Workload expectations at core of nurses’ lawsuit against University of Michigan

Members of the Michigan Nurses Association are accusing the University of Michigan of unlawfully refusing to negotiate over nurses’ workloads in its bargaining with the University of Michigan Professional Nurse Council.

The union, an affiliate of National Nurses United and AFL-CIO, represents about 13,000 registered nurses and healthcare professionals in Michigan, including workers employed by the University of Michigan. The University of Michigan regents hold the contract with the University of Michigan Professional Nurse Council, the largest bargaining unit of the Michigan Nurses Association.

A total of 6,200 University of Michigan Health nurses have been working without a new contract since July 1, and they are working under the terms of the expired agreement, according to hospital and union statements. The University of Michigan Health, the clinical division of Ann Arbor-based Michigan Medicine, told Becker’s in a statement that during negotiations, it has offered a 21 percent base pay increase for nurses over the life of the contract, as well as a new salary step program for nurse practitioners and the safe elimination of mandatory overtime.

The union contends the University of Michigan has refused to bargain over safe workloads regarding the number of patients assigned per nurse, which it says is tied directly to nurses’ patient safety concerns. As a result, it filed a lawsuit Aug. 15 in the Michigan Court of Claims. 

“When nurses are forced to take care of too many people at once, patient care gets compromised and nurses are put in danger of injury or burnout, and that’s happening far too often at our hospital,” said Renee Curtis, RN, president of the University of Michigan Professional Nurse Council, said in a news release. 

“University of Michigan Health makes staffing determinations with patient safety at the forefront of its decisions, and this has produced outstanding safety results,” the health system said in its statement. “The health system continuously receives recognition as Michigan’s safest hospital with recent recognitions by top agencies.”

University of Michigan Health also said it “plans to vigorously defend itself” against the union lawsuit.

Strike set to begin at Cedars-Sinai

Members of the Service Employees International Union-United Healthcare Workers West are set to begin a weeklong strike May 9 at Cedars-Sinai Medical Center in Los Angeles.

The union represents about 2,000 certified nursing assistants, surgical technicians, sterile processing technicians, transporters, environmental service workers, plant operation workers and food service technicians, according to NBC Los Angeles. Cedars-Sinai Medical Center has about 14,000 employees total.

Union members voted to authorize a strike in April. The union and hospital began negotiating a new labor contract March 21, according to NBC Los Angeles. A hospital spokesperson told the local news outlet that upon the start of negotiations, “Cedars-Sinai presented a strong economic proposal that would have continued our market leading pay by providing substantial pay increases to bargaining unit employees as early as March 27.”

The union contends that in its latest round of bargaining, Cedars-Sinai rejected proposals on PPE stockpiles, COVID-19 exposure notifications, keeping pregnant and immunocompromised workers away from COVID-19 patients and other safety measures. “We’re asking for basic workplace protections and respect for the lives and health of caregivers and patients,” an SEIU-UHW statement reads. 

“We respect the rights of SEIU-UHW members to take this step,” the hospital said in a statement. “The most effective way to reach a fair agreement, however, is for both parties to stay at the bargaining table and finish negotiations.”

Stanford Health Care to nurses: No pay for those who strike

Stanford Health Care and Lucile Packard Children’s Hospital administrators have notified union leaders that its nurse members who strike later in April risk losing pay and health benefits, according to Palo Alto Weekly.

The Committee for Recognition of Nursing Achievement, a union at Stanford Health Care and Stanford Children’s Health that represents about 5,000 nurses, has scheduled a strike to begin April 25. The nurses’ contract expired March 31.

If the strike moves forward, Stanford Health Care and the Lucile Packard Children’s Hospital, both based in Palo Alto, Calif., are prepared to continue to provide safe, quality healthcare, according to a statement from Dale Beatty, DNP, RN, chief nurse executive and vice president of patient care services for Stanford Health Care, and Jesus Cepero, PhD, RN, senior vice president of patient care and chief nursing officer for Stanford Children’s Health.

But the statement, which was shared with Becker’s, said nurses who choose to strike will not be paid for shifts they miss.

“In addition, employer-paid health benefits will cease on May 1 for nurses who go out on strike and remain out through the end of the month in which the strike begins,” Drs. Beatty and Cepero said.

The leaders quoted from Committee for Recognition of Nursing Achievement’s “contingency manual” that the union provided to nurses: “If a strike lasts beyond the end of the month in which it begins and the hospitals discontinue medical coverage, you will have the option to pay for continued coverage.”

Drs. Beatty and Cepero said nurses who strike may pay to continue their health coverage through the Consolidated Omnibus Budget Reconciliation Act.

