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Nurses Set To Strike Against New York City’s Healthcare Monopolies

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On New Year’s Eve, the New York State Nurses Association (NYSNA) announced that nearly 17,000 nurses at eight major New York hospitals planned to begin a strike January 9 if management did not meet their demands for increased staffing, fair compensation and health and safety protections.

After the strike was authorized, hospitals began making substantial wage and staffing offers, leading to three bargaining units representing about 7,000 nurses settling contracts in the past week. But nurses at five hospitals, including Montefiore Medical Center, Mount Sinai Hospital and Mount Sinai Morningside, remain on the brink of what could become one of the largest nurses’ strikes in recent years. 

“Tripledemic”

The potential strike comes at a time when nurses are overwhelmed by a “tripledemic” of Covid, flu and Respiratory Syncytial Virus Infection (RSV), but the issues animating the struggle are older, rooted in the creation of mega healthcare systems over the past decade.

A 2018 New York Times report shows that the nation’s hospitals have been consolidating at an exponential rate, forming a monopolistic healthcare system. Mergers and acquisitions put market power firmly in the hands of large hospital systems, which hike up prices knowing that insurance companies will pay to keep those facilities in their networks.

Insurers then pass the financial burden onto patients.

The Times report found that prices for an average hospital stay have gone up between 11% and 54% because of healthcare consolidation. 

From 2015 to 2019, U.S. hospitals’ net patient revenue increased by $8.6 million per year on average. By 2022, the top 25 hospitals in New York alone averaged an annual net patient revenue of close to $2 billion. These mergers have turned independent community hospitals into “nonprofit” conglomerates — “nonprofit” in their tax status, but profit-centric in every decision that counts.

“My hospital, once a humanitarian institution, now behaves like a profit-driven corporate entity,” says Judy Sheridan-Gonzalez, a past president of NYSNA and an emergency room nurse in the Bronx with 40 years of experience. Sheridan-Gonzalez’s hospital has been aggressively acquiring smaller community hospitals for years.

“It cuts staff and services to the Bronx, the county with the worst health indices in the state, investing instead in real estate and lucrative endeavors.”

Nurses are currently overwhelmed by a “tripledemic” of Covid, flu and RSV, but the issues animating the struggle are older—rooted in the creation of mega healthcare systems over the past decade.

Cost-Cutting

Per a Crain’s New York analysis, “the consolidation strategy has given rise to increasingly flush megasystems of hospitals concentrated in whiter, wealthier areas of the city. During the past 25 years, 20 hospitals have closed across the city, amounting to a loss of about 5,800 beds.”

In addition to wholesale hospital closures in poor neighborhoods, hospital managers’ newfound emphasis on increasing profits has led to other cost-cutting measures such as hiring fewer staff nurses and not buying sufficient personal protective equipment (PPE). Those decisions have created unsafe working conditions and extreme burnout. The pandemic exacerbated these issues, and even though many hospitals received Covid relief funding, this did not translate into sufficient PPE, better staffing or improved working conditions. 

Instead, the effects of a monopoly health system have continued: high executive salaries and segregated units where VIPs get concierge services and specialty care,while the majority of wards are understaffed.

Managers within the conglomerated health system also began to use rising profits to fuel more acquisitions, leading to a cycle of hospitals serving the rich at the expense of local communities which had relied on them.

Overflowing ERs

In New York hospitals, these profit-maximizing practices have left Intensive Care Units (ICUs) unequipped to handle the winter surge of patients, especially children, suffering from various repository illness at record levels.

In a statement put out by the NYSNA, Aretha Morgan, a pediatric emergency room nurse at New York-Presbyterian, said: “Our pediatric ER is overflowing and short-staffed on almost all shifts. It is unbearable to see children suffer because we don’t have enough staff to provide safe patient care.” 

Nurses have been fighting back. In 2021, the New York state legislature passed and the governor signed a NYSNA-initiated hospital staffing bill mandating a limit of two ICU patients per nurse and requiring hospital management to negotiate such limits with a committee of nurses for all units of the hospital.

The legislation, which was the result of decades of nurses’ organizing, represented a significant win for the NYSNA, but its implementation has been delayed thanks to successful lobbying by New York City’s hospital conglomerates.

The one-to-two ICU ratio was supposed to have been enforced by the state health department in January 2022, but a year after that deadline, staffing levels continue to be set by budget rather than by patient need — an issue which in part motivated the nurses’ strike vote.

Nurses routinely provide care to three and sometimes four critically ill patients in the ICU, when the standard is at most two. Given the severity of illness, it should often be one-to-one.

Strike for Better Standards

The impending strike is a challenge to the business model of hospital conglomeration. If they cannot undo the mergers, the nurses can at least re-establish community health and professional safety standards.

Jessica Montanaro, a nurse in Mount Sinai Morningside’s intensive care unit, told New York Focus that chronic understaffing was causing burnout among nursing staff, leading to many nurses leaving to pursue less stressful forms of nursing. She said those nurses have not been replaced, leading to a further staffing shortage.

“We’re kind of standing up as a profession and we’re saying, ‘Look, we’re not OK. We don’t have the support. We’re in these untenable ratios. It’s not safe for our mental or physical health or the patient’s safety,’ ” Montanaro said. “And yet it’s not being heeded for whatever reason.”

Decades of legislative activism and multiple rounds of contract bargaining have yet to create a safe hospital environment for nurses and patients, leaving NYSNA nurses with no alternative but to strike. In addition to safe staffing levels, nurses are demanding fair wages, no cuts to their health coverage, and health and safety protections in light of the tripledemic of Covid, RSV and flu. They also want community benefits, such as funding programs to recruit and train nurses from within the communities they serve.

Sheridan-Gonzalez summed up the process and the stakes, saying, “We testified about the brutal inequities that were exacerbated before, during and after the worst of the Covid pandemic … but no one listened. We now take the drastic step to go out on strike so that maybe, finally, someone will hear us.” 

Better Business Model

The NYSNA nurses’ impending strike is a challenge to the business model of hospital consolidations and to the elimination of community-based healthcare services. The need for nursing care is why patients go into a hospital. Nurses can use that power on behalf of communities abandoned and disregarded by the hospital monopolies.

If they cannot undo the mergers, the nurses can at least re-establish community health and professional safety standards.

To demand and win safe staffing and patient care practices is a vital community benefit. And as potential patients, we all have a stake in their struggle. 

This blog originally appeared at In These Times on January 6, 2023. Republished with permission.

About the Author: Michael Lighty is a Sanders Institute Fellow and DSA activist and a consultant for the National Union of Healthcare Workers.


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How the Pandemic Changed U.S. Labor Organizing

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The story of essential workers during the pandemic is part of the long unraveling of the New Deal. The destruction of the welfare state, the attack on unions, and the rise of neoliberalism provide the historical backdrop for the pandemic labor unrest.

As workers’ fortunes came under renewed attack in the early 1970s, the historic gains of the New Deal were rolled back decades. Inequality became the defining feature of our economy as we arrived at a second Gilded Age. This was more than unfair — during the pandemic it had deadly consequences. A 2020 study found that in over 3,000 U.S. counties, income inequality was associated with more cases and more deaths by the virus.

In the immediate aftermath of the Great Recession of 2007 – 2009, the unemployment rate remained stubbornly high long after the crisis had been declared officially over. The solution to lagging employment growth was an explosion of low-wage service jobs.

It was this new servant class of gig workers, low-wage healthcare workers, fast-food employees, maids, delivery drivers, and retail clerks who endured the most intense economic hardship during the Covid pandemic recession. They were deemed essential and worked through the pandemic, or they lost their jobs. Without this longer time frame for context, essential workers appear to be merely the product of the pandemic rather than the outcome of decades of political and economic shifts.

