Q&A with Peggy Smith 

Peggy Smith retired from Providence Holy Family in Spokane after 35 years in medical oncology. She started at Holy Family as a nurse’s aide before getting her nursing degree from Spokane Community College in 1991. Smith cares deeply about nursing, patients, Holy Family, and being part of a union. She was on the WSNA negotiating team for 20 years and served 10 as co-chair.

During one of the negotiations, a person on the management side called Holy Family “a quaint little community hospital,” and that didn’t sit well with her, Smith said.

“I told them, we can do anything any other hospital can do but do it better. Don’t call us that again.”

Holy Family is recognized by the American Nurses Credentialing Center as a Magnet facility — one of five hospitals in the state of Washington that have achieved this designation, and the only one east of the mountains.

We sat down to get her perspective on nursing.

Why Holy Family? 

I started out at Holy Family because that is what was close to me. The people I worked with are like a family. There is hardly anyone I don’t know. One hundred-plus people showed up at my sendoff.

What did you like about medical oncology? 

Cancer patients are a special group of people. They are kind and brave and a pleasure to take care of. I encourage young nurses to become chemo certified.

I tell new nurses: if you belong here on this floor, you will be happy here. If not, you will find where you belong. You may not go into medical nursing, but you will learn all the basics. From here, you can fly. For me, medical was my home. It was where I belonged.

Did you have a memorable patient? 

I had a chemo patient who had a similar sense of humor as me. He was one of the bravest souls I ever met. He said he wasn’t going to have a bone marrow transplant because he was in his 70s. He went home and died. I will never forget him. The kindest, bravest soul ever.

Did you have a difficult patient? 

I have had my hair pulled out, so it left a patch, been punched in the face, and threatened. If I ask a patient, “How are you doing?” and they respond with “It’s none of your business,” then I leave them alone.

I don’t know where my courage came from, but one time when a tall, unsteady patient stood up and didn’t respond to the request for him to sit down, I told him, "You are going to sit. You are not going to fall on my shift.” He sat back down and told the other nurses after I left, “Man, I bet everyone does what she tells them.”

What did you like about being in a union? 

The union is where our voice is. This is where we can stand up to administration without getting in trouble. I liked standing up for what nurses deserved.

I fought for a closed shop at Holy Family in the bargaining unit (meaning all nurses are required to be union members, with certain exceptions). It was the hardest negotiation I had ever experienced. We negotiated for three days straight from 9 a.m. to 10 p.m. And then a fourth day. We weren’t going home without a closed shop. Management was doing everything they could to break the union. Right about the same time, nurses at Deaconess Medical Center in Spokane voted out their union and then were given significant pay cuts.

We need every single nurse to be part of the union. That’s how we are going to be strong. Without the union, you have no one to back you up. If you are a nurse and not part of a union, you need to join. It’s worth every cent of your dues.

How has nursing changed?

It’s harder for nurses now. Nurses have more things put on them. So much has been taken away from ancillary staff and placed back on the plate of the nurse, which adds to some of the stress.

When I first started on my floor, I was partnered with a certified nursing assistant, and we worked as a team. The CNA would be in charge of turning patients, taking blood draws and vital signs, passing trays, answering call lights, helping patients to the toilet, and changing them.

Now, CNAs get twice the number of patients as nurses, and nurses are picking up their duties.

In my unit, certified nursing assistants don’t take vital signs or do blood sugars. I have picked up trays, changed patients, turned them, brought them to a toilet.  What has improved, however, is that it’s easier to get in touch with doctors through instant messaging.

What is your concern for nurses? 

I’m worried about the safety of nurses. In the last five to six years, we have been seeing escalating violence by patients. Nurses don’t always have the training or the tools to safely address violence in the workplace or how to deal with patients with alcoholism or dementia. This is an opportunity to create a safer environment. I feel nurses would benefit from formal workplace violence prevention training, maybe twice per year. Through training, nurses can learn to read body language and understand how to not let a patient get in between them and the door.

What are your words of advice? 

Don’t be afraid. Nurses come out of school so scared. Are you going to make mistakes? You bet. But learn something from every mistake you make. Keep an open mind and don't be afraid towha ask questions. The only dumb question is the one you don't ask. Always look at orders. Read everything from beginning to end, including drop down. You need to know everything about the patient, not just lab values. Get to know the patient. Ask questions. With that, you will be better able to deliver the care they need.

Nursing is hard but it’s such an honor to be a nurse.

What’s next? 

Every morning on the way to work, I talk to God. I told him, I must quit nursing. I’m turning 70. I’m not skinny, it’s hard to turn patients. I just want a little job, one day a week. I got to the hospital recently and ran into a wonderful person. I asked what caused her stress. She told me that she needed to have a few more days a month off. She runs a ministry that teaches CNAs. I’m going to work for them. I still get to be doing nursing but on a different scale. I will miss being part of negotiations with WSNA; it was hard to check out.