Union marks a century of progress

U.S.A. California


Contra Costa Times

Posted on Sun, Sep. 21, 2003

Union marks a century of progress

By Judy Silber


OAKLAND - The nursing profession has changed markedly since a San Francisco nurse first rallied 96 women in 1903 to form the organization that would become California Nurses Association.

One hundred years ago, nurses primarily cared for patients within the traditional roles assumed by women at the time, performing important but mundane tasks. They tended to patients' wounds or treated fevers with ice baths. They washed sheets, cleaned towels and scrubbed floors. They earned low salaries with minimal benefits and had little say with doctors in how to best manage patients' care.

Nursing has not shed its image as a woman's profession. But the job has still come a long way. Registered nurses today have a wide array of duties that require technical skills and scientific expertise acquired through years of expertise and training. They're considered a critical component in contributing to the health and recovery of patients.

Oakland-based California Nurses Association credits its collective bargaining strength with helping bring about many of the changes that have turned nursing into a more respected profession. About 1,000 registered nurses gathered in Oakland last week to celebrate the CNA's centennial and its contributions to nursing.

"The CNA has been on the cutting edge of reform," said Rose Ann DeMoro, executive director of the association. By setting high standards in California, the union has helped raise the bar for nurses across the country, she said.

That the CNA has grown into a forceful organization respected by politicians was clear by the event's guest speakers. California Senate President Pro Tem John Burton, D-San Francisco, consumer activist Ralph Nader, U.S. Representative and Democratic presidential candidate Dennis Kucinich and Gov. Gray Davis all put in appearances.

The association began not as a union but as a professional organization known as the California State Nurses Association. Members sought to legitimize their trade by emphasizing the scientific training that became important as medicine increased in complexity at the turn of the century, said Charles Idelson, a spokesman for the association who researched the CNA's history for the centennial celebration.

In 1905, the California legislature passed the Nursing Practice Act, a bill sponsored by the association that established a licensing board for registered nurses, among the first in the nation. Over the next decades, the CSNA also pushed for autonomy from hospitals, Idelson said. At the time, hospitals trained nurses who worked at the facilities for free during the day and took classes at night. The organization pushed to move nursing education under the auspices of educational facilities.

The first collective-bargaining agreement came in 1946 in a contract with six Alameda hospitals. Before that time, the CSNA had resisted negotiating with hospitals, instead offering voluntary guidelines. Although World War II had served to raise the skill level of nurses, and increased hospital admissions had placed nurses in high demand, hospitals refused to raise salaries and offered no benefits or overtime, Idelson said. The contract in Alameda guaranteed salaries of $200 per month, overtime pay, health benefits, a 40-hour work week and paid holidays, vacations and sick leave.

Kay McVay, the outgoing president of the California Nurses Association, recalls a time early in her career that began 47 years ago when supervisors could guilt-trip her into working overtime for no extra pay. McVay had just received her nursing license from Orange County General Hospital, where instructors lifted up students' skirts each day to make sure they wore cotton slips. Doctors demanded that nurses fetch them coffee and discarded instruments on the floor, expecting nurses to pick them up, she said.

Against this backdrop, the union continued to organize registered nurses and gain more contracts, continually seeking to upgrade working conditions. All the while, the required skill set grew as advancing technology took over more rudimentary techniques. Nurses no longer had to sterilize syringes or crank by hand suction machines that removed bodily fluids. "Nursing today is far more sophisticated with far more responsibility," McVay said. "You have to take care of the patient, the machines, the doctor, the family."

In more recent times, the union counts among its biggest achievements a 1999 law it supported mandating minimum nurse-staffing levels in all hospital wards. Regulators are still sorting out the appropriate minimum nurse-to-patient ratios, but already the law has had an effect. As hospitals have prepared for the law's enactment, they've hired more registered nurses.

The union has grown in numbers as well as strength as an acute nursing shortage has forced hospitals to give in to its demands. Starting salaries at Kaiser Permanente, California's largest hospital system, have jumped from $275 a month in 1953 to $5,427 in 2003. Over the past two years, contract negotiations have yielded pension plans and retiree health benefits in addition to substantial raises for many of its 55,000 members.

Yet union leaders say their work is far from over. They want to guarantee retiree benefits for nurses all over California and the nation so that nurses won't have to worry about retiring in poverty. The organization is also pushing hard for health care reform, favoring a single-payer plan that will provide health care to all people living in the United States.

The union is not without detractors. Hospitals have accused the organization of employing hard-ball tactics because it threatens to go on strike every time there's contention in negotiations. It's engaged in a bitter battle with the Service Employees International Union, a union of health care workers that includes some registered nurses, as the two organizations have fought to increase their numbers. And not all registered nurses appreciate the highly politicized rhetoric of the organization.

Others credit the California Nurses Association with helping their struggle for decent working conditions, wages and the ability to fight for the interests of their patients.

"The CNA has allowed us to articulate who we are and what we stand for," said Trande Phillips, a Kaiser Walnut Creek registered nurse for 21 years. "We were treated as second-class citizens. The CNA has given us the courage to speak up and challenge the establishment."


* 1903: California State Nurses Association, the precursor to the California Nurses Association, is founded

* 1905: California Nurse Practice bill passes, creating a registered nurse licensing board

* 1938: CSNA adopts its first voluntary wage and benefit guidelines for hospitals

* 1946: CSNA signs the first collective bargaining agreements for RNs in Alameda county

* 1969: First CNA strike by nurses at eight San Francisco and East Bay hospitals

* 1976: California enacts minimum staffing levels for hospital intensive care units

* 1999: California legislature passes bill requiring hospitals to adopt minimum nurse staffing levels in all wards

* 2002: CNA negotiates pension and retiree medical benefits for 30,000 nurses across the state

Judy Silber covers biotechnology and the business of health care. Reach her at 925-977-8507 or [email protected].


2,099 Posts

Specializes in Corrections, Psych, Med-Surg.

A century, yes. Progress, that is not so clear.


177 Posts

Specializes in Med-Surg.

A Happy Member here....................

I count myself a lucky member of CNA. I work at a hospital that has had CNA for 20yrs. I have always had a contract and support from my union rep. I was shocked (3 years ago) to realize that nurses in southern california were fighting for basic contracts , and subject to manditory overtime. I know that everyone at CNA (majority are Nurses) are fighting daily to protect our scope of practice and our duty to advocate for our patients. Each CNA represented hospital has nurses involved in CNA and dedicated to the protection of patient care.

CNA gives me hope when dealing with management (who only cares about the bottom line$$$$$$$$$).

I work in med surg and like my job, and think I am good at what I do. When I voice my dissapointment and frustration with administration I find common answers. "maybe it is time for you to move on, there is so much to do in nursing". I like med-surg(the surg part) and I have put up with alot(14yrs). So if you are asking me to move on........................................I feel no reasonable person will work in med-surg for more than 1-2 yrs.

Nurses need to create "teeth" in the way we treat hospital patients. We need a stronger voice in the delivery of patient care.

Nurses work incredibly hard and I cannot imagine working in a state or hospital that does not treat me with respect. Nurses give so much of themselves, and are subject to such risk (HIV, Hepatitis,etc)and yet fight for basic retirement benifits and health care.

Many nurses do their job and then go home to their families. But when it is your mother and family in the hospital ---would you realy feel ok not being there every minute to assess and evaluate their care??

We need more unity in Nursing and a single payer (universal health care) to end the inequities and greed in health care.

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