Bernie Sanders leads panel, striking RWJUH nurses rally at Rutgers

On Friday, the U.S. Senate Committee on Health, Education, Labor and Pensions conducted a field hearing at Nicholas Music Center on Douglass campus to address the concerns of unionized nurses at Robert Wood Johnson University Hospital (RWJUH).

The United Steelworkers (USW) Local 4-200, representing almost 1,700 RWJUH nurses, have been striking for more than 60 days. The striking nurses' demands include safer staffing levels at the hospital, reduced insurance premiums and sufficient retirement benefits, as previously reported by The Daily Targum.

Members of the Senate committee who attended included Committee Chair Sen. Bernie Sanders (I-Vt.) and Ranking Member Sen. Bill Cassidy (R-La.).

On October 26, the day before the hearing, RWJUH issued a press release critiquing the hearing and comments Sanders had made about the labor strike.

"We firmly believe in collective bargaining and that those negotiations should be conducted at the bargaining table — not at a press conference," Wendy Gottsegen, an RWJUH spokesperson, said in the release. "We look forward to our next session where we will continue negotiating transparently and in good faith towards reaching a fair and equitable resolution."

The committee heard from a panel of nurses, union representatives and other experts who provided their insight into labor issues both in the nursing field and at RWJUH.

Mark Manigan, president and chief executive officer of Robert Wood Johnson (RWJ) Barnabas Health, and Alan Lee, president of RWJUH, were also invited to attend but declined. Manigan and Lee each issued written public testimonies addressing their absences and reaffirming RWJUH's dedication to the community.

In light of their nonattendance, Sanders raised a few questions to RWJUH and RWJ Barnabas Health's leadership regarding their profitability and how the labor stoppage had continued for so long.

"I would have asked them how their health care system could afford to spend over $100 million on traveling nurses since the strike began but somehow cannot afford to mandate safe staffing ratios to improve the lives of patients and nurses at the hospital," Sanders said. "I was also very curious to know how this nonprofit hospital could provide some $17 million in CEO compensation for one person in 2021."

Nancy Hagans, president of National Nurses United and the New York State Nurses Association, attributed the extent of the CEO's salary to the disempowerment of unions. She said that compensating the hospital's CEO equates to prioritizing finances over patient well-being and the hospital exercising its abilities to maintain its operations through traveler nurses.

"I would say that any hospital willing to go public with the statement that we spent $102 million on replacement nurses while their nursing staff is walking the picket line should be ashamed of themselves," Debbie White, president of Health Professionals and Allied Employees, said. "Do they think this is a good look for the hospital?"

The event began with Sanders expressing his gratitude to the American nursing workforce for its efforts during the pandemic despite threats to workers' well-being and lack of appropriate protective measures. He said the significance of the nursing field is incomparable to most other American professions.

When discussing the ongoing nursing crisis, Sanders pointed to two reasons: a deficiency in nursing instructors and, more importantly, demotivating and unsafe working conditions.

"I've been in the room, and I've seen the tears in their eyes," he said. "Nurses have told me that they are simply unable to provide the quality care they want to provide and the care their patients deserve. The reason for that is the totally inadequate nurse-patient ratios that they are forced to deal with."

Sanders subsequently moved to ask questions to the nurses and nursing experts invited to speak at the panel.

Each panelist began by introducing themselves and providing an overview of their experiences, what they witnessed throughout the pandemic and the feelings of exploitation they experienced at the hands of their respective hospitals' leaderships. They also stressed the importance of safe staffing levels and what benefits they offer to both hospitals and patients.

Judy Danella, president of USW Local 4-200, spoke about the conditions at RWJUH. She said the hospital perpetuates a cycle of burnout and unsafe conditions for nurses and patients by replacing departing, older nurses with younger, inexperienced nurses who ultimately struggle with the workload and conditions at the hospital.

She said the nursing shortage at RWJ Barnabas Health can be attributed to its management exploiting the nurses' desire and ability to go to extensive lengths to care for ailing individuals. The decision to go on strike, albeit painful, was an act of defiance toward leadership that does not care for patients' well-being and does not pay its employees well, Danella said.

Carol Tanzi, a pediatric nurse at RWJ Barnabas Health, spoke next, highlighting why spending the necessary amount of time with a patient improves their care and allows nurses to uphold their moral and legal duties. She said to best serve her patients, often children, she needs to build relationships, answer questions for both the patient and family and provide the necessary physical care.

