NurseWeek | HealthWeek: Crossing the Line When Nurses walk, more hospitals Hire Strikebreakers

Crossing the line
When nurses walk, more hospitals
hire strikebreakers

By Todd Stein
June 24, 2000


	You've read the article. Now tell us what you think. Related sites Nursing Strike at Worcester, Mass. Stanford Medical Center

When 1,730 nurses at two Stanford University hospitals went on strike June 8, rejecting a wage increase that fell short of union demands, the university had an ace in the hole.

As nurses hit the picket lines carrying signs with slogans such as "Exhausted Nurses Need Intensive Care, Too," buses accompanied by private security guards maneuvered through the strikers and dropped their cargo off at the front door-500 registered nurses flown in from around the country to staff the hospitals for as long as the strike might last.

And because of them, it could last quite a long time.

Temporary "strikebreaker" nurses, as the unions call them, increasingly are being employed by hospitals to undermine the bargaining leverage of strikers.

This spring, strike nurses contributed to prolonging a 42-day walkout at Worcester Medical Center in Massachusetts, and were involved in the longest nurses' strike on record, a five-month marathon at the community hospital in Nyack, N.Y.

Together with the Stanford strike and a handful of other examples around the nation, this spring's East Coast disputes may be early indicators of a national trend that spells trouble for nursing unions.

If more hospitals prove willing to spend millions of dollars to replace striking nurses for months at a time, front-line RNs may shy away from striking altogether.

One company has stepped into the middle of the fray.

U.S. Nursing Corp. of Denver supplied the replacement nurses for the Nyack and Worcester strikes, and all 500 for the striking nurses at Stanford.

In the midst of the worst nursing shortage in history, the 30-employee travel-nursing firm is apparently profitting from finding RNs who don't mind crossing picket lines for upwards of $5,000 a week.

The privately held company, by far the largest supplier of strikebreaking nurses in the country, is famous for its ability to round up hundreds of qualified RNs, fly them into a strike zone, house them, bus them and guard them from harassment, often with no more than the 10 days' notice workers are required to give hospitals to prepare for a strike.

Not surprisingly, the firm has won the ire of unions.

"I can't excuse the behavior of U.S. Nursing Corp.," said Mary Foley, MS, RN, president of the American Nurses Association. "They are making millions of dollars off of strikes by interfering in the natural labor-management negotiations."

"They're not a very nice organization," added Charles Idelson, spokesman for the California Nurses Association (CNA). "You don't see anything like them in any other industry-a national strikebreaking corporation that flies strikebreakers all over the country to cross picket lines."

In an effort to prevent U.S. Nursing from undermining strikes, the union has toughened its tactics.

The CNA Web site invites the company's former strike nurses to e-mail details of bad experiences they had while employed by the company.

Idelson claims to have received dozens of accounts of former U.S. Nursing nurses being "worked to death" or receiving lower pay than they were promised.

"We are continuing to monitor their operation and are very concerned about their activities," Idelson said.

For its part, U.S. Nursing seems to be taking the union's criticism in stride.

"We're CNA's poster child this year," said Gregory Mikkelsen, the company's chief operating officer.

Mikkelsen and company founder Daniel Mordacai were on hand in April to greet Foley and a handful of Colorado nurses who picketed the firm's Denver headquarters to protest its involvement in the Worcester strike.

"They spoke their piece and we spoke ours," Mikkelsen said of the half-hour meeting. "If the unions had their druthers, the hospitals would have to close [during a strike], leaving them no leverage in negotiations. But our law in this country allows the employer the right to maintain his business."

U.S. Nursing Corp. typically requires hospitals to pay up to three times their regularly budgeted payroll for nurses.

Media reports put the cost of the more than 120 U.S. Nursing RNs in Worcester at $4,000 to $5,000 a week each, or a total strike bill of $2.8 million to $3.6 million on the nurse replacements alone.

The company also requires hospitals to pay air travel costs for out-of-state nurses, housing costs-often in expensive hotels-transportation costs between the hotel and the hospital, daily meal allowances and other expenses.

Mikkelsen would not disclose details of the company's financial arrangements with hospitals, but said the firm receives a flat fee for its services.

Founded in 1984, U.S. Nursing began as a typical nursing agency-then called FastStaff-providing temporary travel nurses to a small number of client hospitals. In 1988, the firm received an urgent call from lawyers representing a hospital in San Francisco. The hospital's nursing staff had called a strike and the management team was in a panic. The lawyers had a frantic request: They needed a couple of hundred nurses and they needed them right away. The price, lawyers said, would be right.

It was.

That first foray into labor disputes led to others, and soon the profits from providing strikebreaking nurses began to look so promising that the firm spun off U.S. Nursing Corp. to focus on the market niche.

"What I can earn in a four-week strike might be equivalent to what a travel nursing company can earn from having 40 nurses in a hospital all year," Mikkelsen said.

The money is apparently what draws nurses to work for U.S. Nursing, despite the professional stigma that sometimes accompanies nurses who cross picket lines.

Tim Conner, RN, a former travel nurse who has worked for U.S. Nursing since 1998, said he quit travel nursing after discovering he could earn nearly twice as much working as a strike nurse.

Conner admits he thinks striking nurses are "not acting like professionals," but denies that he is anti-union. His real interest is not money, he said, but taking care of patients who might otherwise be endangered by a strike. "I just see a strike as a struggle in which the patient cannot be left out," Conner said. "Somebody's got to be their advocate when nurses are walking out."

By law, hospitals are required to transfer their sickest patients to other facilities during the 10-day strike notice period. When that is impossible, unions traditionally allow their members to cross the picket lines.

As the Stanford strike got under way, for instance, a half-dozen nurses who usually staff the neonatal intensive care and pediatric intensive care units returned to work to care for about 20 babies in critical condition and several young children who recently had surgery.

"I think strikebreakers who say they're doing it to care for the patients are just trying to assuage their consciences for making thousands of dollars off of a strike," Foley said. "It seems very unlikely that there would be a need to continue to staff a hospital with large numbers of outside staff at a time when [hospitals] are required by law to reduce their level of services."

Still, an increasing number of hospitals faced with the prospect of a strike have responded by threatening to hire replacement nurses.

Officials at Dameron Hospital in Stockton, Calif., attempted to influence a June strike vote among the facility's 220 RNs by threatening to hire replacements from U.S. Nursing Corp. If other hospitals follow suit, nurse leaders will almost certainly send more protesters to picket U.S. Nursing's Denver office.

"If they send in more strikebreakers, they will see us again," Foley promised. n To respond to this article and share your thoughts, go to Nurseweek.com.