After approximately one year of back-and-forth negotiations to form an alliance between the California Nurses Association (CNA) and the United Steelworkers (USW), we finally had the greenlight and union leadership signatures on paper to move forward as a powerhouse in health care organizing. I was meeting with CNA Executive Director, RoseAnn DeMoro and her staff at the USW headquarters in Pittsburgh, PA to finalize the details. At the time, there were over 11 million health care workers in the United States, and less than 10% of them were represented by unions. Several unions were determined to organize their share of these workers.
I knew she would meet her connection
At her feet was a footloose man
I was extremely surprised at the extensive amount of money from the USW general fund that was provided to the CNA to form this alliance. By this point, I had overseen many successful health care organizing campaigns and was very familiar with the resources needed to run successful campaigns at that level; however, millions of dollars were in play for this alliance. When I asked USW President, Leo Gerard, and Executive Assistant to the International President, Kim Siegfried, why we needed to be so generous with this small, independent union, they replied that the USW lacked credibility. By aligning with a group who were successful in health care, we would gain the credibility necessary to meet organizing goals. I understood the need for credibility, as I had been advocating for years for a similar plan. My strategy, however was to form our own health care division and staff it with health care career professional who already had union organizing experience and revolutionize health care organizing strategies.
The plan as devised by the USW and CNA was that the Steelworkers would provide a not-insignificant boost to the CNA's finances. In return, the CNA would support any USW organizing campaigns in California. Together, the USW and CNA would target hospitals in California and then expand our reach to all 50 states. The CNA would organize the nurses, and the USW would target every other unit. The CNA were permitted to organize the nurses first, while the USW would work with the CNA's internal and external organizers to secure support with the hospital's other units. The CNA would then negotiate their new members into the USW pension plan.
I saw her today at the reception
In her glass was a bleeding man
Personally, I was skeptical of the alliance. There was no hard exit language to protect the USW, nor were there any clauses preventing the CNA from sabotaging the alliance and walking away with the millions of dollars that the USW invested. The CNA was successful in organizing, but were spending money far beyond what was required for each campaign's small membership base. I also knew the history of the CNA. They had a parasite-like mindset and a past pattern of aligning with other unions and then walking away after they got what they needed from the deal. They were like a used auto dealer selling the same car repeatedly knowing that it would break down. The CNA had (and still has) a division called the Caregivers and Healthcare Employees' Union (CHEU) that organizes the same group of workers they were supposed to help us target as part of the alliance. We were in direct competition with the CHEU, which meant that the agreement was compromised from the start.
The agreement also pitted the USW against the AFL/CIO as, at the time, there was no Change to Win Federation and the SEIU was a charter member union to the AFL/CIO. The CNA was an independent union (they did eventually join the AFL/CIO), which paid no charter fees to the AFL/CIO. Their closest competitor, the SEIU, did pay money to the AFL/CIO. Even though the SEIU had past peace agreements with the CNA, they were angry with the USW over the alliance. While that did not particularly bother the USW, being pitted against the AFL/CIO did pose some problems. Because the CNA was raiding other AFL/CIO member unions, we were cutting off any support from or participation in national organizing efforts we historically depended on.
I saw her today at the reception
A glass of wine in her hand
I went out to California to establish a relationship with the CNA's organizing department. We had meetings at their Glendale, CA office and I knew right away that this agreement would never pay off for the USW. Establishing the parameters of the agreement (who controlled the targets, budget and staff; and even the logo colors) were all being worked out on the fly. (The CNA wanted the logo to be the same colors as the SEIU, but I overruled.) For some reason, these issues were not worked out in Pittsburg, PA prior to the financial disbursement being made. The CNA leadership was smug and we nearly came to blows at the very first meeting. Everything presented by us was challenged and our frustration was quickly escalating. I was there to make the alliance succeed, so an understanding was achieved, but the frustration certainly continued.
As part of a health care organizing strategy I had put together with the AFL/CIO Director of Organizing, Richard Bensinger, for the George Meany Labor College, we dealt with the psychology of what drives people to health care careers and how to use that psychological makeup to influence those same people to seek and join union representation. Over the years of health care organizing campaigns, we had health care professionals consistently tell us that they did not work hard to get into their positions to go out on strike; they were there to care for patients. We needed to change the narrative so that they said that they joined the union because the union cared for the patients.
I was standing in line with Mr. Jimmy
And man, did he look pretty ill
We began organizing together in San Jose, but the process was moving slowly. I introduced my strategy to not only go on the attack against the health care industry, but to simultaneously become activists for patient care. To do this, we had to find a better way to reach the nurses and other professionals in the health care industry and then connect with their psychological desire to protect their patients.
