Opinion | Why I’m Against Strike Nursing: The Hidden Costs to Our Profession and Mission
Disclaimer: The views and opinions expressed in this article are those of the writer and do not necessarily reflect the views or positions of nurse.org.
Strike nursing refers to nurses who accept short-term contracts at medical facilities to fill vacancies left by permanent staff nurses who participate in a strike. This is not the same as travel nurse contracts. Over the past five years, strike actions in healthcare have become increasingly common, keeping replacement nurses in high demand. The uptick coincided with the discontent felt by nurses during the COVID-19 pandemic ( Stress and Occupational Burnout of Nurses Working with COVID-19 Patients - PMC ). Strike nursing is a contentious and polarizing issue.
Reasons to NOT Work a Strike as a Nurse
While strike nursing may provide temporary relief for individuals, it ultimately weakens collective bargaining power and undermines efforts toward meaningful change. Simply put, crossing strike lines damages the nursing profession as a whole.
A strike is the most powerful tactic used in the negotiation process. When replacement nurses agree to work strikes, it defeats that tactic. It’s often not the strike itself that is impactful, but the threat of strike action. Healthcare facilities are required to have RNs continuously present. If a facility is unable to secure replacement nurses, they are forced to negotiate to avoid the strike. Therefore, when replacement nurses show up, it removes any motivation to negotiate to avoid the strike.
It’s important to pay particular consideration to the reasons nurses are pursuing strike action in the first place. Generally, it is due to a combination of the following:
- Unsafe nurse-patient ratios leading to patient safety concerns
- Unsafe working conditions
- Retaliation against nurses who report safety concerns (a type of unfair labor practice)
- Decreased medical benefits with increased cost to the nurse
- Mandated overtime
- Below average wage compensation.
It should be safe to say all nurses can relate to those issues and understand why nurses decide to strike.
A 20-year study of nursing strikes in New York State showed increased in-hospital mortality by 19.4% and 30-day readmission by 6.5% for patients admitted during a strike. The results suggest that hospitals functioning during nurses' strikes are doing so at a lower quality of patient care.
Counter Arguments
- Patients still need care.
- True, however, when hospitals know they have secured enough replacement nurses, there is no motivation to transfer patients to other facilities; to cancel elective procedures; to go on divert and stop admitting patients. The National Labor Relations Act federally mandates a 10-day notice of intent to strike to allow healthcare organizations to make proper patient care arrangements.
- Allegations of replacement nurses providing unsafe patient care have damaged public trust in nurses. Because of the last-minute, volatile nature of strikes, staffing agencies are not always afforded enough time to thoroughly verify the nurses’ experience. Nurses can lie or inflate their experience in nursing specialties without it being discovered. It is common to hear horror stories, from patients and families, of their nurses not having the knowledge or experience to safely care for them. I have personally witnessed this at most of the strikes I’ve attended. One example that stands out is the recent Ka’piolani Medical Center strike in Hawaii. Two different mothers of currently hospitalized pediatric patients came to the strike line to share experiences of inappropriate nursing care, from replacement nurses, that any experienced pediatric or NICU nurses would recognize as unsafe. They are also unfamiliar with facility procedures, potentially resulting in delayed care or poor patient outcomes.
- Replacement nurses frequently claim they are aiding the striking nurses by costing the facility so much money; that this will push management to end the strike sooner.
- The majority of healthcare facilities carry strike insurance
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- This is a racial issue. Referring to replacement nurses as “scabs” is bullying and racist, primarily against Black nurses.
- According to the Bureau of Labor Statistics, “Black workers remained more likely to be union members than White, Asian, or Hispanic workers.” Since the largest demographic of unionized workers is Black one could easily argue the opposite is true.
- The term “scab” is the universally accepted term for anyone who crosses a strike/picket line.
- In terms of organized labor, “scab” is the derogatory name given to a strikebreaker. The negative connotation is purposeful in dissuading people from doing it. The word’s power comes from its visceral imagery, evoking disgust and moral corruption. Some unions even have “scab reporting websites” requiring members to report any suspected scab/strikebreaking activity. In my opinion, this is a relatively light “punishment” considering that strikebreaking historically led to violence.
- Financial incentive. Travel nurse rates have decreased significantly and this is an opportunity to earn a considerable amount of money in a short time.
- Financially vulnerable nurses are being exploited while perpetuating inequities in pay and conditions.
- While replacement nurses do earn higher compensation, the rates have decreased significantly in recent months. In the past, it was common to see advertised rates of $9,000 per week. Recent strike nurse ads have advertised as low as $2,800 per week.
- There is also a significant risk that they could end up losing money if the strike is canceled. Strike nurse contracts often contain clauses preventing the nurse from being paid if the strike is called off at the last minute. Many nurses must pay for their own travel expenses and have already traveled to the strike location prior to cancellation.
- Expedited licensing and credentialing can be costly and challenging.
Final Thoughts
My goal is to encourage unity and collaboration within the nursing community while advocating for systemic change to address the root causes of strikes. My question to any nurse considering working a strike is, why would you want to work against your own best interests? I urge you to reflect on the long-term consequences and prioritize actions that uplift the nursing profession, instead of adding to the division.
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