Sleeping giant awakes

Over the past three decades, nurses across the globe have engaged in highly politicised action to protect patient safety and the future of the profession, writes Linda Briskin.

Thousands of Victorian nurses are ramping up industrial action with the threat of wide-scale resignations across the public sector. It is a tactic that has been used by nurses in many countries – often with great success – to circumvent bans on striking. It is a reflection also that the nature of their care services, often forces nurses into untraditional forms of resistance and militancy.

Perhaps the most successful use of mass resignations was in Finland in 2007 when nurses mobilised in the context of on-going struggles over pay levels for public healthcare employees. The Union of Health and Social Care Services, (TEHY) banned over-time hours, and announced that “13,000 nurses were ready to hand in their resignations”.1

In response, the government passed the Patient Safety Act (16 November 2007) which could order healthcare professionals to continue working at essential tasks for patient safety even if they had resigned. The Finnish Government also claimed “each individual would [be] criminally responsible if a patient became disabled or died because of the resignations”.2 In response to this legislation, at least 3000 more nurses signed on to the resignation campaign bringing the total to some 16,000 nurses.3 On November 19, the nurses resigned.

The Labour Court ruled, “the mass resignation by TEHY members on permanent employment contracts was against the law.”4 Despite these legislative manoeuvres, the nurses did not back down. On the date on which the first round of resignations would have come into effect, a new collective agreement was signed which gave the nurses a 22-28 per cent pay increase over four years. This successful negotiation became a reference point for the Danish and Swedish nurses’ strikes in 2008.

In the last three decades, nurses have gone on strike in many countries including Canada, the UK, the US, Australia, Japan, New Zealand, Israel, Ireland, Denmark, Sweden, Poland, Portugal and South Africa.

Danish nurses take strike action

In the spring of 2008 in Denmark, an eight-week strike of about 100,000 workers took place, with 70,000 members of the Danish Nurses’ Organisation “spearheading the action” (Agence France-Presse, 23 April 2008). The strike focused on a demand for a 15 per cent wage increase, and “men’s wages for women’s occupations”.5 Striking nurses used creative tactics to draw attention to their low wages. The women in Holstebro handed out a recipe for baking homemade bread with a lump of yeast. “We need a rise in our pay to the level of men’s wages in the same way that yeast rises bread, so we can afford to eat bread, and care for and look after your elderly, children and chronically ill family, relatives and friends,” one nurse said.6

In 1999, two days of wildcat strikes by 47,500 Québec nurses set the stage for a lengthy illegal strike. The nurses faced two draconian pieces of legislation. The nurses resisted the intimidation of both Bill 160, which levied fines (more than CAD$10 million by the end of the strike), withheld union dues and docked two days’ pay for each day off the job (costing individual nurses around CAD$7,000), and Bill 72, back-to-work legislation that targeted the union leadership. Five days after the passage of Bill 72, 93 per cent of nurses voted to continue the illegal strike (Globe and Mail, 26 July 1999).

On 14 November 2002, in what would become the longest nurses’ strike in the United States - lasting over two years – nurses began striking at the Northern Michigan Hospital in Petoskey. The nurses “wanted a voice in how patient care was delivered and in issues related to patient safety given the increasing workload … The fact the nurses remained on strike for so long in spite of the offer of higher wages is a strong indication that having a voice in patient care is more important than money. The nurses have become crusaders, fighting for patient safety and for the future of the nursing profession”.7

The politicisation of caring and public interest

“Nurses are ... protesting about the system and the inefficiency and ineffectiveness of the system ... It's patient care that's in jeopardy, and that's why nurses are on strike. But I know the media will say it's about money … but I don't believe for one minute it's all about money.... you're fighting for the care of patients all the time.” Irish nurse on strike in 1999.8

“This issue is really about the nursing shortage which ... has led to horrific and unsafe working conditions and compromised patient care...We are taking a stand for the people of Saskatchewan: you, me, our families, our communities, as the caregivers and patient advocates that we are.” Laurie Swift, a Saskatchewan (Canada) nurse on strike in 1999.9

“We work in the poorest section of the city, with the highest morbidity and mortality in Philadelphia. This community deserves people who will stand up for them and the care they deserve, because often they are not taken into account when politicians and hospital administrators make decisions about healthcare. We are the voice for those who have none.” Nurse on strike at Temple University Hospital in Philadelphia, 2010.10

“[Victorian Premier] Ted Baillieu is not putting patient safety first - his plans for ‘ratio flexibility' will risk patients' lives for the sake of a dollar. He says he's waiting for the nurses' next move, but this isn't a game of chess, patients aren't pawns and if we get to checkmate and ratios are lost then all Victorians lose." Lisa Fitzpatrick, secretary of the Australian Nursing Federation (Victorian Branch), 4 February, 2012.