By April 2020, about a third of U.S. workers were designated as “essential” or “frontline” workers, tasked with laboring in person through the pandemic.

Who was considered essential or not often seemed capricious. Employers carved out niches for themselves as essential, forcing their employees into dangerous workplaces, even though they served no public benefit. Walmart designated its store greeters as essential, putting countless workers at unnecessary risk. The state of Montana designated elite fly-fishing guides as essential.

Kirk Gibbs, an electrician from Syracuse, New York, summarized his status as an essential worker like this: “I’m essential to the pocketbooks of rich contractors and essential for spreading the virus, but that’s about it.”

Across the world the designations varied even more. In fact, it wasn’t always clear what essential workers were essential for. Economic stability? Corporate wealth accumulation? Public health? Social reproduction? To ensure a pleasant experience for retail shoppers?

This mattered beyond public recognition. Because workers did not have a straightforward relationship to being classified as essential or not, their ability to collectively organize as such when necessary was inhibited.

Still, workers used the rhetorical power of their designation as “essential” to highlight their mistreatment and exploitation. In some cases, workers forced their managers, bosses, and corporate boards to provide lifesaving safety protocols, more paid sick days, raises, and better healthcare and other benefits.

Were it not for workers blowing the whistle, we might never have known the hazards they faced or gotten the kinds of improvements that saved lives. In addition to these much-needed tangible gains for an eclectic class of workers, pandemic-era activism shifted the national conversation about worker justice in ways the previous decade failed to do.

This blog originally appeared in full at In These Times on November 22, 2022. Republished with permission.

About the Author: Jamie McCallum is a professor of sociology at Middlebury College and the author of Worked Over: How Round-the-Clock Work Is Killing the American Dream.


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Monkeypox Is a Workers’ Rights Issue

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As of early last week, over 11,000 cases of monkeypox have been reported in the United States, according to the Centers for Disease Control and Prevention (CDC). The virus that causes the disease, which many cities and towns have now declared a public health emergency, spreads through close personal contact. In certain cases it can reportedly also transmit through contact with surfaces infected people have touched. 

While there are still many unanswered questions regarding monkeypox, some troubling dynamics are already coming into clear view: The recommended quarantine period for those infected is far longer than that of Covid-19 cases. This means those who contract the virus will either have to take substantial time off the job — often not a viable option for those without paid sick leave — or risk going to work while infected.

The virus has been found to disproportionately impact members of the LBGTQ community, who are also disproportionately likely to be poor or working-class. The muddled rollout of the monkeypox vaccine has already created logjams in access, and, as a result, it appears poorer Americans are more likely to be unvaccinated, increasing the hazards to their health. 

Covid Set an Example

During the Covid-19 pandemic, the risks to workers from rapidly spreading communicable diseases became painfully obvious. In addition to contracting and dying from the virus at higher rates than the rest of the population, low-wage workers without union protections also often experienced employment consequences. Some reported that they were forced to work with active Covid infections, while others were fired for taking leave or expressing concern about Covid precautions.

If workers do contract monkeypox, according to CDC recommendations, they may need to isolate for as long as four weeks while waiting for rashes that result from the disease to resolve. But the reality is that many workers will not be able to take that time off of work. Only 56 percent of workers are eligible for Family and Medical Leave Act (FMLA) protections — and these do not require paid leave.

“If employers throughout the country were required, as a matter of law, to provide paid leave to every worker who contracts Covid, I believe we would have seen more of an emphasis on protecting workers by preventing transmission in the workplace,” Matthew Cortland, a senior fellow at Data for Progress, told In These Times.

In March 2020, Congress passed paid leave under the Families First Coronavirus Response Act. However, it expired in December of that year, and was not universal. Many Democrats also advocated national paid leave in their campaigns, but have so far been unable to enact the policy. Congress could pass similar temporary leave legislation, or it could commit to investing in long-term paid leave — a policy originally included in the Build Back Better package but excluded from the Inflation Reduction Act which was signed by President Biden on Tuesday. 

In response to these developments, some states have proactively developed their own paid leave programs. And unions have pushed for them in contract negotiations as well. ?“A workforce that is constantly being reinfected with coronavirus, because of a lack of workplace mitigation measures, including, importantly, paid leave, is an unpredictable and unreliable workforce,” said Cortland.

The Issue of At-Will Employment

But paid leave isn’t the only problem. ?“The background rule of employment-at-will means that, even where these protections exist, workers feel vulnerable,” said Kate E. Andrias, Professor of Law at Columbia Law School. Andrias is a coauthor of a 2021 report on just cause reform.

At-will employment, where workers can be fired for any reason so long as it doesn’t break the law, drives extreme precarity, especially for low-wage workers. This is because the risks of requesting time off for illness, complaining about working conditions, or reporting employers for wage, hour and safety violations are much higher. And, while labor organizing is a protected activity, employers can still develop pretexts for firing workers. Recent examples include Starbucks closing stores that were in the process of unionizing over ?“safety reasons,” and Amazon firing union organizer Chris Smalls after he spoke out about safety on the job.

Unionized workers, however, generally enjoy the protections of just cause in their collective bargaining agreements. Under just cause, employers must document and demonstrate reasons for employment termination, and workers have access to protections throughout the process, including a union representative in any disciplinary meetings. Just cause offers greater cover to workers who want to advocate in the workplace, while collective bargaining agreements offer other critical protections and benefits, often including paid leave. 

The bubbling outbreak of monkeypox illustrates that both paid leave and just cause are public health issues for workers and the people they interact with. And, as with Covid-19, the risks are higher for some workers than others. ?“Being immunocompromised and working in a public facing role that requires interaction with fomites, for example, in food service, is not sufficient to qualify for vaccination against monkeypox,” said Cortland.

Minorities’ Jobs and Health are at Risk

Disability and health status are not the sole risk factors. Members of the LGBTQ community, who are more likely overall to work in low-wage jobs, are at greater risk of contracting monkeypox — especially gay men, who have been prioritized for vaccines in some cities due to high numbers of cases in their communities. For those who cannot get vaccinated, though, going to work can become extremely stressful and potentially dangerous, even more so when employers don’t provide paid leave. 

Gay or straight, disabled or not, without just cause protections and paid leave, those workers may not feel comfortable speaking out — and may not be able to take time off if they get sick. Other workers could then contract the virus and take it home to vulnerable family members and communities. 

In the short term, unions can help secure key protections for workers facing isolation after infection or exposure, including building just cause and paid leave into the bargaining process. And right now, economic conditions are ripe for more organizing. ?“Low unemployment rates give workers more bargaining power,” said Andrias. ?“The best way for workers to increase their bargaining power is to organize with their coworkers and form unions.” 

The high cost of Covid-19 to human health and society at large shows that all workers need protections including paid leave and just cause to ensure they are able to stay safe, just like their white-collar, desk-bound colleagues did for nearly two years. 

As the federal government struggles to respond to monkeypox, Cortland said, ?“workers have largely been abandoned. Even when infectious, many are forced to go into work, further degrading their health and imminently endangering others.”

This blog was originally posted to In These Times on August 16, 2022. Reposted with permission.

About the Author: S. E. Smith is an essayist, journalist, and activist is on social issues, with credits in publications like The Guardian, Nerve, and VICE. 


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Nurses in the U.S. Are Suffering “Moral Injury”

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Kari Lydersen

Minnesota emergency room nurse Cliff Willmeng remembers, during the early days of the pandemic, treating a patient at United Hospital who asked how the nurses were doing. The man was a Vietnam veteran, and Willmeng recalls that he said, “This is your war.”

