December 7, 2023

The unions that represent health workers in the country have emerged as increasingly powerful voices during the still raging pandemic.

With more than 100,000 Americans in hospital and many infected in their ranks, nurses and other health workers remain on a precarious front against the coronavirus and have reached out to unions for help.

“It’s so overwhelming. It’s unlike anything I’ve ever seen before, ”said Erin McIntosh, a nurse at Riverside Community Hospital in Southern California, a part of the country that in some cases has been hit hardest by the surge. “Every day I’m waist-deep in death and dying.”

In her hospital’s intensive care unit, Ms. McIntosh said, nurses sometimes looked after twice as many patients. “We are told to take on more than we can safely handle.”

Your union, the Service Employees International Union, and another union, National Nurses United, which is heavily represented in California, have opposed the state’s decision to allow hospitals to assign more patients to nurses during the crisis.

HCA Healthcare, the for-profit hospital chain owned by Riverside, responded that it has hired additional nurses and is keeping its employees safe.

Healthcare workers have been sorely disappointed with the response of their employers and government agencies to the pandemic. Lack of staff, inadequate and persistent supplies of protective equipment, limited virus testing and work pressure even when they might be sick have led many workers to turn to the unions as their only ally. The virus has killed more than 3,300 healthcare workers across the country, according to a census.

“We wouldn’t be alive today if we didn’t have a union,” said Elizabeth Lalasz, a nurse and steward at National Nurses United in Chicago. National Nurses, the nation’s largest union of registered nurses with more than 170,000 registered nurses, was one of the first to criticize hospitals’ lack of preparation and call for more protective gear like N95 masks.

Despite the decade-long decline of the labor movement and the low number of unionized nurses, labor officials have used the effects of the pandemic to organize new chapters and contract negotiations for better terms and benefits. National Nurses organized seven new negotiating units last year, compared to four in 2019. The SEIU also said interest has increased.

Nurses from various unions across the country have participated in dozens of strikes and protests. National Nurses held a “day of action” Wednesday, with demonstrations in more than a dozen states and in Washington, DC, as negotiations began in hospitals owned by major systems like HCA, Sutter Health and CommonSpirit Health.

Hospitals claim that unions make public health policy during a public health emergency, saying they have no choice but to ask more of their workers. “We are in a moment of crisis that we have never seen before and we need flexibility to care for patients,” said Jan Emerson-Shea, a spokeswoman for the California Hospital Association.

At the University of Illinois Hospital in Chicago, the death of two nurses from the virus helped staff strike for the first time last fall, said Paul Pater, emergency room nurse and union representative for the Illinois Nurses Association. “People really took it to heart, and it really despised the current administration at the hospital.”

In their most recent contract, the nurses there have been given provisions to ensure the hospital hires more staff and provides adequate protective equipment, Father said. “To be honest, we have only made great strides in protecting our employees.”

The hospital did not respond to requests for comment.

Some nurses remain very skeptical of union efforts, and even those who advocate an organization recognize that their options have serious limits. “I’m not sure the union is enough to get us this far,” said Mrs. McIntosh, the riverside nurse.

Many healthcare workers view vaccines as the beginning of the end of the pandemic. But large numbers – especially those who work in nursing homes and outside hospitals and tend to be more reluctant to give vaccines – refuse to be vaccinated. During a crisis that disproportionately threatens health workers from color, a recent analysis found they are receiving vaccinations well below those of their white counterparts.


Jan. 29, 2021, 2:27 p.m. ET

Unions walk a fine line between encouraging their members to vaccinate and protecting them from actions that would compel them.

“There are still unanswered questions,” said Karine Raymond, a nurse at Montefiore Medical Center in the Bronx and an officer with the New York State Nurses Association. “The union believes that all nurses should seriously consider vaccinating,” said Ms. Raymond, who would not say whether she would personally accept the vaccine. “But again it’s the choice of the individual.”

The nurses and their unions want to continue to put pressure on employers to protect workers and patients. “Just because a vaccine is being introduced doesn’t mean we can abandon other important safeguards,” said Michelle Mahon, a National Nurses United official, during a Facebook Live event last month.

The past year has created the conditions for an organization to solve longstanding problems such as inadequate wages, benefits and personnel. This problem is exacerbated by health care illness, burnout, or early retirement for fear of illness. The unions “successfully used the pandemic to rename the same conflicts as very urgent safety concerns,” said Jennifer Stewart, senior vice president at Gist Healthcare, a consulting firm that advises hospitals.

They have also changed the way many nurses see their employers, she said. “The perceptions and experiences become crystallized and begin to be viewed through a certain lens. And I think this lens is very cheap for unions. “

At the Asheville, NC Mission Hospital, safety concerns over the pandemic increased the urgency of nurses to partner with National Nurses United.

Some questioned the union’s ability to create better working conditions and expressed concerns about the union’s creation of divisions within the hospital. A group of 25 missionary nurses signed a letter before voting that read “An outside third party like the NNU is not the solution.”

But last September, 70 percent of the union’s nurses agreed, one of the biggest hospital hospital wins in the south in decades. Susan Fischer, a mission nurse who led the organizing campaign, called National Nurses United “instrumental in finding our voice.”

She said the union had already proven itself in negotiating talks earlier this month pushing management to allow better access to protective equipment and fewer patients being assigned to nurses.

In a statement, the HCA, which owns the mission hospital, said that protecting workers is a top priority and that unions are “taking advantage of the situation to advertise and recruit new members to pay”.

In addition to protests and strikes, the unions have defended workers who speak out against their employers. Several unions have sued hospitals, including a lawsuit by SEIU against Riverside. Similar cases have been dismissed in court, and HCA called the Riverside lawsuit a publicity stunt.

Industry executives say trade unions wrongly blame hospitals for the horrors of the pandemic. While some struggled early on to provide protective equipment, hospitals have done their best to follow government guidelines and keep workers safe, said Chip Kahn, president of the Federation of American Hospitals, which represents nonprofit hospitals.

Mr Kahn said the unions used the crisis to achieve their workers’ organization agenda. “They’re going to push all possible pressure points to force their way into hospitals because that’s exactly what they’re doing.”

According to an analysis of government data, about 17 percent of nurses and 12 percent of other health workers in the U.S. are unionized, and union insurance rates have remained largely unchanged during the pandemic. The proportion of unionized hospital workers has fallen from over 22 percent in 1983 to below 15 percent in 2018, due to decades of decline in the organized workforce.

Some unions, including the outspoken National Nurses, often appear to be on the margins of the labor movement. For years it was better known for advocating proposals like Medicare for All, which would replace private insurance with government health care, and for enthusiastically supporting Vermont Senator Bernie Sanders as president.

The pandemic and the union’s decision to support Joseph R. Biden Jr. after Senator Sanders left the race last year have softened that reputation. Mission nurses said politics was not part of the appeal of National Nurses United. “Of all the unions we could have gone to, they had the best track record,” said Ms. Fischer.

The Biden presidency can give unions a chance to flex their newfound muscles. Mary Kay Henry, SEIU international president, was among the union leaders who practically met with Mr Biden last year.

“In my 40 years as a health worker organizer, I’ve never seen a time when people are more willing to take risks and band together to take action,” said Ms. Henry. “This is a fundamental change.”

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