Many women who serve client groups are ambivalent about making demands around wages and working conditions, and engaging in public protest. All international accounts of strike activity in nursing allude to the tension between striking and caring.11 In fact, women’s responsibility for caring work has been actively mobilised to deter women from striking. “Women are trained to feel responsible for the people they care for, whether at home or on the job. Consequently, they can easily be made to feel guilty if they refuse to take care ... And when they do strike, the media may depict them as ‘heartless and unfeeling’.”12

Spurred on by their professional commitment to quality care, nurses have confronted key challenges in healthcare such as restructuring, workforce shortages, intensification of work, precarious employment and gendered hierarchies with a militant discourse around public interest. Nurses have reconstituted and reclaimed their care roles in what I call the politicisation of caring. In fact, nurses’ dedication to caring work in the late 20th and early 21st centuries may encourage rather than dissuade them from going on strike.

Supported action

Many Canadian nurses' strikes have been characterised by strong popular support, and by active involvement of other unions, the community, the public, and women's and other progressive organisations. In fact, despite 18 high-profile nurses’ strikes in Canada in 1998 and 1999, a 2000 poll gave nurses the highest trust rating of any profession. At 72 per cent, they were significantly higher than clergy (32 per cent), police officers (42 per cent), teachers (50 per cent) and significantly, doctors (52 per cent). Politicians, labour leaders, and public employees were in the single digits.13 A 2004 Gallup poll in the US showed “nurses have a very positive public image, which makes them a formidable political force.”14

Public support for paying nurses a fair wage is noteworthy. In the 2008 Danish nurses’ strike, a poll showed 80 per cent of the population supported the demand for a minimum 15 per cent pay rise.15 In the 2007 Finnish nurses’ struggle which involved mass resignations, 66 per cent considered “the nursing unions’ wage demands were acceptable … 61 per cent of people stated that they approved of the mass resignation planned by TEHY”.16

In 2007, Poland witnessed a major social protest around healthcare, involving doctors and nurses, the latter of whom were demanding a substantial pay rise. Following a refusal by the prime minister to meet with nurses’ representatives, four nurses launched an eight-day sit-in protest. Outside a large number of nurses camped out for four weeks in what became known as the “white village” which “attracted widespread media and public attention”.17 According to one public poll, 75 per cent of the population supported the demands of the doctors and nurses. “Nurses at the protest camp reported complete strangers coming to bring them food and beverages. When the police moved in to forcibly break up a protest by nurses, thousands of miners and railway workers spontaneously travelled to Warsaw to protect the nurses against police brutality”.18

And even when nurses went on strike illegally or break the law in other ways, public support has remained resilient, and sometimes even passionate. The lengthy illegal strike by Québec nurses in 1999 garnered extensive support from the public, 72 per cent of whom thought the nurses' wage demands reasonable (Globe and Mail, 28 June 1999). “Unable to bring the nurses to heel with the existing legislation, the Parti Québecois government … removed the right to strike entirely and upped the penalties. But union members continued their walkout, to an outpouring of public sympathy, including polls showing majority public support and 120,000 signatures on a petition”.19

In the 2001 Nova Scotia (Canada) protest, nurses broke the law. “Two hundred nurses were defying the government and breaking the law. They were sitting in the middle of the busiest Halifax intersection. Traffic was backed up for blocks. The bus driver at the head of the jam wasn't moving: ‘I'm in a union too,’ he said. No passengers complained. The folks on the sidewalks cheered. The cops just stood back and watched.”20

In these times of crisis when public services and public sector workers in US, Canada and Europe are under sustained attack, nurse militancy is instructive, even inspirational. The current president of the New Brunswick (Canada) Nurses’ Union, Marilyn Quinn commented; “It’s always stuck with me that nurses were like sleeping giants; I think sometimes we don’t recognise the potential and the power we could have.”21 Widespread nurse militancy suggests nurses are no longer ‘sleeping’ and increasingly recognise their power and use their collective voice.
Linda Briskin is a Professor in the Department of Social Science and School of Women’s Studies at York University in Toronto, Canada. Contact Linda Briskin at [email protected]

