You can’t even hold their hand and be the nurse you want to be

It’s become the norm that nurses don’t take lunch breaks

Nurses in Massachusetts have been on strike for five weeks now. Bill Shaner, formerly a reporter for Worcester Magazine, who now writes the newsletter Worcester Sucks and I Love It, reports on what they’re asking for, and why their massive employer Tenet Healthcare has so far refused to meet their demands.

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They are just throwing money away that could be spent on patient care

Tenet is a very-for-profit healthcare company based in Dallas, Texas. They own 65 hospitals and 550 outpatient centers and they employ 110,000 people, including the 800 or so nurses that work at Saint Vincent Medical Center here in Worcester which some like to call “The Heart of the Commonwealth” because it’s in the middle of the state and that’s cute until you get to learn how things work around here.

This time last year when we were all getting our shit rocked by the new normal, Tenet’s share price was down around $12. Now it’s at $51.

In the fourth quarter of 2020 alone the company recorded $414 million in profit, and a statement on the matter from CEO Ronald Rittenmeyer read like this:

“We are very proud of every one of our colleagues across the Tenet enterprise for their selfless commitment to our patients, each other and our communities.”

During that entire time and then some, nurses at St. Vincent represented by the Massachusetts Nurses Association, one of the unions in the state that truly does not fuck around, tried and failed to negotiate a new staffing ratio into their contract with the company. That’s still the major point of contention and the point on which Tenet simply refuses to budge.

What the nurses want is a four-patient-to-one-nurse ratio across the board for all its nurses. That means at any given time nurses are only expected to tend to the needs of four patients. This is something which is considered standard at other hospitals in the area, and nurses at St. Vincent are leaving for jobs at those other hospitals in droves. At St. Vincent, nurses have a five-to-one patient ratio. The higher ratio, on top of the added work that comes with donning and changing COVID gear and all the other pandemic-related safety protocols, sets the nurses up for a chaotic and unmanageable workload. I went down to the strike on the first day and talked to a bunch of nurses, and a lot of them described situations where they have patients pressing the buzzer and calling for help and they simply can’t get to them. I’m sure it’s no stretch to imagine yourself a patient, let’s say an elderly one, and for whatever reason you can’t get out of bed and you need a bed pan change and there’s a nurse that should be coming along and doing that. You’ve got to go really bad and the nurse is nowhere to be found and it’s getting to be an emergency so you try and stand up and walk to a bathroom and boom, broken hip. That’ll be another couple exorbitantly expensive weeks in the hospital for you bud.

Here’s what the nurses themselves had to say when I went and talked to them.

Kilsi Espinosa, a nurse in the cardiac unit and the one in the middle in the photo up top, said the company claims to be offering the best contract it has in years, but nurses are leaving St. Vincent to work at other hospitals in the area because the pay is better, the benefits are better, and the nurse-to-patient ratio is better.

“Honestly we’re exhausted training people every six months,” said Espinosa. “Not to mention it’s just unsafe for patients.”

She broke it down for me: Say on a given day you have two cardiac patients and another three patients that need care and you’re also training a new nurse. One of the patients might need extensive attention, they might be confused and need someone there for a longer one-to-one conversation. And you won’t be able to give it to them.

“It’s kind of hard to divide yourself into five places,” she said. “Put it in an agenda. How is it possible that a nurse can do this?”

Nurses routinely pass on lunch breaks and bathroom breaks to meet the demands, said Lamoy Toban, another nurse in the cardiac unit and the one on the left there.

“We do what we have to do to get the job done, but it shouldn’t be that way,” said Toban. “It’s become the norm that nurses don’t take lunch breaks and it shouldn’t be a norm. It’s become a norm now that we don’t take breaks. Like, what is a break?”

Gift Stewart, the nurse on the right up there, worked on the COVID floor. She said nurses struggled even to give patients breakfast, especially elderly patients who may need help eating or need someone to sit with them a while.

“You can’t even take the five minutes to just hold their hand and be the nurse you want to be,” said Steward. “This is why we’re here. Just give us better staffing.”

Toban jumped in.

“That’s not a lot to ask for at all.”

No it isn’t. Not for a company that recorded $414 million in profit in three months during the middle of a global pandemic.

You can’t even take the five minutes to just hold their hand and be the nurse you want to be.

That line hit me like a ton of bricks. Healthcare in America is so cravenly profit-based that nurses are put in the position of having to tell a scared old lady to kick rocks and spoon her own damn oatmeal.

The nurses want other things they deserve too, like better pay and better benefits and better support staff, but they’re all secondary issues to the staffing ratio. Tenet offered a contract several months ago, before the strike, which included a better deal for individual nurses, but the Massachusetts Nurses Association bargaining committee turned it down. As I mentioned before, this union does not fuck around. They see the staffing ratio as the one aspect that will ensure a safer working environment for both nurses and patients and they’re not bending an inch until they get it.