In a separate statement shared with Becker’s, Committee for Recognition of Nursing Achievement President Colleen Borges called Stanford and Packard management’s move regarding nurses’ health benefits “cruel” and “immoral.”

“Health benefits should not be used against workers, especially against the very healthcare professionals who have made Stanford a world-class health system,” said Ms. Borges, who is also a pediatric oncology nurse at Lucile Packard Children’s Hospital. “We have spent our careers caring for others and putting others first — now more than ever we need solutions that will ensure sustainability, safe staffing and strong benefits to retain nurses. But instead of taking our proposals seriously, hospitals are spending their time and energy weaponizing our medical benefits. We refuse to be intimidated from standing up for the fair contracts that we need in order to continue delivering world-class patient care.”

The union has organized a petition to tell Stanford not to cut off medical benefits for nurses and their families during the strike. As of April 19, the petition had more than 25,150 signatures.

Sutter Health: Nurses who staged 1-day strike must wait 5 days to return to work

Sacramento-based Sutter Health said nurses who went on strike April 18 will not be allowed to return to work until the morning of April 23, the San Francisco Chronicle reported.

The strike affected nurses and healthcare workers at Sutter Health facilities in Northern California. The nurses are members of the California Nurses Association, and the other workers are members of the Caregivers and Healthcare Employees Union, an affiliate of the California Nurses Association.

More than 8,000 registered nurses and healthcare workers were expected to participate in the strike, according to an April 18 news release from the unions.

In a statement shared with Becker’s, Sutter Health said the organization conducted strike contingency planning, which included “securing staff to replace nurses who have chosen to strike, and those replacement contracts provide the assurance of five days of guaranteed staffing amid the uncertainty of a widespread work stoppage.” 

“As always, our top priority remains safe, high-quality patient care and nurses may be reinstated sooner based on operational and patient care needs,” the statement said.

The California Nurses Association described Sutter Health’s decision as retaliatory, as well as “completely unnecessary and vindictive.”

“Nurses who are regularly scheduled to work during this lockout period will lose those days of pay,” the union said in a statement shared with Becker’s. “We urge Sutter to respect the nurses’ strike and let all nurses return to work.”

Sutter Health workers authorized a strike in March, and union officials announced an official strike notice April 8. Union members cited lack of transparency about the stockpile of personal protective equipment supplies and contact tracing as a reason for the strike. They also said they seek a contract that will help retain experienced nurses and provide sufficient staffing and training.

Nurses have been in contract negotiations since June. 

More than 4K Stanford nurses vote to strike in California

UPDATE: April 14, 2022: Nurses will begin striking April 25 if they are unable to reach a deal with the system by then, according to a Wednesday statement from the union. The two sides have met with a federal mediator three times, and the strike would be open-ended.

Dive Brief:

  • Unionized nurses at Stanford hospitals in California voted in favor of authorizing a strike Thursday, meaning more than 4,500 nurses could walk off the job in a bid for better staffing, wages and mental health measures in new contracts.
  • Some 93% of nurses represented by the Committee for Recognition of Nursing Achievement voted in favor of the work stoppage, though the union did not set a date, according to a union release. It must give the hospitals 10 days notice before going on strike.
  • Nurses’ contracts expired March 31 and the union and hospital have engaged in more than 30 bargaining sessions over the past three months, including with a federal mediator, according to the union.

Dive Insight:

As the COVID-19 pandemic has worsened working conditions for nurses, some unions have made negotiating contracts a priority. Better staffing is key, along with higher wages and other benefits to help attract and retain employees amid ongoing shortages.

The California nurses’ demands in new contracts focus heavily on recruitment and retention of nursing staff “amid an industry-wide shortage and nurses being exhausted after working through the pandemic, many in short-staffed units,” the union said in the release.

They’re also asking for improved access to time off and more mental health support.

Nurses say their working conditions are becoming untenable and relying on travel staff and overtime shifts is not sustainable, according to the release.

The hospitals are taking precautionary steps to prepare for a potential strike and will resume negotiations with the union and a federal mediator Tuesday, according to a statement from Stanford.

But according to CRONA, nurses have filed significantly more assignment despite objections documents from 2020 to 2021 — forms that notify hospital supervisors of assignments nurses take despite personal objections around lacking resources, training or staff.

And a survey of CRONA nurses conducted in November 2021 founds that as many as 45% were considering quitting their jobs, according to the union.

That’s in line with other national surveys, including one from staffing firm Incredible Health released in March that found more than a third of nurses said they plan to leave their current jobs by the end of this year.

