NURSES ON STRIKE: THE FEMINIZATION OF MILITANCY, THE POLITICIZATION OF CARING LABOUR, AND UNION REVITALIZATION
**[This is the Introduction to this paper. For the full paper, please contact the author].
York University, Toronto
Paper presented at stream on “Worker Power and the Labor Process, Past and Present”at the
International Labour Process Conference, Rutgers University, March 2010
“It is time we stopped being ‘yes girls’ because of the 'Florence' pledge and stood on our own feet, because we have been pushed enough.” A New Brunswick nurse with 25 years of experience (Telegraph Journal -Saint John, 31 January 1975, quoted in Kealey 2008: 4).
“We're not doing this for the sake of money. If it was necessary to do it again, I'd do is again, for the benefit of the health service … Anger at the way the nursing profession has been treated has been building a long time. The profession must be valued and respected by the service for the good of the service.” An Irish nurse on strike in 1999 (quoted in Clarke and O’Neill 2001: 354).
“This issue is really about the nursing shortage which ... has led to horrific and unsafe working conditions and compromised patient care.... We are taking a stand for the people of Saskatchewan: you, me, our families, our communities, as the caregivers and patient advocates that we are.” Laurie Swift, a striking nurse in Saskatchewan (Regina Leader-Post 7 May 1999).
“The government [has] failed to take into account that most nurses are middle-aged women who have plenty of life experience and aren't easily cowed ... If Mr. Romanow [premier of Saskatchewan's NDP government] thinks these 8,000 women are going to back down, he had just better take his testosterone hissy fit and stuff it. He's not giving women their due.” Debra McPherson, the secretary-treasurer of the National Federation of Nurses' Unions about the Saskatchewan nurses’ strike (The Star Phoenix 15 April 1999).
“‘We're not moving,’ said the bus driver to the nurse with the picket sign. ‘I'm in a union too.’ … Two hundred nurses were defying the government and breaking the law. They were sitting in the middle of the busiest Halifax intersection. Traffic was backed up for blocks. The bus driver at the head of the jam wasn't moving. No passengers complained. The folks on the sidewalks cheered. The cops just stood back and watched.” Nova Scotia nurses dispute, 2001 (quoted in Hambling 2002: 12).
“If it comes to losing my job, I’m not concerned. I didn’t sign on to nursing to do slave labour. I didn’t sign on to lose my rights.” Fay MacNeil, a Nova Scotia cardiac nurse. (Times-Colonist [Victoria, BC] 29 June 2001).
Popular and scholarly literature certainly suggests a certain fascination with nurses on strike. From a commonsense point of view, the militancy of nurses seems counter intuitive to the major themes in nursing around gender, professionalism and resistance to unionization. And yet this study of nurses on strike reveals a somewhat hidden history of militancy, perhaps connected to what Hayward and Fee refer to as nurses “unique place in the political economy of health care” (1992: 397). It is timely to examine
nurses’ strikes at this historical conjuncture in which workers and communities are under considerable attack: from privatization and public-private partnerships, the re-construction of work and labour markets, the deepening exploitation of racial and gender differences by corporate capital, and the neo-liberal invocation of patriarchal and individualistic values for workplaces and households.
This paper “Nurses on Strike: The Feminization of Militancy, the Politicization of Caring Labour, and Union Revitalization” is part of a larger project on women’s labour militancies which starts from the assumption that militancies are fluid, contextually located practices, negotiated and re-negotiated in historical circumstances. It illuminates and interrogates the practice of gender in an area where it has traditionally been opaque. I enter the study of nurses’ militancy then, from the point of view of women’s labour militancies rather than as a scholar of nursing. This vantage point has both strengths and limitations.
Part Two considers the demographic transformations in work, the workforce, union density and union membership in Canada which set the stage for the feminization of labour militancy, that is, those involved in strikes are more likely to be women. This trajectory is particularly true in the public sector. Part Two investigates the 105 strikes of Canadian nurses between 1960 and 2007 with reference to the statistical data on work stoppages from Human Resources and Social Development Canada (HRSDC), and also explores the limits of the available data. It notes three ‘waves’ of nursing strikes in Canada: 18 strikes between 1980 and 82; 42 disputes between 1985 and 1991, and 18 strikes between 1998 and 1999. It also considers the relationship between professional nurses’ associations, and unions of nurses, a relationship which informs nursing struggles and strikes.
In Canada and elsewhere, three reference points dominate the discussion of nursing: professionalism, patriarchy, and proletarianization. These deeply-entangled trajectories have had a significant impact on the work, consciousness and militancy of nurses; and have shaped occupation-specific forms of resistance. The goals of professionalism, and in particular the commitment to service, resistance to patriarchal practices and gendered subordination, the challenge of proletarianization, and the confrontation with neoliberal health care restructuring all inform the militancy of nurses in Canada, and in many other countries. It is the argument of Part Three that each strand produces solidaristic alliances – in the first instance among nurses; in the second with the community-based and union movements of women, with nurses based on gender, and potentially with other women workers; and in the third with workers in the health care sector and other public sectors, the labour movement, and other progressive movements. These overlapping solidarities have supported, indeed promoted, militancy among nurses, despite the multiple forces arrayed against them.