“I kind of laughed, like what do you mean by that?” said Willmeng, who recalled he didn’t grasp at the time how horrible the pandemic would become. “He said, ‘We dealt with this in Vietnam. You don’t know it yet but none of you are ever going to be the same again.’”

More than two years later, Willmeng, like countless other nurses and frontline workers nationwide, knows all too well how true those words turned out to be. 

“The combination of the lethality of the virus and the seemingly total abandonment of collaboration from the management I was under produced anxiety and fear in me I had never felt, never,” said Willmeng, who had worked in emergency rooms and a trauma intensive care unit in Colorado and Chicago. “I was watching nurses sign their advance directives right there at the nursing station, preparing to be intubated and die. It was terrifying.”

In recent years, academics and frontline workers have used the terms “moral injury” and “moral distress” to describe the debilitating combination of anxiety, fear, guilt, shame, anger and betrayal that results when workers like nurses are thrust into life-or-death situations without the resources and support structures to carry out the mission they’ve committed to. 

The term “moral injury” was coined by former U.S. Department of Veteran Affairs psychiatrist Jon­athan Shay based on his work with Vietnam veterans, as explained in a December 2020 white paper by the National Nurses United (NNU) union. Moral injury involves the “deleteri­ous long-term, emotional, psychological, behavioral, spiritual, and/or social effects” of “perpetrating or failing to prevent acts that trans­gress deeply held moral beliefs and expectations in a high-stakes environment,” the paper notes. 

Nurses describe deep parallels between the experiences of veterans who are thrust into horrifying conflicts, left to fend for themselves and forced to make painful choices by corrupt or absent leadership—then blamed or punished for their actions.

Academic studies explain that moral injury is closely related to post-traumatic stress disorder, and can be a significant factor in veterans, emergency workers and others developing PTSD, as a number of studies have shown. It is not listed in the Diagnostic and Statical Manual related to mental illness, and moral injury is not considered to be a mental illness or to directly cause mental illness. This is in part because there is some ambiguity in defining exactly what moral injury entails, as it involves philosophical, social and ethical, as well as psychological, questions, which an article the British Journal of Psychiatry and other journals have explained. 

That journal notes that relatively few studies have been done on moral injury, yet it is recognized by many as a serious issue that goes beyond the ethical dilemmas that most people face. With many ethical dilemmas, the journal notes, people have the power to make a choice. “In moral injury, individuals commonly feel at the mercy of events, constrained by an overarching strategy or hierarchical rules that govern their actions. For some, it may erode their sense of meaning and place in the world,” says the 2020 journal article, by Edgar Jones. 

In military situations, an individual can experience moral injury when they are forced to harm civilians or take unjustified military actions, and the emotional and mental impacts are worsened in situations like the Vietnam War, where veterans face blame and hostility from the general public, or situations like the Iraq War, where the general public is largely unaware of what the veterans have been through, studies note. Nurses report a dynamic that has some parallels: They don’t have the resources to serve their patients well, but hospital administrators blame them for failings or don’t acknowledge the extreme conditions they are working under. And where patients often treat them with hostility or even violence. 

During the pandemic, experiences causing moral injury ranged from having to choose which patients got ventilators, to not being able to check in on Covid-19 patients regularly in order to minimize risk of transmission.

Elizabeth Lalasz, a registered nurse and NNU steward at Chicago’s public hospital, explains that the burn-out, depression, stress and anxiety that nurses face has typically been framed as an individual experience, rather than a systemic injustice caused by a broken healthcare system driven by the bottom line.

In 2021, the United States ranked last among high-wealth countries in the quality of its healthcare system, despite spending the highest amount of these countries on healthcare. Countries with much better healthcare systems provide universal coverage so that finances don’t prevent people from accessing healthcare, and money was not wasted on administrative burdens or siphoned off to insurance companies and massive profit for private healthcare companies. 

Lalasz noted that the pandemic just exacerbated and laid bare longstanding problems with the healthcare system, including lack of access for poor people, and private—and cash-strapped public—healthcare systems trying to save money or maximize profit by not investing adequately in staffing and resources. 

“We do this with the intention of trying to help and save lives,” said Lalasz, who worked three stints in Covid-19 wards and contracted the disease herself, missing 18 days of work. “If you’re not able to have what you need to be able to do that, it’s systemic. All these things existed prior to the Covid-19 pandemic, but that really brought it to a head.”

She said nurses like herself who contracted Covid-19 felt management was “minimizing” their experiences and their concerns, and “gaslighting” them into thinking they just had to toughen up. 

“There needs to be an acknowledgement that there is a systemic problem with the way the healthcare system is run in this country,” Lalasz said. “This was something that happened called a worldwide pandemic. It’s not my fault that it happened—it’s capitalism’s fault.” 

During the pandemic, healthcare workers faced guilt and anxiety about bringing Covid-19 home to their families, on top of the trauma of being unable to adequately care for patients and fearing for their own lives. Meanwhile, workers had to fight and fundraise just to get the basic PPE that could help protect them and their patients and communities—a recipe for moral injury. 

“We had managers telling us it wasn’t an airborne disease,” Willmeng remembers. “We’re doing the math on it: If I get it, maybe I’ll be ok, maybe I’ll die. Either way, I could also give it to my patients or my wife or my son or my next door neighbor or that nice woman at the grocery store.” 

As the pandemic has evolved and become slightly less of an acute crisis, the behavior of healthcare institution management has accelerated a nursing shortage that has become its own crisis. Hundreds of thousands of healthcare workers have retired or otherwise left the profession during the pandemic. Meanwhile, thousands of nurses have left staff jobs—often unionized—to work as gig-worker “travel nurses” earning much higher hourly pay but without collective bargaining rights or job security. 

A recent report by McKinsey & Company estimates the United States could face a nursing shortage of 200,000 to 450,000 available nurses—10% to 20% fewer than needed by 2025. A November 2021 industry study found that 90% of nurses surveyed are considering leaving the profession, citing burnout, staff shortages and unmanageable workloads as key reasons. 

The nursing shortage makes conditions more stressful and dangerous for those who stay in the profession, creating an intense negative feedback loop rife with the potential for continued moral injury. 

This cycle is also exacerbated when nurses leave unionized staff jobs to become traveling nurses with much higher pay but no job security, collective organizing rights or sense of permanency with their patients and community. In keeping with the cycle of blame and guilt typical of moral injury, traveling nurses have been criticized for taking high pay and abandoning their staff posts, when the underlying problem is hospitals’ failure to create physically and morally sustainable staff jobs. 

“There’s not a shortage of nurses,” said Lalasz. “There’s a shortage of nurses who want to work under these conditions.” She argued that the system takes advantage of the workforce made up largely of women, disproportionately women of color, assuming they will be willing to do the work without adequate protection or compensation. “It’s like, ‘You’re caring, you’ll do this.’ We’re done with that. That’s why people have gone [into] traveling [jobs]. The working conditions are so bad, the staffing is so horrendous, you’re not respecting us, so we’re done.” 

Especially at a “safety net” hospital like Chicago’s John H. Stroger, Jr. Hospital of Cook County where Lalasz works, Lalasz notes, it’s important to have staff nurses who understand the needs and deep vulnerability of their patients—like the people incarcerated in the county jail whom she treated early in the pandemic. 

