| About strikes |
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| Written by Staff | |
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So you want to know what it is like to work a strike? First, you need an understanding of why nurses strike. But if you want to skip around this long article, use the quick topic navigation below. See also our companion editorial on Working strikes here.
BackgroundDuring the industrial revolution when poverty and massive unemployment were the status quo for most Americans, factory and mine owners gained great power as the major employers of the time. This imbalance of supply and demand meant that employers could pay workers very little. In fact, in many cases there was effectively negative pay, with provided housing and food costing more than it was possible to earn in seven-day workweeks. Working conditions were atrocious, and often life threatening. But for workers, it was the only game in town, and the deteriorating agricultural economy ensured an abundant supply of willing workers. Eventually, workers realized that it was possible to band together in collective groups called unions as a way of gaining power. It is difficult to describe what these early unions went through. Employers were wealthy and could and did use brute force including murder to stop union activities and strikes (work stoppages). Factory and mine owners had far more political power than workers and it was common for unions and strikes to be made illegal by state legislatures. Even without legislation, the police were often beating heads along with employer brute squads. Workers were not without blame themselves and fought back using similar tactics and damaging property. All of this seems like ancient history today. Many think that unions have lost their reason for existing and unions are indeed on the decline in many economic sectors. Some will point to the decline of manufacturing in this country as the result of unions gaining too much power, and becoming corrupt. True or not, it is indisputable that most of the rights we enjoy today as workers came about directly from union pioneers. The 40 hour week, minimum wage laws, child labor laws, overtime, and regulated safe working conditions are some of the major advances that we now take for granted. Workers and employers are of course interdependent and both party’s interests are served by a continuing and mutually successful relationship.
Union basicsExisting unions seeking growth is the usual reason in modern times than you see attempts to organize new workplaces. They generally only succeed where there is widespread dissatisfaction with management, working conditions, and pay. At some point, a secret ballot election is held with an up or down vote on union representation (basically employees are hiring a union to represent them in contract negotiations). Federal laws help create a level playing field for both the union and management so that neither holds too much power during this phase to sway workers inappropriately. Once a union has formed, it then has the power to negotiate a contract for all the covered workers, thus the term collective bargaining. This creates a lot of power to negotiate good contracts. Interestingly, union members and travelers share a common trait: they are both contract workers. Travelers may relate to the powerlessness we often feel in negotiating a single contract for ourselves. Wouldn’t it be nice to have a professional negotiate a contract on our behalf? That is exactly what happens during union contract negotiations, although the professional negotiator has a much stronger hand because they are negotiating for many and always have the threat of a strike (a work stoppage) that can shut down the business involved if compromises are not reached satisfactory to both parties. It is easy to picture one worker (such a traveler) threatening to quit if employment terms are not met. This action would not go far toward improving conditions for other employees (although that one person may find a better job elsewhere).
Healthcare unionsIn areas where union culture is strong, there is support for unions to form outside of the manufacturing industry. Service oriented industries with large employers such as hotels and hospitals are natural candidates for collective organizing. Unions have always been strongest in manufacturing centers and much of US manufacturing took place in the Northeast. This was also the place of the first healthcare unions. For much of the U.S. history of hospitals, most healthcare workers were women and pay was very low. Similar to the early industrial revolution, hospitals controlled the lives of their workers, even to providing dormitory living. Because of the cultural climate in the U.S., it was expected that women made lower pay. Until attitudes started changing in the 1960s, unions were not able to form in hospitals. As a result, union activity in hospitals is still in relatively early development compared to manufacturers. It is worth noting that there may be several unions in a hospital covering different kinds of workers. Nurses may have one, lab workers another one, and assistants another one. Some types of workers may not have a union representing them at all. In a strike by one union at a hospital, some unions may chose not to work to support the striking union. This can be a type of quid pro quo with an expectation of reciprocation if another union goes out on strike later. Many individual workers may also choose not to work in sympathy for the striking workers. There is a real stigma attached to crossing a picket line to go to work, even if not the same union. There is an even stronger stigma to being a replacement worker (strike worker) hired to work the strike. Often such workers are referred to pejoratively as scabs.