Health care professionals are licensed by the state, so some of their personal information was publicly accessible. We began our outreach by sending out statewide surveys asking these professionals their opinions on a list of very irritating issues that were common in the industry. We clearly stated in the survey that these abuses were directly caused by the health care industry prioritizing profits over patient care. The survey form also provided space for individual comments and concerns about their facility. Our goal behind these surveys was to align ourselves with the healthcare professionals' core beliefs and for them to see the union as an advocate for patients' rights.
I also pushed the alliance to start publicly advocating for "patient rights" laws. We needed to get in front of existing issues and/or create new issues to lead. Fortunately, we had a clear list of common concerns that were reported back to us via the surveys. We also offered "patient rights" classes across the state, which gave us direct contact with the professionals.
Along with allowing us to prioritize concerns in accordance with the professionals, the surveys also directed us to the most vulnerable hospitals. After some initial success in the San Jose area and the ramping up of the public political pressure, our next big target for the alliance was Long Beach Memorial Medical Center, the largest hospital in L.A. County, and the second largest private hospital on the West Coast.
I sung my song to Mr. Jimmy
Yeah, and he said one word to me and that was "dead"
I arrived in Long Beach, CA to assist the CNA with their second campaign at the Long Beach Memorial in two years. They had attempted to organize the nurses over a year previously, but it was a disaster for the CNA.
I began with a crew of 16 health care workers and USW members from across the country. We were building our campaign while the CNA tried to gather support among the nurses. Due to our agreement, we had to let the CNA organize and hold their election for the nurses first. We waited to file our petition until the CNA either succeeded or failed their second attempt. I was getting impatient, as I knew that our team was getting everything in order and we would win. The longer we waited to file, the harder it became to maintain employee support of the union. I had to start kicking the CNA's nurses campaign in the pants to get them moving because they had fallen into a rut and were not growing any support. The supporters they had initially won over were starting to fall away. They were performing horribly in their organizing efforts and, in order for the USW to win our part, we had to get the CNA moving in the right direction.
I decided to have my organizers work part-time building nurse support for the CNA so that we could further our own organizing efforts. We began aggressively pushing the internal organizing teams to reach out to fellow employees. The hospital knew about the CNA organizing efforts, but was blind to any organizing activities by the USW, and I intended to keep it that way. I had the nurses disrupt the hospital by protesting the hospital CEO's town hall meetings. I also directed them to disrupt management meetings and to march on donor homes and businesses while I simultaneously brought political support to bear against the hospital. We had local and statewide politicians making public statements supporting the employees' right to unionize.
I went down to the Chelsea drugstore
To get your prescription filled
Today, as a consultant to management, I constantly preach about the importance of a solid no solicitation policy as part of a union free strategy. In the Long Beach Memorial campaign, we have a perfect example of why this is so important. As hospital management allowed vendors like pager/cell phone dealers and others to set up and solicit in the cafeteria and offer discounts to hospital employees, we also had the right to set up tables in the cafeteria to talk with employees during their breaks.
Singing "We're gonna vent our frustration
If we don't we're going to blow a fifty-amp fuse"
We had shifts of organizers going into the hospital 24 hours a day and purposefully engaged in many loud arguments with hospital management and security while stationed in the cafeteria. Our polls indicated that the employees felt intimidated by management and wanted to be protected. We had to portray a sense of strength and confidence to attract the support of the employees, but this course of action did not come easily. If our data were wrong, it could have easily backfired and made us look like bullies, pushing the employees to management. The success of this course quickly became evident as support from the nurses (and our targeted employees) started turning our way. We finally got the stalled units rejuvenated and more energized than at any time during the previous two years.
The hospital wanted to limit our organizers access to the cafeteria, so they increased their security to cover all entrances and floors. It was extremely difficult for security to differentiate between our organizers and the public visiting patients, so they took photos of our organizers and pinned them in the security offices for identification. We employed counter strategies to neutralize their efforts:
- To maintain our freedom of movement, we started staging small but loud groups to certain areas of the hospital to draw security away from normal entrances and entered through other access points.
- We used the stairs to freely travel between floors when we found out that security rarely, if ever, entered the stairwells.
- Internal organizing committee members would meet us and introduce us to targeted personnel.
- We rotated external organizers in and out from other organizing campaigns around the state.
- Unbeknownst to hospital management, we also had the telephone codes to call any and every department of the facility from any hospital phone.
Security and management simply could not keep up with us and we always remained a step ahead of them. A few incidents almost sabotaged our efforts, though.
We decided that we would have a soda
My favorite flavor, cherry red
The CNA organizers started buying lunch at a restaurant off the ocean in downtown Long Beach for groups of employees who wanted to talk with them. When employees showed up, the CNA would only allow card signers to enter the reserved area. If they were not on the list of card signers, the employees would have to sign a card on the spot in order to participate in the lunch meeting. I was flooded with complaints from all the targeted units. Employees who were not ready to sign had the option of either missing lunch or getting back to work late as there was not enough time to stop somewhere else to buy lunch. If the employee was off shift, they would have wasted their time for no benefit, or were forced to signed a card to enter. I put an immediate stop to this and explained to the CNA that I would not authorize alliance funds to be used to collectively shoot ourselves in the foot. Union organizing tactics 101 (furthermore, common sense) should have dictated that this was certain to alienate the very workers we wanted them to reach out to, not to mention that cards signed under duress are not worth the paper they are printed on.
