Frustrated by a decade of managed care, mergers and budget cuts, registered nurses nationwide are rethinking their ideas about organized labor and joining unions by the thousands. And they are using their new bargaining clout to raise questions about patient care in contract talks and state legislatures.
Evidence of the new activism was clear this fall in Sacramento, where Gov. Gray Davis signed four labor-backed nursing bills, including a landmark law that will set minimum nurse-to-patient ratios at all hospitals in the state. The law was the first of its kind in the nation, but similar bills are in the works in Pennsylvania and Nevada.
Unions also are winning tough contract language that sets staffing ratios at hospitals and prohibits cost-saving practices that nurses say leave patients at risk.
The surge of unionization is yet another indication of the rumbling discontent among health care professionals, including doctors and technicians, in an era of belt-tightening by hospitals and health plans.
Unions that specialize in health care say they cannot find enough organizers to respond to calls from nurses, and even such unlikely unions as the Laborers International Union and the United Auto Workers have entered the field.
"It's like the state is on fire," said Rose Ann DeMoro, director of the California Nurses Assn., which is among the most aggressive nursing organizations in the country. "I've been here for 14 years, and I've never seen such a dramatic shift in such a short time."
About 20,000 registered nurses have joined unions nationwide through federally supervised elections in the last two years, and there are active campaigns to sign up at least 10,000 more. About 18% of the 321,404 U.S. registered nurses are represented by unions.
The groups are even making inroads in such traditionally nonunion cities as Los Angeles, where the California Nurses Assn. signed up three hospitals in the last 18 months and is running advanced campaigns at three more. In California, about 35% of eligible registered nurses are organized, DeMoro said.
Those victories did not come without a fight. Hospitals have routinely responded to organizing campaigns by hiring consultants who specialize in defeating unions. Others have countered organizing efforts by raising salaries and improving staffing conditions.
Until recently, many nurses--professional, highly educated and predominantly women--did not see labor as a natural fit.
