Healthcare workers are organized, syndicated

Healthcare workers across the country are organizing and pushing for changes in the workplace, such as better pay or a better balance of staff after waves of burnout and pandemic frustration.

Why it matters: COVID-19 and its consequences led to the eviction of health workers. Those who remain demand more from health systems, which claim to reach their own breaking points.

  • “The pandemic has exacerbated an already existing crisis,” Pittsburgh nurse Michelle Boyle told Axios. “This has gone from a crisis to a catastrophic free fall of staff.”

Driving the news: Some 1,400 local doctors at Los Angeles County public hospitals have called for a strike if their demands for pay parity with other local facilities are not met in contract negotiations this week.

  • Nurses demonstrated in Pennsylvania in early May, protesting against the inaction of a U.S. lawmaker on legislation that would determine the relationship between a nurse and a patient.
  • A battle is brewing in Minnesota as contracts covering 15,000 nurses in several hospital systems expire.
  • About 2,000 local doctors and interns at Stanford University and the University of Vermont Medical Center have joined the SEIU branch of medical professionals, which claims to have more than 20,000 members nationwide.
  • In North Carolina, where union membership is low, Mission Health employees in Asheville voted in favor of unionization largely because of staffing problems.

Less than half of nearly 12,000 nurses surveyed by the American Nurses Association last year believe their employer cares about their concerns, and 52 percent said they intend to quit their job or are considering doing so.

The other side: Hospital operators usually oppose union efforts as well as mandatory staff proportions.

  • “The last thing we need is the demands of someone in Washington on exactly how many nurses need to provide services at a time,” said Chip Kahn, chief executive of the Federation of American Hospitals. “This must be a local decision based on the need for the hospital at the time.”
  • The American Nurses’ Leadership Organization, a subsidiary of the American Hospital Association, also opposes the staffing ratio.
  • The industry says decisions about staffing and workplace rules are best left to local managers, who need to be flexible to meet the changing demand for care.
  • “Essentially, you take away the flexibility of those on stage to determine what is needed to provide the necessary care for patients,” Kahn said.

Go deeper: The pandemic has significantly increased labor costs for hospitals, which have been forced to pay nurses to fill gaps in the workforce during COVID jumps.

  • April marked the fourth month in a row this year that major hospitals and health systems reported negative margins, a Kaufman Hall report found. And executives say things could get worse amid inflation and persistent supply chain problems.

Anyway, some large hospital chains such as Tenet reported strong profits in the first quarter.

Between the lines: California is the only state that has set staffing ratios for nurses, but hospital unions in other states are pushing for similar requirements in their contracts.

  • In California, each nurse on a shared hospital floor has no more than five patients to care for at a time; intensive care nurses should care for no more than two patients.
  • Nurses want similar standards in states like Pennsylvania, where only a few hospitals have a staffing ratio, saying staff shortages threaten patients’ well-being.

What we watch: Although many legislative proposals have failed this year, unions representing health workers say their message is spreading.

  • The unions in Illinois, Pennsylvania and the state of Washington are redoubled their efforts to legislate for a ratio of staff modeled on California.
  • In New York, nurses passed a law that went into effect in January, requiring hospital staff committees.

Bottom row: Labor tensions are a sobering code for a health crisis that is stretching health systems and workers in an unprecedented way.

“What you see is that nurses are finally saying that’s enough, and this system is broken and needs to be fixed,” said Denelle Corinne, coordinator of the Nurses of Pennsylvania Nurses’ Union.

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