What we won by striking at UVMMC

TWO MONTHS after striking the University of Vermont Medical Center (UVMMC), members of the Vermont Federation of Nurses and Health Professionals (VFNHP) ratified a new contract in late September.

It was the final step in a negotiation process that spanned seven months. At the heart of the dispute was the Medical Center’s unwillingness to pay competitive wages to nurses throughout the hospital and affiliated clinics, which created dangerous staffing shortages, unsafe conditions for patients and burnout among hundreds of nurses and other staff.

The union agreed to wage increases for registered nurses (RNs) and licensed practical nurses (LPNs) of 6 percent in year one of the new contract, 6 percent in year two and 4 percent in year three — a total of 16 percent over three years.

Advanced practice registered nurses (APRNS), such as nurse practitioners and nurse midwives, will see raises of 6 percent in year one of the contract and 6 percent 18 months later. Moreover, the bottom 10 steps of the wage scale will be eliminated for APRNs, raising pay substantially for all APRNs with fewer than eight years of experience.

The union was also able to win a number of key items that the hospital has resisted in previous negotiations, going all the way back to 2002, including:

Immediate wage parity for RNs and LPNs who work in outpatient clinics run by the hospital. Outpatient nurses have historically been paid significantly less than nurses who work in the hospital, making it difficult to attract and retain adequate numbers of nurses in the outpatient world.

Elimination of patient assignments for charge nurses, lactation consultants, nurse educators, Critical Access Team nurses and case managers. Nurses in these categories were often given patients to care for during their shifts, despite having full-time responsibilities in their own job classifications.

Creation of union-hospital committees to design staffing grids, aimed at providing safer nurse-patient ratios in units where no grids currently exist.

Improvement in the grievance process to enforce staffing ratios where they already exist.

Improvements in per diem nurse pay and scheduling.

Increased wage differentials for nurses who work nights or per diem, as well as APRNs who precept students.

A raise to $15 an hour for all staff currently paid less than this, to be phased in between October 2018 and October 2019 (because this covers nonunion employees, the medical center would not guarantee this in writing).

THESE ARE significant achievements, particularly considering that UVMMC originally proposed wage increases of 6 to 8 percent over three years, and actually sought to lower starting wages for newly graduated RNs. It refused to move at all toward union staffing proposals for months on end during the negotiations.

These gains were won through an unprecedented level of organizing among VFNHP members.

Seven months before the contract was due to expire, a handful of union members and staffers began organizing Member Action Teams (MATs) to build internal strength, develop new rank and file leaders and facilitate discussion among broad layers of union members.

These teams met regularly throughout negotiations to debate contract proposals, discuss unit issues, and plan participation in marches, pickets, community outreach and the strike itself. Whereas the union had at best a loose network of stewards until about a year ago, it can now claim well over 100 of these Member Action Teams, led by nurse activists.

This level of engagement meant that negotiating sessions — which have always been open to all VFNHP members — drew standing room-only crowds of hundreds of nurses for months on end. Union-organized marches drew 500 to 1,000 members. And the July 12-13 strike saw a 95 percent participation rate.

The union also organized strong community support by making it clear that their fight was not just about their own working conditions and wages, but also providing safe care for patients and challenging the greed of highly paid hospital executives. This meant that support for the nurses was widespread and palpable throughout the community.

However, a debate has been ongoing among VFNHP members about whether the contract gains were sufficient.

Some 28 percent of the membership voted against the agreement, and only about 60 percent participated in the vote. Many members felt the hospital should have agreed to higher wages in order to improve recruitment and retention of nurses, and thus ease chronic understaffing.

Some saw a “no” vote as a means of registering their bitterness toward hospital management.

A central theme throughout the contract campaign was the greed of hospital executives, who have been happy to grant double-digit raises to themselves year after year, but publicly called union demands for raises “unrealistic.” It was clear to nurses and community members alike that the leadership of the Medical Center valued their own pay above the provision of quality health care and sane working conditions.

Molly Wallner, who took over as lead negotiation for VFNHP in August, related that at many of the Member Action Team meetings she attended prior to the ratification vote, members voiced that they would vote no “not because of a specific [wage increase], but to tell the hospital that they need to prove that they respect us with action, not just words.”

UVM MEDICAL Center has maintained high profits for the last several years through keeping wages low and working staff to the breaking point. They could have afforded a higher wage increase for all staff.

However, the union lost some momentum after its strike in July. Many nurses felt that the two-day strike should have been followed by immediate plans for a subsequent strike, especially when hospital management made it clear that it was not going to budge on key issues at the bargaining table.

Instead, the union announced a broader, long-term strategy that included corporate campaign tactics, such as pressuring the regulatory Green Mountain Care Board to withhold approval of the hospital’s budget and targeting hospital board members to side with the union.

Subsequent strike plans would wait until at least October in order to line up the nurses’ negotiations with those of hospital technicians, who are also part of the union, but are covered by a different contract that expires in March 2019.

Such tactics lessened the urgency and pressure felt by management, and failed to galvanize union membership in the way that the strike itself had done. Nurse and community participation in union actions declined in the months that followed.

Thus, the final agreement, while achieving many real and important gains, fell short of what many nurses felt would be necessary for fixing the staffing issues that have plagued the hospital for the past several years.

On the other hand, many members recognize that the union is in a fundamentally different place now than it was prior to the start of negotiations. The experience of organizing and striking is part of the union’s collective consciousness.

As Deb Snell, a critical care nurse and vice president of VFNHP, put it, “The most important thing that came out of this was an understanding that people belong to a union. That we are the union.” She described co-workers continuing to wear their pro-union scrubs and t-shirts to work well after ratification of the contract.

Of note, nurses in other hospitals in Vermont have been in touch with VFNHP to plan unionization drives at their sites. In nearby St. Albans, a majority of nurses have voted in favor of joining VFNHP.

The union is already being challenged to draw on this increased level of organization.

In order to make up for the fact that charge nurses now have no patient assignments, the hospital has attempted to increase the number of patients assigned to all other nurses on any given shift. MAT groups have been meeting throughout the hospital to debate strategies for fighting back.

“We recognize that this fight isn’t over,” Molly Wallner told Socialist Worker. “This contract is only as good as our enforcement of it.”

Thanks to the strike, VFNHP is now in a stronger position yet to implement the gains won in this contract, and prepare to win more in the future.