Nurses Strike for: Quality Health Care

by Andrew Pollack / November 2007 issue of Socialist Action newspaper

Two nurses' strikes that began in October have displayed not only the continued militancy of this part of the health-care workforce but also the key role nurses play in the struggle for quality health care for all. In both strikes nurses were fighting for improved wages and benefits. But even more prominent were their demands for clauses in their contract enabling them to provide quality patient care.

On Oct. 10 and 11, some 5000 registered nurses (RNs) represented by the Calif. Nurses Association (CNA) struck 13 hospitals in the Sutter Health chain and two Fremont-Rideout Health Group hospitals. When the nurses tried to return to work they were locked out for three more days in retaliation.

The Sutter strike overlapped in time with negotiations at Children's Hospital, three Orange County hospitals recently sold by the Tenet Corporation, and the University of California's hospitals. Patient care issues raised at some or all of the hospitals included:

• Contractual language to enforce the RN-to-patient ratios mandated by state law.

• Safe and adequate RN staffing at all times. Nurses often forego breaks for fear of leaving patients unattended. Nurses in new baby nurseries report having to wheel babies to the restroom rather than leave them alone.

• End the forced use of vacation time when nurses are sick, essentially forcing RNs to work when ill, thus endangering patients.

• End to mandatory shift rotation, which erodes alertness, another danger to patient safety.

• End cuts in time allotted to CNA representatives to work with RN patient care committees.

• Use new technology to support, not displace RNs, and not to override their ability to make independent clinical judgments.

• A safe lifting policy to stem the rise of RN back and other injuries and reduce patient falls and accidents. Understaffing is also an issue here, as nurses are often forced to lift patients on their own.

• More training of new nurses in specialized skills required by pediatric hospitals. CNA is also fighting Sutter's "medical redlining"—i.e., cutbacks or closure of facilities—in working-class communities, especially those that are majority people of color.

CNA points out that Sutter has a contractual obligation to bargain over closures. Sutter nurses themselves are impacted by decreasing access and rising health-care costs. One RN told the press her health-care premium tripled overnight from $49 to $155 in the midst of the last contract.

Sutter imported scabs from around the country. In so doing they violated state law requiring proof of competency in nursing tasks. As with the nurse-patient ratios, in 1999 CNA had supplemented legal requirements with contract language on competencies. There has been no settlement yet with Sutter or UC, but agreements at other facilities achieved gains in some of these areas.

Meanwhile, on Oct. 1, 800 RNs in the United American Nurses (UAN) went on strike at nine Appalachian Regional Healthcare (ARH) hospitals in Kentucky and West Virginia. As we go to press in early November, they remain on the picket line. Scabs have been used in this strike as well.

Here too, key demands revolve around patient care, including staffing levels and rampant mandatory overtime. Said one RN in Kentucky: "Some days we have as many as 12 patients to care for. That's too much for one person to do without making a mistake."

Management is also proposing to wipe out proposed modest pay raises by cutting holiday pay and increasing health-care premiums.

UMWA President Cecil Roberts condemned the chain's owners, and pointed to the discrepancy with the hospitals' founding mission. The hospitals in the chain were built in 1956 and run by the union until 1963 "to provide care for miners and others from the coal fields who were overlooked by the health-care system."

The United Steelworkers, whose 2700 members at ARH hospitals walked out for three weeks in the spring, is also supporting the RNs. The USW represents certified nurse aides, licensed practical nurses, housekeepers, maintenance and clerical workers at ARH hospitals.

On Oct. 25, RNs from Louisville and California arrived in Hazard, Ky., to support the strikers' fight, in the words of the AFL-CIO weblog, for "stronger patient care protections." The group included members of the Nurses Professional Organization of Louisville, an affiliate of the 75,000-strong National Nurses Organizing Committee, CNA's national arm.

CNA/NNOC members from Los Angeles and Chicago also attended. Jill Furillo, RN, CNA's Southern California director, pointed to the communality with issues faced back in California: "The central issues of inadequate staffing and forcing nurses to work overtime are critical patient safety problems."

The awareness of the link between worker rights and patient care on the job has inspired CNA/ NNOC to take the fight for quality health care outside the workplace as well. CNA/NNOC has been the most prominent union fighting for single-payer ("Medicare For All") health care, including working with Michael Moore in organizing efforts inspired by his movie "Sicko."

As the fight for universal, free health care for all heats up, hopefully all health-care workers' unions will make this connection.