On Friday, more than 1,600 unionized nurses at Robert Wood Johnson University Hospital (RWJUH) began a labor strike following a vote authorizing the stoppage last month.
United Steel Workers Local 4-200 (USW) members, which include part and full-time nursing staff, have been working without a contract since June 30. Negotiations continued for three months without resolution, as previously reported by The Daily Targum.
Judy Danella, president of the USW Local 4-200 and bedside nurse at RWJUH, said bargaining meetings with the hospital’s leadership were typically cordial. But when the union announced the strike, communications became less amicable.
She said the issues experienced by the nurses predominantly stem from staffing shortages, which can be traced back to the pandemic.
During the pandemic, older nurses often left the field due to burnout, and prospective nurses avoided the profession due to fears about their health.
The experiences of nurses at RWJUH parallel some of those that contributed to the current national staffing crisis, according to an article from the American Association of Medical Colleges (AAMC).
The article stated that even prior to 2020, nurses experienced high levels of burnout on a national level. The pandemic worsened their workload and stress, causing many to depart from the profession.
While RWJUH has replenished some of its nursing workforce since 2020, Danella said she was unsure whether staffing numbers were the same as they were before the start of the pandemic. One of the union's demands includes replenishing RWJUH's nursing workforce to improve levels of burnout and safety.
Typically, RWJUH nurses work three 12-hour shifts weekly, Danella said. When staffing falls short, it creates a deficiency that the hospital's "float pool," or standby staff, needs to fill. This periodic gap arises from the registered nurse-to-patient ratio, which differs between hospital divisions depending on the severity of the patients' conditions in the unit, according to a resource from National Nurses United.
Alongside a larger workforce, the union is asking RWJUH to provide nurses with retirement benefits and apply caps on their health insurance premiums.
Regarding retirement benefits, Danella said while employees working in other public industries, such as law enforcement, transportation and fire safety, may be able to retire comfortably with health benefits, nurses at RWJUH cannot. Instead, nurses like her may have to rely on Medicare, Medicaid or out-of-pocket funds.
"We just wanted to try and get our foot in the door to say, 'Hey, let’s give us something when we retire because we've put so much time into caring for people — let’s care for people as well,'" she said.
Regarding insurance premiums, Danella said nurses pay considerable amounts for health insurance. The union proposed that its new contract prohibit the increasing of health insurance costs. The hospital's alternative proposal would maintain insurance prices for the first year of the nurses' contract and raise them in subsequent years, Danella said.
"They were still going to increase our insurance and we thought, 'Hey, we’re healthcare workers," she said. "Can we not have an increase in our healthcare?"
A statement issued from an RWJUH spokesperson said the hospital's leadership has agreed to the union's requests multiple times and proposed external measures of mediation and enforcement but that the union has turned down such efforts.
With regard to mediation during contract negotiations, Danella said when the union has asked for external arbitration in the past, it lost its cases due to the lack of personal knowledge non-medical mediators have regarding the working conditions nurses face.
She said she is unsure how long the nurses' union strike will take. Regardless, the hospital's statement indicated that it had prepared contingency plans to maintain its operations throughout the action.
To address the lack of staffing during the strike, RWJUH has asked medical students to serve as technicians, according to Danella. But students have rejected the hospital's requests to support the union, she said.
"That’s not what (medical students) went to college for," she said. "They went to college to become doctors, not to become semi-nurses and technicians. I think it’s a little bit insulting."
Danella said RWJUH has also spent approximately $19 million to bring in "traveler" or "scab" nurses — terms used to describe nurses brought in to replace striking staff. The rates they are paid can be two to three times more than the wages of RWJUH’s regular staff.
Traveler nurses are guaranteed payment equivalent to 60 hours of work, divided into 40 hours of regular pay with 20 hours of overtime during their first week, and then 48 hours of work, divided into 40 hours of regular pay and 8 hours of overtime during their second week, Danella said.
She said RWJUH will also provide traveler nurses with free transportation, housing, food and airfare. With such benefits, these nurses are more driven by a financial motive rather than genuine care for the patients at RWJUH, Danella said.
"It’s very sad that nurses hurt nurses because we’re all fighting for the same thing whether its' here or where they come from," she said.
At the end of the day, Danella said the goal is simply to come to an agreement with RWJUH that fulfills the needs of both sides, improve patient welfare and builds a future in which nurses are not excessively burdened or overextending themselves while caring for patients.
Both the union and the hospital have said that they do not want a strike and express a commitment to returning to negotiations in order to prevent one.
"A prolonged strike would be costly for both the hospital and our nurses and their families. Nobody wins in a strike," the statement issued by the University Hospital spokesperson said. "We would respectfully urge the union to reconsider and instead return to the table and work with us in good faith towards reaching an agreement."