Unionized nurses from across the United States gathered last week in San Francisco to gird themselves for a major attack on the restructuring of the U.S. healthcare system.
They denounced the "corporate greed" they said is corrupting healthcare delivery and vowed to rededicate the system to patient care and the needs of healthcare workers.
About 800 nurses and labor representatives met for two days at an International Unity Conference, jointly sponsored by the California Nurses Association and Canada's National Federation of Nurses Unions.
The CNA represents 25,000 nurses, mainly in Northern California, and is re-Nursing
garded as one of the most aggressive nurses' unions in the country. The Canadian federation represents 50,000 nurses in six provincial unions.
The California nurses want to forge an alliance with U.S. labor unions and consumers to insist that quality of care be maintained in the face of what they contend are profit-driven cutbacks in healthcare services. They also want a single-payer healthcare system in California and the United States.
To put fire in their bellies, conference organizers brought in the Rev. Jesse Jackson and consumer advocate Ralph Nader to address the nurses. Both headline speakers denounced the corporatization of healthcare in the United States.
"The rapid consolidation in this industry is unprecedented, with the exception of the concentration of the oil industry in the hands of John D. Rockefeller," Nader said. To counteract this, he said, nurses, unions and consumers need to develop an equally large economic and political constituency. The power of the existing vested interests in the healthcare industry means "we can't get anything done without an organized mass movement," he said.
Jackson echoed that theme: "This thing has been driven by greed. It's downright immoral." He called on healthcare workers to take on "the greedy exploiters of the healthcare world."
Jackson said his Rainbow Coalition has organized ministers in dozens of cities across the country to nationalize the response to the healthcare crisis.
Jackson asked participants to organize for better patient and worker rights in their areas, and to donate $100 to his Rainbow Coalition to help meet payroll.
Richard Wade, senior vice president for communications at the American Hospital Association, said the nurses "raise some very legitimate points. They are pointing to what's happening in the field as we use our human resources in different ways."
Every hospital is undertaking job redesign and downsizing in a different way, Wade said. "There are good ways to do it and not-so-good ways to do it.
"Every hospital when it approaches job redesign needs to think through who the stakeholders are so they can do it with as much involvement of nurses as they can. There's no question that it may have an effect on patient care in some way, whether perceived or real," he said.
But, Wade added, the CNA is "on a track to chart a very different future for themselves than as a state nurses association. This is part of their effort to give their organization some visibility, and they're reacting to issues in California."
Chuck Idelson, a CNA spokesman, said the association will consider a bylaw change next month at its convention to end its affiliation with the American Nurses Association. The proposal would establish the CNA as an independent nurses association that would advocate for nurses, consumers and patients on a national basis, in tandem with other unions and health advocacy groups.
With Nader's encouragement, the CNA is thinking about reviving an effort to pass a single-payer system in California. The group was a strong supporter of Proposition 186, a single-payer ballot initiative that was defeated last November.
The nurses conference, which was followed by a rally and march across the Golden Gate Bridge, enjoyed the support of organized labor in highly unionized Northern California, especially Service Employees International Union Local 250, representing 35,000 health workers.
At the Golden Gate Bridge march, organized under the slogan "healthcare is a human right," members of other San Francisco Bay Area unions served as safety monitors, while Gray Panthers walked beside nurses and members of the American Federation of State, County and Municipal Employees. The CNA said 10,000 people marched, but Officer Dina Bevins of the California Highway Patrol gave an official crowd estimate of 2,000.
Judith Shindul-Rothschild, assistant professor of nursing at Boston College, said nurses need to unionize to have any hope of shifting power in the industry.
"There is not a shred of evidence that nursing adds to rising healthcare costs," she said. The effects of changes in nurse staffing levels are beginning to show up in her research, she said. Ten years ago, nurses in surveys and focus groups never mentioned problems in quality of care. In recent surveys, many nurses indicated they believe some patient deaths can be attributed to staffing cutbacks.
The day after the march and rally, some of the same nurses and union officials appeared at the Aug. 21 morning opening of the AHA convention. About 100 demonstrators marched in a circle in front of San Francisco's Moscone Center, shouting, "Shame on the AHA." AHA President Richard Davidson had warned attendees to expect the demonstration through a letter sent to their hotel rooms.