Likewise, Tenet refuses to give in on that issue, which is why this strike is dragging into its fifth week. The reason why Tenet isn’t budging is obvious to the point it barely warrants articulating. A lower patient-to-nurse ratio would require the company to hire more nurses, and hiring more nurses would cut into the profit margin, and why would you run a hospital for any reason besides the profit margin?

But the way that Tenet chooses to publicly frame it is somehow even more callous and craven than the truth. The nurses at St. Vincent, they say, are being used as pawns by the Massachusetts Nurses Association to achieve their nefarious ends. Just yesterday an article in the Telegram & Gazette, Worcester’s thoroughly gutted paper of record, quoted Tenet Massachusetts & St. Vincent CEO Carolyn Jackson saying as much.

Jackson said that the MNA are using Worcester and St. Vincent as a part of a larger agenda to push for 4-to-1 staffing ratios in hospitals following voter rejection of Question 1 in 2018, which would have mandated a maximum nursing ratio at hospitals

“They are using St. Vincent Hospital, its nurses and the Worcester community as a pawn in their broader agenda to try to push a 4-to-1 med-surg staffing ratio across the state,” Jackson said.

These poor nurses are being duped, she says over and over and over, into believing that having a more manageable workload would be better for both them and their patients. The condescension toward nurses in this particular line of argument has not gone unnoticed, by me or by any of the nurses who are out there every day demonstrating in front of the hospital for conditions they deserve.

And lest we forget, Question 1 was defeated in the polls after the Massachusetts Health and Hospital Association spent $25.18 million, a figure more than double that spent by the nurses, on its smear campaign to make sure it didn’t.

Jackson is trying to cast these nurses as confused little pawns in some cosmic game they couldn’t understand. But the nurses understand very well that they are on the front line of the fight against the incredible avarice and disregard of the healthcare industry. They’re out there day in and day out because they believe they deserve more, they know it wouldn’t be hard at all for the hospital to do it, and they see with clear eyes why the hospital isn’t.

In the month that Tenet has refused to meet the demands of the nurses, they’ve been spending untold amounts of extra money to keep the hospital running. They have to bus in scab nurses every day. They have to put the scab nurses in hotel rooms. They have to pay for police details. The police details alone cost $32,000 a day. I wish that money was going straight into a trash can instead, but to be honest I’m glad the hospital has to pay it.

Meanwhile the company has made some hilariously bad attempts in the local press to win the war of public opinion. My favorite, which I wrote about the other day, is this press release rewrite that ran in the Telegram titled “Non-striking nurses at St. Vincent Hospital campaign to ‘Support Colleagues Above Bullying.’” Or S.C.A.B. for short. Yeah, the hospital is trying to reclaim the word “scab” because some of the nurses who chose to break the strike said the striking nurses were mean to them online. Which, like, good.

The hospital sent out a picture with the release showing eleven nurses wearing the shirts with the S.C.A.B. acronym on the back.

Or at least what I thought was eleven nurses. I had a nurse message me after the story ran and it turns out it’s only six nurses, four clinical care technicians (one of which apologized for not knowing that the acronym was a barb toward the striking nurses), and the tall one on the right there looking at the camera who is literally Carolyn Jackson, Tenet Massachusetts CEO. Strong coalition you got there, Carolyn!

In the release, Tenet writes “Scab is a union term used in a negative manner to degrade workers who act against the union’s agenda.” Yeah, the union agenda to be treated better by the company. Some agenda.

For good measure the hospital decided to double down on the “our poor scabs are getting bullied” storyline by installing new security cameras along the strike line. The cameras went up, according to Jackson, to “review incidents,” which is of course a clear intimidation tactic. The union responded to the implementation of the cameras appropriately, I think. This is how a spokesman framed it:

David Schildmeier, a spokesman for the Massachusetts Nurses Association, criticized the hospital for spending money on the cameras during the labor dispute and called the cameras an intimidation tactic to make it feel like “Big Brother” is watching the nurses.

“They are just throwing money away that could be spent on patient care, on keeping people safer to prolong this strike so they can continue endangering patients every day. It's obscene.” Schildmeier said, “The additional aspect of the cameras is another sign of intimidation by this administration to show over the last two years that they have no respect for the nurses who work for them.”

But as I mentioned before, this is a massive company and a massively profitable one at that. They can absorb the losses fairly easily. And if they give in to these nurses here at one of their 65 hospitals nurses elsewhere in the country might start getting ideas. By refusing to come to the table, the company is making an example of these nurses. They’re saying in no uncertain terms that direct labor action won’t work on them. But how long can they keep saying that? That’s the real question. And bless their hearts, these nurses are going to find out. They’re out there on the picket line every day without pay and without health insurance to fight for what’s right for both them and their patients. Solidarity forever.

Bill Shaner used to work at an alt weekly called Worcester Magazine but it was bought by a media conglomerate and destroyed so now he writes a newsletter called Worcester Sucks and I Love It.

Hey come watch this on Wednesday if you want. Not my problem.

And be sure to check out the new issue of Discontents going out later today. I don’t want to spoil it but we’ve got a disgusting original cartoon by the great Eli Valley going up. Here’s a small preview.

