The association bought attack ads and rallied nurses who heckled him at public appearances around the state. The nurses' version of the Boston Tea Party came when the union hired a banner-toting blimp to fly over a Super Bowl party Schwarzenegger was hosting. The mandates eventually took effect.
Publicity over the flap catapulted the California union onto the national stage. The union launched an effort to organize nurses across the country. It now bargains for nurses in Maine and Illinois and has its sights set on several Texas hospitals.
Nurses' newfound power owes a lot to an aging population and a workforce miscalculation of gargantuan proportions.
As baby boomers grow older, their medical needs increase the demand for nurses. But the supply isn't keeping up.
Like the boomers she cares for, the average working nurse is also nearing retirement age. Half are older than 50. And the nation's nursing schools -- many of which closed down when hospitals were laying off nurses two decades ago -- don't have the capacity to replace them at the rate they are leaving.
Unlike many jobs, however, nursing can't be shipped offshore. "Workers in other nations cannot do it like they can produce flat-screen televisions," said Robert Reich, a public policy professor at UC Berkeley who was secretary of Labor under President Clinton.
Looming physician shortages and efforts to cut costs are likely to push even more of the patient-care workload onto nurses, further stoking demand, as is ever-changing medical technology, which requires skilled workers, often nurses, to operate.
As a result, Reich said, "we're going to see more and more pressure put on hospital systems that are not yet unionized."
Not everyone believes the growing bargaining power and political influence of nurses is the best medicine.
When nurses win pay raises and lower staffing ratios, costs rise, said Steve Malanga, a senior fellow at the Manhattan Institute, a conservative think tank based in New York.
"So it's a little bit naive to expect that their victories are going to also be complete victories for the patient," he said.
And not every nurse believes joining a union is the best way to improve patient care or their own lot.
"I think unions are taking advantage of the crisis in healthcare today," said Suzanne Geimer, an emergency room nurse at Cedars Sinai Medical Center in Los Angeles.
Geimer launched a website for nurses who opposed the unionization efforts at that hospital a few years ago. The California Nurses Assn. won the right to represent the Cedars nurses in an election in 2002, but the National Labor Relations Board overturned the election in a setback the union characterizes as an example of the Bush administration's efforts to undermine labor.
Geimer's website remains a forum for anti-union sentiment among nurses. She said many believed organized labor was merely interested in pumping up its numbers -- and collecting union dues.
"They see healthcare as a fertile field," Geimer said.
Union activists don't disagree.
"Everybody's looking at nurses," said United American Nurses President Cheryl Johnson, a nurse in Michigan.
"Everybody wants to have a say in how to fix" the problems with healthcare, she said. "There are big stakes in this game."
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lisa.girion@latimes.com
