Dr. Helfgott
Picket Lines: June 27 was marked on my calendar as the day to watch. No doubt the union organizers shrewdly selected it to be their strike day because of its proximity to July 1, an auspicious date for teaching hospitals, when rookie interns and residents anxiously assume their heightened roles of responsibility within the medical hierarchy. The operational disruption and relative inexperience of new cohorts of physicians has been termed the “July effect,” and evidence suggests that mortality rates rise among higher risk patients admitted to academic medical centers at the start of the academic year in July compared with May.1
The 3,300 nurses of the Brigham and Women’s Hospital (BWH) in Boston had voted to authorize a one-day strike to protest their treatment by the hospital leaders who, according to the chair of their bargaining unit, “disrespect and undervalue the nurses who provide the vast majority of patient care at the hospital.”2
Usually, workers strike for greater pay, but the financial gulf between the two sides was not wide at all. With an average base salary of $106,000 (excluding benefits) and an established contract that already guaranteed annual pay increases of 5% for their first 18 years of employment, the nurses’ grievances primarily focused on non-monetary issues. These included their opposition to changes in nurse staffing policies for one specific ward (the thoracic intermediate care unit), disputes over the formula used to calculate benefit time off (with a current guaranteed minimum of 33 days per year) and disagreements regarding their options for health insurance coverage.3,4
Fearing that major patient care issues would arise in a facility devoid of nurses, the hospital contracted with a staffing agency to hire 700 temporary nurses to replace the striking staff, not only on their designated strike day but for an additional four days. Administrators justified the need to lock out their own nurses, arguing that it was neither realistic nor financially feasible to expect to hire so many temporary workers for just a single day’s work.
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No doubt the hospital’s lock-out strategy served another purpose: to remind the union that once a strike began, there might not be a way of ensuring a happy and peaceful resolution. Consider the seminal labor event of the 1980s when the newly elected president, Ronald Reagan, declared the air traffic controllers strike to be illegal and proceeded to fire them when they refused to obey his order to return to work, leading to the dissolution of their union, the Professional Air Traffic Controllers Organization.5 The U.S. labor movement suffered irreparable harm and never regained the power it once held.