Ironically, the shift to travel nursing undermines the very organized labor system that is more necessary than ever in a time of crisis. Organizers stress that they want to identify and explain the concept of moral injury so that healthcare workers channel their trauma into organizing rather than turning inward or dropping out. The NNU white paper cites trauma experts saying that:

Those who expe­rience moral injury as a perpetrator of an immoral act or from failing to prevent an immoral act typically respond with internalizing emotions such as guilt and shame, whereas those who experience moral injury as a witness who was unable to prevent an immoral act typically respond with externalizing emotions such as anger and resentment. It is crucial that those involved ascribe the blame to the responsible actor(s) and not inappropriately take responsibility for failing to prevent a transgression, if that was not in their power. Anger and resentment are more likely to lead to the collective action necessary to redress transgressions by authoritative leaders or institutions while emotions such as shame and guilt may lead to withdrawal.

Willmeng is disappointed that healthcare unions didn’t do more to assert their rights and demand changes from the industry during the height of the pandemic. As NNU and other healthcare unions have reiterated, higher levels of unionization and a meaningful role for healthcare workers in making decisions about resource allocation and strategy would go a long way to providing better healthcare for patients and making the profession tolerable for workers. Ultimately, NNU and countless individual healthcare workers and leaders say that universal healthcare would vastly improve patient care, allowing access for people regardless of income and eliminating the profit motive that causes private hospitals and insurance companies to ration care and skimp on resources. A recent study published in the journal Proceedings of the National Academy of Sciences found that universal healthcare would have meant 338,000 fewer people dying of Covid-19. 

Willmeng feels that now unions are better marshaling their forces, with Minnesota nurses threatening a statewide strike as multiple contracts for 15,000 nurses are in negotiations. In early June, nurses picketed at 11 Twin Cities-area hospitals, highlighting stratospheric executive pay even as nurses struggle with debilitating understaffing and Republican legislators killed a bill that would involve nurses in staffing plans and provide loan forgiveness for hospital nurses. 

“U.S. capitalism is calling you essential, and you parlay that into what we failed to rise to a major historical event—we’re trying to put the pieces back together again now,” said Willmeng, who started his current emergency room job hours after the union contract expired. He was fired by a different hospital during the pandemic for wearing hospital-issued scrubs, rather than his own, since he didn’t want the extra contagion risk of bringing scrubs home. He was later reinstated and settled a wrongful termination lawsuit. 

In late June, Chicago hosted the Labor Notes international convention of union members and activists, a gathering of progressive rank-and-file union members and leaders and labor activists from the United States and other countries. Much attention was focused on the need for mental healthcare for frontline workers. 

Elizabeth White, a therapist in Kaiser Permanente’s California system that serves many public union members, described the difficulty of getting crucial mental health appointments for her clients—and the toll that takes on therapists themselves. 

“You’re basically always playing a game of Twister, twisting things to try to make it work for people,” she said. “We want to do the right thing for our patients, and the employers take our good intentions and exploit that. That’s the moral injustice.” 

During one Labor Notes session, nurses and other healthcare workers packed a large ballroom to speak out about their experiences, frequently mentioning moral injury and sharing their tactics for survival and organizing. 

“Nurses who have been through the meat grinder of Covid are now having their benefits taken away, feeling like no one cares if we live or die,” said registered nurse and Michigan Nurses Association former interim president Anne Jackson, after the session. “We’re not able to give the care we used to give, and we’re ashamed, and yet hospitals are making record profits.”

Marty Harrison is a staff registered nurse at Temple University’s hospital in Philadelphia, serving among the country’s poorest zip codes, where patients typically have multiple underlying conditions and complex problems. 

“I feel like I’ve done something evil because I didn’t have the capacity to take care of this person,” she said. “That went from being due to the pandemic to being due to the staffing crisis. The employer doesn’t appreciate the degree to which doing a good job is essential to us. No matter how much money I make, I’m not happy if I can’t take care of my patients. We can’t communicate that to them, because they don’t feel that way about their jobs.” 

She and others said that the hemorrhaging of staff nurses has obliterated the mentoring and organizing networks that used to exist for young nurses. “They’re not letting new nurses even know what quality care would be,” she said.

New nurses often leave the field or move to traveling jobs quickly, she and others said, overwhelmed by the lack of support and depth of dysfunction. While healthcare workers at Labor Notes said they understand that reaction, they hope their colleagues will turn their feelings of moral injury and distress into organizing. 

“What I do is fight back,” said Harrison. “For me that’s an essential mechanism.” 

This blog is printed with permission.

About the Author: Author’s name is Kari Lydersen. Kari is a Chicago-based reporter, author and journalism instructor, leading the Social Justice & Investigative specialization in the graduate program at Northwestern University. She is the author of Mayor 1%: Rahm Emanuel and the Rise of Chicago’s 99%.


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Top 6 Workplace Issues Facing Remote and Hybrid Workers

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Dan Matthews, Author

The world of work has changed dramatically in recent years, and the pandemic only accelerated a shift that was already well underway. Today, millions of Americans find themselves working remotely at least some of the time.

Remote and hybrid work models offer many benefits to employees. Parents and caregivers may not need to worry about finding or funding elder care or childcare. Staff doesn’t have to incur the food and fuel costs of working in the physical office. Employers enjoy reduced overhead and a truly globalized talent pool.

For all its advantages, however, there are several issues of which remote and hybrid workers should be aware.

The Risk of Loneliness, Isolation, and Burnout

Despite the convenience of remote work, there can be a psychological toll. Employees may feel lonely and isolated when working from home because they don’t have the level of personal interaction with their colleagues to which they may have grown accustomed.

In addition, employees are likely to experience higher levels of stress and a greater risk of remote burnout because, ultimately, when you work from home, you never really get to leave your office. 

This means that remote and hybrid workers must prioritize self-care, including establishing firm boundaries around their work hours. Remote workers must commit to turning off their phones and computers and disconnecting from work when they’re officially off the clock.

At the same time, it’s also imperative for those who work from home to enjoy frequent social activities with colleagues, whether through a weekly online game night or a bi-monthly dinner out. Employers should support employees’ mental health by offering up social activities. However, you may need to take the initiative to increase your socialization time.

Digital Privacy

Digital privacy is a concern for any business, but it’s particularly important for employees who are working from home. Cyberthreats, from phishing scams to malware attacks, are a constant threat. Employees may also be concerned with the amount of access their employer has to track remote-work activity. Employees need support in ensuring the security of their systems and personal information when working from home.

For this reason, employers should equip work-from-home staff with the systems they need to protect their own data and that of the company, including VPNs, antivirus software, password-protected routers, and firewalls. You may also want to use a webcam cover to prevent camera hacks. Also, make sure you have a solid understanding of how your employer intends to track your work-related behavior.

Communication and Collaboration

Another significant issue remote workers can face is problems with communication and collaboration. Your staff can’t just walk to the next cubicle or knock on the manager’s door to ask a question or get a status update. 

This can lead to significant delays in workflow if the employee has to jump on the phone to try to reach the person they need to speak to or track down the document they need to complete a project. In addition, without a clear plan for ensuring that all employees are up-to-date on project statuses, home-based workers may find themselves doing redundant work or using outdated processes. 

For this reason, remote workers must have the tools they need to remain in constant communication with their colleagues. This might include internal instant messaging platforms, such as Slack; project management tools, such as Asana; and document sharing tools, such as Google Docs. It’s also helpful to use visual aids, such as a flowchart, to help overcome problems associated with communication and collaboration in remote and hybrid environments. Regardless of what tool you choose, everyone in the company should have frequent, unrestricted access.

Difficulty Unionizing

When you’re working from home, you can feel like you’re on your own. That can make it hard to navigate workplace challenges, particularly when it comes to the need for collective action. The good news, though, is that momentum for the capacity of remote workers to unionize appears to be growing. The bad news, however, is that traditional ways of organizing are often inaccessible to remote workers, placing the onus on employees and unions to discover innovative strategies for integrating work-from-home employees.

