Hospitals

Minnesota nurses-hospitals labor dispute: A post-mortem

The union representing 12,800 Minnesota nurses struck a surprise agreement with 14 Twin Cities Hospitals Thursday, likely ending the threat of what the nurses billed as the largest U.S. nursing strike in history. Just hours before the agreement was announced, the nurses looked all but certain to approve next week what could’ve ended up a […]

The union representing 12,800 Minnesota nurses struck a surprise agreement with 14 Twin Cities Hospitals Thursday, likely ending the threat of what the nurses billed as the largest U.S. nursing strike in history.

Just hours before the agreement was announced, the nurses looked all but certain to approve next week what could’ve ended up a lengthy and costly strike for both sides. Here’s a post-mortem rundown of the dispute’s background, terms of the settlement, reaction and analysis from around the web, and a look at the dispute’s future implications.

The background: The months-long dispute (the two sides began negotiations in March) essentially boiled down to three major factors: staffing rules, wages, and pension–probably in that order of importance. The Minnesota Nurses Association said from the beginning that the dispute and possible open-ended strike was about patient safety. Nurses wanted their new labor contract to stipulate strict nurse-patient staffing ratios to counteract what they saw as unsafe conditions caused by nurses being stretched too thin. To the hospitals, this provision was always a non-starter. The hospitals maintained that staffing ratios do little to enhance patient safety, and would be so damaging to their finances that they’d struggle to survive.

Like nearly all labor disputes, wages were also a big component. Nurses wanted the new three-year deal to include annual raises of 4.5 percent per year. The 14 hospitals countered with a proposal of increases of 0 percent, 1 percent and 2 percent.

Finally, the union’s pensions were a point of negotiation, with nurses hoping to maintain the terms of their previous contract, and the hospitals angling to decrease pensions by an amount the nurses said would cut benefits by a third.

The outcome: The union didn’t get the work rules it wanted, or any change to work rules, for that matter. The sides agreed to handle staffing issues through existing committees at the affected hospitals.

Nor did the wage issue go the union’s way. The settlement calls for the smaller raise amounts that the hospitals advocated.

Pensions were the one area in which the nurses got what they wanted. The new deal calls for the same pension arrangement as the previous contract.

“If you look at it at face value, it looks like the hospitals got what they wanted and the union didn’t really want to go on strike,” said Phil Wilson, president of the Labor Relations Institute, a consulting firm that works with employers that have labor-relations issues (and admittedly an observer who’s typically sympathetic to management’s viewpoint in labor disputes.)

From the union’s perspective, one of three isn’t bad, according to Prof. Peter Rachleff, a labor historian at Macalester College in St. Paul. “Given the economic and political climate here in the summer of 2010, the fact they didn’t go backwards is tantamount to going forwards for unions in the U.S. today,” he said.

What’s next: For the settlement to take effect, 66 percent of voting nurses must approve it in a vote scheduled for July 6. While the agreement falls far short of what the nurses publicly rallied for, it’s probably the best they could do and the rank-and-file likely realize that. Unless the rhetoric heats up, expect the union to approve the deal, though not by the overwhelming 90 percent margin that in May voted for a one-day strike.

The nurses could try another tack–lobbying the state legislature to pass a law instituting the staffing ratios they seek. But the likelihood for success of such a gambit is questionable at best, and past attempts yielded few results, as the Pioneer Press notes.

What people are saying: The Star-Tribune’s editorial page makes the questionable–and politically correct–assertion that “there are no losers” in the outcome. The editorial is right about one thing, at least–the big winners are Twin Cities patients who depend on the 14 hospitals for their health needs. They’ll see no disruption to the hospitals’ care and won’t have to worry about deferring medical procedures. Everyone can be happy about that.

The union predictably did its best to spin the outcome as a positive for its members, and obviously chose to focus on its big win: the preservation of existing pension benefits. “In this economic climate it is literally unheard of to reach a labor agreement with ZERO concessions,” read a statement on the MNA’s blog. “By preventing the dozens of concessions that would have gutted our profession, we ARE working to keep our patients safe!”

Rachleff of Macalester College said the union leadership would’ve been better served with a more sober assessment of the settlement. “I would’ve preferred for the union to come out with a more sanguine statement  to say ‘We’re not happy but this was the best we could get,’ instead of moving into ‘Let’s sell it’ mode,” he said.

Indeed, some nurses who took to Facebook, which was a valuable and widely used tool for communication among the union’s rank-and-file, weren’t so sure that they should buy the union’s happy talk. “We have not made gains folks!” wrote one, according to the Star-Tribune. “I would consider this a loss — no patient ratios, no raise, and I get to keep what I already worked for?”

“You guys CAVED!” wrote another. “I am voting NO…we can now look like the greedy nurses we were portrayed as — not really in it for patient safety at all…”

Certainly, not all the nurses expressed such misgivings over the deal. One labeled the nurses’ collective mood as “ecstatic” that a strike was averted, while another said, “Our prayers have been answered.”

The hospitals seemingly took the high road, declining to gloat over an outcome that had to delight them (though hospital officials could be forgiven if they popped a few champagne corks behind closed doors.) They largely limited their public comments to a joint statement filed with the nurses that proclaimed the settlement to be “in the best interests of patients and our community.”

The future: Nationally, more nursing strikes could be on the horizon in the coming years. That’s in part due to the rise of a new union, National Nurses United, of which the MNA is a member. The new union was formed in December 2009,  is affiliated with the AFL-CIO and has more than 150,000 members. Some observers have opined that the new union pushed the Minnesota nurses towards a strike, as a tough-talking means of demonstrating its value to its new members, though the MNA strongly downplays that idea. Nonetheless, with nursing union activity on the rise nationally, expect the profession–a noble and important one, to be sure–to more loudly and forcefully assert its rights as America is poised to enter a new era of healthcare.

“There will be skirmishes like this all over the country around the details of healthcare reform,” Rachleff predicted.

The last word: As hard as I try, it’s difficult for me to see how any rational observer could conclude that the outcome of this labor dispute is anything but a victory for the hospitals and a disappointment for the union–and I’m as lefty a liberal as they come. After all, on the two most important points of contention, the hospitals flexed their muscles and got their way. And the union’s one perceived victory–pensions–was merely a preservation of the status quo, and that’s hardly change nurses can believe in. Sure, the union is looking to save face and will proclaim its efforts to have resulted in victory (Do they have any other choice?) but if this is a win, I’d sure hate to see what defeat looks like.

“The only conclusion you can draw is that the claims about patient care were bullsh*t,” said Wilson of the Labor Relations Institute. “It was a bargaining ploy using patients as the pawn.”