A world without nurses would be a dismal place indeed. Nurses do many things for us, not the least of which is to care greatly for the health and well being of humankind.

Nursing is a job, but it is so much more. It is a calling that is deeply rooted in the soul of a good and caring nurse. I have been a nurse and answered this calling for the last 37 years. I work in an ICU in an acute care hospital, and have seen many changes impacting my chosen profession over these past years. Some of these change have been for the better. Recently, many of these changes have been detrimental to my profession and the care I am able to provide my patients. So it is appropriate I tell the story of these changes, and how nurses are able to fight back for their practice and their patients. The public has the right to know why the care they receive in an acute care setting has changed so dramatically. And they need to know of my strong, fight-back union, that objects to the negative changes that are being demanded by health care systems here, and all across our nation. I am speaking of the California Nurses Association/National Nurses Union.

Why would a nurse need a union? The answer is simple and complicated. Simply put, the health care industry, as it functions today, has an agenda that is causing the destruction of nursing practice and patient advocacy. The complicated answers are long and convoluted. Some of them are: lack of leadership and respect for direct care RNs from nurse academics and nurse executives; workplace violence that consists of pressure/bullying from nurse managers preying on RNs' job and financial insecurities, which thereby chills and diminishes the patient advocacy role of RNs; the RNs' lack of knowledge of legal requirements for their role in nursing practice and patient advocacy; corporate colonization of education and decay in educational standards. And last, perhaps most importantly, poor staffing, leading to always hurried and beleaguered RNs at the bedside.

In our society the corporate agenda outweighs human and societal needs. In health care the last line of defense for safe patient care is your nurse. For nurses the protection of patients and nursing practice is a difficult lift in the ever expanding corporate model, now firmly entrenched in health care delivery. That model puts profits before patients. There is a ray of hope however, and that hope lies in the work being done by the California Nurses Association (CNA), a nursing professional organization and a bedside nurses' union. The CNA is a union which fights for patients, and the bedside practitioner (RN) who is tasked with the safe care of the sick. The CNA is an activist union, and depends on the engagement of the bedside RNs who are represented in collective bargaining by CNA. But the CNA is so much more than a "contract." CNA resources include nursing practice education, health care research and trending, communication, government relations, legislative action for introduction of bills that support and enhance safe patient care ... such as the California Nurse to Patient Ratio Law.

Why have the nurses in Eureka elected to be a part of the CNA? Health care delivery is rapidly changing. New health care financing schemes, treating human lives as a commodity, results in restructuring on steroids, which drives the de-skilling, fragmentation, routinization, robotization and standardization of RN work. With these changes the work of the RN is less than satisfying. The substitution of technology for care is virtual care; it is not real. It is designed to enhance profit, and billing, and it is a concept that is morally indefensible. Corporate money turns the heads of elected officials away from the advocacy work nurses do on behalf of their patients and their profession. Nurses are truly standing in the gap between patients and those who roll the dice with their lives.

My union, the California Nurses Association, is a leader in fighting for health care access for every citizen regardless of ability to pay. CNA/NNU is also a leader in recognizing the right of the bedside RN to advocate for the health care rights of their patients. The CNA/NNU supports and enhances the nurses' ability to hold our employers accountable for safe, therapeutic, effective patient care and nursing practice. The California Nurses Association, National Nurses Union believes that health care "access" is a human right.

Kathryn Donahue is a Registered Nurse who works at St. Joseph Hospital in the Intensive Care Unit, and a member of the California Nurses Association/National Nurses Union.