"This is physically and emotionally exhausting," she said. "I can't say no to any of the responsibilities, so I literally run ragged daily, still feeling like I haven't done enough. Nurses never turned their back on their patients, never. This is our community, and we carry a huge amount of trauma and guilt because of it."

Hagans followed Tanzi and spoke about her experiences working a 1-nurse-to-8-patient ratio. She said with unsafe rates, the likelihood that a preventable error happens increases and that she has experienced events in which she could have preserved a patient's life had she been able to serve fewer individuals.

She said the issues experienced by New Jersey nurses are unrelated to a shortage of nurses in the state, as more than 50,000 nurses in the state are currently unemployed.

"There is no nursing shortage, there is a staffing crisis," Hagans said. "If we want to solve the nation's staffing crisis, then we must increase nurse retention. To do that, the government must mandate a minimum nurse-to-patient ratio."

She pointed to the successes the health care industry in California experienced once it mandated nursing ratios in 2004. She said these ratios have notably increased patient well-being and nursing retention but criticized how their mandates were only implemented after nurses had to continuously go on strike.

White spoke next, echoing the points raised about exploitation in health care and detailing the Health Professionals and Allied Employees' efforts to support nurses across the country. She called on public support for New Jersey Assembly bill 4536, which would mandate nursing ratios for hospitals in the state.

Finally, Patricia Pittman, director of the Mullan Institute for Health Workforce Equity at George Washington University, spoke about various research conducted on the mental and physical health of nurses and how, while hospital funding increased during later phases of the pandemic, staffing did not.

Similar research has also found that an effective way to increase staffing, as of now, is to mandate nursing ratios, according to Pittman. Once staffing issues have been addressed, hospitals can consider adjustments to pay transparency and structures.

During the event, Sanders asked the panelists to provide human context behind the union's demands.

In response, Danella spoke about the dread and uncertainty of serving patients with an understaffed workforce. She said nurses must make difficult choices about which types of care to prioritize, whether feeding a patient who cannot feed themselves or adjusting the position of a different patient.

Tanzi also said nurses know they need to take their time in caring for patients, especially those who cannot help themselves. But a single nurse might be rushed when they are assigned tasks that require more than one nurse.

While navigating these challenges, nurses receive limited professional and emotional support, she said. More often than not, hospital leadership is unavailable to assist them and their family members simply do not understand the challenges they experience in the workplace.

"To this point, nurses have been afraid to talk about this to the general public because we don't want to alarm anybody that it's scary in the hospital," Tanzi said. "We don't want to raise fears to people that they might not be taken care of properly … Things that need to be done are not getting done, and we have not agreed to that."

This overburdening schedule also results in nurses being unable to eat or use the restroom during the day, Hagans said. It is unreasonable to expect nurses to carry out their obligations when they cannot meet their basic physical needs, a sentiment that White also shared.

"Don't we all say that? 'I'll be right back.' How many hours later do we get back there because something else hijacks our time?" White said. "Simple needs go unmet. Simple toileting needs, self-care needs. Patients don't get it. They don't get their medicine in time. They don't get their dressing changes in time. They don't get their teaching."

Tanzi said she also could not fathom how these experiences and workplace cultures could be marketed to incoming nurses, who will accumulate debt and subject themselves to traumatic experiences.

As the event ended, the panelists and Sanders discussed the future and historical role the federal government plays in nursing staffing.

Pittman called for creating a U.S. Government Accountability Office report regarding how hospitals receive funding to compensate their staff.

Tanzi said that RWJUH should be able to show where the state and federal funding they received during the pandemic went, given that it seemingly was not used to provide nurses with compensation, health insurance or hazard pay.

Sanders added to these remarks by acknowledging the federal government's involvement in the health care system for RWJ Barnabas Health by providing more than $800 million in federal aid and more than $3 billion from Medicare and Medicaid payments.

He concluded the panel by calling on RWJ Barnabas Health's management to return to negotiations and fulfill the nurses' requests for safer staffing ratios. In doing so, RWJ Barnabas Health could become a nationwide leader.

Sanders also thanked the nurses for their continuous dedication to striking as an act of care for each other and their patients. 

"Let me just conclude our health care system is broken," Sanders said. "There are so many problems. Today, we're dealing with one of the major ones, and on a personal note, I want to thank the union for their incredible courage. You are standing up, not just yourself, you're standing up for your patients, and that is an incredible, noble thing to do."

After the event's conclusion, community members, USW Local 4-200, New York State Nurses Association and Health Professionals and Allied Employees rallied outside of the building where the hearing was held.