Nursing Strike: The First Flexing of New Muscle by Empowered Unions
On one level, today's one-day strike of 12,000 nurses against 14 Minnesota hospitals -- reported to be the largest nursing strike in U.S. history -- concerns the same issues that divide nurses and hospitals everywhere: workload and pay. But the breadth of this strike, the aggressive demands of the Minnesota nurses' union and the threatened strike by California nurses against university hospitals suggest that unionized nurses are starting to flex their muscles.
About a year and a half ago, three nursing unions -- the United American Nurses, the California Nurses Association and the Massachusetts Nurses Association -- merged into a national union that claimed 150,000 members. One of the new union's top priorities was to get more states to adopt the strict nurse-to-patient ratios that are required in California.
Not coincidentally, the biggest issue in the contract talks between the Minnesota hospitals and the Minnesota Nurses Association, an affiliate of the national union, is the nurse-to-patient ratio. According to one report, the hospitals want the ability to reduce nurse staffing to levels that the union considers unsafe for patients. Another report says that the union has proposed the most stringent nurse-patient ratios in the country: for example, an ER nurse wouldn't have to care for more than three patients at a time, and labor and delivery nurses would not have to follow more than two patients. The hospitals say that these rules would cost them hundreds of millions of dollars and that they're unnecessary for good patient care.
David Abelson, CEO of Park Nicollet, one of the hospitals being struck, made the case that the hospitals can't afford to raise their costs by hiring more nurses because of the "harsh realities" posed by healthcare reform. He noted that with the Affordable Care Act encouraging a move away from fee for service reimbursement, the financial environment for hospitals is very uncertain. But as Igor Volsky of Health Wonk Room points out, hospitals supported healthcare reform because they expected that the revenue gain from newly insured patients would outweigh the Medicare cuts included in the legislation.
Meanwhile, 12,000 California nurses (I don't know why the number is the same; perhaps it has to do with astrology) are threatening to strike against University of California hospitals if they don't increase nurse staffing. The nurses temporarily backed off on June 9 after a San Francisco County Superior Court judge issued a temporary restraining order against the union. But the two sides are scheduled to return to court soon, and the hospitals are gearing up to fly in thousands of backup nurses at an estimated cost of $10 million to $15 million.
The Minnesota hospitals did the same thing today, supplementing nursing supervisors, non-union nurses and LPNs with 2,800 strikebreaking nurses who were flown in from all over the country. The scabs received $1,600 to $2,200 for the day plus all their expenses.
Where this will land, nobody knows. But here's a prediction: Hospitals can't afford to pay replacement nurses for very long, and the numbers of nurses willing to go on strike are very large in both Minnesota and California. If the nurse unions win in either place, hospitals across the country will soon feel intense pressure to increase their nurse-to-patient ratios. Where they will get the nurses from is anybody's guess, although the nursing shortage has eased recently as a result of the recession.
In the end, the referee of this standoff will be public opinion. After all, the Minnesota Nurses Association authorized only a one-day strike. If a strike lasted any longer than that, and hospitals could claim that patient care was suffering, public opinion could easily turn against the nurses.
Image supplied courtesy of Wikimedia Commons.
