—guest post by Local 328 executive-board member Trisha Crabb—
Every day, I pass beneath the OHSU campus soaring over Portland. I’ve always thought of it as a “Shining City on the Hill,” combining the political rhetoric of my formative years and the ideal of a beacon of good for the world to emulate. I’ve always seen the possibility of what OHSU could be — and should be. I spent the formative years of my life at OHSU. I’ve been shaped by the opportunities it brought into my life as I made Portland home for me and my family. OHSU has brought amazing work experiences and growth my way; my experiences here have made me a better person, and given me friends that I cherish. There is so much that is amazing about OHSU.
Part of my growth has been the development of my political and cultural self, an awakening to realities of economic justice, systemic bias and privilege. Somewhere along the way, I came to see that the “shining city” wasn’t lit by glowing ideals that I should emulate, but rather by the glint of gilded edges polished to a high shine so no one would see the flaws and weaknesses of the structure beneath. I know that OHSU as an entity has never been, at its core, more than a “fake it till you make it” endeavor. I know this because, for the past two decades, I have watched the constant erosion of potential.
OHSU is not reaching its full potential, despite reaching its financial goals. And for the first time, I fear it never will. Not as long as employees and patients are seen only as expense and revenue entries in a spreadsheet. Not as long the only employees who are always asked to sacrifice are the lowest paid workers. Not as long as those sacrifices are made so that OHSU can meet financial objectives that result in fat bonuses for highly paid executives. Not as long as only high-prestige projects and recruits are seen as worthy. Not as long as endless financial growth is the only focus and the money only flows uphill.
OHSU has a communications department that crafts and markets a specific image to the public. OHSU uses its public reputation, built by the marketing strategists, to promote its services to the public. Medical providers, nurses, AFSCME-represented employees and others deliver those services. Every single day, in thousands of moments, in hundreds of locations around the state, we deliver for OHSU. Our efforts give OHSU a platform to stand upon to market itself as a health-care, research and academic leader. But OHSU’s marketing image doesn’t capture the true culture of OHSU — the everyday interactions between coworkers and management, between patients and providers, between business partners and the community. The version of OHSU that is marketed to the public bears little resemblance to the culture we see reflected in OHSU’s actions at the bargaining table in AFSCME Local 328’s current contract negotiations.
I came to OHSU because it had marketed itself as a place where the mission ruled all actions, and in my first year at OHSU I met people every day who lived and breathed the mission with passion and integrity. For me, the first crack in the polished image appeared when the nurses went on strike at the end of 2001. The behaviors I observed — the harmful and retaliatory choices that leadership made, the willingness to throw money away needlessly to fight and to punish the nurses for daring to advocate for themselves and for their patients — tarnished my view of my employer. The determination of the nurses and their union showed me that the only thing that would move the leadership was a threat to the public’s perception of OHSU. It was so puzzling to me that the idea of OHSU was more powerful to OHSU’s leadership than the actual structure and strength of OHSU.
ANNC Magnet status was finally awarded to OHSU because the nurses bargained for it, fought for it and pushed for a decade to make sure it happened. Now OHSU uses that designation to polish its brand; never once have I heard an acknowledgement that it had to be dragged kicking and screaming into the program in the first place, or that only the determination, passion and ceaseless work of those nurses brought down barriers and made it happen. I could likely name a couple dozen smaller projects where the exact same pattern plays out: the employees advocate, agitate and force OHSU into growth, and then OHSU markets that growth to polish those gilded edges, often without acknowledging the difficult path to the change or the incredible dedication of the groups who make change happen.
“We are disappointed that AFSCME did not meaningfully engage with us to help create a more competitive and market-appropriate benefits system.”
“OHSU is breaking ground in so many ways“
Look at those two statements. The Local 328 bargaining team has dedicated an incredible amount of energy and integrity to the proposals they have brought to the table, while OHSU brought austerity proposals (in a time of record profits) that will — literally — make thousands of represented employees poorer. What’s groundbreaking about a health-care organization making health care less affordable for its own employees?
OHSU states that it is “a mission-based organization with a vision to improve the health and wellbeing of Oregonians…” and that it embraces “the pursuit of quality in the broadest possible sense — a commitment to excellence in our mission areas and integrity in our behavior.” Does OHSU’s vision of improving the health and wellbeing of Oregonians not extend to its own employees? Does short-staffing its units signal a commitment to excellence? Is nickel-and-diming its employees a sign of integrity?
By proposing a few weeks of paid parental leave for some members of our bargaining unit, OHSU has failed to recognize (or care?) that an aging workforce needs to care for parents, not children. Why not be a leader and propose paid family leave that all employees could use? By rejecting Local 328’s proposal to offer free transit passes to employees upon request, OHSU has demonstrated a lack of understanding of the difficulties our members face just to get to work. OHSU claims to want to reduce the demand for parking on the hill, yet has turned away a chance to remove a barrier that would help do that. By refusing to engage in discussions with our union about staffing, OHSU has ignored study after study that shows how much of an impact stress has on one’s health. Is the pursuit of ever-higher profits worth the damage done to the morale and health of its employees, many of who are also OHSU patients?
By ignoring Local 328’s proposal to form a community advisory board, OHSU has turned its back on part of its own mission: to “lead and advocate for programs that improve health for all Oregonians, and extend OHSU’s education, research and healthcare missions through community service, partnerships and outreach.” This advisory board will bring together faculty, union-represented employees, students and other OHSU stakeholders address concerns such as health-care costs, housing and transportation issues, sustainability and clinic access. Why would an organization that wants to be a leader in innovation not want to participate?
Sound business strategies that lead to financial success are, of course, important to any corporation. Our union wants OHSU to operate with a sound financial foundation. Profits cannot be the end-all be-all, though — not if OHSU wants to truly be an innovator and leader in the ways that count. During this round of negotiations, OHSU has a chance to break out of the boundaries dictated by “the market” and create a culture where workers at all levels are appreciated, respected and valued.
Attracting and keeping top tier-talent never used to be a problem for OHSU. People with amazing gifts have always flocked to the hill and OHSU’s far-reaching programs for the chance to realize a vision “to make Oregon a national leader in health and science innovation.” If they aren’t coming now (or they aren’t staying) it’s not because OHSU’s wages and benefits aren’t competitive — it’s because the word is out that the real OHSU is hidden by a gilded veneer. That veneer is cracking.
During my time at OHSU, I have been naïve and hopeful, I have been hurt and disillusioned, I have been pragmatic and willing to sacrifice. Through it all I have been understanding and have always given OHSU’s leaders the benefit of the doubt in my heart. Until now. Now I am tired and disappointed, and sad that the OHSU I have always believed we could be become, will never be.