March 5, 2018 – The California Nurses Association, representing 18,000 registered nurses at 21 Kaiser Permanente medical centers and dozens of medical clinics and office buildings in California, announced today that RNs voted by an overwhelming majority to authorize their nurse negotiators to call a strike, if needed, to protest the hospital’s refusal to address eroding patient care standards that nurses warn have a direct impact on health outcomes for Kaiser’s patients. Kaiser is both the largest hospital chain and health insurer in California.
“With this vote nurses are making it absolutely clear: We are ready to strike to make sure our patients get safe care,” said Zenei Cortez, a South San Francisco Kaiser RN and co-president of CNA. “Despite enormous profits, Kaiser continues to implement cost-cutting measures, obviously intended to drive their profits even higher, at the expense of patients. We are united in defense of our patients.”
No strike date has been set at this time but should the bargaining team decide to move forward with a strike, nurses will provide Kaiser and the public ten days advance notice so that facilities can make appropriate preparations, including postponing elective procedures and making necessary patient transfers.
Nurses say fueling the potential strike is Kaiser’s refusal to support a series of RN proposals that would enhance safe staffing and general patient care standards. These proposals include hiring a charge nurse on every unit to provide much needed coordination and hands-on assistance at the bedside, and resource nurses without a full-time specific assignment who can support other RNs by providing meal and break relief, interventions with pharmacy to expedite patients receiving correct medications, and increased staffing when needed due to emergent conditions and heightened patient volume.
“We have been urging Kaiser to address staffing issues for years and the proposals we have put forth at the bargaining table, if implemented, would provide RNs with the resources we need to improve the quality of care,” said Michelle Vo, RN Kaiser Fremont. “Our first priority is our patients and if we have to strike to get Kaiser to prioritize patients over profits, we are ready.”
In addition to rejecting the RNs safe staffing proposals, Kaiser is making demands that will further undermine the staffing crisis. One of these is the demand for a major shift from the computerized system they use to assess patient acuity, which is how ill a patient is, and the appropriate level of care for their condition. Kaiser wants to discard the system they have used for many years, called GRASP, and replace it with a system called EPIC, which has proven to be riddled with problems and frequent breakdowns in the hospitals where it is used, such as those operated by Sutter Health. Under the current system, nurses are able to flag and rectify inappropriate and unsafe assessments and orders. The EPIC system is less transparent, with algorithms designed to enhance Kaiser’s finances, at the expense of patient care, say nurses.
With rising premiums and membership levels and a $3.8 billion profit in 2017, Kaiser can and must act to reverse the growing erosion in care conditions at their facilities by enacting these proposals say nurses.
“Our patients depend on us to fight for the standards that will keep them safe and help them heal. As nurses we are committed to winning the resources and improvements that make that possible,” said Diane McClure, RN, Kaiser South Sacramento. “If Kaiser really cares about patients, it will stop delaying improvements and invest in the patient care proposals we have made.”
Kaiser is also demanding a huge cut in pay for new hires outside the Bay Area, 10% in the Sacramento region, and 20% in Fresno and the Central Valley. This proposal will erode recruitment of new RNs at a time when the current workforce is aging. Nurses note that since Kaiser charges enrollees the same premiums in those areas as they do in the Bay Area, the purpose of the proposed cuts must be to increase Kaiser’s already massive profits, regardless of their detrimental impact on the quality of care.
Another area of contention is Kaiser’s refusal to recognize Patient Care Coordinators as part of the CNA bargaining unit despite their democratic vote to be a part of the Kaiser CNA unit, and a directive from the National Labor Relations Board, recognizing that decision.