Restlessness, Distraction, and Lack of Focus

Working from home is often a lot different than working in an office. This is especially true if you have children or pets at home. Many remote workers report feeling restless, distracted, and unfocused when trying to work remotely. It’s possible to overcome the challenges of remote-work distractions, however.

Try creating a designated work space — ideally a room with a door you can close during your work hours. You will also need to establish clear guidelines for family and friends as to when you will be working and unavailable for personal time.

Tech Issues

Some remote or hybrid workers may feel anxious about being able to use work-from-home technology effectively. For instance, newly remote workers may find themselves needing to install and use more advanced systems than they’ve ever deployed in their homes, from printers and copiers to routers and VPNs.

Employers are obligated to help set their remote workers up for success not only by providing them with the tools they need to do their work effectively but by providing them with the training and support they need to install and use them.

The Takeaway

Remote and hybrid work models can be ideal, particularly for employees who are also caregivers, have medical conditions, or live in remote areas. However, those who are working from home often face an array of challenges they may not have anticipated. Workers and employers alike must take a proactive stance toward understanding and remediating these issues to support employee performance and well-being.

This blog is printed with permission.

About the Author: Dan Matthews is a writer, content consultant, and conservationist. While Dan writes on a variety of topics, he loves to focus on the topics that look inward on mankind that help to make the surrounding world a better place to reside.


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How America Can Stop Violence Against Health Care Workers

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The young man in Cleveland Clinic Akron General’s behavioral crisis intervention unit hadn’t communicated much during his hospitalization, but he showed no signs of violence until Brian Eckley tried to draw his blood early one morning.

The patient stood up, sat back down, rose again and then punched Eckley, a state-tested nurse aide and senior technician, in the left jaw.

Keeping his cool despite the pain, Eckley dodged more punches as he held the needle and tourniquet out of the patient’s reach, banged on the treatment room windows and called for help.

Legislation is Pending

Attacks on health care workers have reached epidemic levels across the country, exacerbating turnover, turning caregivers into patients and further fraying systems of care already worn thin by COVID-19. The Workplace Violence Prevention for Health Care and Social Service Workers Act, twice passed by the House and just reintroduced in the Senate, would require employers to implement the safeguards needed to help keep Eckley and millions of his peers safe on the job.

The legislation—supported by numerous labor unionstrade groups and other stakeholders—would direct the U.S. Occupational Safety and Health Administration (OSHA) to develop a standard requiring health care providers to implement safety plans for clinics, hospitals, nursing homes, rehabilitation centers and other treatment facilities.

The bill calls for facilities to consider measures such as alarm systems, physical barriers and strategic staffing, including having workers in hazardous situations operate in teams. To ensure the plans are as comprehensive and effective as possible, facilities would have to devise them with the input of workers on the front lines and address the specific hazards in each work area or unit.

“Having a safety officer on the unit 24/7 would be a wonderful first step,” observed Eckley, a member of United Steelworkers (USW) Local 1014L, who had calmed down his combative patient by the time a security guard in another part of the hospital complex arrived at the behavioral health unit.

“They just don’t have what we need to do the job safely,” he said of health care employers around the country. “They do the bare minimum, and it’s more reactive than proactive.”

Even before COVID-19, health care workers faced five times more violence on the job than their counterparts in most other professions. Incidents skyrocketed during the pandemic. The crisis exacted a heavy toll on Americans’ emotional health and patients, relatives and community members grew frustrated with staffing shortages at medical facilities.

Violence Against Workers is Increasing

The violence is now so pervasive that many health care workers are victimized over and over again.

Eckley, for example, has been punched repeatedly, stabbed with a pen, and bitten by an HIV-positive patient who disliked the meal he was served. He’s also witnessed numerous attacks on coworkers and once watched a patient batter a door to get to a jar of candy on the other side.

“This is absolutely unacceptable,” Wisconsin Senator Tammy Baldwin, the legislation’s chief sponsor in the Senate, said of the surging number of assaults. “We know we need to do more to protect these workers.”

Under the legislation, employers would not only have to implement safety plans but also train workers to report assaults, conduct real investigations when incidents occur, keep records of injuries and ensure workers get immediate treatment when harmed.

Right now, as Jackie Anklam, president of USW Local 9899, knows all too well, many facilities across the country minimize incidents, dismiss assaults as part of the job, or try to pin the blame on the victims.

Anklam recalled getting a frantic phone call late one night from an emergency department technician at Ascension St. Mary’s Hospital in Saginaw, Michigan. The technician was pushed and threatened by about 20 highly emotional family members who gathered at the facility after a loved one arrived there with a fatal gunshot wound.

The victim’s relatives somehow managed to enter a locked treatment area off the waiting room, and Anklam said the technician was roughed up while following a doctor’s orders to usher them out. Anklam said she expected a robust investigation given the family members’ dangerous breach of a secure area.

Instead, she said, “we reported it, and their investigation was, ‘they don’t know who pushed the button and let them in.’ I think it was downplayed and swept under the rug.”

Action is being Delayed

Amid tireless advocacy by health care workers and their unions, the Democratic-controlled House first passed the violence prevention bill in 2019. But the Senate, then controlled by Republicans, refused even to bring it to a vote.

Under the leadership of Connecticut Representative Joe Courtney, the House passed it again last year with bipartisan support. Now, it’s more crucial than ever that the Senate swiftly take up the bill and pass it.

Some states have attempted to address the crisis by considering or passing laws imposing stiffer penalties on people who assault health care workers. But Eckley and his coworkers know it’s even more essential to prevent violence in the first place.

“As time goes on, it will grow,” Eckley warned, noting attacks are becoming not only more numerous but also more brutal. “The severity seems to keep going up. It doesn’t go down.”

This is blog was originally produced by the Independent Media Institute. Reprinted with permission.

About the author: Tom Conway is the international president of the United Steelworkers Union (USW).

Visit our page on Workplace Fairness to learn more about workplace safety.


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Unionized nursing homes were safer in the pandemic, this week in the war on workers

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Laura Clawson

Unions have increasingly bargained for the common good in recent years, as when teachers negotiate lower class sizes and more school nurses or counselors, or nurses negotiate for improved staffing ratios so they can give every patient the attention they deserve.

Union opponents often try to claim that these are really self-interested measures that only benefit workers (as though there’s anything wrong with benefiting workers), not also students and patients. These are of course the same people who always come up with excuses for how larger classes and more patients per nurse are reasonable, as they are hostile not just to workers but to investments in the public good.

All of which is to set up why this study of resident mortality and worker infection rates in union versus nonunion nursing homes in 2020-2021 is interesting and important.

As the study, by Adam Dean, Jamie McCallum, Simeon Kimmel, and Atheendar Venkataramani notes, “nursing home residents have accounted for roughly one of every six COVID-19 deaths in the United States,” making nursing homes a major site of mortality.

So, how did union and nonunion nursing homes compare? After a lot of data and statistics, “we found that unions were associated with 10.8 percent lower resident COVID-19 mortality rates, as well as 6.8 percent lower worker COVID-19 infection rate.”

Imagine if 1 in 10 of the nursing home residents who died of COVID-19 … hadn’t.

Laura Clawson

This blog originally appeared at Daily Kos on May 14, 2022. Reprinted with permission.

About the author: Laura Clawson has been a Daily Kos contributing editor since December 2006. Full-time staff since 2011, currently assistant managing editor. 


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Biden’s vaccine-or-test mandate to go before Cincinnati-based federal court

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The mandate will be tested before a court with a majority of Republican appointees.

