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.
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