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NEWS & LETTERS, December 2007 - January 2008WorkShop TalksToothless laws force workers to actBy Htun Lin On Oct. 12, over 5,000 registered nurses of the California Nurses Association (CNA) returned to the picket line in a two-day strike at hospitals affiliated with Sutter Health. The primary issue in the strike was not salary or benefits, but the nurses' right to provide quality care in the face of pervasive non-compliance with state-mandated nurse-to-patient ratios. These ratios were hard fought legislative victories, yet RNs themselves say that these laws lack teeth. There's little enforcement. Therefore, union nurses now want the same legal language in their own union contracts. They realize that the question of law cannot be separated from the fundamental conflict from which it arose in the workplace. REGAINING CONTROL The issue for frontline workers is one of regaining control over their labor. The lack of enforcement of this law reopened this issue for nurses. They are telling union officials to return to the shop floor. A movement doesn't stand still. It either moves forward or falls back. The nurses' union at the hospital where I work learned that truth the hard way. For the last several years, professional campaigners and labor advocates from both the CNA and the service workers' union (Health Care West or HCW) rubbed shoulders with legislators in the halls of the state capitol, and won legislative victories. The key victory was the state-mandated nurse-to-patient ratio. Feeling confident, CNA then launched a major electoral campaign to pass a California proposition to rid state elections of dirty campaign money. That measure failed miserably after the very same dirty money, which the nurses targeted, defeated the proposition. All the corporate donors (including HMO's, real estate, and insurance industries) flooded the state initiative process with tens of millions of dollars to defeat a proposition which big business correctly deemed as "a stepping stone" towards a single-payer universal health care. It was a rude awakening for CNA. With that defeat of the effort by the nurses' union, Gov. Schwarzenegger was able to launch his own state-mandated "universal" health insurance, which the insurance industry helped to draft. It turned out to be a formula which requires every single individual to buy health insurance, even at the risk of taking food away from one's table. This is similar to the proposals being put forward by leading Democratic presidential candidates. IT'S THE LAW--MAYBE In 2004, California became the first state in the nation requiring a set nurse-to-patient ratio. Surgical units, for example, must have no more than five patients for every nurse. In units with sicker patients, such as emergency departments, the ratio can go as low as one to one. However, the state bureaucrats have left compliance up to individual hospital administrations. They have not enforced a single standard, applied across the board, to all HMOs and hospitals as the law mandates. Nurses complain that compliance has been spotty, especially at Sutter. The deterioration of work conditions due to understaffing at Sutter meant nurses constantly missed meals and breaks in order to minimize endangering patients. There have been state penalties assessed against Bay Area hospitals owned by the Sutter chain, like a $2 million fine imposed for failing to provide adequate meals and breaks in 2005 and 2006. These million dollar fines of $3 million are treated by the HMOs as just another cost of doing business. WORKPLACE AS BATTLEFIELD The CNA strike demonstrates that, after spending the better part of the last decade on their political campaigns in the governor's office and the state legislature, after so many legislative victories and defeats, the nurses' union has come full circle. They've come to realize that real power resides in the workplace, with the ideas and concerns of their membership. Nurses on the ground keep discovering the woeful inadequacy of state initiatives. That was true when the nurses turned to direct solidarity by creating RNRN (RN Response Network) as they deemed the government's efforts totally worthless during and after Hurricane Katrina. Now they are returning to their own self-direction in the face of capital's efforts to get around the laws nurses struggled to enact. The fundamental struggle in the workplace is against being alienated from one's own labor, a struggle, which reaches beyond any law that keeps the system intact. A different future depends on workers fully realizing direct solidarity with each other as the way to overcome alienated labor. |
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