Why we struck at Baystate

Nurses at the Baystate Franklin Medical Center in Greenfield, Mass., held a one-day strike October 5 to highlight their struggle for a fair contract. Baystate Health Systems, one of the largest health care conglomerates in New England, has tried to steamroll the nurses.

Nurses at Baystate Franklin are represented by the Massachusetts Nurses Association (MNA), an affiliate of National Nurses United. In this interview conducted before the strike, Donna Stearn, a registered nurse and one of two MNA co-chairs, spoke with David John and Wayne Standley about the issues behind the strike, the way union members have been galvanized by the struggle and the enthusiastic support of the wider community.

Donna Stern (center, in red) joins other nurses on the picket lineDonna Stern (center, in red) joins other nurses on the picket line

WHAT HAS been happening in the latest negotiations, and what's the union's response?

AS YOU know, we've been in negotiations now for a year. On August 29, we had our 27th negotiation session. We had well over 100 nurses in the room. Our bargaining unit is 209 nurses, so we had over half of the bargaining unit present throughout the day. They were coming in to support the bargaining committee--and to support themselves--by sending a message to Baystate that this is unacceptable.

How did Baystate conduct itself? They didn't even have enough courage to come in the room and show enough respect to negotiate across the table with our nurses. The only time they came in the room was when the lawyers from Jackson Lewis [the union-busting law firm hired by Baystate to negotiate for them] and another representative from the hospital came in and stayed for 10 minutes.

At that point, we said to Howard Bloom, the lawyer from Jackson Lewis, "There seems to be confusion on your part about how we feel about your overtime proposal. Just so there's no more confusion, for all of us who are against your overtime proposal, please stand up." And we all stood up. At that point, there were probably 80 or 90 nurses in the room. It was really powerful.

After that, Bloom and the rep stood up and said, "We're taking a 10-minute caucus. We may or may not be back." They never showed their faces to us again. Never once did they come back in the room to negotiate with us. So they tell the newspapers and they tell the community how much they respect their nurses, but this is how they show their respect?

WHAT DID you do all day since they were basically missing in action?

WE SAID, "Fine, if you don't want to negotiate with us, we're going to keep moving forward. We're not going to stop, because we're not backing down." We were completely galvanized, supporting each other, educating each other in terms of the next steps, getting ready for the strike, organizing picket captains, organizing the plan of action for the picket line itself, and doing more in-house organizing.

The message we want to send is that this isn't just for us. This is for all the employees of Baystate. When we win this fight, it's about sending a message to the rest of the employees that you do not have to be treated as badly as you're being treated.

HOW HAS the community been responding?

WE HAVE an external campaign, which is about doing outreach to the community and working with the people who support us. One of the things we did earlier this week was to stop by the office of the president of Baystate Franklin Medical Center, along with community representatives, including a town counselor, and drop off a petition with close to 2,000 signatures from the community. The petition reads, "We support our nurses, and we are asking for a fair contract for our nurses."

And a fair contract for us means good care for the patient. So that is what this is really about--a collective voice that says, "I can provide the best care possible." One of our key jobs as nurses is to be advocates--to advocate for safe care, safe working conditions and a safe environment. And for that, you need a protected union voice so that you can go to management and say, "What's going on here is unacceptable. We need to change it."

COULD YOU talk more about how a victory for the nurses relates directly to improving patient care?

FOR THIS, it's important for people to understand the basic sticking points in the negotiations. The first sticking point: overtime. Baystate is proposing to pay nurses overtime only after working 40 hours in a given week. What they've been trying to do is to keep their workers at part-time, so most nurses work 24 to 32 hours. So if you work 12-hour shifts and you have to work beyond that, you're not going to get paid overtime.

Not only are you not going to get paid, the hospital then says, "You are below 40 hours a week, so that means there isn't a staffing problem here." Everyone in health care knows that if you're not tracking how much you're paying for overtime, it means you don't have to pay attention to the chronic staffing problems that exist in the hospital. This is a serious problem on most floors. They are chronically understaffed.

To get around this, Baystate has been staffing the hospital with forced overtime. And this past summer, the MNA fought really hard to get a ban on mandatory overtime, which we won, because most everyone in the state recognized that mandatory overtime was really unsafe for patients.

