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Fighting for Union Recognition and Quality Care: An Interview with a Madison, WI Nurse

Left Voice member and NYC healthcare worker Mike Pappas interviews a nurse from Madison, Wisconsin about his and his coworkers’ lengthy fight for union recognition. Nurses are currently preparing for a potential strike if the hospital continues to deny recognizing their union.

Left Voice

August 31, 2022
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Mike: Could you start by telling me your name, where you work, what you do there, and how long you’ve been working in that position? 

Colin: I’m a nurse at University of Wisconsin Hospital, University Hospital, which is their main adult inpatient hospital. I’ve worked there for 5 years. I’m on a unit called F65 and have worked there for most of my career. Prior to Covid, it was General Medicine and Geriatrics, which meant that we cared for — and we still care for this population — a lot of people with chronic illnesses that come in for exacerbations of those illnesses. Since Covid, one of our main services has been taking care of Covid patients, and that’s still ongoing. And I’m a charge nurse, which means that I supervise the flow of patients in and out of the unit, write staffing assignments and help people out as they’re going about their day. I’ve been at this hospital for the entirety of my nursing career.

Mike: Originally I had reached out to you because I saw some information about the fight that you all are having for union recognition. Could you tell me a little bit more about how that fight has been going? And as part of that, could you tell me what the response of the hospital administration has been?

Colin: We’ve been demanding union recognition, voluntary recognition in some form or another, since 2019. We actually had a union until 2014 or 2015 and that’s when our contract expired. Then just like that, the hospitals didn’t continue to recognize the union because of Act 10, which was Scott Walker’s anti-public sector union bill which he was using to try to run for president. So we’re still stuck with that now, unfortunately. 

In 2019, because Tony Evers, a Democratic governor was elected, we thought that the political landscape had changed in such a way that made it possible for us to get voluntary recognition. We’ve been asking nicely for three years through escalating actions, marching on the administration, having an informational picket and collecting cards. We basically collected cards twice. And the administration is just stonewalling our efforts and claiming that Act 10 makes it so that there’s a legal obstacle to their recognition of our union. But we know that there isn’t. The attorney general recently issued a lengthy and detailed public opinion which concluded without any doubt that voluntary recognition is possible. And now we’re considering the difficult decision of whether or not to go on strike for recognition. We’ve been considering striking since at least May of this year. 

Mike: For health care workers in general that might be reading this who don’t have a union, could you highlight from your perspective how having a recognized union would benefit both yourself as health care worker and the other health care workers where you work, and then how it could even potentially benefit patient care? 

Colin: Well, I think the primary reason that we’re organizing this union and willing to go on strike to get it recognized is because it will improve patient care. Basically, since we lost our union, there have been changes in policy with regard to staffing that have led to a chronic staffing shortage and a shortage of experienced nurses, because most of the nurses working at the hospital now are new nurses. A union gives us a real voice at the table with real power. Ostensibly, we are told that we have a voice now through shared governance, which is basically an extension of management that allows nurses to have conversations about how to improve conditions on their unit. But with shared governance, like unit councils and area councils, they don’t have real power to make changes that affect conditions in the workplace. And that’s what a union can do.

There’s a couple of ways this works. The primary one is that we’re going to demand safe staffing, retention packages, and safe policies that make our hospital a better place to work and a place where people want to not only start their careers, but to spend a longer part of their careers, if not their whole careers. Our hospital was very much considered a destination for life, like a career destination. It was a place where people who work outside of hospitals would try to get experience so that they could get a job at our hospital. Since we lost the union, we’ve lost all the benefits that come with that. Now it’s no longer the case that we are a destination place of employment. People start their careers here and then they leave.

