Priscilla let many rules slide, actually. She seemed to try to look out for the nurses as best she could, which couldn’t have been easy because she also had to enforce the new policies thrust upon them by the Westnorth Corporation, the giant healthcare system that had taken over the hospital six months earlier.

At 7:20 p.m., the charge nurse assigned Molly to put a Foley catheter in an obese paralyzed patient, a somewhat time-consuming procedure that required assistance. Molly walked to the nurses station, where five nurses were giving report to the oncoming shift. “Y’all, can I get a little help in Room 3 with the Foley?” she asked. The nurses ignored her. They didn’t even make eye contact with her.

These weren’t generally uncivil nurses; they were just busy. The outgoing nurses were determined to give report and go home, and the incoming nurses didn’t want to be bothered with someone who was not their patient. The nurse Molly would give report to was already working on a trauma patient. Molly knew that if her friend Juliette had been on duty, she would have been at Molly’s side in a heartbeat.

Molly looked over each of the nurses with her piercing green eyes. A tall, striking brunette, she was hard to miss. Five people were ignoring her—and she was not a quiet person. She had hoped that one of them would sense her frustration and offer to assist. But she would not badger them into helping her out.

Typically, many of the nurses at Pines worked well together, giving aid when needed, knowing they were in it together. Erica, for example, was constantly assisting her coworkers at bedside on top of her supervisory duties, as she was today. Ever since the buyout, however, the atmosphere had changed. The morale was as low as Molly had ever seen it. People were just too tired and angry to help each other out. The staff knew why Pines had allowed the buyout: Independent hospitals across the country were having trouble turning a profit because new insurance guidelines made getting reimbursement for medical care more difficult. Westnorth had instituted several changes that angered the nurses, including cutting their weekend overtime pay and slicing vacation accrual in half.

One of the worst new policies forced nurses to pay for parking at the hospital while techs and physicians could still park for free. The nurses who didn’t want to pay for the covered garage would have to park at a satellite garage that was a shuttle bus ride away from the hospital. To catch the bus, nurses would have to get to work thirty minutes before their shift began and wouldn’t get back to their cars until at least thirty minutes after their shift ended, effectively adding an unpaid hour to their workday. What kind of company wants to make money off its employees like that?! Molly had wondered, dismayed.

The hospital takeover had directly and indirectly affected patient care, too, which was evident when Molly ended up struggling to insert the Foley alone. The procedure took longer than it would have if another nurse had helped to lift the obese patient. ER staffing was supposed to be determined by the number of patients who came in. The number had increased drastically enough to justify an additional staff nurse for every shift, but Westnorth had refused to hire anyone. Consequently, waiting time to get into the short-staffed ER had increased from an average of thirty minutes to three hours.

That night, on the drive home, Molly cried with frustration. She was known as being thick-skinned rather than a crier. She was so tough that once while playing pickup basketball, she tripped and broke her arm, but waited hours before going to the hospital because she was having too much fun to stop playing. Now she cried because the once tight-knit hospital no longer seemed to care about the welfare of its nurses, and her usually co- operative coworkers were so worn down that they “acted like I was invisible.”

As Pines Memorial’s treatment of nurses deteriorated under Westnorth, Molly had toyed with the idea of leaving the hospital. Earlier in her career, she’d worked as a nurse for an agency that assigned her shifts at different hospitals. As an agency nurse, she could choose which days she worked, and the pay was slightly higher. To return to the agency, where she was a nurse in good standing, all she had to do was fill out paperwork and send in her latest certifications.

Molly had stayed at Pines because she enjoyed learning from her experienced colleagues. But lately, there had been too many days like today. That night, she called Priscilla and left a voice message about the day’s events. “I have gone home angry and in tears more in the last two months than I have in my whole career. If I leave work angry again, I will not come back.” It may not have been the best way to let her boss know that she was close to quitting, but she was too frustrated to care.

The next morning, Molly, the designated trauma nurse, was able to focus exclusively on her patients without having to deal with politics, or so she thought. A middle-aged woman had multiple injuries from a car accident, and the operating team would have to repair her ruptured spleen. Molly’s job was to keep her stable in the trauma room until the OR was ready. As Molly connected the patient to a monitor, a nurse sitting at a computer called out from the nurses station.

“You’re going to love this one, Molly,” she said. “Now we’re going to have to pay for fancy uniforms!”

Molly froze. “What?” She breathed deeply. She had a patient to take care of. “Just a minute. Let me finish what I’m doing and I’ll come over.”

While Molly continued to work on the patient, the other nurse read aloud the policy, which administrators had posted on the employee website without notifying the ER nurses. All staff would now be required to wear a standard uniform. But only the nurses would have to pay for the uniforms out of pocket.

“What about the doctors and the techs?” Molly asked.

“Nope,” the nurse replied. “They’re covered.”

That was the last straw. It wasn’t the uniform, specifically. It was what the uniform expense represented: Pines didn’t appreciate its nurses. Furthermore, management gave employees little motivation to work hard. Hospital employees weren’t held accountable for their actions, and the supervisors were either too wimpy to enforce important hospital rules (Priscilla) or played favorites (Charlene). Too frequently, certain nurses and techs called in sick, then posted vacation pictures on Facebook. Or they were unprofessional: Lucy, the laziest tech in the unit, had refused to do lab work on patients she deemed too “gross” to touch. As Molly said, “There are no consequences for poor work ethic and no rewards for good work ethic.”

Later that morning, Priscilla gathered the ER nurses to tell them about the new uniform policy. While the group splintered into side conversations, Priscilla brushed her dark bangs off her face and put a hand on Molly’s arm. “I got your message,” she said.

“This place is coming apart at the seams,” Molly told her.

“I know.”

“I’m holding to my word on my message yesterday.”

Priscilla nodded, placating.

“I’m not changing my mind,” Molly said. “I’m giving you one month’s notice. The uniform is just the last straw.” She could call the agency tonight, start the re-registering process, and begin orientation within weeks. She was giving Pines Memorial ample notice because she didn’t want to leave her coworkers even more shorthanded.

Throughout the rest of the day, nurses complained about the policy. “They’re kicking us when we’re down,” they said. “The changes are making things worse.” They looked at Molly because she was one of the most outspoken nurses.

“Doesn’t matter to me,” she said. “I just quit.” Her coworkers laughed dismissively. “No, I actually did, y’all. I gave notice.”