I became a Nurse to care for people in their most vulnerable moments.

Now I’m on strike.

by Kathy Montanino, RN

I’m a Nurse in the Open Heart/Trauma/ICU unit at Riverside Community Hospital (RCH). I’ve worked there for 12 years. I help mentor new Nurses in our department. During the COVID-19 pandemic, I also often work as part of the hospital’s Rapid Response Team, coming to the aid of Nurses working with “code blue” situations when patients are failing.

We’re being called heroes during this pandemic. Restaurants randomly bring us all lunch. Others in the community have supplied us with masks and other protective gear. It’s been heartwarming. On behalf of all RCH Nurses, thank you!

As many in the community know, my colleagues and I made the difficult decision to go on strike on June 26, after giving RCH a ten-day advance notice to ensure they could hire temporary replacement staff.

Our strike is part of a long tradition of Union Nurses leading the fight for patient and Nurse safety and, unfortunately, having to battle at every step. Nearly 40 years ago, it was Union Nurses who successfully fought for and opened the first AIDS unit in the nation at San Francisco General Hospital. It was Union Nurses who pushed for needle safety laws to prevent the spread of diseases. It was Union Nurses who won safe staffing regulations for every hospital unit in California to ensure safe patient care would be possible.

And it’s that last one—ensuring that every unit has enough qualified Nurses on the floor at all times to ensure patient safety—that RCH frequently violates.

And it’s why we’re on strike.

More than a year ago, I was part of my Union’s Staffing Issues Committee, made up of Nurses at RCH. We were fed up with the chronic staffing shortages that left too few Nurses and support staff on duty to safely care for our patients. To make the hospital understand how serious this was, we took a strike vote to demonstrate our advocacy for our patients. Seeing our nearly unanimous “YES” vote, the hospital agreed to bring in a professional mediator and sat down with us to discuss our patient safety concerns.

The result was a temporary agreement that improved staffing. The agreement stipulated that the hospital would stop accepting transfers from other hospitals (to bump their revenues) if we didn’t have the necessary staff on hand. They agreed to stop asking new hire candidates if they’d be willing to accept illegal and unsafe patient loads during their job interviews. They agreed to ensure there was enough staff on hand to safely care for patients while a Nurse was on a meal or rest break.  They agreed to maintain sufficient support staff throughout the hospital to help us provide the best care to our patients.

These changes were long overdue. Nurses were very relieved when the hospital extended the period of this temporary agreement several times. The most recent extension expired on May 31, 2020—smack in the middle of this pandemic. We initially proposed to extend the agreement for a three-month period, and our hospital refused.  We then went through the mediation process again, and the hospital refused to accept a renewed staffing agreement with minor improvements related to regulatory language. With COVID-19, we need a commitment to safe staffing now more than ever. We even continued reaching out to the hospital after they rejected our proposals through the mediation process.

But the hospital ended the mediation process, refused to extend the original agreement and refused to accept a proposal we made after mediation ended. Days after the original agreement expired, Nurses in the COVID-19 unit were given an increased patient load. Fewer than 14 days after the agreement expired, Nurses in three different units reported having nurse-to-patient ratios in violation of legal regulations.

It’s not that RCH doesn’t have enough staff to adequately cover shifts. They simply took nurses and support staff off the schedule. It’s not that they don’t have the funds. They do. Their parent company, Hospital Corporation of America, is worth $68 billion. Despite the pandemic, HCA will remain profitable this year, while other hospitals are just struggling to survive. RCH alone is worth more than $1 billion. And HCA just received $5 billion in federal bailout money, $1 billion of it that they never even have to pay back.

So, they’re using that money to battle Nurses once again. They’re paying their replacement staff double what they pay us. They are also providing them with more PPE than they provided us—proving what we’ve suspected all along: that they are aggressively rationing the life-saving equipment to save money.

More than 60 of my colleagues at the hospital have tested positive for COVID-19 so far, more than at any other hospital where my Union represents Nurses. Two of my co-workers at the hospital have died of the disease.

If you’ve driven by the hospital during our strike, you might see “we need breaks” on our signs. That might not seem like a big deal if you’re not a Nurse during a pandemic, so I want to explain. It means that many of us have spent 8, 10, 12 hours without being able to remove our N95 masks—unable to take even one small sip of water, use the restroom or get some nourishment. I’ve worked as many as 25 hours straight without a break since the pandemic began.  This isn’t safe for me or my patients, but the hospital would rather increase profits by cutting staff than to invest in staff to protect us and our patients.

When we pleaded with management in our mediation, they told us to just fill out a missed break form and they’d give us “penalty pay” as required by law. We don’t want penalty pay.

We want safe staffing.

And for your sake and ours, we are willing to strike for it.