The CRONA nurses “readiness to strike demonstrates the urgency of the great professional and personal crisis they are facing and the solutions they are demanding from hospital executives,” the union said in the release.

No major strikes among healthcare workers have occurred so far this year, though several happened in 2021 and in 2020, the first year of the pandemic.

Kaiser Permanente averts strike in tentative deal with health care workers

Kaiser Permanente security guards monitor an informational picket outside of the Kaiser Permanente San Francisco Medical Center on November 10, 2021 in San Francisco, California.

Union leaders representing nearly 50,000 health care workers and medical staff reached a tentative agreement in a labor dispute Saturday, avoiding a strike set to begin Monday.

Why it matters: The breakthrough in talks comes as nurses, front-line technicians and other hospital employees face worker shortages and burnout due to the ongoing COVID-19 pandemic.

The big picture: More than 30,000 Kaiser Permanente employees in Oregon, Washington, California and other states threatened to walk out on Monday over lower pay for new hires, Reuters reports.

  • Kaiser and the Alliance of Health Care Unions ended up reaching a tentative four-year deal that includes wage increases, health and retirement benefits and bonus opportunities, per CBS News.

What they’re saying: “This agreement will mean patients will continue to receive the best care, and Alliance members will have the best jobs,” Hal Ruddick, executive director of Alliance, said in the statement.

  • “This landmark agreement positions Kaiser Permanente for a successful future focused on providing high-quality health care that is affordable and accessible for our more than 12 million members and the communities we serve,” said Christian Meisner, senior vice president and chief human resources officer at Kaiser.

What’s next: The agreement heads to union members for ratification, and, if ratified, it will become retroactive to Oct. 1.

UPMC workers to strike Nov. 18

Workers at Pittsburgh-based UPMC plan to strike over wages and benefits, the Post-Gazette reported Nov. 5. 

Service Employees International Union Healthcare Pennsylvania, which does not represent the workers but is supporting them, told Becker’s Hospital Review the strike would involve workers at UPMC hospitals in Pittsburgh, including transporters, dietary workers, housekeepers, nurses, patient care techs, medical assistants, pharmacy techs, surgical techs, valets, therapists, health unit coordinators and administrative assistants. Workers plan to strike for one day on Nov. 18.

The workers are demanding a $20 per hour minimum wage, affordable high-quality healthcare, elimination of all medical debt and respect for union rights, according to a union news release.

Their strike notice came after UPMC announced Nov. 2 that the health system is giving 92,000 staff members a bonus of $500 to thank them for their work during the pandemic. UPMC will issue the bonuses on Nov. 26. The health system also announced improvements to employee compensation and benefit programs, including raising the entry level wage to $15.75 in January, according to the Post-Gazette

“There was no ‘thank you pay’ until we started organizing to strike,” Juilia Centofanti, pharmacy tech at UPMC Children’s Hospital of Pittsburgh, said in a news release.

Ms. Centofanti added that employees are “owed this [$20 per hour wage] and so much more,” and said she “will continue organizing with my co-workers for the pay, safer staffing and union rights we deserve.”

In announcing the bonuses, Leslie Davis, president and CEO of UPMC, told workers, “Over the past 20 months, you have risen in truly exceptional ways to meet challenges we could have never anticipated. With your critical support, UPMC continues to care for so many.”

A UPMC spokesperson declined to comment to Becker’s on Nov. 5.

UPMC is a $23 billion healthcare provider and insurer. SEIU Healthcare Pennsylvania has been trying to organize about 3,500 hourly workers at UPMC Presbyterian and Shadyside hospitals for nearly a decade, but has not yet held a unionization vote, according to the Post-Gazette.

Read the full report here.

Are recent labor actions getting nursing unions what they want?

While nurses in Cook County, Illinois, struck a deal in recent days, those on a three-month-plus strike against a Tenet hospital in Massachusetts plan a protest at the chain’s Dallas headquarters.

Thousands of healthcare workers have waged strikes this summer to demand better staffing levels as the pandemic brought greater attention to what happens when a nurse must take care of more patients than they can reasonably handle.

In New York, a report from the attorney general that found nursing homes with low staffing ratings had higher fatality rates during the worst COVID-19 surges last spring helped spur legislators to pass a safe staffing law long-advocated for by the New York State Nurses Association.

While unions elsewhere face a steeper climb to win the success found in New York, through strikes and other actions, they’re attempting to get new staffing rules outlined in their employment contracts.

Most nursing strikes include demands for ratios, or limits on the number of patients a nurse can be required to care for, Rebecca Givan, associate professor in the School of Management and Labor Relations at Rutgers University, said.

