While many health systems are entering 2023 with significant financial losses, setting up the industry for a year of potentially tightened budgets, unions representing workers remain optimistic about their bargaining prospects.
Much like in 2022, the main issues for unions representing clinicians will be burnout due to a shortage of nurses and the need for flexibility and mental health breaks for those experiencing moral injury, said Dan Braun, director of research and strategic planning at SEIU Local 121RN, based in Southern California.
“Some of the provisions that we're proposing include things like understanding the situation if there's a public health emergency or staffing challenges due to the pandemic, and how they’re evaluating nurses and supporting people's ability to take time off and protecting sick days,” Braun said.
The last year saw some major contract wins for healthcare workers. Hundreds of agreements ended and workers conducted dozens of strikes nationwide over inadequate staffing and other labor practices they deemed unfair.
In November, Kaiser Permanente agreed to create more than 2,000 nurse positions, offer clinicians a 22.5% wage increase over four years and maintain a three-month stockpile of personal protective equipment while continually screening for infectious diseases.
Months earlier, University of Michigan Medicine nurses won an end to mandatory overtime, an improved mechanism to enforce contractual workload ratios and competitive wages to recruit and retain skilled staff.
“I'm confident that next year we're going to achieve the same victories,” said Sal Rosselli, president of the National Union of Healthcare Workers. “And not because these hospital systems want it, but because their employees are gonna force them to do it, under the threat of the picket line.”
Around 30,000 nurses represented by the New York State Nurses Association are working under contracts set to expire Dec. 31 or in early 2023, meaning private and public sector nurses at more than two dozen facilities will be negotiating contracts for the first time since the beginning of the COVID-19 pandemic, according to a union spokesperson. Issues to raise during bargaining will include wages, protecting quality healthcare and retirement benefits for workers and responding to community health needs.
The union also is advocating for patients through New York’s new hospital staffing committee law, which will allow the public to gain insight into employment levels and empower the Department of Health to hold health systems accountable for failing to meet safe staffing standards, the spokesperson said.
Many labor groups that recently negotiated contract gains are deciding on their next priorities.
Even after winning a favorable three-year contract in July, union members at Good Samaritan Hospital in San Jose, California are looking ahead to future negotiations and working to organize more clinicians and maintain agreed-upon standards, said Lydia Gmerek, the hospital’s National Nurses United chief nurse representative.
“There's not really a honeymoon,” Gmerek said. “We are all the time taking action, talking to new nurses, letting them know what our union can do. We are going to be constantly on the watch for what's happening in our community making sure that we have adequate staffing.”
The contract for 570 nurses at Good Samaritan included wage increases of 17.4% to 29.4% over the three years, infectious disease testing for nurses and a provision ensuring newly graduated nurses will not work at "floaters" during the first six months of employment.
Although the root cause is different, financial stressors are nothing new for health systems and shouldn’t affect union negotiations any more than before the pandemic, SEIU's Braun said. With the cost pressures due to travel nurses and other temporary staff, union members are working with hospital leaders to determine how to retain staff and focus on care safety and quality rather than short-term worker costs, he said.
Union members at Placentia-Linda Hospital in Placentia, California, have been bargaining for more than 10 months to get their first contract, one that addresses burnout and short staffing.
“We're trying to get the community informed of what's going on in their local hospital, because we would like them to know what kind of care that they can expect to get when they’re seeking help, or their family members are seeking help,” said Robert Allison, an x-ray technologist at the hospital and part of the union's bargaining team.