The Minnesota Nurses Association began briefing its members Wednesday on its open-ended strike strategy. Twin Cities nurses will vote Monday on whether to authorize the union's plan.
The stakes are high for hospitals, but also for nurses. An open-ended walkout could cause severe financial hardship for many of them. Both sides are walking a fine line and lots of people are watching.
Nurses union spokesman John Nemo says there are lots of links to resources and other advice posted on the union's website as the union prepares its member to weather a long strike.
"As far as what steps they can do to talk to their bank and talk about mortgage payments or car payments and things like that," Nemo said. "And how you can call your creditors ahead of time and try to make arrangements to delay or make partial payments."
Everyone is looking at Minnesota to see how effectively nurses can strike.Labor professor Gary Chaison
The union says most employers pay their health premiums at the beginning of the month, so if another strike occurs in early July, nurses would retain their coverage for at least a few weeks.
After that, they'll be able to purchase a temporary COBRA plan that would maintain their same health benefits, if a strike continues into August.
The nurses union also has a strike fund. Nemo won't reveal how much money is available to help striking nurses, but he says members have more ways of getting help than they might think.
"The purpose of sharing all that information is to help them understand that they can do this, that it is very feasible and it's not nearly as scary as it might seem at first blush," he said.
For nurses who have money in savings, going without a paycheck for a few weeks might not be that scary. But for those who live paycheck to paycheck, there's plenty to worry about, even if they're able to delay some of their bills.
Gary Chaison, a labor relations professor at Clark University in Worcester, Mass., said the union is walking a fine line right now. Tt needs to show the hospitals that its nurses are preparing for a long strike, he said, but those preparations will make some nurses very uneasy.
"It's important for the union to communicate that a vote for a strike doesn't mean they have to go on strike," Chaison said. "It just means that the officers now can back up their bargaining demands with the ability to strike and they can call a strike at any time."
The nurses union said as much yesterday when it invited hospitals back to the bargaining table next week and promised to delay filing an intent-to-strike notice, as long as negotiations show signs of progress.
Twenty-four hours after receiving the union's request for more talks, the hospitals are still evaluating the offer.
Economist Aaron Sojourner predicts a break in the impasse soon.
"Now we can expect to see the real negotiations get started," he said.
Sojourner, who teaches labor relations at the Carlson School of Management at the University of Minnesota, said the prospect of an open-ended strike is just as scary to hospitals as it is to nurses.
"It's pretty easy to adjust for a one-day strike, to just reschedule some elective procedures, to bring in managers to do front-line work. It's not very disruptive," he said. "But an open-ended, long strike, you know those little adjustments can't get you through."
Hospitals still haven't provided estimates on what the one-day strike cost, but many of their 2,800 replacement nurses reportedly earned three times the daily rate that a union nurse earns, meaning they likely spent a minimum of several million dollars -- and probably significantly more than that -- to staff the one-day walkout. An open-ended strike would likely increase those costs substantially.
But Sojourner says losing money isn't the only risk. He says findings from a recent study of 50 strikes in New York state show that the quality of care isn't as good during strikes. The study found that the in-hospital mortality rate rose, as well as the 30-day readmission rate.
"This is good research and it shows that for the hospitals, for the patients, for the public the stakes are quite high," he said.
Just as the stakes of this labor dispute are high, even outside of Minnesota's borders.
Labor professor Gary Chaison says health care leaders across the country are grappling with similar budget issues and no one has an easy solution.
"Everyone is looking at Minnesota to see how effectively nurses can strike, whether they're willing to go on strike, and key issues of staffing as well," he said. "I think everyone in the health care industry is looking at how do we deal with these tremendous pressures to reduce costs? Can we get the nurses to go along with this or do we have to find alternative ways of dealing with it?"
In many ways, this labor dispute is a sign of the times. Poor economic conditions have influenced many of the concessions that the hospitals are seeking from the nurses. But Chaison thinks it's also an unintended consequence of health care reform which will force hospitals to trim their costs even more in the years ahead.