References

1 Pertti Jokivuori, “Nurses’ Union Rejects Pay Offer and Calls for Industrial Action”, The European Industrial Relations Observatory (EIRO) Online, 12 November 2007 www.eurofound.europa.eu/eiro/2007/10/articles/fi0710039i.htm

2 Pertti Jokivuori, “Controversy over Law Restricting Right to Strike in Healthcare Sector”, The European Industrial Relations Observatory (EIRO) Online 14 January 2008 www.eurofound.europa.eu/eiro/2007/12/articles/fi0712039i.htm

3 “Nurses Union Announces More Resignations”, 12 Nov 2007. YLE: (Finnish Broadcasting Company) www.yle.fi/uutiset/news

4 Pertti Jokivuori, “Nurses’ Dispute in Settlement Talks”, The European Industrial Relations Observatory (EIRO) Online 21 January 2008b www.eurofound.europa.eu/eiro/2007/11/articles/fi0711019i.htm

5 Carsten Jørgensen, “Longest Strike in Public Sector Ends with Pay Settlement”, The European Industrial Relations Observatory (EIRO) Online 29 September 2008 www.eurofound.europa.eu/eiro/2008/04/articles/DK0804029I.htm

6 Callum Laggan, “Danish Nurses' Strike”, New Worker Features 3 May 2008 www.newworkerfeatures.blogspot.com/2008/05/danish-nurses-strike.html

7 Lisa Hayes, “Nurses on Strike”, in Aaron Brenner, Benjamin Day, & Immanuel Ness (eds.), The Encyclopedia of Strikes in American History, Armonk, NY: M.E. Sharpe 2009, s. 712-3.

8 Gary D. Brown, Anna-Marie Greaney, Mary E Kelly-Fitzgibbon, & Jane McCarthy, “The 1999 Irish Nurses’ Strike: Nursing Versions of the Strike and Self-Identity in a General Hospital”, Journal of Advanced Nursing 56 (2), 2006, s. 205.

9 Regina Leader-Post 7 May 1999.

10 Quoted in www.workinglife.org/users/index.php?home=nationalnursesmovement

11 Brown et al. 2006, s.206f.

12 Judy Darcy & Catherine Lauzon, “The Right to Strike”, in Linda Briskin & Lynda Yanz (eds.), Union Sisters, Toronto: The Women's Press 1983, s. 175.

13 O’Brien 2002, s. 28f.

14 Paul Clark & Darlene Clark, “Union Strategies for Improving Patient Care: the Key to Nurse Unionism”, Labor Studies Journal 31 (1), 2006, s. 63.

15 Frederik Ohsten, “Denmark: 100,000 Public Sector Workers on Strike”, International Marxist Tendency 29 April 2008 www.marxist.com/denmark-public-sector-workers-strike.htm

16 Jokivuori 2007.

17 Jan Czarzasty, “Pay Disputes in Public Health Sector Escalate”, The European Industrial Relations Observatory (EIRO) Online, 20 August 2007 www.eurofound.europa.eu/eiro/2007/07/articles/pl0707019i.htm

18 Marius Heuser, “The Way Forward in the Polish Doctors and Nurses Strike,” World Socialist Web Site 19 July 2007 www.wsws.org/articles/2007/jul2007/pola-j19.shtml

19 Larry Haiven & Judy Haiven, “The Right to Strike and the Provision of Emergency Services in Canadian Health Care”, Report from Canadian Centre for Policy Alternatives, 2002, s. 7 www.policyalternatives.ca/publications/reports/right-strike-and-provision-emergency-services-canadian-health-care

20 Skip Hambling, “Hearts and Minds: a Response to Tom O’Brien’s ‘Targeting Tories’ Article”, Our Times 21 (4), 2002, s. 12.

21 Quoted in Linda Kealey, “A Bitter Pill to Swallow: New Brunswick Nurses, Professional Identity and Collective Bargaining, 1991-92”, in Janet Guildford & Suzanne Morton, (eds.), Making up the State: Atlantic Canadian Women in the 20th Century, Fredericton, New Brunswick: Acadiensis Press 2010, s. 227.