Shortly after the Labor Day weekend, the annual holiday dedicated to the appreciation of the American worker, officers from the Alameda County sheriff's department were summoned to Castro Valley's normally placid Eden Medical Center to investigate the disappearance of $8,000 worth of equipment. There wasn't much to investigate. Hospital administrators had a pretty good idea who had taken the equipment, and an even better idea about why. It had something to do with workers feeling unappreciated.
The missing items should have been the easiest things to find in the whole hospital -- several dozen portable locating devices designed to keep track of the nursing staff as they made their rounds. Eden had purchased the locator tags as part of a $273,000 nurse communications system for its busy medical and surgical units, and administrators hoped that the new technology would improve communication between doctors, patients, and nurses. About 85 nurses, as well as several dozen aides, techs, and managers, were supposed to wear the tiny badges that would allow them to find and talk to one another when linked up to a new intercom system. A computer would record when they entered and exited each room, theoretically ensuring that patients' calls were answered in a timely manner.
The system was designed to save time, trouble, and lives. While eliminating the noise and inefficiency of the hospital's antiquated call-light and paging system, it would allow nurses to call for emergency aid without leaving their patients' sides or having to step out into the halls and shout. Most of all, nurses could respond to one another at a moment's notice. "In health care, things happen so quickly that every second counts," says Eden spokeswoman Cassandra Phelps. "It greatly improves the ability to care for patients -- there is no doubt about that."
But the new system came with one big problem: Many nurses hated it. Some said the badges were useful, but others found being monitored from afar too Orwellian for their tastes. The main complaints were that the system could be used to invade employees' privacy, or allow management to second-guess staff work habits in ways that might ultimately be used for job evaluations or disciplinary purposes. Of greater concern to patients, many nurses also saw the badges as symbols of an increasingly corporate industry's efforts to routinize and speed up the complex work done by nursing professionals at a time of chronic understaffing.
As hundreds of US hospitals have installed similar systems in recent years, their presence has become the subject of heated national debate. Web forums such as Allnurses.com are rife with the complaints of hospital workers who say they are being tagged like dogs and made to wear monitoring devices similar to those used to keep tabs on paroled prisoners. They scornfully deride the devices as the "Nurse Lo-Jack," and complain that Big Brother -- or, perhaps more appropriately in a mostly female profession, "Big Mother" -- is watching. Nurses at some hospitals have expressed their distaste by consistently "forgetting" to wear their badges. Elsewhere, there are whispers of badges being "accidentally" flushed down toilets or dropped in patients' bedpans.
At Eden, objections to the new system took some time to boil over. The California Nurses Association, a lobbying powerhouse that represents more than 45,000 nurses, first complained back in October 2001 that nurses had not been informed about the system during the contract negotiations held earlier that year. By this February, a petition from dozens of employees asked the administration to negotiate with the union over how the system would be used. Nurses also demanded that the hospital and the system's manufacturer show proof that wearing the infrared badges would not produce long-term health effects. And there were scattered acts of individual defiance; some nurses flatly told their supervisors they would not wear their badges, while others took to leaving them in lockers.
The dissent reached a peak Labor Day weekend, when Eden's staff became the nation's first to refuse en masse to wear the badges. At the urging of union reps, more than fifty of the roughly 120 staff members instructed to wear the tags took them off and dropped them into a cardboard box.
Then the box disappeared.
Although the union said it had planned to hold a press conference the following Thursday -- during which the tags would be returned to the hospital along with a firm refusal to put them back on -- the arrival of the sheriff's department changed the situation. Instead, a union rep simply tipped off administrators that the box was behind some tennis shoes in the nurses' lounge closet. "What was done was not stealing them, but giving them back," says CNA rep Allan Brill. Hospital spokeswoman Phelps dismisses the badges' disappearance as nothing more than a "misguided publicity stunt."
But the protest's impact lingers. Once a critical mass of people refused to participate, the tracking system was rendered useless. Currently, only a few Eden employees regularly wear the badges, most notably Eden president and CEO George Bischalaney, and fourth-floor nurse manager Priscilla Seiveno, who both donned badges after being challenged by the staff to prove that they're safe. But their tag-wearing is more symbolic than anything, particularly in Bischalaney's case. Not only are there no sensors on the floor where he works, but use of the system is suspended throughout the hospital while management and the nurses try to work something out.
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