Nurses of a maternity hospital in Kolomna go on a hunger strike because of the slave labor

But this is not about machine-tool production with output in units of the product, but about the maternity hospital - a special place.

Julia Suntsova

A hunger strike is an extreme measure, and we were forced to approach it, say the junior nurses of the Kolomna Perinatal Center. Before deciding to take a desperate step, they tried to convey their arguments to various instances in official ways.

They called for a dialogue with the leadership, appealed to the prosecutor's office, the state labor inspectorate, divisions of Roszdravnadzor and Rospotrebnadzor, the Ministry of Health of the region. But legal methods - complaints and lawsuits - did not help. Worse, for trying to defend their labor rights and the rights of patients to quality medical care, the authorities unleashed persecution against the “rebels”.

"Since 2019, the indexation of salaries has been stopped, and this despite the fact that during this time there have already been two layoffs - accordingly, the load on the remaining nurses, that is, us, has increased significantly. Before each reorganization, at general meetings, they promise to increase wages, but over the past two years this has not happened", - comments junior nurse Natalya Trukhina, one of the participants in the planned hunger strike.

In 2019, with all the part-time jobs and bonuses, junior nurses could receive under 40 thousand rubles a month, but now they can’t jump out for 29-32 thousand rubles , while the volume of work has doubled. This is a 12-hour work shift, serving several posts at the same time, without lunch breaks. Where else is it?

The employees, tortured by slave labor, are only asking to sit down with them at the negotiating table and bring the payment in line with labor legislation.

"If our proposals are not discussed by January 31, we will be forced to start a hunger strike to draw the attention of the authorities, the public and the media to chronically unsolvable problems. The first participant goes on a hunger strike on February 2 at 8 am, the next will join with an interval of 5 days. There will be at least five of us", - says Natalya Trukhina.

The nurses also thought about a real strike, the right to which is provided for by Russian law. However, in this case, hospitalized women and their newborn children, who are already suffering due to a lack of staff, will be seriously affected. Stopping the work of even a few nurses can lead to sad consequences, the workers explain.

Today, instead of 160 junior nurses, provided for by the staffing standards of the Ministry of Health of Russia, there are only 22 junior nurses and about 20 outsourced cleaners. In addition, junior nurses were relieved of the duties of "optimized" nurses to zero, although this is unacceptable by professional standards - different professions, different labor functions.

What does staff shortage mean in practice? Suffering for the women and children in the center. For example, after 20:00, junior nurses of the admission department are forced to serve several departments and 8 posts at the same time: one post of the "receiver", one post of gynecology, two posts in the department of pathology of pregnant women, two posts in the postpartum, two posts of gynecology, and also with a large number of births, they are called to help in the maternity wards, our interlocutors explain.

"Imagine: in the department of pathology, a pregnant woman's water broke. The midwife calls the emergency department, calls the junior nurse to her to clean up after the woman. At the same time, the woman who gave birth began to bleed, and the midwife of the postpartum department also requires the “younger” to help herself. At the same time, a similar situation occurs in the gynecological department, the nurse of which also calls the junior nurse. And if at the same time an ambulance delivers a woman who is already in labor to the emergency department, then where should the junior nurse run? How can she break into all branches? But we have to break - these are our daily realities, unfortunately. With such multitasking, does a woman in labor and her child get proper help and care? The answer is obvious”, - says junior nurse Tatyana Momot, the second participant in the planned hunger strike.

The difficult situation is in the postnatal department, which combines three departments: the postnatal women's department, the postnatal children's department, and the department of premature babies. If in the department of premature babies there is an urgent general cleaning in the morning, then in other departments the middle staff is forced to either wait for the “juniors” or do everything themselves. For example, general cleaning in the intensive care unit is about two hours. This means that in the postnatal period, women are not washed up for doctors' rounds, bed linen is not changed, stockings are not put on, the vessels are not removed after the night. If the youngest is busy in the postpartum, then they suffer in the premature ward: both mothers and staff sit and wait for the youngest to be released. After 20:00, these three departments are left without their "juniors" at all. If a child is admitted to the department of newborns or premature babies, tests are taken from him, ward nurses are forced to leave their posts unattended ...

According to the nurses, in order to “disguise” the reorganization bacchanalia, the administration of the Kolomna Perinatal Center, with another reduction in the rates of junior medical staff, canceled the assignment of junior nurses to specific departments, classifying them as “general institution” personnel, which is a direct violation of the procedure for providing medical care, approved by the Order of the Ministry of Health of Russia dated October 20, 2020 No. 1130n.

The new provisions, in addition, allow the employer not to pay employees for processing, as the very concept of "additional / overtime work" is excluded.

The Ministry of Health of the Moscow Region, in its response to the claims of the nurses of the Kolomna Perinatal Center, replies that the staff standards are supposedly advisory in nature.

“<…> In the healthcare sector, there are no mandatory staffing standards, all of them are advisory in nature, including the recommended staffing standards that are part of the procedures for providing medical care”, - says a letter dated 12/24/2021 signed by the head of the department for organizing medical care for mothers and children of Aidar Sattarov.

Despite the discrepancy between the number of federal standards, the official also has the courage to assert that the staff list is drawn up "in accordance with the actual workload of the staff". This statement is absolutely unfounded and is not based either on documents or on the study of real work processes, employees of the Kolomna Perinatal Center say.

“Ignoring staff norms and labor legislation, especially as radical as in the Kolomna Perinatal Center, is unacceptable. The mandatory Rules for organizing the activities of the perinatal center clearly state that "the structure and staffing of the Center are established taking into account the recommended staffing standards." This means that taking into account staff standards (even if they are called “recommended”) is mandatory, and Comrade Sattarov, obviously, is substituting concepts for some of his own purposes, - comments Andrei Konoval, chairman of the interregional trade union of medical workers "Action".

In September 2021, the Kolomna City Prosecutor’s Office nevertheless filed a submission to the head doctor of the Kolomna Perinatal Center Tatyana Shavrak about eliminating violations of labor laws and announced that incentive payments were organized in the medical institution to employees providing medical care to patients with Covid-19. (Response of the Prosecutor's Office dated September 30, 2021 No. 1707-2021). In fact, junior nurses did not wait for any covid surcharges, and information about infected patients began to be hidden even more carefully, the interlocutors comment.

Half of the junior nurses (eleven) signed today's demands to the administration, five declared their readiness to participate in the hunger strike.

The head physician of the Kolomna Perinatal Center, Tatyana Shavrak, has repeatedly stated at general meetings that the reduction of nurses and junior nurses is supposedly a general trend dictated from above. “Junior medical staff will be completely reduced in all maternity hospitals in the region”, - she said (audio recording available).

"The leadership all the time turns the arrows to the Ministry of Health, as if it were there, at the top, that they are reducing our salaries and rates. But if there are such orders, show them to us. None of us saw these orders in our eyes. We are trying to defend not only our salaries, we are trying to defend the rights of pregnant women, women in labor and newborns to high-quality and timely medical care, to proper care, to worthy conditions of stay in maternity hospitals. Each of us or our loved ones may find themselves in the role of a patient, deprived of the help of a nurse or a nurse. This is scary!..", - the interlocutors explain.