NEW YORK NURSE: July/August 2010
by Mark Genovese
NYSNA has said hospitals take a risk when they entrust care of their patients to strikebreaking agencies. Now there is research to support this assertion.
“Do Strikes Kill?” released in March by the National Bureau of Economic Research, studied the effect of hospital nurses’ strikes on patient outcomes. It suggests that “hospitals functioning during nurses’ strikes are doing so at a lower quality of care.”
Results indicated that during strikes, in-hospital deaths increased by 19.4 percent and 30-day readmissions by 6.5 percent. It estimated that out of 38,228 patients admitted, 138 died and 344 returned.
These findings are of particular concern to NYSNA, because data was collected from 50 strikes at 43 hospitals in New York state between 1984 and 2004. Twenty-three of those strikes were conducted by NYSNA bargaining units.
“Nurses vote to strike because they feel all other avenues have been exhausted,” said NYSNA President Karen Ballard. “They’ve spent months at the negotiating table, telling their employer there are serious workplace or patient care problems that must be resolved. They know it’s a last resort, they understand the impact, and take this situation seriously.”
NYSNA RNs are concerned about their patients’ care, even when on strike. This is why LBUs establish a committee to send RNs back into the hospital in an emergency.
Hospital administrators often contract with staffing agencies whose sole purpose is to prolong strikes and break the unions’ will. The agency hustles in temporary replacements, often paying little attention to background checks and certification. Many of these replacement nurses, often called “scabs,” are recruited by ads suggesting they use their sick and vacation time to take advantage of an opportunity to earn extra money.
NYSNA President-Elect Winifred Kennedy, one of the 700 NYSNA members on strike at Maimonides in 1998, described how she obtained valuable “inside” information. “I ‘signed up’ for scab agency work – giving different names and background information. I was usually called within a very short time and told to come to the hospital, prepared to work.”
While Kennedy was on the phone with one agency, an emergency call came in from the hospital. “They said they were given my (false) name and asked how soon I could show up for a shift. All I did was call an ‘800’ number a few minutes before!”
These temporary replacement nurses are put to work by the employer with no regard for skills and little orientation, encouraged to work extended hours, often without sufficient rest breaks, for extra money and bonuses.
Hospital administrators, meanwhile, contend care is being delivered at the same level and without interruption. But colleagues from other unions working inside relate stories of medication orders not being picked up, wrong medications being administered, or replacements not knowing the location of an important piece of equipment – costing precious minutes in an emergency. “I remember that each time we raised a concern, the Department of Health said there was no impact,” Kennedy added.
“There have always been informal reports of patient care mistakes when scab labor is in the house, but it is often difficult to verify the details for the Department of Health from outside the hospital,” said Lorraine Seidel, director of NYSNA’s Economic and General Welfare Program. “The healthcare work environment is highly specialized. It is not possible to just drop unfamiliar nurses into a unit for which they have not been fully and specifically oriented and expect them to perform at a safe and effective level.” A strike can also have an effect on the community as a whole, as the study indicated that nearby hospitals saw a 3 percent increase in admissions during strikes.
A strike may remain a bargaining unit’s only tool to persuade an employer, after negotiations and community pressure haven’t resolved the issues. Nurses understand their ethical responsibility to deliver care. But, sometimes the workplace situation is so desperate that there is no other option. “The report itself said that strikes have led to long-term improvements in the workplace and in the delivery of care,” Ballard said, “and this indeed has been NYSNA’s experience.”
“Sometimes it takes months, even years, for the truth to come out. But it eventually does,” Seidel added.