Nurses on the Frontlines of Compassion
By Bob Simpson at Dec 24, 2011
Unless you are wealthy, sick economies are bad for your health. Jobs become scarce. Living conditions deteriorate. Medical care becomes more expensive and more restricted. Conflicts increase among family members, unrelated individuals and even nations. These conflicts can lead to wars—global wars, regional wars, civil wars, class wars, neighborhood wars….you name it. Sick economies breed bad consequences and nurses must deal with those on a daily basis.
“Is there any man, is there any woman, let me say any child here that does not know that the seed of war in the modern world is industrial and commercial rivalry?”—Woodrow Wilson”
Anzio Beachhead, World War II Italy, 1944: The German fighter-bomber came in low over the tents and foxholes of the 95th Evac hospital. Pursued by a British RAF Spitfire fighter, the Luftwaffe pilot dumped his load of 5 anti-personnel bombs on to the hospital complex. He was probably trying to lighten his plane to gain altitude and speed to evade his British pursuer. German anti-personnel bombs were designed to explode at about 5 feet from the ground and spread jagged steel fragments as far as possible.
Captain Marshall Bauer had just returned to the Operating Room tent from mail call. He told a nurse named Lt. Claudine “Speedy” Glidewell to take a break from surgery and read the letters that were addressed to her. The nurse sat down on a stool while Bauer resumed Glidewell’s task of administering anesthesia to a patient on the operating table. Glidewell was sorting through her mail when she was suddenly knocked to the floor by a terrifying explosion. Shrapnel was raining down from the new holes in the tent roof. Glidewell put on her helmet to resume the surgery.â€¨
The team calmly finished the operation as new casualties from the latest bombing came in. Glidewell’s first new patient was a pharmacist named Bob Knecht, the fiancee of her tent mate, Lt. Bernice “Hut Sut” Walden. Before she could even administer a shot of coramine, an emergency cardiac stimulant, he died in her arms. Glidewell had the job of telling Walden her fiancee was dead. She later said,”Telling her about Bob’s death was almost as painful as the bombing itself.”
Among the many dead and wounded were three Army nurses: Chief Nurse Blanche Sigman, Assistant Chief Nurse Carrie Sheetz and Lt. Marjorie Morrow. All three women had survived the sinking of the hospital ship Newfoundland by German bombers four months earlier during the Salerno invasion. They were not the last nurses to die at Anzio.
Nursing at the Anzio beachhead was conducted in an area nicknamed “Hell’s Half-acre”. So many German artillery shells and bombs fell on it that some of the wounded would sneak out of their beds and go back to their foxholes because they figured they’d have a better chance there.
The Anzio hospital complex
The nurses also had their foxholes, but only used them when off duty. If the bombing and shelling hit when they were attending patients, they remained at their posts, sometimes operating by flashlight. Because of the heavy casualties at Anzio, nurses, doctors and other medical personnel worked around the clock in shifts, haggard and tired because of the shelling and the fear.
Besides the many ghastly wounds that nurses treated, soldiers came in with pneumonia, bronchitis, malaria, and trench foot. Pinned down by relentless Germany artillery and air raids, GI’s spent weeks in flooded unsanitary muddy foxholes in freezing rain, sleet and snow. Trench foot could lead to gangrene and limb loss. Post-Traumatic Stress Disorder (PTSD) cases, then called battle fatigue, rose sharply.
At one point, there was talk of pulling out the nurses, who resisted the idea of evacuation. Their patients needed them. Command decided that evacuating the nurses would be a terrible blow to the sinking morale of the troops. The courage of the women was needed to sustain the men.
Modern nursing as it was created by Dorothea Dix, Clara Barton and Florence Nightingale during the wars of the 19th century is based on more than binding wounds and administering medicine. It is a declaration of the sanctity of human life even in the midst of its mass destruction.
For the nurses of Anzio it meant placing the lives of their patients before their own. It meant treating wounded German prisoners of war along side of the Allied wounded. It mean offering words of encouragement to those in pain and despair. For some mortally wounded GI’s the words of a nurse were the last words they heard on this earth. Their work was an expression of the deepest human compassion.
The Anzio operation was one of those disasters that gave rise to the WWII slang term, SNAFU. After completely surprising the Germans with the unexpected Anzio amphibious landing, human error within the fog of war turned it into a charnel house. The allies lost 7000 killed, 36,000 wounded or missing and 44,000 more non-battle injuries and illnesses over a 4 month period.
One Anzio veteran told me years later that he was surprised the Allies even won the war after what he witnessed in Italy. Allied casualties during the Italian campaign were some of the worst in World War II.
