COVID-19 brought tensions between healthcare workers and their employers to a boiling point this year.
Strikes, picketing and organizing efforts cropped up as the pandemic wore on, as frontline workers used their collective power to put pressure on their administrations. And, as cases COVID-19 continue to surge, tensions don't seem to be lightening.
Workers, on the front lines of the pandemic, say employers aren't taking their safety seriously and are endangering both them and patients through lack of personal protective equipment and low staffing levels. Meanwhile, employers say they're doing their best to handle supply shortages, COVID-19 surges and skyrocketing costs.
"It's opened the eyes of a lot of nurses," said Jean Ross, co-president of the National Nurses United union and a nurse for 46 years. "I think people are more willing to stage actions whether they're unionized or not. It's almost like right now like what do you have to lose?"
The federal government estimated that, as of Dec. 18, 287,010 healthcare providers have tested positive for COVID-19, 953 of whom have died, although that data is lower than other tabulations. As of the same date, Kaiser Health News and The Guardian have recorded at least 1,463 U.S. healthcare workers who have died from COVID-19.
But Ivan Smith, a labor and employment attorney at law firm Buchanan Ingersoll & Rooney, says unions are taking advantage of the pandemic. Healthcare workers are exhausted from working a lot of hours to care for COVID-19 patients, are emotionally stressed and are dealing with nationwide PPE shortages, said Smith, who represents healthcare facilities in labor disputes.
"When that is all going on at the same time, it is ripe for unions to say the employers are not looking out for you. They make the attack," Smith said.
The American Hospital Association declined to comment on union activity. But recently, California Hospital Association President and CEO Carmela Coyle called it "unconscionable" for healthcare workers to go on strike during a pandemic. Nurses and licensed professionals represented by SEIU Local 121RN had authorized a 10-day strike that would have started Christmas Eve at three Hospital Corporation of America facilities in the Greater Los Angeles area.
"In times like these, California's healthcare providers need, without exaggeration, every hand on deck to save people's lives," Coyle said.
That strike was averted Dec. 18 when HCA and the union came to an agreement that secured greater access to testing and equipment and guaranteed safe quarantine policies and staffing levels, the union said.
"Not only are (workers) risking their lives every day to fight this disease, they also stood up and insisted that this big corporation listen to the health and safety recommendations of the trained professionals on the front lines," SEIU Local 121RN Executive Director Rosanna Mendez said in a prepared statement.
Improving communication with workers can go a long way, Smith said. In some cases, unions were able to help systems procure more PPE this year.
"You have to recognize whenever you have situations that put hospitals under this kind of stress, your workers are feeling that kind of stress…As many things as you're going through, the financials and everything else, you have people on the front lines experiencing things they never expected," Smith said. "Whenever you get situations like that, it is extra important the hospitals and their staff communicate more."
Ross said systems need to listen to workers who see what is happening on the front lines.
"We're the best ally you've got. Stop fighting us," Ross said.
Doris Carroll, president of the Illinois Nurses Association and a nurse at the University of Illinois Hospital, said nurses across the country have called INA for advice during the pandemic. After a strike in September, INA was able to negotiate a four-year contract with UI Health that secured a number of protections, including a rolling 90-day supply of PPE, universal N95 masking, hazard pay and a commitment to hiring more workers to improve nursing ratios.
"There are many nurses that talk about doing a strike movement across the country. This has to be pivotal for healthcare delivery," said Carroll. The issue of staffing for nursing has been a longstanding chronic problem, and COVID just put a flashlight on it."