Rank and File Interview Series: Dennis Kosuth

Rank and File Interview Series: Dennis Kosuth

This interview is part of an initiative that the Chicago DSA Labor Branch has made to encourage people to take jobs in two selected priority areas: Logistics/Teamsters and Healthcare. No one should take such challenging jobs without understanding both the difficulties and the political rewards of working alongside people have power and influence in today’s economy. We believe that taking part in working class struggles from within as a rank-and-file member is the best way to directly assist in those struggles while learning from the people you are fighting with.


Why did you decide to go into healthcare?

When I dropped out of college, a comrade was working as a certified nursing assistant (CNA) and said it was a union job where they would certify you on the job. I only worked there for a few months after completing my training, because while I liked taking care of people, the working conditions were terrible. I worked the night shift and if they were short staffed on days, our union contract allowed management to force us to work another 8 hours. When that happened twice in one week, I quit. The pay was also garbage, as I was taking care of human beings, making just over $6/hr, (this was in the late 90’s), and I went over to UPS and made $8.50 to toss boxes around.

How did you end up back in healthcare after having such a bad experience as a CNA?

After spending about 4 years at UPS, I decided that being a package car driver was not for me, as I didn’t want to work 60 hour weeks out in the heat and cold, or develop the repetitive stress injuries many drivers had. I went back to school and became a registered nurse, because I could get back into healthcare, and have better working conditions than a CNA. I graduated from Malcolm X College in 2007, spending maybe $5,000 in tuition over the course of two years, and was making $25/hr at Mt Sinai Hospital – more than I have ever made before then.

After your initial experience in an understaffed nursing facility and then being at UPS and finding different challenges why return to healthcare?

There is no sugar coating it, nursing is not an easy job, especially if you are working in a hospital, and in particular if there is a pandemic. Turnover is very high, especially among new grads, as some people quickly discover it’s not for them. People handle the challenges in various ways, and some are more healthy than others. The one positive thing about nursing is there are many kinds of jobs a nurse can have, so if you can no longer stand the job you are in, there are other options out there. I left Sinai as the working conditions and benefits were terrible – it was a non-union job where a unionization campaign failed in the months after I started. Over the course of a year, in a campaign that started long before I had gotten there, management was able to flip 1/3 of the nurses from pro union to voting against it. I took a union job at Cook County’s emergency room, and it was much better in terms of working conditions.

Much of the healthcare industry is nonunion and the unsuccessful unionization campaign at Sinai is typical.  What should people know if they take jobs in healthcare and would like to form a union?  What sort of time investment should they be willing to make to have a chance to unionize a workplace?

It takes significant time, work, and politics to organize a union, it is not quick or something that has a specific end date, as there is a continuum from starting a unionization campaign through maintaining an effective fighting organization. It’s not the same as organizing within a socialist organization because unions represent all workers, from all over the political spectrum. This doesn’t mean you have to hide your socialist politics, but you do have to consider that most of your coworkers will not share your political views. While being a socialist will definitely be an asset in the efforts, you will also have to learn and develop new skills, especially when it comes to organizing alongside people with various backgrounds and politics.

What advice would you give to people who want to work in healthcare in terms of preparation for the job and what they should expect in terms of pay and schedule?

The majority of nurses start out and work in hospitals. The schedule is typically three 12 hour shifts a week, they work every other weekend and half the holidays, and if you are new, you might have to work nights before coming onto the day shift. The pay varies by hospital, and union hospitals pay better and have decent benefits. As a nurse with a masters degree and 15 years of experience, I currently make about $55 an hour.

What are the differences between certified or registered nurses?  What are the differences in responsibilities and how does the classification affect your schedule and compensation?

There are multiple levels of nursing, all of them requiring licensing and training on some level. CNA’s require a week’s long program, a licensed practical nurse is a yearlong program, and registered nurses can be trained by a two year associates program, or via a bachelor’s degree program. There isn’t a particular reason to start with your bachelors, as getting a job with a RN license is not difficult, due to high demand. More so, many hospitals provide tuition reimbursement to get your bachelors, so why pay for what you can get for free. There are also advanced practice nurses, which requires graduate level training, and is typically seen as a more professional and prestigious job since you are working independently from medical doctors and is less likely to be unionized – and people can research those independently. Typically speaking, the higher up you are in your training and license, the greater the pay and responsibility,

Would you suggest that a person interested in such a job first start working in a less skilled job than a nurse to see if they find the job rewarding and if they do what opportunities are there to acquire the training and skills that can move you into a job of a nurse?

People should go into nursing if they are interested in healthcare and working directly with the people who need it. While there are many different kinds of nursing, if you have zero interest in those things, then nursing is probably not for you. It certainly makes sense to start out working in some sort of healthcare field, or at least accompanying someone in that job, to get a sense if this is something you’d be interested in, as investing a lot of time, effort, and money into building skills you won’t stick with – would be unfortunate. There are many volunteer opportunities in hospitals and doing that will give you a view of the job and hopefully insight into if it is for you.

Can you contrast your responsibilities in both a hospital and school setting?

I left being a full-time emergency room nurse in 2016 and started working in schools. It’s very different work as the students in schools are typically healthy, and your primary responsibility is managing the health of the community, which includes educating people on health, providing first aid, making sure students are immunized, and that the health needs of students with health conditions are well managed, School nurses work the hours of schools, which means you are off weekends, holidays, and summer. The overall pay is less than in hospitals, but it’s mainly because you work less hours every year, which is why I still work one day a week at a hospital.

In a system where equal healthcare is not a right, how does that affect the people seeking healthcare and those providing it?

