RE Nursing strikes Replacement workers:Health field becomes battlefield


    Health field becomes battlefield


    Adam Geller
    Brockton, Mass.

    - Julie Connors leads picketers against Brockton Hospital, one of thousands of unionized nurses across the U.S. on strike over wages, mandatory overtime and inadequate staffing.

    Hospital and nursing home executives have responded to the walkouts by flying in corps of highly paid temporary replacement nurses to keep their facilities running.

    Strikers say management is trying to break unions and that the imported nurses provide substandard care, while hospitals contend that they are fulfilling an obligation to their patients.

    Both sides agree that the use of replacements is prolonging nursing strikes.

    "Without them, the strike wouldn't last as long because we would have to cave in," said Robert Hughes, vice president of Brockton Hospital.

    That perceived advantage may help explain a 73-day strike at a hospital in Flint, Mich., last winter, a five-month walkout at a hospital in Nyack, N.Y., last fall and a strike under way in Youngstown that has stretched into its third month.

    "We give [hospital and nursing home administrators] the time so they don't have to say the things they don't want to say," said Dan Mordecai, chairman and chief executive of U.S. Nursing Corp., a privately held Denver company that is by far the largest supplier of strike replacements.

    The availability of replacements is a particularly valuable bargaining chip, given the tight labor market for nurses that strengthens the economic hand of unions. But it also risks deepening the divide between managers and nurses, experts say.

    "The hospital is signaling we don't need the nurses. The nurses are signaling we don't need the hospitals," said Jack Needleman, who teaches economics and health policy at Harvard University. "That creates a real distance that is the exact opposite of the kind of team orientation and mutual respect among parties that is needed to make improvement happen."

    Temporary nurses aren't a new phenomenon. Hospitals have long called on traveling nurses and small, local temporary agencies when short of staff or to work alongside non-union supervisors during strikes.

    As recently as a decade ago, many hospitals responded to infrequent strikes by scaling back, canceling elective procedures and referring patients to other health care facilities. But U.S. Nursing, founded in 1989 by Mordecai, a former benefits consultant whose wife is a nurse, offers a ready force of nurses from around the country who can staff hospitals at full strength.

    They don't come cheap. Replacements supplied by U.S. Nursing Corp. and a smaller firm, Nurse Bridge, often earn $40 an hour, double the rate of many regular nurses. The costs multiply once hotel bills, airfare and other costs are added in.

    U.S. Nursing and some hospital executives would not discuss what the company charges, its profits or details of its contracts.

    The average U.S. Nursing replacement works 12 hours a day, five or six days a week, and earns $3,000 a week, Mordecai says. Executives at Nurse Bridge, a subsidiary of Health Personnel Options Corp. of New Albany, Miss., did not return calls for comment.

    Union officials say the total cost to hospitals is about $5,000 per week for each replacement. But the cost has not dissuaded hospitals from calling on the replacement firms.

    U.S. Nursing staffed its first strike in Burlington, Iowa, in 1990 - for that job it dispatched 35 nurses. This year the company will employ between 4,000 and 5,000 nurses at U.S. strikes.

    The increased role of replacements has seeded a new strain of tensions.

    In Connecticut, Gov. John G. Rowland enraged union leaders this spring when he authorized the use of more than $20 million in state funds to pay replacements at 39 nursing homes targeted by a strike. The homes, which contracted with U.S. Nursing, ran up bills of about $1.2 million a day at the peak of the strike in May.

    In Michigan, nurses at Flint's McLaren Regional Medical Center returned to work in January. But because about 100 nurses found work elsewhere and decided not to come back, hospital administrators have held on to a small group of U.S. Nursing replacements to work alongside lower-paid returning strikers.

    "They are very open in talking with each other about how lucrative it is to be here, as they're standing there working," said Al Napier, president of the nurses union at the Flint hospital.

    In Massachusetts and other states, unions deride replacements as dangerous, saying their lack of familiarity with hospitals and long working hours put patients at risk.

    To illustrate, they point to St. Vincent Hospital in Worcester, where an 87-year-old woman died after gall bladder surgery during a strike in May 2000. A state investigation found that U.S. Nursing replacements misunderstood doctors' instructions about how the woman was to be monitored.

    U.S. Nursing's Mordecai says such mistakes are rare and reflect the challenges all medical professionals must cope with.

    "We do make mistakes. We have the same kinds of problems that, from time to time, occur in any hospital environment," he said.

    Hospital executives praise replacements and defend their choice to call them in.

    "We had to do everything in our power to be prepared to continue patient care," said Kathy Nimmo, chief nursing officer at McLaren.