What that looks like for a patient is that we never have enough staff. There’s always fewer nurses and nursing assistants taking care of the patients than needed. That means that patients are waiting for us to do the things that they can’t do for themselves that are really urgent needs. Sometimes that’s going to the bathroom, or cleaning up for them after they’ve gone to the bathroom because they couldn’t wait. Or it’s getting them on medication that they need or helping them walk around the hospital. It’s walking through the hallways and talking to patients about their care and all of the things that they’re counting on us to do. If we have a union, I think of it like a tourniquet that stops the bleeding in terms of staffing issues. So we can establish and then lock in safer nurse to patient ratios. And with meaningful retention packages, we can start to create a workplace where people don’t leave after a year or two because they’re so burned out. Obviously we need new nurses, right? But we also need experienced nurses. Nursing is a team sport and often on a shift I’m the most experienced nurse with five years of experience, and that’s not the way it’s supposed to be. I certainly know a lot, and I think I’m a good nurse, but there’s certain things that just come with experience that you can’t reproduce in a year. 

Mike: As a quick aside from the questions, I have just one observation. It’s clear that the problem with staffing is a nationwide issue. And it’s interesting because I did my residency training at Mount Sinai Hospital in New York City. When I was there, the nurses were ready to go on strike, and part of it was around not having the safe staffing ratios that led to all the problems with patient care. I was just talking with a nurse friend of mine who was saying that Sinai has something like 500 vacant positions because so many people have left because they don’t want to work in that environment, because it negatively affects patient care. 

Colin: Absolutely. There’s burnout from working a lot, but there’s also a moral injury from not being able to take care of your patients in a way that you want to. If you’re the nurse and you’re unable to care for the patient in the way they need to be cared for, that affects how they do, anything from whether they get better or whether they’re comfortable at the end of life. People don’t want to come back to work after that. They don’t want to come back the next day, let alone come back and spend the rest of their careers somewhere where they have to work in such a poor environment.

The hospital administrations are also quick to point out that there’s a national staffing crisis. They say, “well, where are the nurses going to come from?” And the answer to that is when we’re talking about getting our union back, it is a way of addressing the staffing crisis. The answer is that the nurses are already here. The answer is keeping the nurses we have and making the conditions better so nurses will want to work. It’s like trying to save a boat with a hole in the bottom. If we plug the hole it’ll save the boat. If we improve working conditions, eventually we’ll get an adequately staffed hospital. But if we can’t keep nurses in the hospital there’s going to be a continual staffing crisis. 

Mike: You mentioned that you’re debating this difficult decision of potentially striking for union recognition. A lot of times when health care workers anywhere strike, the hospital administration is one of the first to chastise health care workers. We see this not only in the U.S., but also in other parts of the world, when health care workers strike, the bosses say things like, “Oh, they’re selfish or they’re abandoning patients.” I’m wondering, how you would respond to such a ridiculous critique? 

Colin: Yeah, we’re already hearing that from our administration. When I had the meeting a couple of weeks ago, I was one of three nurses who met with the top hospital leadership, including our CEO. And he said something like “I just don’t understand why you would abandon your patients like that.” That statement is just preposterous on its face. The nurses who are in the union and who are willing to strike for the union are nurses who don’t want to abandon their patients. They’re the nurses who are committed to the hospital as an institution that’s necessary for its community. And they’re willing to  put their livelihoods at risk in order to protect that institution in the long term, because they see it as absolutely in peril the way things are going. The only reason that we’re even considering a strike as an option is the fact that the problem we’re already facing on a daily basis has compromised patient care. We want to start moving in a completely different direction where we’re centering patient care instead of profits as the structuring principle for how our healthcare system is organized. And if we did decide to strike for union recognition, we would give the hospital leadership a certain amount of notice, which would require the hospital to arrange for more expensive travel nurses or substitute staff, which would hurt the hospital’s bottom-line, and we expect they would like to avoid.

Mike: Throughout the U.S. right now unions have some of the highest approval ratings in some time. We even see sectors of workers throughout the country fighting to unionize. In that context, I’m wondering how you see your fight for union recognition connected to those other fights? 

Colin: I often announce or send in text messages, a phrase that I first heard from Chris Smalls, the founder of the Amazon Labor Union: “It’s hot labor summer.” I certainly feel like there’s something in the air and there are a lot of factors behind that. But the reality is that we take inspiration from the Starbucks workers, Amazon workers, Trader Joe’s workers, John Deere workers, all of the workers who have come together in the last couple of years and have fought to improve their working conditions through the labor movement. They give us hope and courage.