Nurses have a front row view of how broken our healthcare system is. When I worked at County’s ER, I would come into work at 7 am, and patients will have been waiting 8-10 hours to see a doctor – in the third largest city in the richest country human society has ever created. The racist nature of healthcare distribution is plain to anyone with eyes – and slaps you in the face every single day. Nurses are affected by this and as Marx wrote about work in general, are alienated by it. We are told our job is to heal, but we are not given the tools to provide actual healing. This is why I believe many nurses leave the job, because the gap between what we are expected to do, and what we can accomplish, is more than anyone can or should have to tolerate.

This sounds bleak.  How can healthcare employees turn their frustration into anger and agitation to change this broken system?

It is bleak, capitalism centers profit, not our humanity or healing – and there is no way to gloss over that fundamental fact. If you work in healthcare you will see bad things happening to people almost every day. Our society doesn’t have an interest in providing a political framework for anyone to understand why these bad things happen, so the most common explanation people have is: “they did something wrong.” This blame the victim mentality is pervasive in healthcare, but is beginning to shift, as an understanding of the social determinants of health become more widely integrated into our practice. Most healthcare workers are not given tools or options to turn their anger into action, much like most workers in our society. As a socialist, we should do our best to provide a materialist explanation to our coworkers and patients: capitalism is bad for your health, we need to change everything, starting with us having more control over our working conditions.

In the time you’ve been working in healthcare how have conditions changed for both workers and patients?

I started in 2007 and one thing that has improved with the Affordable Care Act is that more people, relative to before, are now insured, which is a positive thing – but still not what we need in a single payer, healthcare for all system. COVID has definitely exacerbated long standing chronic issues and brought them more to light. It has also resulted in many nurses leaving or planning to leave the bedside. In some cases, worsening conditions have also resulted in nurses organizing to fight back, by unionizing or striking.

Can you contrast working in union and non-union environments in terms of the quality of care and the working conditions within them?  If there is a typical day in a hospital, what does it look like?

I started answering this above but the difference between union and non-union are clear. At my non-union job I got paid less, had shorter and less breaks, had less sick time, no pension, and this jacked up vacation policy where if I called in sick, they would use up to three days of vacation before touching sick time. The working conditions in a union hospital were slightly better because we had a bit more staff. People tend to stick around the job if they have better working conditions. I was only at Sinai for a year, and people came and left even in that short time. A typical day in the hospital is busy, there is always something going on and never enough people to accomplish the needed tasks.

For people considering working in healthcare what strategies do you suggest for making it a sustainable job?

Find a kind of nursing that is sustainable to your life. Listen to yourself regarding your limits. Don’t overextend or be a hero and work a job that is bad for your physical and/or mental health. There are many kinds of nursing jobs, and if one is not good for you, switch jobs.

Your critique of the mythology that nurses are “heroes” resonates with me in a similar way with a mantra that educators face of “we’re doing it for the kids”.  These ideas of self-sacrifice for a job are often believed by workers being manipulated by their bosses to avoid adequate staffing or provide the necessary resources both human and material.  How cynical are nurses when confronted with unsustainable conditions on one hand and praise, but not pay on the other?

The contradiction between the two things is as clear as daylight, but what people should do about it is much less apparent. The majority of nurses, like workers in general, take an individualistic approach, which is to either suck it up and put your shoulder to the grindstone, or by quitting and finding a new job. Nurses in effective unions, however, have better options at their disposal, mainly organizing and fighting for the working and healing conditions our patients deserve.

How has the pandemic changed your work, and has it affected willingness of the people you work with to organize to change conditions?  Has it affected the turnover of skilled and less skilled jobs the same?

Covid has driven many out of the workforce and pushed others to organize, so it has had various effects. It has brought to light all the terrible things about how healthcare is run in this country and the effect it has on the people who work in it. In organized workplaces, an outlet has been to fight back and organize. In other areas where people don’t have that possibility, nurses have quit working the bedside and either found better jobs or left the industry altogether.

Much has been said about nurses leaving their jobs to take traveling nurse jobs purely because it pays better.  This seems destabilizing to me and an opportunity to fight for better conditions.  Have you seen any signs of the current crisis in moving people in the direction of trying to organize?

Organizing has been a path that many nurses have taken. For example, when the Federal government was considering capping the pay of travel nurses, a protest was organized via a Facebook group called National Nurses March which has over 200,000 members – but the turnout to the May 2022 event in DC was in the low thousands and politically all over the place, explicitly stating they are not “a strike, a riot,” or “a protest.” Nurses are also continuing to organize themselves into unions, such as at Howard Brown Health here in Chicago with the Illinois Nurses Association. Workers at Planned Parenthood across five states have also unionized, partially in response to the banning of abortion – which is an interesting intersection between politics and labor unions. Hopefully more healthcare workers will see the benefits of unionization and follow the examples being provided by fellow workers such as those who work at Starbucks or Amazon.

What are the rewards and challenges in working in your job?

The reward is you get to help people who need it, the challenge is that you are never really given the tools to give people the health they deserve. You will have multiple opportunities to speak about what you will witness and will have the moral authority to do so. Organizing coworkers will be a challenge, much as in any environment, as not all nurses share a left-wing political outlook, and as in general, most of your colleagues are not activists. You will, however, be in an industry where people will share with you a lot of similar concerns, and hopefully some of them will join in whatever organizing campaigns which present themselves.  

What advice would you give to people considering getting a job in healthcare today?

My main advice is to be sure you are interested in working in healthcare. Becoming a nurse is not an insignificant investment of time and money. If you have the opportunity, get a job in a place that either already has a union, or is in the process of organizing one. It is a very rewarding job with lots of organizing opportunities. It typically pays a living wage, and having those skills means you will likely never have trouble finding employment.


Join CDSA’s healthcare professionals at Healthcare Worker Organizing on Tuesday, September 20th, from 6:00 – 8:00 pm. We will be organizing within unions and supporting new organizing.