    At Brockton, 17 doctors signed a public notice declaring that the replacements "have our full respect and support. As licensed and experienced medical professionals, these nurses provide high-quality medical care in every department of the hospital."
    Last edit by NRSKarenRN on Jul 17, '01
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  3. by   CarolineRn
    Hi there!

    Union officials say the total cost to hospitals is about $5,000 per week for each replacement. But the cost has not dissuaded hospitals from calling on the replacement firms.

    I just don't understand this. Hospitals are spending more money on replacements than they would spend if they would negotiate with the unions, and treat their own nurses fairly.

    I'm just a student nurse, so I'm not familiar with all the politics, but this just doesn't seem like sound business sense.

    Is the reasoning behind this just to make a point that strikes will not be tolerated? Are the strikers asking too much? Someone fill me in, as I am completely clueless!

  4. by   -jt
    I just don't understand this. Hospitals are spending more money on replacements than they would spend if they would negotiate with the unions, and treat their own nurses fairly. >

    no they arent. they arent spending anything but they would be if they settled with the nurses to make the improvements the nurses need. Thats why they resist & force a strike. It will cost the hospital money & increase expenses (cutting into the profits) to make those improvements like hiring enough staff & paying decent salaries to recruit them. But If they force the nurses out on strike & wait it out until the nurses give up their insistence on those expensive improvements, they can write off the cost of the strike, count it as a business loss, use strike insurance to cover the costs & in places like Conneticut, now have the TAXPAYERS pay for the strike the hospital forced! - so the hospital doesnt care how much it is going to cost - its not coming out of its operating-budget or pockets like the improvements would if they agree to them. So by forcing a strike (that others are funding) its no skin off their nose to hold out until the nurses give up & then the hospital doesnt have to make those expensive improvements at all.
    (The only thing that they arent getting through their thick heads yet is that the nurses are not giving up.)
  5. by   OC_An Khe
    Another factor in the hospitals fighting the RNs is the issue of power. The administrators have it and will do anything not to share it with nurses. They see an organized Nursing profession as a threat to them and will continue to take actions to prevent Nursing from becoming united. Whether this is a in the form of a Union or not. Divide and conquor. Most MDs , in my expirience, also feel this way.
  6. by   -jt
    <<<Youngstown, Ohio GDNA - Ohio Nurses Association/UAN/ANA
    Rosalie Nemeth Testimony

    "I am a striking registered nurse at Forum Health. I would like to talk to you about my thoughts on the strike. What constitutes good business decisions? Utilizing resources wisely? Having a good working relationship with employees so that they buy into the goals of the organization? Having a safe and pleasant working environment to attract and retain good employees? Being competitive for both clients and employees? Delivering a superior product and trimming the excess and keeping the essentials? Do these ideas sound familiar?

    Nurses at Forum think these are common sense ideas. Our goal is to deliver a superior products (excellent nursing care) to our clients (our patients) in a safe manner. Hospitals exist solely for nursing care. Safety is cost effective. Safe care by adequate staffing has been shown to shorten patient's hospital stay and decrease complications. A safe working environment reduces injuries to nurses, which in turn is a savings for the hospital. A safe and pleasant working environment attracts and retains employees as well as clients. If an employee feels respected and appreciated, she or he will buy into the corporate goal and project that to the patient.

    Forum Health has been paying scab nurses $40.00 to $90.00/hr. plus agency fees, lodging, food and bar bills and long distance phone calls so these scab nurses can work 12 hours a day, 6 days a week. Does this sound cost effective or safe to you? Forum Health has 24 vice presidents. Does this sound cost effective to you? Forum Health has 765 qualified, experienced and committed nurses on strike since May 1st. Many have found employment elsewhere. Do you think they feel respected and appreciated?

    Forum Health has told it's nurses "When you retire at less than 65 years of age, we are not interested in making available to you the ability to buy into our health care plan". Forum Health has told its nurses "Even if given the opportunity to resolve mandatory overtime you must accept forced and mandatory overtime as a way of life". Forum Health continues to introduce new issues each time and old issue is resolved. Does this sound like someone trying to resolve a strike?

    This is a hospital that has historically served at least half of our community. These are nurses who have provided that care within the hospital. How long will the community tolerate the stalled resolution of this strike? How long will the community tolerate outsiders invading our community and taking our resources to other cities? We have heard form the scab's own mouth that they are in this business for the money. It pays very well. They have laughed in our faces and have shown us their paychecks. How long will we have to tolerate this injustice to our working people who have spent their entire careers giving care to the sick and injured of this community? How long? >>>