The professional commitments of nurses to the provision of care have confronted health care restructuring and gendered hierarchies with a militant discourse around the public interest, and a reconstitution and reclamation of ‘caring’.Part Four notes the emergence, in the last three decades, of this new discourse and practice. Nurses’ dedication to caring work may encourage rather than prevent them from going on strike, a shift that I call the politicization of caring. The discursive frames focussed on the public interest and the politicization of caring have also provided a basis for nurses to build alliances with other unions, the community, the public, and women's and other progressive organizations, and in fact, many nurses' strikes have been characterized by strong popular support, mapped in the concluding section of Part Four.
The final part of this paper considers the relationship between nursing militancy and union renewal.
The militancy of nurses, and indeed of health care workers suggests new sources of leverage and worker power. Their capacity to mobilise public support offers direction for envisioning union renewal.
The militancy of nurses speaks to many of the strategic threads in the union renewal project. In considering the militancy of women, this discussion genders the union renewal debate. At the same time, it broadens the focus of the women and unions scholarship from issues of representation and leadership, constituency and cross-constituency organizing, and equity policy and bargaining. The discussion of union renewal in Part Five touches upon four themes: women’s militancy, rank and file militancy, coalition building and community outreach, and professionals in the labour movement. The capacity of union movements to re-invent themselves in these critical times might well rest on what can be learned from militant nurses, and public sector workers.
Undoubtedly the most illuminating studies of nurse militancy may be in-depth accounts of particular struggles, which capture what Johnston calls “messy multidimensionality” (1994: 216). In his study of strikes, he also concludes that, given that “no case is typical”: “[W]e can only generalize from these cases at the level of theory -- through the conceptual tools used to grasp their histories, rather than through those histories themselves” (213). This paper embraces a level of generalities in order to map the militancies of nurses, and draws on examples from Canada, the UK, Australia, Japan, New Zealand, Israel, Ireland, the US, Denmark, Sweden, Finland, Poland, and Portugal. Undoubtedly certain risks attend such generalizations. Although the paper is suggestive and exploratory, the rich picture of nursing militancy which emerges using this approach, in my view, justifies the crossing of context. As Phelan points out, researchers need to resist both “the temptations to cloak crucial differences with the cloak of universality and to deny generalities for fear of essentialism” (1993: 786).
In the attempt to map nurse militancy, this paper is trans-disciplinary (drawing on sociology, women’s studies, history, and industrial relations), and multi-methodological (using qualitative material and quantitative data, statistical and theoretical approaches, narrative and documentary strategies). It includes statistical data from Human Resources and Social Development Canada (HRSDC) on the 24,475 strikes and lockouts in Canada between 1960 and 2007, and particularly on the 105 Canadian nurses’ strikes in this period; newspaper accounts of nurses’ strikes which represent a vital primary source to highlight the voices of striking nurses (Briskin 2010a); documents from nurses’ unions where available; and references to the popular and scholarly literature on nursing militancy in Canada and elsewhere. Using a trans-disciplinary methodology, and both qualitative material and quantitative data provides a layered and complex presentation of nursing militancy.
A Materialist Social Construction Approach
This research assumes that women's experiences are socially constituted, that is, grounded in and emerging from the material experiences of their lives rather than from any narrow biological imperatives. Such an approach recognizes that women enter unions differently than men because of their workplace locations and their household/family responsibilities; women's work bridges the public and the private, and each impacts on the other;and the pervasive discrimination and violence women experience in both public and private spaces influence workplace, family and union experience, and also women's political strategies. Without reference to essentialist ideas that women are, for example, more nurturing, relational, or emotional by nature, this approach recognizes that women may identify different issues as salient, as well as organize, resist and lead in distinct ways. This project, then, assumes that it is possible to reject both an essentialist reading of the militancies of nurses, and a gender-neutral frame, in favour of a contextual understanding of the gender-specific patterns of militancy among nurses.
Given the fact that any discussion which focuses on gender specificity can resonate with essentialism, in this research, I do not talk about female or feminine militancy or resistance. Such language can unproblematically invoke biologistic and stereotypical thinking. Rather my focus is on the militancy of women, and specifically in this paper, on the militancy of nurses.
Narratives of Militancy
Before turning to a thematic analysis of the strike patterns of nurses and their implications for union revitalization, this paper shares some short narratives of a few key strikes by Canadian nurses, and of an occupation-specific tactic: mass resignations.The themes of gendered discrimination, professionalism and neo-liberal health restructuring are all visible in these narratives.
Canadian Nurses on Strike
In 1988, more than 11,000 staff nurses in Alberta went on illegal strike for 19 days and faced very serious retaliatory measures by both employers and the state. In reference to this strike, the organization Edmonton Working Women commented, “They defied the law to defend their own democratic rights, and to oppose the erosion of workers’ rights on all fronts ... [and to] fight for patients’ rights to quality publicly funded health care” (quoted in Coulter 1993: 56). In 1999, Alberta nurses reached a settlement on the brink of what would have been another illegal strike.
