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Unions Battle for Nurses

Two groups vie to dominate the state's hospitals. Patients could see better service, higher prices.

August 03, 2003|Ronald D. White | Times Staff Writer

After a 12-hour shift in the operating room, nurse Martha Salcedo left Monterey Park Hospital and walked toward her car in the parking lot. That's where a band of purple-shirted labor activists approached her.

"We're the union that brought Tenet to the bargaining table," said a representative of the Service Employees International Union, referring to the big hospital chain.

Another SEIU rep said: "We have a guaranteed salary increase." Then the rep offered Salcedo a union card to sign.

A few days later she again was approached in the parking lot by labor organizers. This time they were with a different union -- the California Nurses Assn. These activists described the CNA as the real voice for registered nurses, and, denouncing the SEIU as selling out to management, implored her to join them.

On both occasions, Salcedo drove off without saying a word.

"I was too scared" of being seen by hospital administrators, she said.

Like it or not, Salcedo and thousands of other nurses in California have become targets of aggressive campaigns by two unions that are competing for labor dominance in the state's hospital sector.

In recent weeks, the SEIU and the CNA -- two fast-growing unions with opposing cultures and agendas -- have filed for union elections at about 20 hospitals owned by Tenet Healthcare Corp. and other companies. And they're just getting started.

With sights on organizing dozens more hospitals, they have taken their campaigns not only to hospital parking lots but also to nurses' break rooms, workers' homes and the National Labor Relations Board.

The battle has drawn national attention and left many in the labor movement cringing.

"This fight has turned very personal and very ugly," said Kate Bronfenbrenner, director of labor education research at Cornell University. "It's very unfortunate. It's only hurting the labor movement."

The stepped-up organizing by the unions could have broader repercussions, as hospitals face cuts in public funding, a nursing shortage and new state rules that will require them to add nurses next year.

Based on union and company estimates, 20% to 25% of the 1.3 million health-care workers in California are represented by labor unions, including employees at some of the biggest hospital chains -- Sutter Health, Catholic Healthcare West and Kaiser Permanente.

About 275,000 of the union members belong to the SEIU, which is affiliated with the AFL-CIO and represents hospital janitors and respiratory-care operators as well as all types of nurses. The CNA, a century-old group based in Oakland and fiercely independent, has 50,000 members, all of them registered nurses.

In the next few years, industry executives predict, the percentage of health workers in the state represented by unions could double. Most hospital employees, given the chance, are likely to join one of the two unions, the executives say, in large part because of frustration over their working conditions and pay.

Patients and their families could stand to gain, because collective bargaining agreements offer better pay and working conditions, which could draw talented people to the health profession.

On the other hand, industry executives and observers agree that if unions win higher wages at Tenet and other major hospital chains, nonunion competitors will have to keep pace. And salary increases "obviously will be passed on to consumers, patients," said Fred Harter, a former hospital chief executive who is senior vice president of public policy at California Healthcare Assn., a hospital trade group.

By Harter's estimate, 55% to 60% of a hospital's operating budget is labor expenses. "If you look at hospital costs now, the No. 1 driver is labor, absolutely."

Mutual Advantage?

For years, neither of the unions had much success organizing employees of Tenet, the nation's second-largest hospital operator, which is widely known for its tough anti-union campaigns. But in May, the Santa Barbara-based company announced a pact with the SEIU that essentially opened the door for the union to organize Tenet's 40 hospitals in California and their 35,000 employees.

Wall Street analysts viewed the deal as a shrewd move by the company -- under severe pressure from multiple government investigations of its business practices -- to buy labor peace and quell criticism from a union with deep resources and strong political connections in Sacramento.

As part of the accord, Tenet agreed to provide raises totaling 29% over four years to employees at hospitals where a majority of workers had voted for the SEIU. Tenet's pact made the same pledge to a smaller health-care union, the American Federation of State, County and Municipal Employees.

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