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"In Our Unit" highlights unique practices, innovations, research, or resourceful solutions to commonly encountered problems in critical care areas and settings where critically ill patients are cared for. If you have an idea for an upcoming "In Our Unit," send it to CRITICAL CARE NURSE, 101 Columbia, Aliso Viejo, CA 92656; fax, (949) 362-2049; e-mail, ccn{at}aacn.org.
The nurses in our unit were conflicted over whether they should "stay to care for the critically ill patients" or "strike for the future of nursing through better working conditions." Adding to their indecisiveness was the fact that we are an extremely tight-knit, cohesive, caring group. When we realized that the strike was imminent, our concern was heightened, particularly with respect to how long we might be apart and the effect that would have on our positive working relationship.
Motivated by this "separation anxiety," many of the nurses in our unit made a conscious commitment to continue communicating during the strike. Communication was achieved not only by e-mail, but also by weekly dinners. All the unit’s nurses were invited to participate, regardless of their decision to continue working or to join the strike.
At the beginning of the strike, we e-mailed almost daily. Because we did not know whether our hospital e-mail addresses would be available during the strike, we had decided in advance to exchange home e-mail addresses. E-mailing was truly a lifeline, especially for the nurses who had taken temporary jobs in other cities. As the strike continued, some of the unit’s multidisciplinary team members also began to participate in the e-mail exchanges. In addition, to help the striking nurses keep "on their toes" clinically, we focused attention on the "Practice CCRN Exam Questions" booklet.
Our first dinner get-together drew 16 nurses, including 3 who had decided to continue working instead of striking. It wasn’t until later that the inclusion of these "insiders" was fully appreciated.
Although there wasn’t agreement on issues related to the strike, these dinners were a time of support and encouragement. As in "war," the first casualty in a strike is the "truth." However, keeping the lines of communication open helped us wade through the rhetoric to get as close to factual information as possible.
After 56 days, a settlement was reached, and the striking nurses returned to work. Everyone wondered how well those who crossed the picket line and those participating in the strike would interact. Our group tested the waters with one last dinner, which served as a time of reacquaintance for those who had not interacted during the strike—a time for healing and celebrating the strike’s end.
The hospital planned reintegration meetings for staff on each unit. However, because we had maintained communication throughout the strike, our unit’s leadership did not feel the need to meet in this more formal context.
Overall, our unit fared better than most in our institution in returning to "normal." In fact, our unit was used as a model of unification at the reintegration meetings.
In hindsight, inviting the multidisciplinary team members to some of the weekly dinners may have been a key to enhancing our unit’s reunification success. They were the ones who stayed and worked with the fallout left by the striking nurses. To address this issue, everyone on the unit was invited to a team-building retreat.
Our intentional communication efforts kept the nurses connected. Each individual had had to make a difficult decision to stay or to strike, and each decision was respected. Although it is difficult for a unit to be unaffected by something as divisive as a strike, our nursing staff remained, for the most part, professional and supportive. Beginning with the end in mind, really did make a difference!
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