Nurses at Robert Wood Johnson University Hospital picketed outside the hospital in New Brunswick on Aug. 30, 2023. The nurses have been on strike since Aug. 4, with contract negotiations stalled over the union’s demands for a lower nurse-to-patient ratio. (Dana DiFilippo | New Jersey Monitor)
Union leaders for 1,700 striking nurses will return to the bargaining table on Sunday — 73 days after their walkout started — in hopes of hammering out a new contract with administrators at Robert Wood Johnson University Hospital in New Brunswick.
The two sides met all day Tuesday and Wednesday without reaching an agreement, as nurses stuck firm to their demand for mandatory minimum staffing ratios that would require the hospital to schedule one nurse for every one to five patients, depending on the patient’s need.
On Thursday, Sen. Bernie Sanders (D-Vermont), who threw his support behind the nurses about two weeks after the strike started, announced he will hold a hearing of the Senate’s health committee on Oct. 27 at Rutgers University about hospital labor shortages.
“Nurses in New Jersey and all over America have been stretched to the breaking point as a result of unsafe and totally inadequate staffing levels that threaten the health of patients and cause massive burnout among health care workers. That has got to change,” Sanders said in a statement. “What the nurses at Robert Wood Johnson University Hospital are asking for is not radical. For the sake of patient safety, they need strong nurse-to-patient staffing ratios.”
Administrators have said the hospital has some of the best staffing ratios statewide.
“Staffing at RWJUH is not just proper, but among the highest in New Jersey,” spokeswoman Wendy Gottsegen said last week.
The staffing proposal the union rejected “meets or exceeds levels set forth by legislation in states like California and in a number of hospital labor settlements across the country,” Gottsegen said.
Strikes becoming more frequent
The strike at Robert Wood Johnson University Hospital is part of a rising tide of labor actions in the health care industry — although few have lasted as long.
There have been 18 health care strikes so far this year, according to Becker’s Healthcare Review — not counting the recent three-day Kaiser Permanente walkout, which was the largest in U.S. history with 75,000 workers off the job.
The Cornell-ILR labor action tracker tallied 40 others last year in health care and social services, with most in hospitals. Combined, that’s almost as many as occurred in the previous three decades, with 85 major strikes in hospitals from 1993 to 2021, according to the federal Bureau of Labor Statistics.
That spike in strikes is largely due to the pandemic, said John August, director of health care labor relations at the Scheinman Institute at Cornell University’s ILR School.
“The pandemic scared people to death, and the residual of that is that people’s emotions and their professionalism were challenged like never before. As contracts expired around the country, as this one did, nurses and other health care workers were feeling more vulnerable than ever,” August said. “The root cause is staffing. It’s kind of like peeling off the bandage, like ‘now, we’re really bleeding.’”
Staffing ratios have long been a source of contention in health care, August said.
“Everybody in health care knows that there needs to be appropriate staffing ratios. The problem is how do you maintain those ratios. If you have a mandate, the mandate doesn’t exist in an ether. It exists in a world of recruitment, retention, retirement, mentorship, voice, and development — all the kinds of things that keep people on the job,” August said. “And that needs a tripartite dialogue between government, industry, and labor.”
New Jersey’s government leaders have largely been missing from that dialogue.
Gov. Phil Murphy intervened to end last spring’s faculty strike at Rutgers University, has visited other picket lines, and tweeted support for striking Starbucks workers. But he hasn’t waded into the nurses’ strike other than to offer assurances that he is pro-labor and regards nurses as heroes.
That’s not enough, said Patricia Campos-Medina.
Campos-Medina heads The Worker Institute at Cornell, which advocates for workers’ rights. She pointed to the size of the hospital’s workforce, along with nurses’ demand for “safe staffing.” The 620-bed hospital is the biggest in the RWJBarnabas Health system, which is New Jersey’s largest health care system and employs the most nurses statewide.
“These are working-conditions issues, not just a wage issue,” she said. “There should be a political willingness to say the nurses ought to be receiving responsive answers to their working-conditions demands.”
Most nurses are women, she added.
“If you don’t stand with nurses, you don’t stand with the women who are holding that health care system together,” she said.
Murphy spokeswoman Tyler Jones said he “has been engaged” with both hospital management and union leaders but didn’t explain how.
“Governor Murphy, a strong proponent of organized labor, recognizes and values the hard work of all essential workers, especially our nurses, who provide critical services to countless patients in our state,” Jones said. “Our administration continues to urge open dialogue between both parties.”
$87M on replacement nurses
Since the strike started, the hospital has spent a staggering $87 million, as of Tuesday, on replacement nurses, according to a public letter signed by hospital President Alan Lee.
Campos-Medina regards the hospital’s costly reliance on “travel nurses,” the industry’s increasingly common antidote to labor shortages, as its “short-term strategy to avoid long-term commitments to workers.”
“It’s just shameful for the largest health care employer in New Jersey, who actually sets the tone for everybody else,” Campos-Medina said.
Some employers have strike insurance to cover the costs of labor disputes. A hospital spokesman said Thursday that he didn’t know if the hospital has strike insurance.
By federal law, though, the hospital assumes all liability for strike-related costs, which would include claims of denial of care or patient mistreatment, August said.
“It’s going to come out of their revenue one way or the other,” he said.
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