[As part of Massachusetts new health cost control legislation passed in August, a hospital could not, except in the case of a declared emergency, require a nurse to work beyond a scheduled shift, and no nurse would be required to work more than 12 hours in a 24-hour period. Hospitals that assign a mandatory overtime shift are required to report such incidents to the Department of Public Health, along with the justification for its use. Any nurse can refuse overtime without fear of retribution or discipline of any kind from the employer.--Ed.]

We as nurses recognize this is only step one, but this was the best that we could do for the law right now. But it needs to extend to all health care workers in all settings. Right now, the ban on mandatory overtime only covers nurses who work in an acute care hospital. It doesn't cover nurses who work in nursing homes or rehab. It doesn't cover EMTs, CNAs, mental health workers, cafeteria workers or environmental service workers.

HOW DOES this affect safe patient-to-staff ratios?

UNFORTUNATELY THE only state in the union that has a law that forces hospitals to have safe staffing ratios is California. And the ratio depends on what kind of unit you work in. In California, for example, you can't have more than four patients pre nurse on a medical/surgical floor.

Not only that, but they have meal replacement workers--a nurse has to come to relieve you, by law, when you take a break. On a medical/surgical floor at Baystate, there is no cap on how many patients one nurse can have. Seven, eight, nine patients, sometimes more than that. If you look at discharges and admissions throughout the day, that nurse could be caring for even more in a 12-hour shift.

And they keep cutting back the ancillary staff that is so crucial to patient care. It's a very unsafe practice. Even though there isn't a law, at Baystate Franklin we do unsafe staffing reports all the time that are legal records and legal documentation. We meet with management every month, and we make it pretty hard for them to get away with unsafe staffing.

So on average, on a medical/surgical floor, the Franklin nurse has five patients. But the non-union nurses at Baystate Springfield have no voice. They cannot stand up. No one has a leg to stand on that's not unionized. When patient's lives are on the line, nurses' licenses are also on the line. Inadequate staffing is a seriously dangerous practice.

WHAT ARE the other issues in the negotiations?

THE NUMBER two sticking point is that Baystate has a punitive attendance policy. We see this as unacceptable that you are given a sick benefit, and then after three or four "occurrences," you get disciplined for using it. Right now, even if you have to leave work only 30 or 45 minutes early for a family emergency or if you are sick, that counts as an unplanned event--as one "occurrence."

We have people coming to work sick because they are afraid of being disciplined. And who wants to have a sick nurse taking care of them? You are already compromised. Unfortunately this policy was put into our last contract--because we weren't as organized or as galvanized as we are now, they were able to get that policy into the contract.

You never ever want a hospital policy in your contract. It's like a cancer in the contract. They were able to get that policy in, and we can't get it completely out, so we are trying to get modifications to the policy. So for example, we have three personal days and five family sick days in our contract, so we want it so people can take a personal day or family sick day and not have it count as an "occurrence."

Another sticking point is health insurance. Health New England is the only insurance that's provided to the employees of Baystate. And they own Health New England. So not only do they own it, they put the co-pays and premiums onto the backs of the employees. But it's even worse than that. They were charging union nurses more for certain coverage than any other employees in the health system.

So some nurses, for example, were paying $2,000 to $3,000 more for the "Bronze Plan" than any other employee in the system, and we said this is totally unacceptable. How can you ethically do that? For years, they've been charging us more, and we're saying you own the company and this is how you treat your employees? They keep raising the premiums and the co-pays every year. They're making money off of us! They're basically getting a profit off the backs of their own employees.

In every contract negotiation, they have been looking at ways to target and weaken the contract to the point where there is no contract. They were trying to mess with our ability to collectively bargain over wages. We don't care about the money so much, we really don't. To us, it's about the integrity of the contract. Here's the other thing: they have spent more on their union-busting law firm, than it costs to pay all the nurses overtime at Baystate Franklin. So this is not about the money. This is about power and control. This is about union busting.

DO YOU know how much Baystate is paying Jackson Lewis?