I think what’s happening in health care is that it’s on the bleeding edge because a lot of these changes came about through COVID. And for me, what put me in a position where I felt like I had no option but to do whatever it takes to get our union back was my experience early in the pandemic. I don’t know for a fact, but I’m confident that there were meetings taking place on a daily basis where policy decisions were made about what kind of protective equipment was appropriate, what kind of patient ratios were appropriate, and so on for taking care of COVID patients. Those policy decisions are made without direct input from bedside nurses, and without bedside nurses having any final say or any significant contribution to those discussions. I just felt profoundly replaceable. I felt that when my administrators were telling me that all I had to wear into patient rooms with known COVID positive patients was one barrier mask per week, a face shield and a gown, and that was all I was allowed to wear because there was a PPE shortage. The message to me was clear that I wasn’t that important. That if I died, they could find another nurse to replace me.

They must have had meetings where they were talking about rationing PPE and about what it would look like if there was a wave of COVID infections among nursing staff that spread quickly and caused them to be out of work because they were ill or because they died. I’m sure they just looked at the numbers and were like, “you know what? Conserving N95s and the bottom line is more important than ensuring that these nurses survive.” It hits differently when you’re the person who’s actually going in the room, you know? So I think that experience is similar to the one that inspired the Amazon workers, where they were considered essential and they were forced to work under conditions they didn’t believe were safe. Once your life becomes something that your boss is making decisions on and is weighing in the balance with decisions about how to preserve the bottom line, things start to look different and something that was a problem at work that was maybe tolerable one day now no longer seems tolerable. And it’s something that you’re willing to fight for. 

Mike: I completely agree, thanks for that answer. In terms of health care workers fighting for those types of better conditions, what advice do you have for other health care workers who might be organizing? What advice would you have for other health care workers? 

Colin: I would say to healthcare workers that are organizing anywhere just to be prepared for the worst, but hope for the best. Health care can be a really hostile place for labor, in part because labor is one of the few costs that administrators can control. They really want to live in a world where they set the terms for how they control the price of labor and for that reason, they’re going to fight unionization at every turn. But the fact is that it’s not just about improving the conditions at your workplace. When you’re organizing in health care, you’re fighting not only for your patients and for the safety of yourself and your coworkers, you’re also fighting for the safety of the whole community. And I think that helps put things in perspective.

When I think about going on strike in our situation and I consider the prospect of potentially losing my job, if it were just about a little bit of extra money every year, that wouldn’t be worth it to me. But when I think about it as the future of our hospital and potentially the future of healthcare in the United States, then it starts to make sense. That’s what keeps me motivated. When workers take back power in their workplaces anywhere, I think it’s a good thing. But in health care, we have the potential to really revolutionize the way our industry looks, not just by unionizing, but by making sure that the human costs of industry decisions about profits over people get reported and that people are aware of it.

Hospitals are an institution that serve many purposes. One thing they do is serve as a place where people go to get taken care of and to get better. But they are also a place where we keep sick people out of public sight. People by and large have no idea what’s going on in hospitals. And I think privacy laws, which are important and valuable in one sense, also reduce the amount that people get to hear about what’s truly going on in hospitals. But if more and more workers in hospitals — and I’m talking about not just nurses, but doctors, housekeepers and cafeteria workers — if those workers join together and talk about the problems that they’re encountering, not just with each other, but with the public at large, I think that could be a catalyst for some major changes in health care. And ultimately, I think we need to move towards some kind of public health care system if we’re going to have anything approaching justice in our country. I think that expanding organized labor in healthcare is a first step towards that. I guess my advice would be, remember that, your whole community is at stake. It’s not only about your paycheck. It’s about the safety of your whole community. And that keeps me motivated. 

Mike: Thank you. Lastly, how can others support your fight? And then anything else that you wanted to say or plug? 

Colin: People can donate to our hardship fund here. And if people live in the Madison area, we can get them a yard sign or other public materials to show support.

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