and published in the journal Health Services Research," The Sacramento Bee reports.

Link to the study:

The CA Ratio
"The minimum licensed nurse-to-patient ratio in medical, surgical,
medical/surgical, and mixed units is 1:5."