WE TRIED to figure it out--at least $600 to $700 an hour. And realize that this has been going on for a year, and not just with us but also with the Visiting Nurses Association in Springfield. The 48 visiting nurses and the 209 of us at Franklin are the only unionized employees in the Baystate Health System. Now figure in all the hours spent negotiating, all the off-site billing that they've been doing for both bargaining units. The VNA nurses have been in negotiations for well over two years. So you can imagine how much money Jackson Lewis is making.

WHAT ARE they saying is the reason they are not making any money?

THIS IS the other phenomenon that's really important for people to understand. Baystate is a huge octopus. All these satellite places--whether it's Baystate Franklin, Baystate Mary Lane, all the physician's practices, all the satellite offices they own--are all feeders to Baystate Springfield. So Franklin is always going to look like it's losing money because it feeds all its profits to Springfield.

Before Baystate gobbled up Franklin, there were things that you could get done at Franklin Medical Center. It was an all-inclusive hospital. You could walk in if you had a sick kid, or you needed a surgery, or you needed a procedure, no matter what it was. Now all of the most expensive procedures get sent to Springfield. So they're getting all the profits, while we're looking like we're losing profits.

And not only that, but we are non-profit for them; that's a tax write-off for them. And as a non-profit, you're always going to look like you are losing money. So it's ridiculous--you are getting a massive tax break from Franklin County, and yet you are trying to basically dismantle us, the workers in Franklin County. You get this tax break, and then you turn around and this is how you treat the workers of Franklin County and the workers of western Massachusetts?

WHY DO you think they're putting that many resources into fighting just a few unionized nurses?

BECAUSE THEY want a completely union-free workplace. We know nurses who used to work in Springfield and now work at Franklin, and they tell us that they were told directly by their manager in Springfield that if you talk about the union, if you talk about organizing a union, you will be fired.

HAVE YOU noticed that this increase in struggle has given people a different sense of what being in a union means?

THAT'S A great question because I've been now part of Baystate Franklin for seven years. This is a bargaining unit that's been in existence with the MNA since the early 1970's. In the beginning, the nurses were galvanized and together, and they would fill up the room. And then what happened was, over the years, there was some erosion. And there was some apathy. And then people forgot, or they weren't educated about the labor movement, or about the importance of a union. "Oh, why do we need this union?"

It wasn't until Baystate started really upping the ante by demanding more take-backs that things started to change. First they started to change how much nurses paid for health insurance, then they started implementing that sick policy, and now they want to take away the overtime and ignore the staffing problem. And they've tried to take away our right to collectively bargain over wages and health insurance. Then all of a sudden, people started saying, "Wait a second!"

WHAT ARE the nurses that you're working with saying now? Do people have fears? How are people overcoming those fears?

TO ADDRESS any fears, we do walk-throughs throughout the hospital so that the hospital can see us and know that we're not afraid. Our unit is set up with Linda Judd and myself as co-chairs, and then we have reps that come from all the different units in the hospital.

We go there at all hours. I've gone to the hospital in the middle of the night. During a walk-through, we go from unit to unit. We follow federal law and make sure that we're not talking about union activities in patient-care areas, but we proudly talk to nurses about what's going on and why this struggle is so important.

The reason that we don't have to be afraid is because we know we're protected by a union, and these activities are legally protected. And that's what it means to be part of a union. That's the message we send to all nurses.

WHAT IF Baystate doesn't budge after the October 5 one-day strike?

THEN WE'LL keep doing it. This is a democratic organization, and every time we move forward to make an important decision, we do it collectively. So my hope is that the bargaining unit will continue to be strong and that we will continue upping the ante. My hope is that if we don't break them that we just keep putting pressure on them because this is costing them a lot of money. And we are starting to tarnish their glossy image. And more than anything--more than the money--the one place that Baystate is vulnerable is that glossy image. They can't handle having the community know the truth about what kind of an employer Baystate is.

WHAT DO you think a win would mean for the rest of the employees? What would it mean for workers in western Massachusetts in general?

I DON'T know if everyone will get it right away. But believe me, when this is over and when we win, we will be united. We're trying to unite all the rest of the employees. Our message is, "You don't have to be treated like this. It's time to take your power back. It's time to organize. And it's time to send a message to Baystate that you also will not be treated so horrifically." It's unacceptable for them to treat any of their employees like that. It looks like it's our fight right now, but we know this is everybody's fight.