But wasn’t WWII itself the grandest SNAFU at all? Born out of the clash of cruel empires that marked World War I, nurtured by the profligate greed of international finance that finally crashed the world economy in 1929, and then brought to maturity by the fantasies of dictators, demagogues and political sociopaths who feasted on economic misery and built empires on their peoples’ desperation and fear.
Nurses place a higher value on human life than all those whose blunders, greed or delusions of grandeur get us into wars in the first place.
“Nurses have come a long way in a few short decades. In the past our attention focused on physical, mental and emotional healing. Now we talk of healing your life, healing the environment and healing the planet.” – Lynn Keegan R.N
Grant Park, Chicago, 2011- Nurses Jan Rodolfo and Martese Chism of National Nurses United waited inside their first aid tent on a cool Chicago fall evening as the police began arresting the 130 members of Occupy Chicago who were conducting a peaceful sit-in. Rodolfo and Chism had set up the tent to provide medical assistance to Occupy Chicago as well as anyone else who needed it. Among the Occupy movement are low income and homeless people who have been rejected by the USA’s broken health care system.
The sit-in defending the nurses tent
As part of Occupy Chicago, Rodolfo and Chism were also there to advocate for a universal health care system and to protest the growing income gap between rich and poor. Nurses from National Nurses United(NNU), a 150,000 member nurses union, had set up similar tents New York City, Washington D.C., San Francisco, Oakland, Detroit, Los Angeles and San Diego, all in support of the Occupy Movement.
Rodolfo and Chism were the last to be arrested and spent 24 hours in a Chicago jail for the crime of providing medical care and drawing attention to the poor economic health of the USA. One veteran Chicago nurse told me that arresting nurses at Chicago protests was highly unusual. Normally the police leave them alone because they too have need for emergency medical assistance.
I saw Rodolfo staring angrily out of her jail cell as I was being processed out for my part in the sit-in around the NNU first aid tent. I thought to myself,”Never get between nurses and the patients they want to care for.” In a better world, Chicago Mayor Rahm Emanuel would have come to their first aid station to pledge support for their efforts.
Jan Rodolfo speaking outside of the Mayor’s Office
Once again, nurses are on the front lines of compassion, this time in America’s growing class war. The American Journal of Public Health estimates that 45,000 people die in the United States because of a lack of health insurance. U.S. Department of Health and Human Services reports that profits for health insurance companies have risen 250% in the past 10 years. If that’s not class war, I don’t know what is.
Nurses report that among their patients stress related illness are up and mental illness is going untreated. This is true even among children who are deeply affected by their parent’s anxieties and the talk about losing jobs and homes. People are going to work sick because losing their job is more frightening than the condition of their health. Emergency rooms say that they are seeing more malnourished and underweight children, conditions brought on by increasing poverty.
“Every day patients call me to say that are putting off a procedure, like a colonoscopy, because they cannot afford the co-pay. Employers change the terms of health insurance coverage, raising costs to workers, and many do not know it’s happened until they show up in need of care and are shocked and unable to pay. People are working harder than ever, two or even three jobs to make ends meet. Often it’s tied to a problem in the household or extended family—unemployment or sickness. Men in their 50s, engineers who were laid off and living in my community, have given up looking for work. There is nothing out there.”—–NNU Co-president Deborah Burger, RN
Another NNU Co_president, Karen Higgins talks about how nurses themselves are affected by the economic crisis:
“RNs are scared and nervous. Some are single moms, others have laid off spouses, and their paycheck is critical. Many work an extra shift or two to get by. Many of us have to put off retirement. We are back involved in the lives of our parents because they are aging and vulnerable and do not have the resources to get by.”
In addition, assaults against nurses are on the increase according to the federal Substance Abuse and Mental Health Services Administration.Many experts link the violence to the poor state of the economy. Cleveland nurse Erin Riley was attacked and suffered bruises, scratched and a broken tooth. New York nurse Rita Anderson had her jaw broken. Seattle nurse Jeaux Rinehart had his face so badly injured that he sucked food through a straw for weeks.
The Emergency Nurses Association reported that about half of their members who responded to a survey had been assaulted. Donna Graves, a University of Cincinnati professor who studies the problem thinks that:
“What’s bringing attention to it now is the type of violence: the increase in guns, in weapons coming in, in drugs, the many psychiatric patients, the alcohol, the people with dementia.”
