Los Angeles County emergency room nurses and nurse practitioners threatened Tuesday to go on strike as early as Thanksgiving, saying the county is not paying enough to attract and retain nurses, leaving emergency rooms and intensive care units understaffed and patients at risk.
Dozens of nurses and their supporters gathered on the steps of the Kenneth Hahn Hall of Administration in advance of the Board of Supervisors meeting, where a union representative delivered a 10-day strike authorization notice.
Ninety-eight percent of the more than 7,000 nurses represented by the Service Employees International Union Local 721 voted to authorize an unfair labor practice strike, according to the union, which claims the county is violating labor laws by not complying with legally mandated nurse-to-patient safety ratios.
A revolving door of nurses in and out of county positions amounts to a training ground for more highly paid jobs in the private sector, said Ileana Meza-Ward, a registered nurse at LAC+USC Medical Center who works with cancer patients and chairs the nurses’ bargaining units.
“Los Angeles County has a chronic retention crisis that is putting our patients at risk,” Meza-Ward told the assembled crowd.
“The last thing we want to do is leave our patients’ bedsides but we’re ready to walk the picket line because patient safety is on the line. Management clearly has no problem with more than 11,000 patients leaving L.A. County ERs without receiving any treatment — in just one year alone.”
That occurred in 2016, according to the union.
Rabbi Jonathan Klein, executive director of Clergy & Laity United for Economic Justice or CLUE, spoke out on behalf of the nurses and told City News Service “options outside of striking are disappearing.”
Nurses and union representatives did not precisely quantify the gap between the county’s current “last, best and final” offer and the union’s demands. Several who were interviewed by CNS said it wasn’t a simple matter of wage increases, but includes the need to hire more staff to bring down patient-to-nurse ratios. They also said needs differ for public health nurses, emergency nurses and nurse practitioners.
When Meza-Ward presented the strike notice to the board she said the offer for nurse practitioners covered only 20 percent of those nurses, those with one to three years of experience, leaving others with no wage increase.
“The message that was sent was that there is no priority for quality patient care,” Meza-Ward told the board.
SEIU 721 President Bob Schoonover said, “This is a department in which experience counts.”
The union pointed to more than 1,000 open and budgeted nursing positions that haven’t been filled as evidence that county wages are insufficient to support a well-trained workforce and ensure quality patient care.
“The impact of the revolving door is evident in key departments, including the county’s emergency rooms, where RNs handle more than 300,000 ER visits annually,” the union said in a statement. “As an example, in the last three years, while LAC+USC Medical Center’s ER department hired 100 new RNs, it also lost 66 RNs.”
The situation puts experienced nurses in the position of constantly training newcomers, according to the union.
“Instead of investing in the retention of experienced nurses, management continually relies on Band-Aid remedies that jeopardize patient care and only prolong the pain, like over-reliance on nurse registries and shifting high-need patients to beds where they won’t receive the intensive care they need,” Schoonover said.
The union claims that beds in county hospitals’ intensive care units remain empty not because they are not needed, but because there are not enough nurses to operate them, as the county staffs to 57 percent of capacity.
The county has a policy of not discussing labor negotiations and no board action was taken.
Klein said he supported a strike as “an important tool to get what is just and what is right,” but was hopeful that the board would intervene to avert that outcome, adding, “It’s time to do the right thing and to do it now.”
The contract for SEIU 721 registered nurses in bargaining units 311 and 312 expired in September and has been temporarily extended. The union has filed charges with the Employee Relations Commission claiming that the county engaged in regressive bargaining and other labor law violations.
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