About 2,200 University of Chicago Medical Center nurses represented by National Nurses United have voted to walk out on Nov. 26.
The nurses, who went on strike Sept. 20, continue to protest alleged chronic understaffing that has impeded patient care. The University of Chicago claimed UCMC's staffing levels are the best in the state.
UCMC's alleged proposal to eliminate 24 patient care support nurses fueled the latest strike threats, the union said. These nurses care for complex patients and act as a mentor to younger nurses, said Kristin Yokovich, a registered nurse at UCMC.
"If we are no longer there to help out in these critical conditions, I know patient safety will be compromised," she said in prepared remarks.
The University of Chicago said that the union refused to compromise and opted to strike rather than negotiate. The claim that the university proposed laying off patient care support nurses is false, the organization said.
"Once again, rather than stay at the table and engage in the hard work of reaching the compromises that will produce a new contract, the union is ordering nurses to walk out on their patients and their co-workers during a holiday," University of Chicago executives wrote in a memo to staff.
The university said in a statement that it proposed adding more than 40 new positions over the next 18 months to provide nurses more support as well as transition the 24 patient care support nurses into these and other new roles.
According to the University of Chicago, the union asked for supplemental staff, a dispute resolution process via a neutral third party to resolve staffing issues, better nurse-to-patient staffing ratios, limited requests for nurses to stay late, reduced caseloads, 3% annual cost of living wage increases, new wage scales for newly organized nurses and better benefits, among other mandates.
Total medical-surgical nursing hours per patient day was 10.89 in 2017 for the University of Chicago, which exceeded the state average of 10.54 hours, according to the most recent data available for the Illinois Department of Health.
Although the University of Chicago nursing hours per patient day were below the state average for nurses in the neonatal intensive care, mother-baby and critical-care units.
The last strike forced the 618-bed academic medical center to divert patients to other hospitals for emergency care, close several inpatient units, reschedule procedures and pause operations at its Level 1 trauma center. While the university didn't have an estimate on the cost, prolonged strikes can result in losses of tens of million of dollars as well as reduce care quality, research suggests.
"In healthcare, just the credible threat of a strike can cost real money," said Rebecca Kolins Givan, an associate professor of labor studies and employment relations at Rutgers University, explaining that replacement workers are expensive and the loss of patient income can be significant.
The threat of a strike is almost as powerful as a strike itself, Kolins Givan said, likening it to a game of chicken.
Threats to strike and walkouts are ramping up throughout the country. While many health systems claim these are unsubstantiated attempts to gain leverage at the bargaining table, unions argue that this is the only means to hold hospitals accountable and force change.
Unions have recently been emboldened by other successful strikes, the inherently conflicted profit-driven healthcare model, pay inequity, the nursing shortage, consolidation, healthcare's projected job growth amid a tightening labor market and deteriorating working conditions, employment experts said.
Nurse practitioners will have one of the fastest growing jobs from 2018 to 2028, with employment rising more than 28%, according to the Bureau of Labor Statistics.
Hiring will vary widely by state, according to the Health Resources and Services Administration, ranging from a shortage of 44,500 registered nurses in California to a surplus of 53,700 full-time employees in Florida by 2030, HRSA projected. Illinois is projected to a have a 2.6% surplus.
"In most states, with the exception of California, we really haven't seen substantial enough hiring to offset higher patient loads for nurses," said Robert Bruno, a professor and director of the University of Illinois' labor education program. "Patient loads have only gotten larger and the end result is the working conditions begin to deteriorate and worsen."
Bruno has studied the Illinois nursing market, finding that the nursing workforce is not keeping pace with rising demand, occupational hazards are a barrier to retaining qualified nurses and full-time registered nurses in Illinois earn between 6% to 10% less than their counterparts in other states, relative to their higher levels of education.
"That is why we have seen a fair amount of energy in nurse-to-patient staffing legislation," he said.
California is the only state to mandate nurse-to-patient staffing ratios. A bill that would have imposed minimum nurse staffing levels for Illinois hospitals stalled in the House this year. Massachusetts voters turned down a ballot initiative last year.
In addition to Chicago, about 15,000 nurses at Swedish Medical Center and other Providence hospitals who are part of the Services Employees International Union Healthcare 1199 NW announced Friday that they voted to strike.
About 4,000 mental health workers represented by the National Union of Healthcare Workers postponed a five-day strike at Kaiser Permanente hospitals that was set to begin this week, following the unexpected death of Bernard Tyson, Kaiser's chief executive.
Kaiser narrowly avoided a strike of more than 85,000 unionized Kaiser workers in September, ultimately agreeing to a four-year deal.
About 6,500 National Nurses United members staged a one-day strike at 12 Tenet Healthcare Corp. hospitals in Arizona, California and Florida.
There will likely be more nursing strikes in the near future, Kolins Givan said.
"They are in a very strong position—the highly skilled labor and a short supply of nurses, who are beloved by patients," she said. "They are organizing at a fairly rapid rate and I think strikes will continue and increase in frequency."