Shortage Prompts Labor Action by Nurses

Emboldened by a worsening nursing shortage, unionized nurses throughout California are conducting informational pickets, threatening strikes and walking off the job to demand higher pay and better working conditions.

The heightened activism is being led by two rival unions that have seized upon nurses’ frustration to launch large-scale organizing drives and push for major contract improvements.

The workplace climate clearly has hospitals on edge. Two medical centers affiliated with Sutter Health in Northern California have asked temporary nurse staffing agencies to prepare for strikes, even though union contracts with the hospitals haven’t expired.

“When you look at the labor activity around the state and when you look at some of the tough issues that are out there in negotiations, we have to be prepared for a worst-case scenario,” said Debbie Goodin, vice president of administrative services at Mills-Peninsula Health Services, affiliated with Sutter Health.

By coincidence, many of the contracts negotiated by the California Nurses Assn., the state’s largest nurses’ union, will come up for renewal this summer.

“It’s going to be a very hot summer in California,” said Rose Ann DeMoro, executive director of the CNA, which represents more than 44,000 registered nurses. “The nurses are stepping up and taking the power they should have always had. It’s incumbent upon the nurses to save the [hospital] industry from itself.”

Consolidation of the hospital industry, especially takeovers by large corporations, has emboldened the nurses, said Lois Friss, an emeritus professor of health administration at USC.

“When you’re in the neighborhood and you’re working for your community hospital, they don’t come across as big, powerful, important, rich organizations,” Friss said. “But when you see a big system, a UC system, you become aware that it isn’t individual orders of nuns with one or two hospitals. It’s easer to say, ‘Hey, maybe we’re being taken advantage of and we need to do something about it.’”

Among the recent job actions:

* The union representing nearly 8,000 nurses within the massive University of California health system voted to strike last month after negotiations stalled. Days before a planned one-day walkout, the UC agreed to drop its long-standing merit pay plan, which had been a key dividing point with the California Nurses Assn. The strike was averted.

* Health-care workers, including registered nurses, staged a walkout over the Memorial Day weekend at Queen of Angels-Hollywood Presbyterian Medical Center to protest low wages. This week, the hospital suspended at least 30 nurses who called in sick the day before the walkout. The Service Employees International Union has filed charges against the hospital of retaliation and intimidation with the National Labor Relations Board. A hospital spokeswoman wouldn’t comment.

* Nurses at 20 Catholic Healthcare West hospitals--including Glendale Memorial Hospital and California Hospital Medical Center in Los Angeles--held an informational picket on Thursday to draw attention to what they consider problems affecting nurse retention and recruitment. A spokesman for Catholic Healthcare West said the system stands by its latest contract with the nurses, which was ratified six months ago

* Registered nurses at Palomar Medical Center in Escondido voted in favor of a protest strike in June, even though they are not represented by a union. The nurses and the hospital’s governing board disagree about which nurses are eligible for union representation, delaying a union recognition vote.

“Nurses are so willing to organize to deal with patient issues, they’re willing to strike before they have representation,” said David Johnson, the CNA’s Southern California director.

The largest contract set for renewal this summer involves 10,000 nurses who work for Kaiser Permanente in Northern California. In 1997-98, when the previous contract expired, the CNA held six strikes--each lasting one to three days--at Kaiser’s 47 facilities from Fresno to Sacramento.

Kaiser spokesman Jim Anderson said the company wants to ensure that its nurses are happy. “We’re doing a lot to listen to what our nurses are saying and the concerns they’re raising, and we’re trying to address them both within and without the upcoming bargaining process,” he said.

Health labor experts say several issues are coming together at once. Nurses have grown increasingly upset about working conditions, wages and benefits. They want a share of the proceeds from double-digit HMO premium increases. And they want limits on mandatory overtime shifts and the number of patients assigned to each nurse.

Nationally, the average salary of a full-time registered nurse in 2000 was $46,410, according to the U.S. Bureau of Labor Statistics. In California, the average annual salary was $56,140.

Many veteran nurses see less need to work, and not enough young ones are being trained to replace them.

“You’ve had a drumbeat now for 18 months, with people from different quarters saying, ‘This is a crisis,’” said Edward O’Neil, director of the Center for the Health Professions at UC San Francisco.

In addition, thanks to advances in medical care, patients in regular units are sicker than those treated in intensive care 25 years ago, said Luisa Blue, president of the SEIU Nurse Alliance of California. At the same time, she said, “because of managed care, there is this tremendous pressure to get patients out of the hospital sooner.”

Jan Emerson, spokeswoman for the California Healthcare Assn., a hospital industry organization, said registered nurses have an advantage because of the worsening shortage.

“They can threaten to strike and get some concessions,” she said. “What they have in their favor is economics of supply and demand.”

Goodin of Mills-Peninsula said her medical center went into negotiations with the nurses knowing that “we would have to be very generous with our offers.... It’s definitely not a negotiating environment in which one can introduce any significant take-aways.”

The CNA and SEIU have both seen their ranks increase in recent years, but the two unions have taken opposing positions on several important issues such as staffing levels, collaboration with hospitals and the role of licensed vocational nurses.

One labor expert called the longtime battle between the two unions unfortunate.

“Most of the people in both of those organizations actually have the same vision for the labor movement, but they’ve been stepping on each other’s toes for a long time,” said Kate Bronfenbrenner, director of labor education research at Cornell University.

Nurses say hospitals haven’t done enough to keep them happy.

“A lot of hospitals have been losing senior nurses because of benefits,” said Myrna Valmeo-Ogilvie, a registered nurse at Glendale Memorial Hospital who picketed on Thursday. “This is a good time. The nurses are all inspired.”