Additionally, this practice of public lunches was vulnerable to either management plants and/or company supporters to infiltrate the committee's inner circle and attack it from within. I agreed to allow the lunch meetings to continue, but with a filter system to prevent infiltration of persons whose goal was to weaken the bond that was being achieved through meeting in a low stress environment. From that point, the meeting participants would be directed to the internal organizing committee where the sincerity of the attendees could be better judged.
The CNA also began publicly attacking the hospital's quality of care and started a hot line through which patients could complain and the alleged abuses could be reported to the state for investigation. They went so far as to rent a highway billboard with a picture of the hospital asking, "How was your patient experience?" and providing the abuse hot line phone number. This was perceived as an attack on the health care workers themselves, rather than the hospital. The employees were justifiably proud of their care and considered this tactic to be a slap in their faces. I also put a stop to this smear campaign because it was reversing the significant progress we had been making with all the hospital units. I had no problem attacking the hospital management and, in fact, had been doing so on a daily basis, but in an effective manner. I also explained to the CNA that if they continued to make blundering mistakes then I would no longer honor the agreement to allow the CNA to complete their second election before we filed our petition with the NLRB.
We went down to the demonstration
To get our fair share of abuse
The CNA was furious with me for stepping in and overriding their horrible tactics and they strongly complained to the USW about me. They wanted me pulled from my leadership position, but to no avail. I was also fighting with the USW about the CNA's desire to continue these practices and was ready to walk away if I did not have the authority to control the alliance's strategy on the ground. I did not have time to waste because I was also overseeing glass industry and meat packing campaigns.
The campaign momentum was growing and my organizers were now holding one-on-one and small-group meetings on the hospital floors. The lead nurses and non-nurse front line supervisors had all but given up trying to control our activity for the most part, as long as the work was getting done. We also had some ex-supervisors who were very active and effectively trashing management from their personal experiences. We had them use our meetings to passionately describe conversations where hospital management attacked employees. Many of these stories were either made up or exaggerated, but we used them to target weak supporters who we needed to get personally angry at, afraid of, or offended by management.
As the CNA election neared, we needed to frustrate and redirect the hospital's attention and resources, so we began picking up homeless people who needed medical attention (very easy to find in the city) in a van. We brought them to the emergency room to get the medical attention they needed. It was very easy and cheap to get them to go the emergency room; all we had to do was give them a few dollars for lunch and they were more than happy to come with us. This forced the hospital to bring in more staff and caused more internal chaos. The hospital had to dedicate more resources to handle the staffing issues and it shook them off their game.
At this time, we were also working with the local AFL/CIO Central Labor Council (CLC) to work with union retirement groups in the area. The union retirement groups were already visiting sick members as part of their charter duties. We coordinated with their current activities to have them assist us in outreach to hospital employees. They already wore pro-union shirts and buttons; we gave them talking points to have pro-union conversations with employees in patient areas where union talk was prohibited by anyone else but patients and visitors. We also gave talking points to willing vendors who moved throughout the hospital freely; in many cases, they had built up casual relationships with large numbers of the employees.
The nurses finally had their second election 21 months after they voted down the CNA the first time. We successfully turned the election rhetoric around to be about patient care and nurse-to-patient ratios. We created or got in front of existing issues that the nurses felt strongly about and became defenders of the patients in their eyes. But to us, it was just an organizing tactics to gain the employees' support, nothing more! The nurses' election was a great success and we used the momentum to immediately turn all of our resources towards the other units.
She was practiced in the art of deception
Well I could tell by her blood-stained hands
Unfortunately, my instincts were correct and the alliance between the CNA and USW did not last much longer. For the CNA, the alliance was simply about gaining power and financial resources for their own benefit. I remember meeting personally with RoseAnn DeMoro, the head of the CNA; I knew that she was trouble for the USW when she stated that she wanted ultimate power over hospitals across the country to make them put her on their Board of Directors. This showed that she was most interested in her own personal power and, to me, her alliance with the USW was more about financing her personal dream than a win for health care workers. Although the USW/CNA alliance dissolved shortly after this organizing drive, the USW held an election the follow year and was successful in organizing a few more units.
Organizing is like a chess game; perception means everything. The only reality that matters from an organizer's perspective is whether you win or lose. In this case, I was charged not only with a USW organizing win, but also with assisting the CNA succeed in their campaign. I worked to create the perception that the unions not only cared about the workers, but also their patients; the CNA was shown basic organizing principles that won their campaign. Again, the only thing that matters in unions is whether you or lose, not how you get it done.
You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes you might find
You might just find
You get what you need