Benefits of unionized hospitalsPay and working conditions are generally better in unionized hospitals. Studies show that patient morbidity and mortality are lower as a result. These effects occur even in nearby non union hospitals that have to compete with the unionized hospitals. Reports from travelers with experience in both types of hospitals reveal that the union hospitals almost always have superior working environments. The primary complaints heard are that unions protect problematic employees. Complaints from employees that unions are not doing enough for them are also common. Unions can also wield political power. Their strong voter base often overcomes the lobbying power that the employer's deep pockets enables. This is the reason why labor laws exist today. The California Nurses Association has been particularly effective in California in passing very progressive staffing ratio laws. This is the only state that currently has ratio laws, although individual union hospitals may have mandated staffing ratios in their contracts. The benefit of these staffing laws has been several fold. It has created an environment where nursing pay has rapidly increased, working conditions are superior to every other state overall, and patient morbidity and mortality has decreased. It is noteworthy that these efforts have not led to higher insurance costs in California, or to hospital closures. The California Nurses Association is attempting to bring these successes nationwide via political lobbying efforts and national unionization efforts via their nationwide arm, the NNOC.
Contracts, at will laws, and right to work lawsJust like travelers, union workers are covered by a contract. Contract law governs these agreements, just as they do for travelers. Basic labor laws still apply, however in many cases contract provisions pre-empt or trump labor laws. For example, at will is the law by either explicit legislation (in 39 states) or by legal precedent in other jurisdictions. At will means that that either an employee may quit, or an employer can fire employees, without notice or cause. A contract trumps at will laws and indeed there could be no unions at all if this was not so. Likewise, traveler contracts would be meaningless if agencies could fire travelers at will.
An important part of union contracts is saying that the union employer may employ only union employees. This clause is modified in the 22 states that have passed right to work legislation. Right-to-work laws that says you don’t have to belong to the union to get a job, even for employers that are unionized. Right-to-work statutes effectively break one strong union power: that of what is effectively a closed shop. A closed shop means that a union employer may only hire union employees1 . In the open shop environment allowed in a right to work state, union and non union employees work side by side. Generally, both must pay union dues though and the pay and benefits are the same. However, if non union employees eventually outnumber union employees, it is then much easier to vote the union out than in non right-to-work states. Where unions are the strongest, in the Northeast, the industrial Midwest, and the West Coast, right to work laws have never passed. They are the strongest in Southern and Southwestern states that have few unions and strong anti union sentiment. It is an interesting paradox that the places that need unions the most because of low pay and poor working condition, in the South and Southwest, have the fewest unions. Notably, it is also in the states where right to work laws have never been implemented and where unions are strong that wages are the highest.
So why are unions unpopular in the South and Southwest?The South and Southwest have historically had a dominant agricultural based economy. Agricultural employment has been diminishing for almost a hundred years in the US as more efficient farming methods and mechanization have taken over. This decline in agricultural jobs has happened while population has steadily increased. One direct result has been workers moving to cities and industrial areas to find employment as this change occurred in the American economy. Agricultural economies do not typically have the large employers unions require. This is demonstrated by the difficulties migrant workers have had in unionizing. The larger non-agricultural employers do a great job in convincing their employees that unions will cause job loss, cost big money in union dues, and not result in better benefits. These ideas have been ingrained in worker culture over time and without local examples of union workplaces, it is difficult to overcome these beliefs with mere statistics. Understandably, workers tend to resist joining organizations, when they fear it could lead to termination or losing a raise or promotion.
Polarizing attitudes and beliefs towards unions and strikesUnions and strikes appear to exist in a belief system where people are either strongly for or against them, similar to other areas of strong beliefs such as religion or political philosophy. Facts generally do not sway either pro or anti union supporters, anymore than they do in religion or politics. Your parent’s beliefs and how you were raised may be just as important in forming opinions about unions as your personal experiences. It is likely if your parents expressed a certain ideology that you will embrace that ideology as well. It might be easy to visualize a kid whose union father comes home after struggling with his daily toil to bring home a decent wage, would support unions because his father did. Likewise, a kid whose father owns a factory and is struggling to pay his creditors may end up resenting unions. Political philosophy may be important as well. Generally, pro-business factions such as Republicans are more likely to oppose unions and labor friendly legislation such as minimum wage laws. Worker supported Democratic politicians are more likely to support union friendly legislation such as current attempts to make voting for new unions easier. As with many polarizing issues, what is best for both sides probably lies somewhere in the middle. However, reasonable discussion is hard to find.
