Striking out

Festivus, the fictional December holiday popularized by TV's “Seinfeld,” featured an annual airing of grievances, and thousands of nurses across the country celebrated the ritual with a flurry of union activity as the year closed.

California nurses on Dec. 23, for the second time in three months, declared a one-day strike affecting 6,000 nurses at 10 hospitals. That same day, nurses at 181-bed Cypress Fairbanks Medical Center in Houston filed a complaint with the National Labor Relations Board against the hospital over concerns about a sick-day policy that union nurses said forces them to work while they have the flu.

On the East Coast, nurses at St. Luke's-Roosevelt Hospital Center in New York City called for a Jan. 3 strike at the 711-bed hospital, but the walkout was averted when the New York State Nurses Association reached an agreement late Dec. 26. Two other New York City hospitals also were threatened with strikes by nurses, including 1,039-bed Mt. Sinai Hospital, which a few days later reached an agreement with its nurses. However, negotiations broke down with 1,490-bed Montefiore Medical Center, and its union responded by calling for a Jan. 10 walkout. Whether those talks with Montefiore produced an agreement was unknown as of press time.

Officials at Sutter Health, the parent of eight California hospitals where nurses missed work Dec. 23, criticized the union for their pre-Christmas timing: “It's always tougher for patients, especially tougher for the holidays,” said Karen Garner, director of communications for Sutter in Sacramento, Calif.

Karen Higgins, one of three National Nurses United co-presidents, scoffed at that notion and said the close rapport nurses hold with patients gives them better knowledge than most of how holidays affect patients, and added that hospitals served fewer patients during the holidays: “If you want to make a point with as little effect on patient care, around the holidays is a better time,” she said.

Some don't see the holiday timing as anything but the sign of a trend toward more acrimonious labor relations between organized nurses and their hospital employers.

“I think this is the new norm, unfortunately,” said Anthony Rizzotti, an attorney who focuses on collective bargaining with the firm of Littler Mendelson in Boston.

Jim Trivisonno, president of IRI Consultants, a management firm based in Detroit, agreed and stressed labor talks revolve around when contracts expire, which explained the abundance of labor activity in December.

However, for the NYSNA, the timing wasn't a coincidence. The union made a concerted effort to push for agreements at the end of year, union spokesman Bernie Mulligan said. Montefiore remains the only outstanding situation, but sides are close, despite setting a strike date.

Unions remained busy in 2011, as a report unveiled in October by IRI and the Chicago-based American Society for Healthcare Human Resources Administration showed the NNU threatened strikes 18 times in 2011, affecting 46 hospitals. Trivisonno dubbed the unions' ability to call strikes “the ultimate hammer,” as they force hospitals to hire replacement nurses for at least 60 hours to five days, which dents hospital budgets.

For the latest one-day strike in California, Sutter hired replacement nurses for two days, unlike a September one-day strike when they agreed to five-day contracts. The replacement nurses didn't want to work during Christmas, Garner said.

An increasingly friendly climate for unions makes it more comfortable for union officials to call strikes, with federal policies aimed to make union-organizing easier, Trivisonno said. Hospitals have noticed and are attempting to counter. Right before Christmas, the American Hospital Association, as part of the Coalition for a Democratic Workplace, filed a lawsuit against the NLRB, challenging the legality of a final rule that they claimed allowed employees to quickly unionize without allowing employers a chance to respond to allegations of unfair labor practices.

But despite the friendlier climate, survey results from the IRI/ASHHRA report showed employers held fewer concerns over union organizing compared with 2010. Results showed a 19% dip in respondents answering they were either “very concerned” or “somewhat concerned” about potential union organizing activity in 2011. That same survey showed 42% were “not concerned but staying alert,” which is a 17% increase compared with 2010. Meanwhile, 5% responded they were “not concerned at all.”

Rizzotti warned strikes could backfire, as unions overestimate public and political support, given dwindling revenue: “Unions ignore that such activity not only hurt the hospital but also employees and patients,” he said. “In this economy, missing a paycheck is a significant burden for employees.”

But members of the NNU, the largest nurses union in country, reason an increased willingness to call strikes is needed with hospitals calling for concessions affecting sick time, health insurance premiums and health insurance coverage for part-time workers. NNU Executive Director RoseAnn DeMoro said she doesn't believe hospitals' claims that concessions are needed to compensate for declining profits.

“They're one of the most profitable industries in the country, by far,” she said.