“And employers are very anxious about that because it threatens their bottom line, so often when a compromise is found, it’s something that approaches a ratio but maybe has a bit more flexibility,” Givan said.

Some have been successful, like the 1,000 Chicago-area nurses at Stroger Hospital, Provident Hospital and Cook County Jail who waged a one-day strike on June 24 after negotiating with the county over a new contract for nearly eight months.

They reached a tentative agreement shortly after the strike, stipulating the hiring of 300 nurses, including 125 newly added positions throughout the system within the next 18 months.

The deal also includes wage increases to help retain staff, ranging from 12% to 31% over the contract’s four-year term, according to National Nurses United.

Meanwhile, 700 nurses at Tenet’s St. Vincent Hospital in Worcester, Massachusetts, have been on strike for over 100 days over staffing levels. Nurses represented by the Massachusetts Nurses Association have been trying to get an actual nurse-to-patient ratio outlined for specific units in their next contract.

The two sides haven’t come close to reaching a deal yet, and some nurses will travel to Tenet’s headquarters in Dallas on Wednesday in an attempt to appeal to corporate executives, according to MNA.

At the same time, federal lawmakers wrote to Tenet CEO Ron Rittenmeyer seeking details on the chain’s use of federal coronavirus relief funds amid the strike and alongside record profits it turned last year.

The hospital denied lawmakers’ claims in the letter that Tenet used federal funds to enrich executives and shareholders rather than meet patient and staff needs, saying in a statement it strongly objects to the “mischaracterization of the facts and false allegations of noncompliance with any federal program.”

The strike is currently the longest among nurses nationally in a decade, according to the union.

A number of other major hospital chains have contracts covering their nurses expiring this summer, including for-profit HCA Healthcare and nonprofit Sutter Health.

Unionized nurses at 10 HCA hospitals in Florida have reached a deal on a new collective bargaining agreement, though members still need to ratify it, according to National Nurses United. The details are still unclear.

And after joining NNU just last year, 2,000 nurses at HCA’s Mission Hospital in Asheville, North Carolina, ratified their first contract Saturday, which includes wage increases and the formation of a nurse-led staffing committee.

Newly-formed unions take an average of 409 days to win a first contract, according to an analysis from Bloomberg Law. In the healthcare industry, new unions take an average of 528 days to win a first contract, the longest among all sectors examined.

Across the country at Sutter’s California hospitals, disputes haven’t been so easily resolved. Healthcare workers at eight Sutter hospitals planned protests throughout July “to expose the threat to workers and patients caused by understaffing, long patient wait times and worker safety issues at Sutter facilities,” according to Service Employees International Union United Healthcare Workers West, which represents the workers.

Similar to the ongoing Tenet hospital strike, SEIU is highlighting Sutter’s profits so far this year and the federal relief funds it received.

Tenet California hospital workers set May 6 union rally after shareholders meeting

South California healthcare workers plan payment, safety protest during Tenet  Healthcare investor meeting | FierceHealthcare

Workers at three Tenet Healthcare hospitals in Southern California will hold a rally May 6 to highlight their concerns about staffing, wages and benefits during the COVID-19 pandemic, according to the union that represents them. 

The rally comes as the National Union of Healthcare Workers is in negotiations with Dallas-based Tenet for more than 600 direct Tenet employees at Fountain Valley Regional, including respiratory therapists, nursing assistants and X-ray technicians. The union is also in negotiations with the Compass Group, a food and support services provider, for about 225 housekeepers and food service workers at Tenet California hospitals in Fountain Valley, Los Alamitos and Lakewood, who are subcontracted by Tenet and employees of Compass.

Union spokesperson Matt Artz told Becker’s workers contend Tenet has remained profitable during the pandemic, but it did not implement appropriate safety measures. He said Tenet also rejected proposals to better staff certain units, and it has rejected the union’s proposal to stop subcontracting out the housekeepers and food service workers who have struggled to afford healthcare.

The union said Tenet, a major for-profit hospital operator, has the financial means to address these issues. The company reported a $97 million profit in the first quarter of 2021. Tenet stock also recently hit a new 52-week high, according to an April 29 report from Zacks Equity Research. 

“These profits are not helping workers or patients,” Christina Rodriguez, a respiratory therapist at Fountain Valley (Calif.) Regional Hospital, said in a May 5 news release. “They’re being made at the expense of patient care and the people who have put their health on the line to help patients during this pandemic. At the height of the surge, I would go home crying that we didn’t have enough staff to help patients struggling to survive.”

Tenet contends the issue is not about Tenet but rather about negotiations between Compass and the union. Tenet said it is focused on staff and patients. 