Why strikes occurStrikes today are very different from those that occurred in early union history. Advances made have been incorporated into federal and state labor laws that provide substantial protections for all workers. Often the reasons for strikes seem incomprehensible to those who are not local. Disputes about compensation for San Francisco Bay area nurses who may be making $60 are just amazing to nurses in the deep South who may be barely making $20 an hour. The issues are always local. It is difficult to double guess local decisions from a distant perspective, as we have not walked in the shoes of those workers or the hospital. Many if not most strikes are not about hourly pay. Often, they are triggered by deep dissatisfaction by healthcare workers with management. Working conditions, particularly related to standards of care, understaffing, and mandatory overtime, are common issues. Benefits are another large area of concern. Understandably, with healthcare insurance costs rising by 20 percent a year, hospitals try to shift the costs to employees at contract negotiation time. With stagnant wages relative to the cost of living, increasing costs can be a major issue to workers. Most of the time, strikes only occur when existing contracts expire. Wildcat strikes in the middle of contracts are very rare, and usually the contract itself limits such strikes severely.
Strike negotiating tacticsUnion contracts typically have an expiration date, as much as five years or longer from the time it was signed. Before the expiration date come due, administration and union negotiators sit down and try to come to terms. The hospital puts an offer on the table that is much less than they are willing to settle for. Likewise the union may ask for much more than they are willing to settle for. Both may engage in propaganda efforts with the workers and even the general public to gain support for their proposals. The big sticks of worker lockout or strikes may be threatened early, however they usually do not occur until both sides are deadlocked and negotiations have been stalled for some period of time. The time frame for negotiating can be long enough that the existing contract expires. Usually when this happens, the hospital sticks to the terms of the prior contract while negotiations continue (mandated by federal law). Otherwise, unilateral moves by the hospital could lead an immediate and premature strike. Both hospitals and unions go to great lengths to avoid strikes. They are very costly to both sides. Hospitals have to hire very expensive strike workers and suffer the loss of employee and community good will. They also take a big chance that referring doctors will go to other hospitals and not come back. For workers, not only is there a loss of income and benefits while a strike is ongoing (which can sometimes take months to years to resolve), but there is a real risk of permanent job loss. Issues with management may not improve with a new contract and may even result in deteriorating working conditions. This is not uncommon. Unions, at times, do use less than a full fledged strike to put pressure on the hospital. One ploy is to schedule a strike, forcing the hospital to pay money to strike agencies for logistics in hiring strike workers, and then cancelling the strike. Another common ploy is to schedule a 1 to 5 day strike, forcing hospitals to hire replacement workers and giving hospital administration a taste of what would happen in a larger strike. This carries a risk to the union of a lockout of union workers after the walkout is “over”, converting the limited work action into a more serious affair than desired by the workers.
Strike insuranceLarge union hospitals often carry strike insurance to cover some of the costs of strikes. Strike insurance can account for some of the observed actions during contract or strike negotiation. For starters, strike insurance, while covering the costs of hiring strike companies and workers, is limited, often by a specified period of two weeks. You may observe an ongoing strike, with seemingly no progress being made at all to settle. Then suddenly it is over. The hidden reason could have been that the strike insurance was about to run out and the hospital would have had to bear the full cost of paying the strike workers. Some of the union rationale for scheduling (and sometimes cancelling) short strikes is to use up some of this insurance reserve. This gives the union more power in a negotiation. Likewise, in a short strike, the hospital may lock out union workers from returning, continuing to use the strike workers. This is kind of a reverse strike, to put pressure on the union and their workers to settle on their terms. Again, strike insurance plays a role in that extra money was available to pay for the replacement workers. Strike insurance is costly, especially if you need to use it. Just like any other kind of insurance, premiums go up if you use it. In a way, it is like prepaying for strike costs. Although the money is saved up ready to use, if you use it, you deplete your emergency funds. There is a balancing act, but having the “free” money available does encourage the hospital to use it.
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