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With the ratification of the California Nurses Association’s (CNA) contracts with five Sutter Health Hospitals in the East Bay on Thursday, more than 3,000 nurses and several hundred technicians joined roughly 2,500 other union members in reaping the benefits of a pitched two-year battle. The new contract turned back most Sutter’s nearly 200 demands for concessions, which included eliminating paid sick days and cutting health insurance for many workers.
The fight wasn’t easy. Since ten contracts covering more than a dozen Sutter Health medical campuses expired in 2011, the union had called for a total of nine strikes against the hospital chain. Although most of the strikes were intended to last only one day, says CNA spokesperson Joanne Jung, hospital executives retaliated in eight cases by locking workers out, so that nurses who intended to strike for one day were replaced by “traveling nurses” for five. In response, workers’ determination increased and even more nurses joined subsequent strikes. “[The lockouts] really backfired big-time,” says nurse representative and bargainer Mike Hill.
According to CNA, the union represents nurses at roughly half of the non-profit chain’s network of hospitals in northern California. Sutter has long refused to negotiate a master contract, and its negotiators began settling with hospitals individually while management continued to insist on givebacks — and faced growing resistance — at the East Bay hospitals, which included some of the chain’s largest facilities.
CNA Executive Director Rose Ann DeMoro said in a statement after the final contracts were ratified that the two-year fight showed that “through unity and a willingness to stand up and say, ‘no,’ it is possible to hold the line and win.”
CNA says it garnered public support by arguing that many of Sutter’s demands, such as eliminating health insurance and other benefits for the hundreds of nurses who were likely to work fewer than 30 hours a week, would hurt patients and people in the community as well as workers and their families. According to Jung, yard signs supporting the nurses cropped up in neighborhood yards, and the nurses were joined at rallies and picket lines by local politicians, as well as representatives of local housing, health care and community coalitions. These groups had allied with the CNA during a concurrent fight to block Sutter’s plans to close two community hospitals.
Sutter is financially strong: In 2010, it paid 28 executives more than $1 million each, and its hospitals collected more patient revenue per employee than any other U.S. hospital system, according to Modern Healthcare magazine.
Nevertheless, Sutter negotiators tried to use provisions of the Affordable Care Act (ACA) in an inappropriate and inaccurate way. For example, they argued that ACA’s provision that employers did not have to provide insurance for employees working less than 30 hours a week justified their plans to set the threshold at 30 hours, not the existing 20 hours, for workers to receive health insurance. But ACA does not prohibit employers from setting a more generous standard. They also claimed that they had to impose cutbacks because, as the ACA goes into effect, the legislation will cause financial hardship to the hospital chain, even though groups like the American Hospital Association supported the act because it will provide more paying clients. Indeed, according to a CNA analysis, Sutter’s revenue will likely rise substantially under the ACA.
Workers on union negotiating teams reportedly offered alternative ways to save money, such as through more efficient organization of work, but according to Hill, Sutter Health representatives weren’t interested.
Instead, management continued to hold fast in their attempts to enforce contractual changes, such as forcing nurses to work in areas for which they had not been adequately trained or increasing nurses’ out-of-pocket healthcare costs.
“It was a total outrage,” said Thorild Urdal, a labor and delivery nurse at the Alta Bates hospital in the East Bay for 38 years. “I felt there were so many take-backs. Sutter was attempting to break the union.”
The East Bay hospital workers’ refusal to accept concessions may have strengthened the hand of nurses in negotiations with other Sutter hospitals — and even CNA-member nurses at the unrelated Dignity chain (formerly Catholic Healthcare West), union officials said. According to the CNA, their fellow union members’ continuing show of resistance helped workers at Sutter hospitals in other regions negotiate largely non-concessionary contracts before union members ratified the East Bay settlements last week.
The union held together and got stronger over the two years, Urdal said, and members’ willingness to fight avoided what she regarded as the unacceptable compromises by other unions at the hospital, such as the Service Employees. (CNA spokeswoman Joanne Jung said that in many hospitals, non-nursing workers in SEIU were upset at the concessions their negotiators had accepted.) During the contract fight, CNA also continued its organizing at Sutter, adding nurses at one new hospital in Tracy to the union.
Workers at Sutter are confident that the union’s ability to win on their behalf will continue into the future.
“I think people are feeling really good,” Urdal said. “We showed our strength. Next time management will know we’re up for the fight, know how to organize, and understand their proposals.”
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David Moberg, a former senior editor of In These Times, was on staff with the magazine from when it began publishing in 1976 until his passing in July 2022. Before joining In These Times, he completed his work for a Ph.D. in anthropology at the University of Chicago and worked for Newsweek. He received fellowships from the John D. and Catherine T. MacArthur Foundation and the Nation Institute for research on the new global economy.