The legal fight over the Biden administration’s vaccine-or-test mandate will be heard before the 6th Circuit Court of Appeals, after a lottery conducted Tuesday by an obscure federal judicial panel.

Nearly three dozen lawsuits have been filed in multiple federal appeals courts against the requirement, triggering the lottery to consolidate the cases before one court.

The rule, released by the federal Occupational Safety and Health Administration on Nov. 5, requires private businesses with more than 100 employees to ensure that their workers are vaccinated or tested weekly for Covid-19, starting Jan. 4.

The lawsuits — brought by several Republican-controlled states, private businesses and religious groups — argue that the rule exceeds the Labor Department’s authority and Congress’ ability to delegate to federal agencies, as well as the First Amendment, the Constitution’s Commerce clause, and laws protecting religious freedom, among other legal arguments.

The Judicial Panel on Multidistrict Litigation selected the 6th circuit as part of a random selection where each court’s name was entered into a drum.

The New Orleans-based 5th Circuit Court of Appeals issued a stay against the requirement earlier this month, and further instructed the Biden administration to “take no steps to implement or enforce” it, finding that the states and businesses challenging the rule “show a great likelihood of success on the merits.”

The Biden administration will now issue its response to that order in the 6th Circuit. The Cincinnati-based court has 16 judges: 11 appointed by Republican presidents and five by Democratic presidents. Six of the judges were appointed by former President Donald Trump.

However, the three-judge circuit panel that will hear the arguments is unlikely to be the final arbiter, since the losing side can request a rehearing before all the judges in that circuit and request Supreme Court review.

While it’s unclear what specific judges on the panel will hear the consolidated challenge, notably, three judges on the 6th circuit struck down a court order late last year that would have allowed Kentucky religious and private schools to reopen for in-person education amid a surge in coronavirus cases.

The First Liberty Institute, a Texas-based group that takes up court battles on behalf of Christian issues, represented one of the parties in that Kentucky school case and also filed one of the challenges against the OSHA vaccine-or-test rule in the 5th Circuit.

Josh Gerstein contributed to this report.

This blgo originally appeared at Politico on November 16, 2021. Reprinted with permission.

About the Author: Rebecca Rainey is an employment and immigration reporter with POLITICO Pro and the author of the Morning Shift newsletter.


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Biden vaccine mandates will hit after holiday season, offering relief to businesses

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The announcement follows weeks of pressure from business leaders who complained the rules would wreak havoc on the supply chain and possibly aggravate worker shortages.

The Biden administration’s forthcoming vaccine mandates for millions of private employers, certain health care workers and federal contractors will not be enforced until after the holiday season, following weeks of pressure from business leaders who complained the rules would wreak havoc on the supply chain and aggravate worker shortages.

The administration released two new rules on Thursday that will be enforced starting Jan. 4 — one setting up new vaccination-or-test requirements for businesses with more than 100 workers and another implementing a vaccine mandate for health care workers at facilities participating in Medicare and Medicaid. Together, the rules are expected to affect over 1 million workers.

“COVID-19 has had a devastating impact on workers, and we continue to see dangerous levels of cases,” Labor Secretary Marty Walsh said. “Many businesses understand the benefits of having their workers vaccinated against COVID-19, and we expect many will be pleased to see this OSHA rule go into effect.”

Officials also said the administration is pushing back the Dec. 8 deadline for federal contractors to ensure their workers are fully vaccinated, so that all three mandates will go into force on Jan. 4.

While employers were given a brief reprieve from immediately implementing the test piece of the rule, the administration clarified that businesses must be in compliance on Dec. 5 with all other requirements, such as providing paid time off for employees to get vaccinated and requiring unvaccinated workers to wear a mask in the workplace.

Under the rules, workers at private businesses with more than 100 employees will have the option to wear a mask at work and submit to weekly Covid-19 testing in lieu of getting vaccinated. Health care workers and government contractors do not have the testing option.

Unvaccinated workers who claim they have a legally protected exception to getting the vaccine could be fired if their employer says it would be an “undue hardship” to offer remote work or some other accommodation.

Companies that fail to follow the vaccine-or-test rules can be fined up to $14,000 per infraction.

The temporary rules for private employers go into effect immediately and stay in place for six months, but can be directly challenged in the U.S. Court of Appeals.

Private employers will not be required to pay for weekly Covid-19 tests for employees who refuse to get vaccinated, according to the new emergency temporary standard released by the Labor Department on Thursday. Whether insurers will cover the cost of testing for unvaccinated workers is up to individual insurance plans, according to Deputy Assistant Secretary of Labor for Occupational Safety and Health Jim Frederick.

Private employers subject to the emergency standard must also provide paid time off for workers to receive and recover from the Covid-19 vaccine, according to the rule.

Senior administration officials told reporters Wednesday that the vaccine-or-test requirement for private businesses alone “will protect more than 84 million workers from the spread of the Coronavirus” on the job and estimate that it will prevent over 250,000 hospitalizations.

The requirements, which President Joe Biden announced in September as part of his latest campaign to combat Covid-19, have already ignited a legal battle with conservative states and businesses over the government’s authority to impose such directives.

Shortly after the emergency rule for private businesses was announced, the Job Creators Network, a small business advocacy group, filed a lawsuit on behalf of several businesses in federal appeals court seeking to block the requirements from going into effect, arguing that the Occupational Safety and Health Administration doesn’t have the authority to issue the rule.

“The Biden Administration’s vaccine mandate is clearly illegal and will have a devastating impact on our small business community and our entire economy,” said Alfredo Ortiz, president and CEO of the group, in a statement on the lawsuit.

“The Administration’s mandate will exacerbate the worst labor shortage in recorded history by requiring small business owners to terminate some employees who wish not to get vaccinated while also shrinking the pool of job applicants available for hiring,” he said.

Nineteen states, including Florida and Texas, sued the Biden administration last month over the vaccine mandate for federal contractors, arguing the requirement was an unlawful overreach. And 24 state attorneys general and various business groups have warned the administration that it would face legal challenges if it moved forward with the vaccine-or-test rules for private employers.

Some Republican governors, including Florida’s Ron DeSantis and Alabama’s Kay Ivey, have tried to preemptively block private businesses from imposing mandates of any kind via executive order, although legal experts and the administration say those state rules are preempted by the new federal requirements.

“I expect to see battle royale in Texas, in Florida or anywhere else that wants to try to stop these” rules, David Miller of Bryant Miller Olive P.A., said. States are likely to argue the federal mandate violates the First Amendment, as applied to states through the 14th Amendment, Miller said.

“I really think that’s where it’s finally going to come to the nub in front of the U.S. Supreme Court. That’s the only way this is getting settled,” he added.

The administration’s move to delay the federal contractor mandate comes after trade groups, businesses and Republicans complained that the requirements will force employers to fire workers who refuse to get the vaccine or lead to mass resignations among workers who don’t want to comply, leading to more disruption in the labor market and the supply chain ahead of the crucial holiday season.

“In response to similar state and federal mandates, many private companies have begun firing workers who refuse the Covid-19 vaccine,” said Rep. Russ Fulcher (R-Idaho), during a labor subcommittee hearing on the mandate for private employers last month. “This federal vaccine mandate will worsen the supply chain crisis, almost guaranteeing Americans will go without this Christmas.”

But Biden brushed off those concerns Thursday, arguing that vaccination requirements are popular and also good for the economy.

“As we’ve seen with businesses – large and small – across all sectors of our economy, the overwhelming majority of Americans choose to get vaccinated,” Biden said in a statement on the new rules. “There have been no ‘mass firings’ and worker shortages because of vaccination requirements. Despite what some predicted and falsely assert, vaccination requirements have broad public support.”

