Patricia Miller has been a registered nurse for 15 years, the last five of them at Group Health Association in Washington. She is paid $17,300 a year, $2,000 less than the national average, $300 less than the beginning salary of a GS8.
Money is not the sole reason, says the woman with the short salt-and-pepper hair, horn-rim glasses and white rubber-soled shoes, she is walking the picket line eight hours a day outside the offices of the area's largest health maintenance organization.
At GHA, her job requires that she not only care for the sick, she said, but also field a seemingly endless barrage of telephone calls from patients, set up appointments, even help fill out forms--time consuming tasks that could be done by clerical workers. "Most days, lunch is out of the question," she said.
"I'm on strike because nurses need the recognition they strongly deserve," Miller said. "Nurses do a good job, a very hard job, that goes largely unappreciated, except by their patients."
Miller is one of 80 registered nurses and five physical therapists on strike against GHA since last Thursday. Negotiations between the nurses and GHA management continued last night. A federal mediator imposed a gag order on both sides regarding discussion of progress in the talks.
The nurses, represented by the independent Registered Nurses and Physical Therapists Association, are seeking higher wages and additional staff members. GHA has acknowledged that the nurses should be paid more, but its proposed increases have not been accepted. GHA has insisted that staffing is not a real issue.
Yesterday, the union of GHA physicians, about half of whom have honored the picket line in which Miller and her colleagues have been walking at 2121 Pennsylvania Ave. NW, issued a statement of support for the nurses.
"GHA management has precipitated a crisis that impinges on the medical care of 113,000 people in the metropolitan Washington area," said Dr. Donald E. Mitchell, the union president. He accused GHA of using delay tactics, "unnecessarily prolonging a sad situation" and said management's wage offers were "unrealistic." However, the statement made no appeal for union members to take any kind of job action.
Since the strike began in the wake of a breakdown in contract negotiations, GHA has been rescheduling nonemergency appointments in all five of its clinics in Washington, Maryland and Virginia because of the absence of all nurses and the reduced attendance by physicians.
All emergency cases are being treated, association spokesmen say, and all patients who visit a center are assured of treatment, although only after unusually long waiting periods.
Miller, speaking in a makeshift strike headquarters around the corner from the picket line, said she considers it an important part of her job to introduce an element of calm into the disturbed lives of her patients.
"We're the front line at GHA," she said. "It's not a matter of dealing with a predetermined number of patients each day. We're called for advice, we help set up appointments, we listen to patients' problems, we assess whether a doctor is required or if a nurse or therapist can handle the problem, we explain to patients what a particular disease or health problem will mean to them, we teach them techniques like self-injection.
"That's fine. But then there are the phones. Patients tell us they can rarely get through, the phones are so busy, the forms to be expedited. This is work that can, that should, be handled by clerical people."
Miller said she went to work for GHA after she married and moved to Washington to join her husband Jeffery, a writer. With controlled irony, she said that she's now earning $3,000 less than she was paid at her last job in a Boston hospital five years ago.
"It may be because of its old Southern identity," she said, "but Washington salaries for nurses are well behind Boston, New York, Philadelphia, the whole East Coast. When I started here five years ago, they paid me $11,349."
Leaving her home in Arlington at 7:30 each morning, Miller said she reaches the downtown GHA center at 8 a.m., "to drink coffee and read the paper."
By the time office hours begin, at 9 a.m., she said, patients are already waiting in the earth-toned comfort of the waiting room. "That calm, friendly looking atmosphere is so deceptive," she said. "My stomach is usually tied up in knots."
But there are rewards, too. "Some people get better and they get better because of your help," she said. "Sometimes they call on the phone and ask for you by name: 'I want to speak to Mrs. Miller.' That means a lot. It's like the old relationship between the neighborhood doctor and his patients, it's one-on-one."
Miller dismissed the notion that a walkout by nurses might be considered professionally unethical. "Nurses and doctors are--whether the public believes it or not--workers," she said. "And I don't think we should try to separate ourselves from any other workers."