Is it ethical for nurses to go on strike?

[ManuelaBeltran]

Hi,

We are a group of nursing students in Canada writing an ethical dilemma paper and we would like to know your opinions on the following issue:

The nurses at a large hospital have been doing negotiation for months but since they haven't obtained any positive results they are deciding to strike for better pay and working conditions. A new graduate nurse is not sure about what to do, or how to vote.

We have learned that in Ontario it is illegal for hospital nurses to strike.

So, our question is: If all or most of the necessary steps to seek negotiation have been taken, to what extent do you think it would be ethical to have an illegal strike? Would the purpose of an illegal strike outweight its consequences?

[Ginger's Mom, MSN, RN]

I think nurses have the right to strike, I do feel the same nurses need to accept the right some nurses don't want to strike.

In answer to the question is it ethical, Yes. Is it the right thing to do, one needs to evaluate the situation.

[Chico David, BSN, RN]

either way sounds strange to me.

from medicalnews today.com:

"An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient records that was released today by HealthGrades, the healthcare quality company."

Studies like this vary in their methodology and conlusions. I did a little google research and found estimates of preventable, in-hospital deaths due to medical error that ranged from a highest of 195,000 to a lowest of 37,000. So 100,000 is a pretty reasonable middle ground. Certainly not out of the ballpark. Then add to that the 18,000 to 25,000 deaths that are generally attributed to lack of health insurance and you have a picture of a broken system. Call it a number pretty similar to the number of people who died in the World Trade Center attacks - every week.

[loricatus]

In response to your SPECIFIC question:

IMO, it would be ethical to strike (although it may be illegal) if the basis of the strike where not self serving interests such as higher pay, better, benefits, increased retirement package... The motive behind the strike would determine how ethical the strike would be.

[NotReady4PrimeTime, RN]

The original poster stated that s/he is a nursing student from Canada. It is illegal for nurses to strike in both Ontario and Alberta. Other provinces have quite restrictive essential services agreements that eviscerate strike action. Manitoba for example has an essential services baseline staffing number that exceeds the usual day-to-day staffing on virtually evey unit in every hospital.

Is it ethical for nurses to strike? Yes. Most strikes are only peripherally about money. The meat of the argument is usually working conditions, such as safe patient ratios, safe patient assignments, reasonable schedules, disability insurance, health benefits and so on.

[Californiasunshine]

No, it's unethical. We are in a big shortage, we have sicker then ever patients, we are in very troubling times.

I would hope that we would all take that into consideration that we are too important to strike.

[herring_RN, ASN, BSN]

An alternative to a strike. But I think if all else fails for the sake of our patients and as a last resort a strike notice can be necessary.

And of course nurses are honest so won't vote for a strike unless we intend to do so IF management refuses to bargain in good faith.

WE are responsible to opur patients not the budget.

http://www.nysna.org/news/tcc.htm#rv

[Iam46yearsold]

The original poster stated that s/he is a nursing student from Canada. It is illegal for nurses to strike in both Ontario and Alberta. Other provinces have quite restrictive essential services agreements that eviscerate strike action. Manitoba for example has an essential services baseline staffing number that exceeds the usual day-to-day staffing on virtually evey unit in every hospital.

Is it ethical for nurses to strike? Yes. Most strikes are only peripherally about money. The meat of the argument is usually working conditions, such as safe patient ratios, safe patient assignments, reasonable schedules, disability insurance, health benefits and so on.

My experience with SEIU was strikes are solely about money and very little else. Thinly disguised as safe pt ratios, safe pt assignments, reasonable schedules. Very thinly disguised indeed.

[jsrRN]

As a union member and a member of our bargaining team, I believe that it's ethical for nurses to go on strike. If conditions are unsafe and you've exhausted your options, it is unethical not to strike when a majority of your coworkers voted democratically to authorize the strike.

Adequate compensation is essential for recruitment and retention which effects patient safety. However, the reality is that in RN unions strikes often have nothing to do with compensation. The Sutter Health strikes in California (I was on strike) were about unsafe staffing conditions and the hospitals' refusal to follow the law around meal and break relief. We did not even propose a wage proposal until the end of negotiations (18 months after bargaining started) AFTER the strikes and AFTER the hospitals agreed to our staffing proposals.

A majority of RNs in a facility (think about your co-workers) simply will not vote to authorize a strike unless they

believe that conditions warrant it AND that the bargaining team has exhausted the negotiating process and needs the leverage of a strike to move negotiations forward. When faced with a trike deadline, most employers suddenly feel motivated to settle the contract and avoid the strike.

[Iam46yearsold]

As jsrRN points out himself strikes are about compensation and retention. Also wage proposals even if at the end of the strike. So as I point out strikes are even at the end solely about money. Everything else is just fluff.

[jsrRN]

The strikes were necessary to accomplish the staffing improvements. Once the hospital agreed to staffing improvements, we were willing and able to negotiate wages. It took about 2 hours for us to agree to their wage proposal. 18 months and 3 strikes to bargain over staffing and two hours to bargain over wages. Why? Because, wages are in fact, the easiest and least controversial thing to negotiate. What hospitals fight over are any issues that give RNs control over our practice--in this case staffing and the ability to go to an neutral arbitrator to enforce our right to RN staffing to allow us to safely take our meals and breaks.

[Iam46yearsold]

State labor laws already addresses meals and breaks.So it took 18 mos and 3 strikes to agree with mandated labor laws. Seems curious to me. Then it takes 2 hours to handle money. Handle the money first, 2 hours. Then comply with state labor laws. Seems very simple to me. Save all that effort. for something important, like doing patient care.

[Chico David, BSN, RN]

State labor laws already addresses meals and breaks.So it took 18 mos and 3 strikes to agree with mandated labor laws. Seems curious to me. Then it takes 2 hours to handle money. Handle the money first, 2 hours. Then comply with state labor laws. Seems very simple to me. Save all that effort. for something important, like doing patient care.

Actually, since we have a governor in place who does not believe in enforcing the law, many of the state laws to protect nurses and patients have become essentially moot in California the last few years. So the only way to get hospitals to comply is the put contractual methods of enforcement in place. The part that has been the issue is not the part covered by labor law - the right of a worker to have a break - but rather the part that is covered under the safe staffing law - the right of the patient to have a nurse when their regular nurse is on break. And of course, even the labor law part is under active attack by the governor and legislature right now, since Arnie and the Republicans in the state leg are demanding gutting of meal and break laws as the price of their agreement to a budget revision. Without unions to fight for them, those laws would have been gone long before now.