Unions, labor advocates, health officials and even some businesses have lauded the effort from the administration, calling the vaccine-or-test rules for private companies long overdue and finally unifying a state-by-state patchwork of requirements.

“One of the biggest struggles of the last two years is that we are dealing with an ever-changing patchwork of health and safety regulations that, in many cases, have differed not just state to state, but county by county,” Richelle Luther, chief human resources officer at Columbia Sportswear Company, told lawmakers during a hearing in October.

“A federal mandate is needed,” she added. “We do not believe it is more regulation for business, but rather, less. A quilt of local laws and approaches created vastly more regulation of business, more uncertainty, risk and inefficiency.”

Some economists predict the federal vaccine mandates could have a positive effect on the labor force. Goldman Sachs analysts wrote in September that “an increase in vaccination and almost full vaccination at workplaces should encourage many of the 5 [million] workers that have left the labor force since the start of the pandemic to return.”

The Equal Employment Opportunity Commission, which is the federal agency that polices employment discrimination, has given employers the greenlight to mandate Covid-19 vaccination in their workplace, so long as they provide accommodations for workers who say they can’t get the shot because of their religious beliefs or a disability.

Last month, the EEOC clarified that “social, political, or personal preferences” are not considered protected religious beliefs under federal anti-discrimination law.

The Occupational Safety and Health Administration, the federal agency tasked with policing worker safety, has the authority to issue emergency temporary safety rules that go into effect immediately if it determines that workers are “in grave danger” due to exposure to something “determined to be toxic or physically harmful or to new hazards.”

Emergency temporary standards are rarely issued by OSHA. Before an emergency Covid-19 workplace safety rule went into place for health care workers earlier this year, the agency hadn’t released an emergency standard since the 1980s.

OSHA has issued 10 emergency temporary standards in its five-decade history. Of those, at least five were stayed or blocked by the courts, according to the Congressional Research Service.

This blog originally appeared at Politico on November 4, 2021. Reprinted with permission.

About the Author: Rebecca Rainey is an employment and immigration reporter with POLITICO Pro and the author of the Morning Shift newsletter.


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How Workers at Beverage Giant Refresco Defeated a “Notorious” Union Buster

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Refresco has waged a prolonged and costly fight to stop the workers from unionizing.

As the spread of Covid-19 forced millions of workplaces to close in March 2020, Cesar Moreira continued to report to a bottling plant in Wharton, N.J., where he works as a batching technician. During 12-hour shifts, Moreira mixes vats of powdered concentrate and sugar to churn out brand-name beverages like Gatorade and Arizona Iced Tea.

Management for Resfresco Beverages Inc., the owner of the plant and one of the largest bottling companies, told workers these operations fell under the umbrella of “essential services.” Moreira was incredulous.

That the company would risk the health of its employees to maintain the supply of sugary drinks angered him. In mid-March, as workers at the plant began to call in sick with coronavirus symptoms, Moreira says plant management ignored their concerns and refused to temporarily halt production. 

On March 21, 2020, Moreira and his coworkers walked off the job to demand adequate protections and contact tracing, part of a wave of safety-related stoppages in the first months of the pandemic. Workers at a Perdue chicken plant in Georgia and a meatpacking facility in Nebraska soon followed suit, the food production sector being a particular hotspot for Covid-19 cases and emergency organizing by a heavily immigrant workforce. 

But workers at the Wharton plant didn’t stop there. Their spontaneous protest quickly blossomed into a full-fledged union drive. In June, 15 months after the walkout, Refresco workers voted 114–101 to join the United Electrical, Radio and Machine Workers of America (UE). Their 250-person bargaining unit is one of the biggest victories of blue-collar organizing during the pandemic.


To win the election, Moreira and his co-workers also had to overcome an aggressive anti-union campaign targeting their predominantly Spanish-speaking workforce. The company pulled out all the stops, posting anti-union flyers and a fake UE contract—and hiring Lupe Cruz, a union avoidance expert who specializes in “bilingual consulting.” In These Times obtained more than eight hours of recordings from six weeks of mandatory anti-union meetings led by Cruz at the Refresco plant this spring. The recordings provide a window into an especially insidious union-busting strategy: exploiting ethnic and linguistic differences to sow doubt and confusion among immigrant workers.

The tactic is old, but it speaks to the increasing specialization of a multi-million-dollar union-busting industry. Labor activists say Cruz, himself a former union organizer, is infamous for his attempts to thwart organizing in industries with large numbers of immigrant workers.

Alejandro Coriat, who encountered Cruz in 2017 while organizing a union at his job at a Hilton Hotel in Stamford, Conn., even coined a term to describe this approach: “intersectional union-busting.” In a workplace dominated by Latino and Haitian immigrants, Cruz and his team “divided us according to two language groups, and with each group, they tried a different tack,” Coriat says. The workers ultimately won their union by a near-unanimous vote.

Cruz’s strategy also failed at Refresco, but the workers’ fight isn’t over. After the union won the election, Refresco moved rapidly to scrap the results on a technicality. While a representative for the National Labor Relations Board (NLRB) recommended certification of the union in September, Refresco has signaled that it intends to appeal.

That leaves the Refresco workers in limbo, unable to start contract negotiations. At a time when essential workers are reporting more willingness to take collective action, the Refresco drive shows just how many hurdles they still face.

Licinia Ochoa has worked as a machine operator at the Wharton bottling plant for 22 years. It was her first job after she moved from Colombia to New Jersey in 1999. UE estimates that, of the 250-some workers who mix, bottle and pack beverages at the Refresco plant, more than 85 percent are Latin American immigrants.

Work at the plant, which opened in 1980, was never easy, Ochoa says. But until recently, it was dignified. Her schedule was regular, the hours weren’t too bad and she knew she would be covered if she got injured or sick.

Then, in 2016, the plant’s original owner sold it to Refresco.

The beverage giant has grown rapidly by gobbling up smaller companies in North America and Europe; its gross profit in 2020 was 1.9 billion euros, according to an annual report. Refresco operates more than 60 plants worldwide, including about 30 in the United States. The majority of workers in the U.S. facilities are not unionized.

“Many things changed since Refresco came,” Ochoa says.

Soon after acquiring the Wharton plant, Refresco switched the company’s healthcare plan to one with high deductibles and skimpier coverage. Later, the company replaced many 8-hour shifts with 12-hour shifts. For many workers, wages stagnated below $20 per hour.

Cesar Moreira immigrated to the United States from Ecuador and has worked at the plant for seven years. He suffers from sleep apnea. “I’m paying $750 [for treatment], plus $1,500 to the company that makes the mask that sends oxygen to my brain,” he says. “That’s $2,200.

“We are talking about a multinational corporation. So why couldn’t they keep our health insurance [from before]?”

Ochoa, 62, was among those assigned to 12-hour shifts. Ochoa makes $17 an hour and says her healthcare copays are so high she avoids seeing a doctor. But she had no choice after becoming seriously ill in March 2020, eventually requiring hospitalization for Covid-19. The virus put her out of work for two months.

Ochoa and several coworkers had reached out to UE in 2019, beginning talks over healthcare and scheduling concerns. But the drive didn’t kick into high gear until spring 2020.

Anthony Sanchez, an employee of 15 years, says when he tested positive for Covid-19 in March 2020, he tried to alert the company. “They didn’t talk to the coworkers I interact with all the time,” he says. “They didn’t give tests. They didn’t put anybody in quarantine.”

For months, workers kept their intentions to unionize quiet, while distributing and amassing signed union cards to demonstrate majority support.

“They never would have thought we would do this under their noses,” Ochoa says. “It was brutal when they found out.”