In 1999, the first strike in 20 years by nurses in Newfoundland ended after nine days when the provincial government passed back-to-work legislation. Also in 1999, two days of wildcat strikes by 47,500 Quebec nurses, who had previously went on a week-long strike in 1989, set the stage for a lengthy illegal strike. The nurses faced two draconian pieces of legislation which Michele Biscay, vice-president of the Quebec Federation of Nurses, thought the government was using to try to “kill the union” (Globe and Mail 6 July 1999). The nurses resisted the intimidation of both Bill 160, which levied fines (more than $10 million by the end of the strike), withheld union dues and docked two days of pay for each day off the job (costing individual nurses around $7,000), and Bill 72, back-to-work legislation that targeted the union leadership. Five days after the passage of Bill 72, 93 per cent of nurses voted to continue the illegal strike. One week later, an agreement in principle was reached, which the membership later turned down by 75 per cent. The nurses continued to use “local guerrilla” tactics, including working to rule, insisting on overtime pay, and filing grievances for all breaches of the collective agreement (Globe and Mail 26 July 1999).
Following strikes in 1988 and 1991, Saskatchewan nurses defied back-to-work legislation for ten days in 1999. Saskatchewan nurse Nancy Syles spoke to the convention of the Canadian Labour Congress: “There were nurses on the picket line who told me, ‘I’ve never even had a speeding ticket.’ But you know they never flinched. They were willing to stay on that picket line and maybe even be sent to jail.. All we want to do as nurses is to deliver safe, excellent nursing care.. We cannot do this in the working conditions we have now” (Globe and Mail 13 July 1999). Laurie Swift, a nurse in Regina, wrote in a letter to the Editor of the Regina Leader-Post (7 May 1999), “This issue is really about the nursing shortage which ... has led to horrific and unsafe working conditions and compromised patient care.... We are taking a stand for the people of Saskatchewan: you, me, our families, our communities, as the caregivers and patient advocates that we are.”
Debra McPherson, the secretary-treasurer of the National Federation of Nurses' Unions was interviewed in The Star Phoenix (15 April 1999): “The government [has] failed to take into account that most nurses are middle-aged women who have plenty of life experience and aren't easily cowed... If Mr. Romanow [premier of Saskatchewan's NDP government] thinks these 8,000 women are going to back down, he had just better take his testosterone hissy fit and stuff it. He's not giving women their due.” She explained that the resentment stemmed from the fact that governments everywhere have shown no reluctance to cut or freeze the wages of public sector employees, most of whom are women. “The public sector is constantly the brunt of wage restraint. We have our federal government pushing back pay equity decisions from the courts. But if they think they can keep women working for less, they are going to have to think again. We're past that.”
These nurses’ strikes were characterized by strong popular support, and by backing from other unions and the women’s movements. The 1999 illegal strike by Quebec nurses garnered massive support from the Quebec public, 72 per cent of whom thought the nurses’ wage demands were reasonable (Globe and Mail 28 June 1999), and brought out doctors, other unionized workers, and members of the women’s rights federation to their picket lines. In reference to the 1999 Saskatchewan nurses’ strike, Barb Byers, then president of the Saskatchewan Federation of Labour (SFL) said, “I’ve never seen a membership so solid and I’ve never seen this level of support from the public.”[i] Byers told a demonstration in support of the nurses: “We've got to let them know that women workers in this province are not going to be discriminated against” (quoted in The Star Phoenix 12 April 1999). Byers thought the government had “underestimated the nurses in a sexist and patronizing way.”[ii] A May 1, 1999 opinion piece in the Phoenix was titled “Premier Faces Women's Fury.”
Mass Resignations and Non-Strike Tactics
Although this paper focuses largely on strikes, both legal and illegal, it does not assume that strikes are the only form of workplace militancy. In his discussion of workplace conflict, Hebdon (2005) distinguishes among covert collective actions (such as sick-outs, slow-downs and work-to-rule), other collective actions such as claims of unfair labour practices, and individual forms of militancy around grievances. Like other workers, nurses have engaged in multiple forms of resistance over many decades. Some examples. In 1975 in New Brunswick, nurses booked off sick to back their demand for contract reopening. The campaign was dubbed the “blue flu” as 700 nurses in 15 hospitals called in sick the first day (Kealey 2008: 10). In 1976, nurses in New South Wales (Australia) instituted bans “such as those on overtime, non-nursing domestic and clerical duties, and non-emergency surgery and admissions; they rallied, marched in the streets, burnt their caps. and held stop-work meetings as a symbol of protest in pursuit of wage increases” (Strachan 1997: 300). At a 2,000-bed hospital and trauma center in Southern California nurses staged a two day sick out in 1987 (Kravitz, Leake and Zawacki 1992). In 1989 in British Columbia, nurses refused “to perform ‘non-nursing duties’ (eg. cleaning, housekeeping, portering, post-discharge charting) through a ban on overtime” (Haiven 1991: 18-19). Given bans on striking, and essential and emergency service requirements, nurses have often been forced to seek alternative forms of resistance and militancy.