The stress that nurses endure is made worse by staff cuts and increased patient loads. Traditionally nursing has involved close relationships and careful observation of patients. Too few nurses and too many patients can be fatal. In a 2010 study by Health Services Research found that:
”…each patient added to nurses’ workloads was associated with a 7 percent increase in mortality following common surgeries, and that nurse burnout and job dissatisfaction, precursors of voluntary turnover, also increased signifcantly as nurses’ workloads increased.”
ER Nurse Paul Duke put it another way in a guest column to Newsweek magazine:
”I often find myself hopping from task to task just to keep everyone alive. By the end of the shift I often wonder, did I kill anyone today? I go home tired and beaten down, praying like mad that I didn’t make any mistakes that hurt anyone.”
Overall an estimated 200,000 Americans die from medical errors and hospital infections. Many of these deaths could be prevented by better staffing ratios, better training and better monitoring of hospitals. But all of that costs money, money that our broken medical system would rather divert to profits instead of patient care.â€¨
If you see nurses on a picket line, you can bet they are there to improve patient care as well as their own work situation.
The 2008 financial crash, that grand economic SNAFU, exacerbated all of these problems and more. Prompt government action prevented a total global meltdown, but the bank bailout did little else for working class America. Effective government job creation was blocked by our dysfunctional corporate owned political system.
In response the NNU has launched its Heal America Campaign. Nurses across the USA have joined protests and lobbying efforts to enact a financial transactions tax on Wall Street. The SNAFU economics of greed and speculation from Wall Street triggered the crisis and Wall Street has shown no interest in voluntarily fixing the problems that it caused.
NNU nurses demanded the following:
Jobs at living wages to reinvest in America.
Equal access to quality, public education.
Guaranteed healthcare with a single standard of care.
A secure retirement with the ability to retire in dignity.
Good housing, and protection from hunger.
A safe and healthy environment.
A just taxation system where corporations and the wealthy pay their fair share.
None of those demands will come easily or cheaply. But nurses know that prevention is better than cure. The 7 demands of the Heal America Campaign would make the the USA a world leader in health care for its citizens. Even before Occupy Wall Street, NNU nurses by the thousands were demanding a financial transaction tax on Wall Street to pay for the cost of healing this nation.
But the nurses of the NNU don’t stop there. They understand this is a global class war.â€¨â€¨In November, NNU sent a delegation to the G-20 meeting in Cannes who joined other organizations to push for a global financial transactions tax. Even billionaire Bill Gates endorsed the concept. Nurses from 4 continents joined 100,000 marchers in opposition to the austerity measures favored by global finance.
Nurses protest at the G-20
To be on the frontlines of compassion in the 21st century means healing a dysfunctional global economy that condemns millions to poor health while the privileged few turn their faces away. Nurses around the planet are rolling up their sleeves and joining in that effort.
This determination is expressed by the Nightingale Declaration, signed by nurses in 106 countries. It is named for pioneering British nurse Florence Nightingale.
Nightingale Declaration for A Healthy World
“We, the nurses and concerned citizens of the global community, hereby dedicate ourselves to the accomplishment of a healthy world by the year 2020.
We declare our willingness to unite in a program of action, sharing information and solutions to resolve problems and improve conditions — locally, nationally and globally — in order to achieve health for all humanity.
We further resolve to adopt personal practices and to implement public policies in our communities and nations, making this goal for the year 2020 achievable and inevitable, beginning today in our own lives, in the life of our nations and in the world at large.”
And If I Perish: Frontline U.S. Army Nurses in World War II by
Evelyn Monahan, Rosemary Neidel-Greenlee
Anzio: Italy and the Battle for Rome by Lloyd Clark
Personal recollections of Sgt. William L. Simpson (US Army 1942-1946)
Nursing Ethics and the Military by Janet R. Southby 2003
“NNU Nurses Take Risks to Give First Aid at National Occupy Sites”, National Nurse Magazine, October 2011
“New study finds 45,000 deaths annually linked to lack of health coverage” by David Cecere,Harvard Gazette, September 17, 2009
“Health Insurer Profits Jumped 250% in Last Decade” by Melly Alazraki, Daily Finance, February 18, 2010
“What America’s Nurses Can Tell You About the Great Economic Crisis of 2011” by Ed Moloney,The Broken Elbow, June 6, 2011
“Violent assaults on ER nurses rise as programs cut” by Julie Smyth, Associated Press, August 10, 2010
“Implications of the California Nurse Stafï¬ÂÂÂÂÂÂÂÂng Mandate for Other States”, Health Services Research, 2010
“If ER Nurses Crash, Will Patients Follow?” by Paul Duke, Newsweek February 1, 2004.
“Time for a Main Street Contract” National Nurses United 2011