November 2010, Week 1


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Mon, 1 Nov 2010 22:51:32 -0400
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When Nurses Unite, Health Care Wins A Battle for
Healthcare and Unionism in DC Nurses' Struggle

by Brian Tierney

Published on Monday, November 1, 2010 by

In June, President Obama told a meeting of delegates of
the American Nurses Association that "Nurses are the
beating heart of our healthcare system."

Unfortunately, when it comes to working conditions and
cuts, nurses across the country have more and more
become the bleeding heart of our healthcare system. And
the worsening conditions faced by the single largest
section of the healthcare workforce have raised the
stakes for unionization and collective bargaining
battles in that sector.

In early October, a snapshot of this reality could be
seen at the largest hospital in the nation's capital.
Nearly 1,600 registered nurses at the Washington
Hospital Center (WHC) voted overwhelming to affiliate
with National Nurses United (NNU), the largest nurses'
union in the country. Formerly members of the
independent organization Nurses United of the National
Capital Region, 1,121 nurses among a turnout of 1,190
voted in favor of joining NNU.

Tense relations between the nurses and hospital
management were the backdrop to the NNU election
victory. Hospital executives have taken an increasingly
combative stance against the nurses' union in their
efforts to cut costs.

When asked about the overwhelming turnout by nurses to
vote to join NNU, Stephen Frum, an RN and lead
negotiator for the union explained the nurses' support
for affiliation in light of management's ongoing
hostility against them.

"Nurses at WHC are impressed with NNU and want to seek
broader and stronger allies in their fight for patient
care at our hospital," Frum said. "Frankly, the attacks
by management have been so terrible, we felt we needed
to bring more power to the fight for justice at the
hospital. Being a part of NNU will give us that
additional power."

Nurses hope that the new affiliation with a stronger
national union will not only give the nurses more power
at the bargaining table to negotiate a fair contract,
but also the extra muscle to reverse the hospital's
latest attacks.

A week before the NNU affiliation vote, the hospital
unilaterally cut take-home pay for most of the nurses.
The imposed takeaway, which includes cuts in shift pay
for evenings, nights and weekends, resembles similarly
harsh takeaways in management's last contract proposal
which 98 percent of the nurses voted against. The
nurses have been working without a contract since June.

"Management has shown tremendous disrespect for the
registered nurses and a callous disregard for the needs
of our patients, and the hospital's latest move only
adds insult to injury," Frum said in a press release
following the election.

He also noted that understaffing and other issues have
contributed to worsening work conditions and in turn
have led to increased turnover, with over 220 nurses
leaving WHC since the beginning of the year.

"The overwhelming decision by the Washington Hospital
Center nurses to join NNU sends a strong signal to
management that we're prepared to fight back."

While WHC management has tried to push through severe
wage cuts, the nurses' union has pointed out that the
hospital - which is run by a $3.8 billion non-profit
called MedStar Health - has maintained healthy margins.
MedStar Health's CEO makes an average of $2.7 million a

The hospital has been on the warpath against the
nurses, particularly over the past year as it has
sought to intimate and break their union. The hostile
atmosphere was set by management ahead of contract
negotiations earlier in the year when WHC terminated 18
nurses in March for not reporting to work during the
biggest blizzard to hit Washington, DC in more than 70

When this egregious attack hit the press, the union
mobilized its members to challenge the firings and
garnered the support of the local labor community.

Since the firings, nine of the 18 nurses were
reinstated following an investigation. But nurses
continued to stand in solidarity with each other. The
union filed an Unfair Labor Practice (ULP) charge in
July, citing the firings as a violation of the
hospital's snow emergency policy.

In August, 80 percent of voting nurses approved a
one-day ULP strike to demand that the other terminated
nurses be rehired and receive back pay. The union
ultimately called off the 24-hour strike because
leaders assessed that there was not enough support.

