When COVID-19 cases swelled in New York and other northern states this spring, Erik Andrews, a rapid response nurse at Riverside Community Hospital in southern California, thought his hospital should have enough time to prepare for the worst.
Instead, he said his hospital faced staffing cuts and a lack of adequate personal protective equipment that led around 600 of its nurses to strike for 10 days starting in late June, just before negotiating a new contract with the hospital and its owner, Nashville-based HCA Healthcare.
"To feel like you were just put out there on the front lines with as minimal support necessary was incredibly disheartening," Andrews said. Two employees at RCH have died from COVID-19, according to SEIU Local 121RN, the union representing them.
A spokesperson for HCA told Healthcare Dive the "strike has very little to do with the best interest of their members and everything to do with contract negotiations."
Across the country, the pandemic is exacerbating labor tensions with nurses and other healthcare workers, leading to a string of disputes around what health systems are doing to keep front-line staff safe. The workers' main concerns are adequate staffing and PPE. Ongoing or upcoming contract negotiations could boost their leverage.
But many of the systems that employ these workers are themselves stressed in a number of ways, above all financially, after months of delayed elective procedures and depleted volumes. Many have instituted furloughs and layoffs or other workforce reduction measures.
Striking a balance between doing union action at hospitals and continuing care for patients could be an ongoing challenge, Patricia Campos-Medina, co-director of New York State AFL-CIO/Cornell Union Leadership Institute.
"The nurses association has been very active since the beginning of the crisis, demanding PPE and doing internal activities in their hospitals demanding proper procedures," Campos-Medina said. "They are front-line workers, so they have to be thoughtful in how they continue to provide care but also protect themselves and their patients."
At Prime Healthcare's Encino Hospital Medical Center, just outside Los Angeles, medical staff voted to unionize July 5, a week after the hospital laid off about half of its staff, including its entire clinical lab team, according to SEIU Local 121RN, which now represents those workers.
One of the first things the newly formed union will fight is "the unjust layoffs of their colleagues," it said in a statement.
A Prime Healthcare spokesperson told Healthcare Dive 25 positions were cut. "These Encino positions were not part of front-line care and involved departments such as HR, food services, and lab services," the system said.
Hospital service workers elsewhere who already have bargaining rights are also bringing attention to what they deem as staffing and safety issues.
In Chicago, workers at Loretto Hospital voted to authorize a strike Thursday. Those workers include patient care technicians, emergency room technicians, mental health staff and dietary and housekeeping staff, according to SEIU Healthcare Illinois, the union that represents them. They've been bargaining with hospital management for a new contract since December and plan to go on strike July 20.
Loretto Hospital is a safety-net facility, catering primarily to "Black and Brown West Side communities plagued with disproportionate numbers of COVID illnesses and deaths in recent months," the union said.
The "Strike For Black Lives" is in response to "management's failure to bargain in good faith on critical issues impacting the safety and well-being of both workers and patients — including poverty level wages and short staffing," according to the union.
A Loretto spokesperson told Healthcare Dive the system is hopeful that continuing negotiations will bring an agreement, though it's "planning as if a strike is eminent and considering the best options to continue to provide healthcare services to our community."
Meanwhile in Joliet, Illinois, more than 700 nurses at Amita St. Joseph Medical Center went on strike July 4.
The Illinois Nurses Association which represents Amita nurses, cited ongoing concerns about staff and patient safety during the pandemic, namely adequate PPE, nurse-to-patient ratios and sick pay, they want addressed in the next contract. They are currently bargaining for a new one, and said negotiations stalled. The duration of the strike is still unclear.
However, a hospital spokesperson told Healthcare Dive, "Negotiations have been ongoing with proposals and counter proposals exchanged."
The hospital's most recent proposal "was not accepted, but negotiations will continue," the system said.
INA is also upset with Amita's recruitment of out-of-state nurses to replace striking ones during the COVID-19 pandemic.
It sent a letter to the Illinois Department of Financial and Professional Regulation, asserting the hospital used "emergency permits that are intended only for responding to the pandemic for purposes of aiding the hospital in a labor dispute."