Travesty in the Twin Cities

Lackluster union leadership doomed the most significant nurses' strike in recent US history.

Minnesota nurses on strike against Allina Health in June 2016. Kelsey Miller / Flickr

The largest open-ended nurses’ strike in recent US history is over. After thirty-eight days on the picket line at various sites in the Minneapolis–St Paul area, 4,800 defiant members of the Minnesota Nurses Association (MNA) voted last week to accept a deal hammered out after seventeen straight hours of negotiations with the largest hospital chain in the Twin Cities, Allina Health.

The walkout was the logical (and to some degree inevitable) consequence of the increased corporatization of health care in the US. While legally and structurally a non-profit, Allina Health (and most other health care institutions) nonetheless operates like a profit-seeking enterprise, exhibiting little regard for workers’ wellbeing.

The conditions that drove Allina nurses to strike are the same conditions facing so many workers in caregiving industries today: the unholy trinity of health insurance cuts, declining staff levels, and increasingly unsafe working conditions.

Often, employers exploit care workers’ desire to help others to justify worsening conditions, insisting that standing up for their rights is a selfish act. The militancy of striking nurses, therefore, stands as a welcome riposte: workplace activism is not a barrier to providing good care, but a prerequisite.

The MNA, an affiliate of National Nurses United, represents nurses at nearly every major hospital in the Twin Cities. Historically, it has bargained contracts with all of the metropolitan employers simultaneously. This time around, however, the other major hospital chains settled with the 14,000-member MNA, and Allina held out.

One big sticking point was the nurses’ high-quality health insurance: the company wanted to move nurses onto the same inferior plans offered to other Allina employees.

Another was less pecuniary. While it’s unlikely there would’ve been a strike without the insurance issue, the nurses I met on the line said it was staffing that mattered to them most. Management, they told me, refused to accept the reality that sometimes one patient requires more attention than five, and inadequate and inflexible staffing policies meant that nurses were unable to provide the care they needed to. A one-day strike in 2010 over staffing issues resolved nothing, and in some sense both sides had been waiting for this rematch.

A rematch the union lost.

The deal the nurses ultimately agreed to was remarkably similar to the offer they voted down on October 3. That October 3 offer was, in turn, little different from management’s last proposal before the strike began on Labor Day. The final deal contained just enough in the way of changes (mostly new short-term money to mask the long-term impact of insurance cuts) that the union’s leaders could tell their members they had gotten something worthwhile.

But all they really wanted to do at the point was save face and end the strike. Because the MNA leadership never had a viable plan to win.

It’s been a long time since strikers in any industry could win just by walking the picket line. (This is especially true in health care, where even striking unions accept that the workplace will remain open during the walkout.) A strike must be one part of a comprehensive, strategic, escalating campaign of surgical precision. Walking off the job is relatively easy; getting back to work is the hard part. Yet the MNA really seemed to think it was going to win by staying out on the line.

The walkout was mismanaged from the start. The MNA held a one-week strike in June centered on the insurance issue. They got good coverage, the public was sympathetic, and Allina looked foolish spending $20 million on strikebreakers when the difference at the bargaining table was less than that.

And yet, just days before the strike, the union’s negotiating team agreed to give up members’ health plans and take the lower-cost insurance proposed by the employer. They disagreed with Allina on the timing and how the costs would be managed, but on the principle they buckled. Nevertheless, the MNA still encouraged the members to support a strike over a handful of small differences.

Let me be clear: the spirit of the differences was enormous, especially on the question of safe staffing levels. But in terms of actual proposals, there wasn’t much daylight, and the final deal shows that.

On safe staffing, for example, the MNA pushed for an increase in personnel levels so that charge nurses did not have a patient assignment. Allina preferred a labor-management team to “implement changes” to charge nurse assignments. The final agreement set no formal staffing levels and established a labor-management committee to discuss staffing levels — just as Allina had wanted. What the union ostensibly won was non-binding mediation, with management still having the final say.

Different? Yes. But thirty-eight-days-on-strike different?

The MNA had no strike plan. They picketed. Political allies appeared on the line and signed a letter of support, but no politician threatened hearings on Allina’s staffing practices. The MNA got celebrities to wear union buttons at this year’s Ryder Cup, but didn’t use the media spotlight to hold actions. They ran radio ads, but the ads didn’t just fail to ask the public to take action or take their non-emergency health care to another provider — they didn’t even mention that nurses were on strike.

Some of this lack of preparation may be due to the rarity of open-ended strikes by the MNA’s parent affiliate, National Nurses United. NNU members have gone on strike many times in recent years, but always for a limited period of time. Some were one-day affairs, like a 2014 walkout in fourteen states over adequate safety precautions for the Ebola outbreak. In every case the union set an end date prior to the strike.

So perhaps the MNA didn’t realize that an open-ended strike was something very different from a limited-duration work stoppage. In any case, it wasn’t until the end of the strike’s first week that the MNA began to launch actions outside of the picket line. A few of these — like one at a shareholders meeting for General Mills, whose CEO is an Allina board member — garnered some favorable press. But they were one-off events with no follow-up.

A 4,800-person strike can’t be settled with a two-hour action outside a shareholders meeting. To win, the MNA needed to escalate. They needed to do more than chant, march, and make phone calls. But there’s precious little evidence that the union leadership ever prepared its members to ramp up the pressure. Even in the last days on the picket line, the nurses I spoke to thought the mere withholding of their labor was going to bring Allina down.

Why didn’t MNA leaders have that conversation with their members? I met dozens of striking nurses over the nearly six weeks they were out. They are — uniformly — tough, committed, passionate, and brave. They are now back at work, unbowed and proud.

But if you had asked them to march their picket line up to the gate at a hospital construction site to block vehicles from entering, it would’ve been immediately apparent that their leaders had never suggested such an idea. Why not?

In recent years, with books like Joe Burns’s Reviving the Strike, the labor movement has come back around to the necessity of labor militancy. But, as union-buster extraordinaire Ronald Reagan liked to put it, just because an idea is simple doesn’t mean it’s easy. If a union’s leadership is going to put its members’ lives and livelihoods on the line, it needs to be prepared to do what it takes to win. And the MNA wasn’t.

We’re not talking about a sellout. The MNA leadership wants the best for its membership. But the union lacked a plan to win, beyond simply holding out in a war of attrition.

Those of us committed to a more vibrant, more militant, and more powerful labor movement owe it to these nurses to make sure such lackluster leadership is called out. We need to have hard conversations within unions about what it really takes to win a strike. If we don’t, then the only thing we will learn is how to lose.