But the remaining nurses who were unjustly fired last
February may stand a better chance of getting their
jobs back with NNU support. Last week, the hospital
finally submitted to the first arbitration on the
matter and while the union is confident it has a solid
case, it is not ruling out other means to pursue
justice for the terminated nurses.

Prior to the NNU vote, contract negotiations had made
little or no progress as management continued to demand
cuts in pay and benefits. The union held several
pickets throughout the summer, including a nearly
2,000-strong picket of RNs and supporters at the
hospital in May.

With the added clout of NNU, registered nurses at WHC
have armed themselves with more leverage in their
negotiations with an obstinate employer. But the issues
facing nurses and their union at WHC are reflective of
a nationwide crisis in primary-care hospital services.

Understaffing is rampant in hospitals throughout the
country. Yet, as the new healthcare "reform" law takes
effect, the role of primary-care givers is expected to
grow significantly.

A year ago nurses and their unions were at the heart of
the fight around healthcare reform, with many pushing
for the public option or single-payer at a time when
the White House had already removed those options from
the table.

What ultimately passed as "reform" will bolster, rather
than eliminate, the private health insurance industry
as the central arbiter of who gets care and who
doesn't. But with millions forced into private health
insurance plans, the influx of new patients will
heighten the need for nurses. The growth of employment
opportunities in nursing that is expected over the next
decade will expand the nursing sector and could
translate to more power for nurses - if they are
organized. Currently, 21 percent of registered nurses
in the country are union members, according to the
Bureau of Labor Statistics. From an organizing
perspective, this reality raises the stakes for
unionization efforts among nurses.

With its most recent victory in DC, the National Nurses
Union is building on its membership of more than
155,000 RNs across the country. NNU is a new national
formation created last December with the merger of the
several smaller and largely state-based unions.

This unification signified a break from nurse
unionism's more fragmented history, offering the
potential of a more powerful voice for nurses
nationwide. NNU also represents a more militant
alternative to the other large nurses' organization,
the National Federation of Nurses, which is aligned
with the American Nurses Association and its penchant
for partnerships with management.

And the timing of NNU's inception may be pivotal. On
the one hand, the recession has led to cost cutting and
increased workloads in hospitals that are cutting back
on staff and nurse training. The impact on the nursing
profession in hospitals, both public and private, is
devastating in many cases, leading to high turnover
rates - to say nothing of the dangerous effect these
practices have on patient care.

On the other hand, hospitals in general expect
financial difficulties brought on by the economic
crisis to ease as the new healthcare law is
implemented. Hospitals will theoretically be less
burdened by the costs of caring for uninsured patients.
But as long as the economy remains weak and with
private insurance companies still at the center of the
healthcare equation, those potential benefits for
hospitals may be negligible.

As Judy Shindul-Rothschild, a nursing researcher at
Boston College, observed earlier this year, "If we
don't find a way either at the state or federal level
to once and for all put the private insurance companies
out of business, we will see more of these cyclical
efforts to squeeze the workers who provide care."

Understaffing and attacks on nurses' pay and benefits
have led to a number of other labor disputes at
hospitals in recent months, including 12,000 nurses at
14 Minnesota hospitals who came close to striking in
July, and the 28-day strike by some 1,500 nurses at
Temple University Hospital in Philadelphia in April.

Back in Washington, DC, NNU's role in fighting for
lower nurse-to-patient ratios will be important for the
nurses and patients at WHC. One nurse told the
Washington Post that she has double the amount of
patients that she has to care for at any given time
compared to when she started working at the hospital 11
years ago.

"I feel like I'm not doing the job that I want to do,"
she said. "I'm not doing a good job of taking care of
them, of meeting the emotional needs. It just breaks my

But now WHC nurses have larger forces backing their
efforts to win a decent contract. Their victory will be
a victory not just for NNU, but for the labor movement
as a whole and for all those at the heart of
healthcare: the nurses battling for their patients on
the frontlines of a profit-driven system. Brian Tierney
is a freelance labor journalist in Washington, DC.


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