Internal Bleeding

Jessica Winning echoes Crain's point: "We are pulled within a sister network. They may have changed where they put their IV bottles, but for the most part I feel very comfortable. I have not been given an assignment that I personally cannot handle."

But judging from the question in one of the hospital Q&A newsletters, not everyone's as calm as Winning, or as experienced. "What is the criteria for being a charge nurse?" the writer asked. "Our area is frightening. There are many night shifts where the combined RN experience is six months!" The reply was that administrators knew of no such area, unless the writer was talking about nights when someone was "floated" to the area. "To be a primary charge nurse, six months of experience is required."

Cost-cutting has meant cheaper supplies (sutures that break faster) and different priorities. Nurses say that when a patient dies, there's new pressure to whisk the body away and make room for a new patient, instead of decorously sealing the room for a while. "We're often sent prisoners," notes one nurse, "and recently they put a prisoner who was shackled to the bed with a guard in the same room with a regular patient who happened to be aphasic, totally alert but unable to speak. The nurse on duty objected, but they said they had to fill that bed."

RNs get furious when they talk about such practices -- but later they agonize over what they've said, afraid of hurting co-workers' feelings or slighting the head nurses they do respect. "People say, 'Oh, you are going to make people hate St. John's,'" sighs Prade. "No! We're just trying to improve the care!"

This union push is, in the end, not so much a battle for workers' rights as it is a crusade -- for old-fashioned patient care and for nurses' long-ignored dignity. In many ways, they've been their own worst enemies -- even the feminists refer to each other as "girls," and they joke self-consciously about being "good" and "sweet" and "co-dependent." Kretschmer's quick to explain the "nursing psychology" they feel administrators exploit: "Nurses will bend over backwards; they will stretch and they will cover." She pauses. "I am to the point where I am no longer able to do that. I can only stretch so far. And I don't feel safe.