For the last two months, the University of Michigan nurses and their union representatives have been engaged in contract negotiations with Michigan Medicine. As part of a public pressure campaign, the Michigan Nurses Association – University of Michigan Professional Nurses Council (MNA-UMPNC) have called several rallies, including at University of Michigan Board of Regents meetings, where rank-and-file nurses made public comment, describing their work conditions and their demands for a better, more equitable contract. The nurses were joined by the University of Michigan Lecturers’ Employee Organization, also fighting for a better contract, and supporters from Comrades in Coffee, Detroit Will Breathe, and Left Voice. Although the contract expired on June 30th, no deal has yet been struck.
The nurses’ demands are straightforward. They want to be able to do their jobs safely, effectively, and to be compensated for it. They want working conditions that will allow them to provide the level of care that the patients deserve. One nurse, who has worked at the hospital since 1984 told Left Voice, “I used to be proud to be a UM nurse because you could give care that patients deserve. Now it’s running to put out fires.”
This trend is becoming the norm within hospitals and care industries. These institutions, which are meant to provide an essential service to people, are run as businesses. While some hospitals have been run as businesses since the early 20th century, the last 30 years has seen a substantial shift towards large-scale multihospital systems and, although frequently defined as “not-for-profit”, investor talks and billion dollar acquisitions and mergers are increasingly common. Larger speculative investment financing in hospitals is driving the prioritization of profit, relegating any ethical working conditions or standards of care to an aspirational afterthought instead of a mandate. The healthcare industry has become nothing less than a means to extract wealth out of the sick and injured.
As soon as nurses entered the building last May, they were met with a show of force: strict security procedures and heavy police presence. The group was told to get into a single-file line to be screened through a metal detector and bag check. This greeting showed in no uncertain terms the limits of the “hero” rhetoric so often heard from hospital executives and politicians during the pandemic. Indeed, far from creating a “university atmosphere,” these measures served to distance the elected Regents from the public employees and students, while reminding them that their power is backed by the armed state.
During the Regents meeting, MNA nurses spoke to the risks of overworking as a crisis for both patients and nurses. One nurse said there isn’t a nurse shortage, but “a shortage of nurses willing to work in these conditions.” A recently-hired nurse mentioned that they observed a concerted effort to push veteran nurses out. Conditions in the hospital have been dire since the start of the pandemic in March 2020. While there is more PPE available, the staff lost to the wave of layoffs in July 2020, burnout, higher-paying jobs as travel nurses, and high Covid morbidity rates have not been replaced. Units are short — sometimes up to 10 nurses short — and there aren’t enough support staff, leaving nurses to take on every job from pharmacist to transporter. Nurses are tired: “Tired to your bones tired. Every nurse across the country, including University of Michigan,” as one long-time nurse put it. As a result, according to MNA nurses, patient falls have increased dramatically.
This posture stands in stark contrast to the “hero narrative” that essential workers were encouraged to identify with in the thick of the Covid-19 crisis. Somehow, amidst another surge and another variant, essential workers advocating for fair pay, overtime incentives, and ethical staffing ratios are being met with staunch resistance from the hospital. The language of “essential workers” has proved to be nothing more than lip-service as the University of Michigan Hospital seeks to inflate their profits by squeezing nurses — and thereby patients.
Some nurses see the changes as a result of Michigan Medicine’s shift to a corporate hospital model. The prioritization of profit over patients is epitomized in their “concierge care” service, which allows wealthy patients to skip the line and get fast, high quality care while “normal” patients linger in over-crowded ERs. This shift is consistent with capitalism’s push toward “innovation’’ always results in – a more “modern” and “efficient” system that benefits the larger monied interests’ pocketbooks and does nothing to improve quality of care or access. In other words, institutions provide the bare minimum of care, keeping the working class just well enough to show up to work and perform essential duties which keep the system running and the bosses raking in profits.
Nurses are tough — they have shouldered much of the burden during the pandemic. Now they are standing up for themselves and each other by demanding safe working conditions, a living wage, and to be treated with dignity by the administration. So far, Michigan Medicine appears to be stonewalling the nurses – threatening to rewrite the whole contract, refusing to make concessions on hiring practices, and offering just a 3 percent raise despite record inflation. Now with the contract expired, according to MNA-UMPNC, the administration is withholding step pay increases and asking for 101 concessions.
After a traumatic, exhausting two years, and following a great exodus of nurses from the field, UM nurses are now forced to fight to be able to provide the quality of care that people deserve. One thing is clear, though: Michigan nurses are not afraid to strike. They have done so before in 1989 and voted to strike in 2018. Now it looks like they may have to again if they want the University to hear their voice. Through long, difficult experience, nurses know precisely how essential their work is. They’re tired of being exploited and abused by hospital administration for the sake of profit maximization. If Michigan nurses want to win a better contract and the respect they deserve, they will need to flex their muscles and strike. Against the knee-jerk reaction that striking nurses are “abandoning their patients”, the truth is that conditions in the hospital are already bad. Strikes are not a holiday — they’re a way nurses can and should fight for better outcomes for both themselves and their patients. Hospital administrators need to understand that it’s nurses who provide care — not investors.
The nurses’ contract ended June 30th at midnight, with no agreement in sight. The union leadership has called an informational picket on July 16th at 10am starting at Fuller Field Park in Ann Arbor, MI. If you are in the area, join us in solidarity.
