An educator's trip to the ER reveals an unpleasant truth about our city's budget
By Sasha Cuttler
OPINION San Francisco Unified School District teachers and Department of Public Health nurses are going through difficult times. Despite years of service reductions, layoffs, and ceaseless budget pressures, teachers continue to educate San Francisco's young people while nurses care for the sick and injured.
One week before the end of this school year, Balboa High School math teacher Ruth Radetsky was found unconscious after flying over the handlebars of her bicycle. She was brought to San Francisco General Hospital and Trauma Center, where she was treated for broken ribs, scapula, and cracked vertebrae. Although she suffered a concussion, she avoided a more severe head injury because she wore her bicycle helmet.
After being stabilized in intensive care unit and transferred to the step-down unit, Ruth was instructed by nurses to call for help before trying to get up. She was afraid of the pain but understood the importance of regaining mobility. Her injuries and the side effects of the pain medication put her at high risk for falling. Noting how busy the nurses were, however, Ruth felt badly about having to "bother" the staff.
Ruth and the nurses at SFGH who cared for her have a lot in common. Both education and health care rely upon appropriate ratios: teachers to students and nurses to patients. Students and patients alike benefit from these ratios. Despite the need for enough human resources, adequate staffing depends on other factors as well.
Ruth explained how a reduced class size is not enough. In one of her classes, nearly half of the students had learning needs that required preferential seating. Not everyone can sit in the front seat. Nurses with a floor full of patients who need close observation because they are experiencing delirium tremens, traumatic brain injury, or even a mass casualty event have to do similar triage. In both cases, maintaining the minimum staffing may be inadequate — which is why nurses and teachers need support to achieve quality education and healthcare. And UCLA researchers have demonstrated that lower nursing staffing in hospital wards is associated with increased patient mortality.
While researchers argue about the effect of increased class size and nurse-patient ratios, teachers and nurses in the public sector struggle to maintain professional standards of education and care. Ruth is worried about the effects of teacher layoffs on her students. At the same time, the nurses who cared for her at San Francisco General Hospital are being told that layoffs could result if wages and benefits and staffing aren't reduced. In both professions, staff is concerned about maintaining adequate services with fewer resources.
Teachers and nurses in the public sector continue to be predominately female. Perhaps because of traditional gender roles, teachers and nurses tend to be apologetic about taking a stand for their own working conditions. Unlike an assembly line worker, a teacher or nurse's profession is all about people, not things. It is only logical that too many students make it difficult for each to receive the amount of support needed. It's dangerous for nurses to not have enough time for patient assessment and care.
Teachers such as Ruth Radetsky and the nurses who cared for her embody the very best of public education and health. San Francisco Unified teachers and Department of Public Health nurses should not have to apologize for upholding high standards and demanding a professional environment to teach the young and care for all of San Francisco.
Sasha Cuttler, RN Ph.D, is a nurse and activist in the SEIU Local 1021 RN chapter. He has been friends with Ruth Radetsky for more than 25 years.