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The nursing profession routinely ranks at the top of those most trusted and appreciated, and the COVID crisis boosted that support even higher. But news reports of nurses’ strikes raise mixed feelings because strikes undercut the very reasons nurses have earned such high public esteem.
Theirs is the Florence Nightingale Pledge, their counterpart to the Hippocratic Oath, vowing to put their patients above themselves. Yet labor leaders are now pushing many nurses to make a difficult choice.
Certainly, nurses have proper concerns about their workloads, hours, and conditions. But it’s not just about them. Union tactics of picketing and boycotting are one thing. But when their union leaders force nurses to strike, it causes harm because a strike by nurses is also a blow that hurts patient care. One medical ethicist has called it “trying to cure a disease by administering poison.”
An example is St. Vincent Hospital in Worcester, Massachusetts. In January, the hospital and its nurses ratified a new contract after a nearly 10-month-long strike. During that time, 700 members of the Massachusetts Nursing Association were cut off from wages and unemployment benefits. The hospital brought in nonunion nurses when it could but still had to reduce beds by 100, close some surgery units, end some cardiac and wound care, and cut mental healthcare in half.
The strike cost the hospital over $40 million (not counting the new higher payroll costs), plus the hospital paid $4 million for extra police protection during the chaos. But just last month, the same Massachusetts hospital and its nurses union got bogged down again by new disputes, demonstrating the endless nature of the union-employer conflict.
Unfortunately, this was not an isolated event, and more like it may be ahead. Organizing nurses into unions is a top priority for the labor movement. Reportedly, in 2020, about 20% of registered nurses and 10% of licensed practical nurses were union members. With about 5 million nurses in the country (and more needed), this membership is attractive to organizers.
In November, 32,000 California nurses announced a strike that was barely averted. In April, the 5,000 nurses at two of California’s Stanford-run hospitals did go on strike for a week until they got a new contract. There were at least 14 nurses’ strikes across the United States last year. Most were far shorter than the one in Massachusetts, but some still required the closing of emergency rooms and other denials of patient care.
This year, nurses’ strikes that occurred in May included Newark, New Jersey; multiple Hawaii hospitals; and California, while strike votes are pending elsewhere in states such as Oregon. Another 7,000-nurse strike was narrowly avoided in Los Angeles, and the same happened in multiple states.
Unfortunately, this draconian impact of closing emergency rooms, keeping beds empty, and curtailing care is the type of massive leverage that unions want — not to mention dues such as $100 per month per nurse.
But even as it brought a new appreciation for healthcare workers, the COVID crisis severely hurt hospitals’ ability to pay their people. Massive numbers of revenue-generating elective procedures were canceled. Many facilities went into the red to keep their employees paid and their doors open, meaning they now cannot afford the major demands from unions, especially amid critical shortages of workers.
Nurses are debating what they should do to balance their noble commitments with the legitimate needs of their own families and with the emotional and physical strains of nursing. To many, it’s not just a job — it’s a calling.
As staff at one industry publication write, “While unions protect and advocate for workers … unions may fight for their members at the expense of patients and other stakeholders. … Striking nurses aren’t paid. … Promotions and/or raises are based on seniority. … Stellar performers receive the same rewards as those who are only adequate workers.”
The fact that some nurses have chosen to strike, creating problems such as those seen in Massachusetts, should not be a black mark against the profession.
We should do all we can for our healthcare heroes while also living within tight budgets. We should maintain our high regard for nurses not just to avoid pushing them toward unionizing and striking but because they’ve earned our respect. And union leaders should become a part of the solution — and not create public health crises to advance union-first agendas.
Former Rep. Ernest Istook served on the Labor, Health and Human Services subcommittee of the House Appropriations Committee and is married to a retired nurse.
