Thousands of registered nurses at 86 Kaiser Permanente hospitals and clinics in northern California walked out this week to draw attention to what the California Nurses Union describes as the health system's lack of preparation to handle Ebola. Kaiser officials say they're puzzled by the union's demands.
The union and its parent, National Nurses United—which estimated that 18,000 nurses participated in the walkout—say the health system has not provided nurses with “optimal” personal protective equipment or given them adequate training to ensure that nurses are ready to safely treat a potential Ebola patient. The union, which has been in collective bargaining negotiations with Kaiser since August, is calling for full-body PPE suits that meet industry standards, leave no skin exposed or unprotected and that use powered air purifying respirators, or PAPRs, rather than N95 respirator masks, even though both are permitted by federal guidelines.
“Instead of putting (profit) back into the community in terms of direct patient care, they're cutting back on services. We know that they're going too far when they literally won't prepare for a deadly disease,” said Bonnie Castillo, a leader at National Nurses United and director of the union's disaster-response network. Castillo said they would like something in writing, like the deal that the University of Michigan Health System signed with its nurses this week.
A Kaiser spokesman, however, said the hazmat suits the company distributed leave no skin exposed and employ PAPRs, as the nurses have demanded. The system also said it has been training its employees in practice drills and other educational sessions and has a command center that is coordinating training and supplies and responding to issues.
“We have repeatedly asked union leadership to work with us on our Ebola strategy, which they have refused to do,” Kaiser spokesman John Nelson said in a statement.
Earlene Person, a licensed vocational nurse at Kaiser's Oakland Medical Center and a member of Service Employees International Union-United Healthcare Workers West, said the strikes are clearly not about Ebola, but rather about CNA's negotiations with Kaiser.
Person spoke on behalf of SEIU-UHW, which represents front-line workers such as LVNs, nurses' assistants, radiology technicians and nutritional workers at Kaiser and other systems. She said the CNA's membership, like all employees in the system, know that Kaiser is prepared.
“They know that Kaiser is exceeding the Ebola standards,” Person said. “They know we have the equipment we need, the resources, the training.”
Though the union has been pushing Ebola as the reason for the strikes, Castillo acknowledged that nurses are also concerned about an “erosion of care.” She said Kaiser does not provide adequate staffing to ensure that patients receive the highest quality of care possible.
“Ebola has shined a light on how fundamentally unprepared they were in regards to investing in the resources,” Castillo said.
Michael LeRoy, a professor of labor and employment relations at the University of Illinois, Urbana-Champaign, said NNU may be primarily using the Ebola crisis as an internal organizing strategy, even if it looks as if from the outside like it's devised to draw public scrutiny.
“It's something that all nurses can rally around, whereas they might have differences on what to prioritize from an economic principle,” LeRoy said.
Joanne Spetz, an economics professor at the University of California at San Francisco's Institute for Health Policy Studies, said CNA had been raising concerns about staffing and occupational safety before the Ebola crisis took hold, and leaders have been ambiguous lately on whether that's still the case.
Spetz said the number of workers who walked off their jobs this week is unprecedented for the healthcare industry, and “hugely disruptive.” She also said it's particularly unusual that the union has been adamant about staffing and Ebola safety, but not wages or benefits.
“I cannot think of a time previously when there has been a strike in California where there has not been a discussion of wages or benefits in it,” she said.
NNU actions also took place at Sutter-Tracy Community Hospital in Tracy, Calif., Watsonville Community Hospital in Watsonville, Calif., and Providence Hospital in Washington, D.C. They were also joined by 100,000 affiliated nurses in non-disruptive actions around the world such as picketing, vigils and rallies.
Follow Adam Rubenfire on Twitter: @arubenfire