I Needed a Break

By John P

I am a rank-and-file emergency room nurse in Oakland, California, and president of a chapter within The Service Employees International Union (SEIU) Local 1021. My chapter represents 3,000 workers in the county health system–almost everyone except doctors and senior management.

I got involved in the union in 2014, shortly after I got a job at a county hospital. I was angry that I wasn’t getting the breaks that both the law and our contract required; I can’t work a 12-hour shift without eating or going to the toilet. I was also angry that chronic short staffing forced me to choose between multiple patients who badly needed my attention. One of my critically ill patients crawled over her bed-rail and fell to the floor after my boss ordered me to respond to another critical patient’s needs. Another patient went missing after my coworker was told to transport a different patient to a separate building. Later, the missing patient was found locked in a bathroom, dead.

When I asked coworkers why we weren’t getting breaks, some responded that they felt like asking about breaks showed laziness. Others said, “It’s always been like this,” or referred me to the “union people,” coworkers who had been on the bargaining team. These “union people” said the contract provisions about breaks don’t apply to nurses, and reported me to management. All four nursing supervisors individually pulled me aside and told me, “We don’t ask about that around here…We’re old school…Just walk away from your patients whenever you want to take a break.”

Such rationalizations allow people to explain away the undeniable exploitation of their labor, and result in patients receiving inadequate care. Everyone wants to feel that they are helping, not harming patients. It’s uncomfortable to confront exploitation and neglect, especially if you feel like you don’t have the power to change the situation.

Key Tactics

Many coworkers shared my concerns but were afraid to speak openly, and about two dozen were allied with management. So, a handful of other nurses and I started a whisper campaign. We passed out information about the contractual rights hospital workers have to take breaks, and about how enlarging hospital staffs has been shown to benefit patients. We talked one-on-one with coworkers and collected their contact information, so we could invite them to a union meeting where nurses from another bargaining unit explained how they won a similar fight.

Word got to the boss about the planned meeting, and she demanded a private talk with me. We ignored her, so she sent a spy to the meeting. We got the spy to admit she was there to write down our names, and we kicked her out. The same day, the boss began providing extra staffing to cover lunch breaks.

Next, we collected data on how many workers on each shift had an unsafe number of patients, and we spread the fight to the rest of the county hospital system. Janitors passed notes from unit to unit. Clerks collected staffing plans and assignment sheets for us. Nursing assistants reported when they were expected to do nurses’ work. I filed a 15-page grievance that showed that management’s staffing plans were a load of horse hockey: It was mathematically impossible for them to provide breaks given the inadequate number of nurses in their plan!

While this was going on, we successfully defeated a proposal to lay off about 400 people. In the end, zero workers lost their jobs. We won a fight over staffing in a psychiatric hospital. We stopped the attempted closure of the county’s only substance abuse clinic for new parents. These wins helped us learn how to organize and built solidarity.

The breaking point came during a big meeting with the director of nursing, who had apparently been hired to win “Magnet Status” certification for the hospital. Everyone was sick of her communications about “Magnet Status” and “Our Magnet Journey.” Why was she fixating on this PR badge when patients weren’t getting their basic needs met and the hospital couldn’t provide workers with badly needed breaks?

People told their stories about working 12 hours without a break, and still being unable to provide the care patients needed due to perpetual understaffing. It was powerful. People cried. “What are you going to do about this?” someone asked, looking the Director of Nursing in the eye. When she used the word “magnet” in the first sentence of her reply, everyone in the packed room burst out laughing. Startled, the Director spilled the mixed nuts she was eating. At that moment I knew we were winning.

What we won

This kind of organizing forced management to increase the budget to hire more nurses to cover breaks in several departments. Now nurses are planning and imposing new staffing plans that include breaks. We also negotiated a back-pay settlement for all breaks missed; most nurses got thousands of dollars.

More broadly, we changed how our members and the bosses think about breaks. Breaks are now a right that the boss has to provide, not a favor or a privilege. People understand that breaks for nurses are good for patients because the nurses provide better care.

Last but not least, the Director of Nursing resigned, after apologizing on the hospital intranet for not providing breaks, and losing much of her power.

Building on success

The next year, we organized a group to campaign for seats on the bargaining team and we beat the laissez-faire old guard. Last year, we ran a slate that took over the chapter board; I’m now its president. Solidarity is strong across job categories. We now have janitors and kitchen laborers representing nurses when they get disciplined, nurses organizing janitors to march on their bosses, and nursing assistants organizing mass boycotts of nursing home management plans.

There’s also massive potential for us to be a powerful voice against austerity in public healthcare and to pressure for good jobs. We are leveraging our victory on breaks for nurses to help lower-paid workers to challenge their own notion of “normal.” They don’t get breaks either!

This article was adapted from a recent talk that John P gave at a NYC-DSA Labor Branch panel.