When workers attempt to organize a union, it’s almost a given they’ll face resistance. A 2019 report by the Economic Policy Institute reveals employers spend about $340 million on anti-union services annually. Hiring professional “union avoidance” consultants to interrogate workers and carry out so-called captive audience meetings is an especially common tactic.

As the union avoidance industry has grown, it’s also become increasingly sophisticated. Richard Rehberg, a researcher for the International Union of Operating Engineers, says he first encountered Cruz and his special brand of culturally competent union-busting while working for Food and Allied Service Trades, an AFL-CIO affiliate, in the early 2000s.

“It was a new thing,” Rehberg says. “Basically, the union-busters were pandering. You know, ‘OK, how are we going to deal with these Latino workers and Spanish speakers?’”

Now, says Rehberg, this kind of specialization is common. Employers can hire union-busters to appeal—sometimes crudely—to almost any demographic. On campaigns to organize construction and building trades, for example, Rehberg says he has repeatedly encountered one man with a “pseudo-biker look” apparently intended to help a well-paid consultant relate to blue-collar workers.

In 2020, employers gained another anti-union strategy: They could simply lay off workers attempting to organize and blame it on Covid-19. That appears to have successfully stalled active union drives among nurses in North Carolina, truck drivers in New Jersey and a host of others, according to an April 2020 New York Times investigation.

“This is a continuation of behavior that has become all too common, of employers being willing to use increasingly aggressive tactics to stop unionizing,” Sharon Block, a former NLRB board member, told the Times. “The pandemic has given them another tool.”

The situation creates a kind of paradox: While unions report workers increasingly want to organize (spurred by the pandemic), the number of actual union drives has declined.

The number of union representation elections fell by 30% from 2019 to 2020—partly due to a total stoppage of NLRB elections in March 2020 and the new challenges that in-person organizing faced. The Refresco workers’ campaign was a bright spot amid the lull.

Soon after Refresco workers submitted their union cards in May, management ushered them into the first of six weeks of mandatory meetings. In a recording of one of the first meetings, obtained by In These Times, Lupe Cruz introduces himself.

“Where are you from, sir?” Cruz asks employees in the audience in Spanish. One is from Ecuador. Another is from Peru. Venezuela, Colombia, El Salvador and Mexico are also represented.

“All different countries—six for six!” Cruz says. The workers’ immigration backgrounds will become an ongoing theme.

“One of the first things we’re going to teach you is, What is the process and the system here in the United States,’” Cruz says. “Because the way this works in Mexico, in Colombia, in Venezuela—it’s very different.”

Throughout the meetings, Cruz and the other consultants refer to the sessions as “classes,” saying they intend to provide the workers an education about U.S. labor law.

In one session, a worker chimes in with a story about how Refresco changed the plant. Cruz interrupts him: “I’m giving you a legal opinion, not an emotional one. There’s a difference. This is objective.” 

“They wanted to trick people with an image that they were neutral,” says Anthony Sanchez, who sat through multiple anti-union meetings.

In another session, Cruz presents a truncated history of UE, implying that thousands of workers jumped ship from the union after learning about U.S. labor.

“You know what the highest number of members this union has had?” Cruz says. “Six hundred thousand. What happened with those members? They left. Those who understood the system left.”

In fact, UE’s steep decline in membership, beginning in the 1950s, followed a wave of plant closures and vicious anti-Communist attacks, including by Sen. Joseph McCarthy’s notorious House Un-American Activities Committee.

In the same session, Cruz suggests UE is incapable of defending workers: “If this union isn’t one of the big ones, and Refresco is the biggest in the world, what kind of funds does this union have to help you in a fight?”

In an apparent attempt to cast doubt on the union, a document with the header “legal and binding contract between UE and the employees of Refresco” was posted at the plant. It contained a list of benefits and raises, as well as a blank signature line for the union—as if to say the union couldn’t actually guarantee improvements.

After casting the union as underfunded and impotent, Cruz describes a hypothetical scenario in which Refresco loses its big clients, like Pepsi, and workers are laid off.

“Who’s the real boss?” Cruz asks. “The real boss is Pepsi. If you’re Pepsi, you’re in the best position to negotiate [with bottling companies] because they all want your business. So if Pepsi looks into contracts with other businesses, what if they like them? They steal Refresco’s business. And then what happens to your jobs?” According to UE, the possibility of layoffs came up frequently in anti-union meetings.

The National Labor Relations Act prohibits employers from threatening workers with layoffs or reduced benefits if they join a union. Because of this, “employers are more likely to make implied rather than direct threats of job loss,” explains Kate Bronfenbrenner, labor scholar and director of labor education research at Cornell University. “They are much harder to prove [as legal violations], because so much is dependent on the culture and history of a particular workplace.”

In a statement emailed to In These Times, a spokesperson for Refresco says the company’s actions are entirely legal. “As it has done throughout this election process, Refresco has and will continue to follow all the legal rules governing its behavior in connection with and arising out of the union’s efforts to organize employees at its Wharton, New Jersey facility,” writes Antonella Sacconi, Refresco’s communications manager. “This includes, but is not limited to, neither retaliating against nor rewarding employees based on their union sympathies or support.”

Neither UE nor pro-union Refresco workers allege the company’s anti-union campaign broke any laws, just that Refresco and its hired consultants sought to confuse and manipulate workers—the legality of which, they say, serves as evidence of the weak labor protections for U.S. workers.

Cruz did not respond to multiple requests for commentBut to union organizers and labor activists, he is a familiar figure. Bronfenbrenner calls him “notorious.”

Cruz once worked as an organizer for the hospitality union Unite Here but has been battling the campaigns of his former union for more than a decade. In 2006, the owners of a Hilton Hotel in Los Angeles paid Cruz $480,000 during a particularly bruising anti-union fight, according to reporting by the Los Angeles TimesHilton fired an employee active in the union drive who had allegedly been caught stealing by a “mystery shopper” posing as a guest. When workers gathered in the cafeteria to protest the firing, management suspended more than 70 of them for a week.

Cruz has since gone on to consult for such employers as Trump Hotels, the auto club AAA and others. His involvement helped quash high-profile union campaigns at American Apparel in 2015 and a New Seasons Market grocery store in Oregon in 2019.

Cruz is associated with at least two firms that have filed disclosures with the Office of Labor Management Standards (OLMS), which requires third-party labor consultants to report income from employers. The firm Cruz & Associates reported more than $3.5 million in income in 2018 but has not filed additional reports since 2019. Quest Consulting, established in 2019 with Cruz as its president, reported $1.4 million in revenue for 2020, according to OLMS records.

Workers who have encountered Cruz on other union campaigns report seeing similar tactics to those at Refresco.

During a union drive at Tartine Bakery in 2020, workers say monolingual Spanish speakers were siloed for separate captive audience meetings. OLMS data shows Quest collected $243,363 from Tartine in 2020.

Refresco has since hired Seyfarth & Shaw, a prominent employer-side law firm, to appeal the union election results to the NLRB, which Bronfenbrenner says is an “extremely common” tactic. “It gives the employer more chances to raise questions about what the union really wants. And [make] the workers who voted for the union feel less secure,” she says.

For their part, workers on the organizing committee are preparing for steward elections and the eventuality of contract negotiations.

“I’m OK, but I’m uneasy,” Moreira says. “The only way to make a change is to pressure these people into understanding that we aren’t … animals to control at their will.”

This blog originally appeared at In These Times on October 19, 2021. Reprinted with permission.

About the Author: Alice Herman is a 2020–2021 Leonard C. Goodman Institute for Investigative Reporting Fellow with In These Times.


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