At 6 a.m. on the morning of July 2, 2001, it looked as if nurses and health care professionals at Bergen Regional Medical Center were going to be out on the picket line come 7 a.m. "The hospital was already escorting our members out of the building," recalls Barbara Rosen, president of the Bergen Regional Medical Center HPAE/AFT Local 5091. "The management bargaining team told us they were going home. We shook hands and said, 'Well, good-bye then. Take care.'"

But when the clock struck 6:15 a.m., Rosen and her exhausted negotiators found out that the management team hadn't left at all. They were right down the hall and--after months of tense negotiating at New Jersey's largest hospital--were finally ready to make a deal. At 6:55 a.m., the union and management reached an agreement.

And what a deal it is: not just a few token concessions from hospital management, but a solid victory for Rosen and her 400-member strong local union. The new agreement ensures nurses and health professionals a real role in making and monitoring staffing decisions; puts limits on mandatory overtime; and guarantees nurses a 10 percent raise over the next three years.

Contract highlights include:

• A quality liaison program that establishes an independent review of staffing and quality-of-care issues by the union, which will make recommendations to the CEO and report regularly to a Community Oversight Board.
• A requirement that all "floating" will be reviewed by union reps and that nurses who are floated will receive proper orientation and training.
• Restrictions on mandatory overtime for RNs and other healthcare professionals, including a ban on the practice of using routine sick calls and problematic scheduling times as justification for forced overtime.

In addition to the 10 percent raise for nurses, the contract adds significant salary increases for non-nursing healthcare professionals including social workers, psychologists, occupational and recreational therapists, and pharmacists. The increases will bring these professionals' salaries, which had been lagging far behind the market value for this region nearly up to par with the "going rate."

Rosen stresses that it was patient care, not monetary concerns, that caused her members to be willing to walk away from their units if it came to that. "It was more than a job action for us, it was patient advocacy. Every problem faced by nurses at our hospital in the last three years has been a symptom of the hospital not paying attention to staffing and workflow issues."

Until three years ago, Bergen Regional Medical Center was Bergen Pines County Hospital, an 1,100-bed community hospital with nearly a century's history of providing top-notch care to rich and poor alike in this metropolitan area just outside New York City. Then, in 1998, the hospital was taken over by a for-profit company, Solomon Health Services, and conditions went downhill fast.

"Professional practice issues were the number one problem cited in our contract survey results, and no wonder," says Rosen. "Unsafe staffing reports were coming to us on a daily basis. Nurses were being floated all over the place without the proper training. Solomon was downsizing nurse labor to a huge extent."

The hospital's attitude when these concerns were raised at the bargaining table? An immediate threat to lock out union nurses and replace them with "scab" nurses from an out-of state agency, a "playing chicken" gambit that usually gives hospitals considerable leverage in strike situations. This time, though, it was different. The union notified the hospital that it was prepared to go to court to file an injunction that would prevent the out-of-state agency from supplying the hospital with replacement nurses until the agency had received a state license to operate in New Jersey.

Rosen received much-appreciated support from both her state and national union. "Our nurses were the troops ready to hit the beach. Our state and national affiliates were right behind us with the big guns," she says.

Although Rosen calls hospital management "one tough nut to crack," she never doubted that her members would be just as tough in fighting for their patients. "This is a real union hospital, with a longstanding history as a charity hospital that puts patients' welfare first and foremost."