Strikes by healthcare workers declined significantly last year, according to figures obtained by MODERN HEALTHCARE. But many of those that did occur-especially work stoppages at hospitals-involved nurses and were particularly nasty.
The nurse strikes at hospitals may be a glimpse of the festering ill will between organized nursing and hospitals, which are dramatically restructuring their work forces to cut operating costs.
Some 27% of the hospitals that are trimming their work forces cited nursing as a target for cutbacks, according to the 1994 hospital human resources survey by MODERN HEALTHCARE and Deloitte & Touche (Dec. 12, 1994, p. 33).
Organized nursing, led by the American Nurses Association and the Service Employees International Union, is orchestrating a national campaign against hospital restructuring, which it says is jeopardizing patient care (Feb. 13, p. 38).
In fact, the ANA was scheduled to lead a march on Washington late last week to raise the visibility of the restructuring debate. The ANA said it expected 10,000 to 20,000 nurses to participate in the rally.
But if last year's strikes are any indication, nurses' opposition to hospital restructuring has as much to do with job security as it does patient safety.
That apparently was the case at Marquette (Mich.) General Hospital, where more than 300 registered nurses went on strike for nearly eight weeks last summer to protest the hospital's ongoing work redesign project.
It's not clear whether the project will result in lost nursing jobs, but that's what the Michigan Nurses Association was thinking when it called for the strike, said Bob Raica, assistant administrator at the 359-bed facility.
"The MNA's motivation was to protect union membership," Raica charged.
The strike ended after the hospital agreed to form a 10-member joint hospital-nursing committee to review all changes in nurse staffing levels.
The strike at Marquette General was one of six work stoppages by unionized hospital employees in fiscal 1994, according to data obtained by MODERN HEALTHCARE from the Federal Mediation and Conciliation Service.
MODERN HEALTHCARE requested the data under the federal Freedom of Information Act. The data cover strikes during the federal government's fiscal 1994, which ended Sept. 30.
The FMCS is a federal agency that monitors labor disputes. Federal law requires unions to notify the FMCS of a strike. Compliance with the law isn't universal, and the actual number of strikes against healthcare providers may be higher. Also, the FMCS doesn't have data on threatened or actual work stoppages by non-union employees.
According to FMCS data, at least 26 strikes occurred in the healthcare industry in fiscal 1994. That's down 38% from fiscal 1993's total of 42 healthcare strikes (Jan. 17, 1994, p. 38). The healthcare industry figures are for work stoppages in all settings, including hospitals, nursing homes and outpatient clinics.
At hospitals, however, unionized workers walked off the job at just six hospitals last year (See chart). That's half the hospital strikes that occurred in both 1993 and 1992.
In five of the six hospital strikes,the picketing employees were nurses, and many of the work stoppages were loaded with labor rhetoric worthy of the fiercest industrial labor disputes.
More than 600 nurses struck Jersey Shore Medical Center in Neptune, N.J., last year for 98 days. The nurses, represented by a branch of the American Federation of Teachers, objected to a proposal by the 499-bed hospital to replace a system of across-the-board pay raises with merit-based pay.
During the strike, the nurses accused the hospital of abusing its tax-exempt status by generating high profits, limiting charity care, entering into business deals that benefited insiders and paying exorbitant executive salaries.
"Such hospitals want to conceal their prosperity to keep large donors from shying away from making contributions, patients from balking at high medical charges, state regulatory agencies from asking too many questions about charity care and employee unions from demanding higher wages and benefits," the union said in a report released about a month after the strike began.
The strike ended March 12, 1994, after the union gave up its opposition to the proposed merit-pay system.
Just as ugly was the six-month nurses strike at 120-bed Mercy Community Hospital in Port Jervis, N.Y.
Some 65 full- and part-time nurses walked off the job last Sept. 1 and didn't return until 187 days later. It was the longest hospital strike recorded by the FMCS in fiscal 1994.
The nurses' union, 1199 National Health and Human Service Employees Union, also conducted a labor campaign in Michigan, home of the hospital's management company, Mercy Health Services of Farmington Hills.
In January, Mercy obtained a temporary restraining order from a federal district court that stopped the union from running radio and television advertisements targeted at the alleged anti-labor policies of the Roman Catholic hospital system.
The dispute centered on the hospital's refusal to recognize the union as the legitimate collective bargaining agent for the nurses.
The strike ended last month after the hospital's sponsor, the Sisters of Mercy, Regional Community of New York, expanded the hospital's governing board to 24 from 15, and the stacked board voted to reverse the position of the old board and recognize the union.
The hospital and the union subsequently entered into a three-year contract retroactive to Sept. 1, 1994, when the nurses walked out.
The contract bars the hospital from laying off nurses with five or more years of experience, and it limits the replacement of registered nurses with lesser-skilled workers. The nurses also will get four pay increases of 4% each over the life of the contract.
However, the labor strife at the hospital is far from over despite the new contract. Some 105 nonstriking nurses have filed a petition with the National Labor Relations Board to decertify 1199 as the nurses' collective bargaining unit, and the litigation over 1199's actions in Michigan is still pending.