“This matter is not about us. It’s about a negotiation strictly between the NUHW and the Compass Group, which is a vendor that provides a range of food, laundry and other support services to hospitals,” Tenet told Becker’s. “At all times, our main concern is the safety of our staff, the integrity of our facilities and the best possible outcomes for our patients, and we remain hopeful that the NUHW and Compass will reach a positive outcome at the conclusion of their respective negotiations.”

But the union said Tenet can decide whether to bring the subcontracted housekeepers and food service workers in-house, which would benefit them in terms of wages and health benefits. 

Meanwhile, Compass said it will continue to negotiate in good faith, with union members.

“Our hardworking team members are at the heart of what we do, and their determination to provide best-in-class care and service is inspiring,” a Compass spokesperson told Becker’s. “We take pride in paying competitive wages and providing affordable benefits and continue to uphold our agreement with the NUHW. We have a long history of listening to our employees, working productively with unions, and will continue to meet and negotiate — always in good faith.” 

Respiratory therapists, housekeepers, nursing assistants, medical technicians, dietary workers and others represented by the union said they plan to rally from 11 a.m. to noon May 6 outside Fountain Valley Regional. 

The rally, scheduled after Tenet’s shareholders meeting, includes workers from Los Alamitos (Calif.) Medical Center and Lakewood (Calif.) Regional Medical Center. Union workers whose jobs are subcontracted to Compass will speak during the rally, the union said. 

Striking Tenet nurses, hospital CEO trade jabs with no end in sight for standoff

About 800 nurses at a Tenet hospital are on the third week of a strike that’s shaping up to be one of the longest among healthcare workers in recent years.

At the hospital chain’s St. Vincent Hospital in Worcester, Massachusetts, nurses represented by the Massachusetts Nurses Association have been on strike since March 8 following a breakdown in negotiations over a new contract they’ve been bargaining for since November 2019.

Nurses have been active on the labor organization front in wake of the COVID-19 pandemic, and share a common issue at stake — staffing levels, and more specifically the nurse to patient ratio.

At St. Vincent, unionized nurses say their staffing has been worsened by the pandemic, affecting their ability to adequately care for patients. They point to hundreds of unsafe staffing reports filed by nurses over the past year, and the departure of more than 100 St. Vincent nurses over the past 10 months.

The hospital rejects those claims, and said only two citations have been issued by the Massachusetts Department of Public Health since 2019, according to a release.

The changes MNA is asking for are “excessive,” St. Vincent Hospital CEO Carolyn Jackson contended in an interview with Healthcare Dive, and the hospital cannot agree to the “aggressive” levels the union is proposing.

The two sides haven’t met again since the strike began, and do not have a timeline to get back to the table.

Right now, St. Vincent operates on staffing guidelines brokered after its nurses waged a 49-day strike over their first union contract in 2000Under those terms, one nurse in its medical surgical units can be assigned to either four or five patients.

The terms proposed by MNA stipulate that one nurse in those units would be assigned to four patients at a maximum. MNA is also asking for a five-nurse critical care float pool, and for the hospital to double its emergency department staff from 71 employees to 157, Jackson said.

California is currently the only state with mandated ratios of one nurse to five patients in medical surgical units.

“It has been our request for them to remove some of those unreasonable, or preferably all of those unreasonable staffing requests, and come back to the table and really work on getting a reasonable deal done,” Jackson said.

During the first week of the strike, the hospital paid over $5 million to hire replacement nurses, according to a release. When asked directly about how much the hospital has spent so far, Jackson declined to answer.

“It is definitely an added expense to the hospital, and that is challenging,” she said.

The strike in 2000 ended when both parties reached a deal brokered by former Sen. Ted Kennedy, D-Mass., that resulted in provisions to limit mandatory overtime and the staffing guidelines currently in place.

But this time it seems “there is no point at which anybody’s going to step in and settle this for the two parties,” Paul Clark, professor and director of Penn State’s school of labor and employment relations said.

The union has garnered support from Massachusetts lawmakers including Sen. Elizabeth Warren, Rep. James McGovern and former Rep. Joe Kennedy, who visited the picket line on March 12, along with state Attorney General Maura Healey, who visited Wednesday.

The Worcester City Council also approved a resolution in support of the striking nurses at St. Vincent on March 16.

But those moves wield little power to break the strike, although the political pressure could hurt the hospital.

“The increased cost is, perhaps, public opinion beginning to coalesce behind the union,” Clark said.

Strikes have costs for both sides, as nurses on the picket line have gone without pay for almost three weeks now.

“Until the cost becomes too great to one or the other sides, they’re going to continue down this road,” Clark said.