Ayy real quick does anyone have $3,150 I can borrow? I gotta go to Israel with Ray Lewis and Darryl Strawberry for some reason.

Read more about the trip we’re all definitely going on on Icon Destinations’ very normal website:

Come with us on this pilgrimage as we transform the Bible into reality. We’ll follow in Jesus’s footsteps and visit iconic locations throughout Israel.

Champions 4 Christ is all about training champions to grab ahold of those opportunities for life-changing moments with God. He called us to train the Church to become the Glorious Church Jesus is coming back for! It’s all for the Glory of God and for souls!


Giancarlo DiTrapano the founder and publisher of Tyrant Books has died unexpectedly at 47. Among many other great titles DiTrapano was largely responsible for bringing Hell World’s favorite novel Cherry — the movie of which I still have not seen — to the world. Here’s a great quote of his from this obituary in Publishers Weekly.

“DiTrapano had his critics, but that was never a problem. ‘Tyrant stuff isn’t for everyone, but nothing should be for everyone,’ he once said. ‘Or at least nothing that’s worth anything. You know what’s for everyone? Water. Water is for everyone. And if you’re publishing something for everyone, well, you’re publishing water.’”

Here’s a revolting story from the Guardian about a woman named Mariana Pineda who has suffered just an insane number of lingering and very serious health problems since contracting Covid last April. In order to pay for her treatment she of course relies on GoFundMe despite being insured. The experience has only reinforced her determination to fight for Medicare for All she says.

Pineda’s passion for Medicare for All formed when she was volunteering for Bernie Sanders’ 2016 presidential bid, knocking on hundreds of doors while pregnant. She cast her ballot in the New York primary while 4cm dilated and gave birth the next day.

Five years later, Pineda vowed to keep pushing politicians for health reform. Pineda said: “I am going to harass them until I drop dead and I hope I drop dead on their door stop for a good photo op.”

I love Worcester very much by the way! Please enjoy this gif of me representing outside of maybe the best dive bar in Massachusetts.

Here’s a little something I wrote about “The Paris of the 80’s” in a previous Hell World I still think is good.

Brockton is called the City of Champions because Rocky Marciano and Marvin Hagler were born there and also probably because they used to smash my head in real good whenever we would play them in sports growing up. I think they have statues of those two guys there but they also might consider erecting one of a teenage me laying on my ass in the dirt wanting to give up.

My grandmother grew up there and she’s dead now so I guess another thing I know about Brockton is if you grow up there you die someday.

One of the reasons it’s still affordable is because the state doesn’t give the schools there any money. Brockton and Worcester and New Bedford are the big cities of Massachusetts that you’ve probably never heard of if you don’t live here unless you have a particular interest in crumbling manufacturing towns and port cities which is to say the history of America. They have all been considering suing the state for a while now because of the lack of funding.

In Worcester the say they have 773 fewer teachers than they need and in Brockton they say it’s 414.

Worcester is where I went to college and I just looked and it costs about $50,000 a year in tuition at Holy Cross now which is a cruel joke. They don’t have me on the list of alumni on the Wikipedia page yet which is fucked up man but some other famous people who went there are Dan Shaughnessy and Bill Simmons and Chris Matthews and Ann Dowd and Billy Collins the former poet laureate and I guess Jon Favreau the podcast guy who I know nothing about except for when everyone yells at him on Twitter. The most famous piece of shit to go to my school was Clarence Thomas and one time when I was an intern in D.C. they took us to meet him. I don’t remember it any more but there is a picture of me shaking his hand that I have but no one is ever going to see it due to I don’t want to get canceled.

Kurt Cobain died 27 years ago today which means he has now been dead for as long as he was ever alive. Many of you will have already read this piece — I think the first ever “good one” on here — but in case not here you go.

The electrician found the body that morning but I guess it took a little while for the news to spread. It had been waiting there for three days but we didn’t know that yet we just knew all of a sudden that a person was a body now and that was that. It would have been early evening when I found out about it. April. My football coach broke the news to me in a football coach voice because that was how you found out about things back then. You’d walk around not knowing some shit until someone would tell you and then you had to wait to bump into someone else and go ahead and tell them. I don’t remember exactly what he said but it was something like ay your boyfriend Kurt Cobain killed himself. Football coaches don’t like it when you care about anything other than football such as music for example which is for homosexuals. Kurt was twenty-seven years old which everyone remembers as the famous age to be dead at. I remember my coach mispronounced his name as Co-burn which is something a football coach would do on purpose to fuck with you and then we had to go and lift weights. I don’t remember if we listened to Nirvana while we lifted the weights but I hope we did not.

This movie is quite good and I think you should watch it especially if you like body horror and eco horror. Being a proud(ish) son of the South Shore I have eaten hundreds of oysters in my life but what I like about this movie is that it reminds you that eating cold sea jizz is actually really fucking gross and will degrade your molecules into oblivion in the uncaring cosmos of the alien ocean.

OK bye for today see you again soon.