Corrosion of the most basic patient right—safety—is a problem no matter where health professionals work. For this reason, thousands of healthcare workers in New Jersey have united to fight for a common set of standards that will improve patient care and working conditions.

Health Professionals and Allied Employees (HPAE) launched its One Voice campaign to raise the decibel level on the issues of safe staffing, salaries, pensions and retiree health benefits. HPAE has successfully negotiated on each of these issues in previous contract negotiations, but the One Voice campaign is designed to set a uniform standard of care and compensation. This approach is more aggressive, in line with today’s challenges, says Ann Twomey, president of HPAE and an AFT vice president.

“Millions of healthcare dollars are being siphoned off to the pockets of greedy CEOs and corporations,” she points out. “Unless nurses and healthcare workers speak out about the ravaged and unsafe patient care conditions that have resulted, the public won’t know.”

To increase its clout, the campaign united 10 HPAE locals by lining up their contract dates to expire on or around May 31. Unions have always relied on power in numbers to produce change—that’s the basic concept of a union, says Twomey. “Being part of a union means individuals can join their voices with others and make them heard that much more.”

One Voice results from years of planning. When HPAE began to formulate the campaign, it set up a coordinated bargaining committee to plan strategies related to bargaining, contract and other issues. Although committee members knew that each local’s contract demands and settlements would be different, the proposals on key issues had to be consistent with the standards HPAE was trying to achieve.

Bad conditions targeted

Staffing should be based on well-researched links to quality care and retaining good employees, says Twomey. In fact, understaffing in hospitals produces a “clear and present danger” of further attrition in staffing, according to HPAE’s own survey, “Setting the Standard for Safe and Effective Patient Care in New Jersey,” released in May.

In the survey, nearly 80 percent of registered nurses described their facilities as short-staffed. And the report cites studies that support what’s been said for years: Inadequate and dangerous staffing levels are not a product of any overall shortage of nurses, pharmacists, respiratory therapists and other health professionals, as hospitals would have you believe. They are instead the result of a shortage of nurses willing to work under the prevailing conditions in many New Jersey hospitals. Those conditions come from years of cost-cutting, understaffing, forced overtime, unsafe working conditions and a lack of retirement security.

Understaffing creates a cycle of overworked caregivers who take on more patients than they feel is safe, then suffer the burnout and job dissatisfaction that prompt them to leave.

Donna Benjamin, the president of Local 5185 at Bayonne Hospital, says a lot of her colleagues have left because they can’t stand the conditions. “We cannot retain staff because of abominable nurse-to-patient ratios.”

Typical strategies used to shore up staffing—signing bonuses, recruiting nurses from overseas, and contracting with travel and temporary staffing agencies—are quick fixes that only weaken the continuity of care and exacerbate the shortages, says HPAE. In addition, while hospitals use short-term fixes, they do little to retain and reward current staff.

“The hospitals don’t care about loyalty and longevity, even though experience is what is really needed in nursing,” says Benjamin.

HPAE also is addressing the problem of inadequate retirement benefits. According to a study by the American Hospital Association, more hospitals are moving away from offering defined benefit plans, which are funded by employers and provide a guaranteed level of benefits, to defined contribution plans or 401(k) plans. Such plans are tied to stock market prices and therefore riskier. HPAE wants its members to be able to retire with dignity. The union has championed the establishment of a statewide commission on pension reform in healthcare to improve retirement security for nurses and healthcare workers.

“We are public servants,” says Benjamin. “We deserve a pension funded by the state.”

Not a one-shot deal

The ambitious plan by HPAE also contains an aggressive legislative agenda, including measures to establish staffing ratios and provide public disclosure from hospitals about their nurse-to-patient ratios.

“The public knows more about healthcare than they did 10 or 15 years ago, but they need to be informed about what the ratios really mean,” says Shirley Terwilliger, president of Local 5029 at Pascack (N.J.) Valley Hospital. Disclosure may hurt the hospital but it will help health professionals and the patients, says Terwilliger.

HPAE also crafted a public relations component for the campaign. For several months, the union posted billboards and signs in various New Jersey townships that read: “Our fight is your fight. By your side. On your side,” and “A hospital that’s bad for nurses and caregivers isn’t good for you.”

HPAE’s members have been active in informational picketing, speaking at local and county legislative meetings and getting petitions and postcards signed.

So far, HPAE’s campaign has worked well. Early in the campaign, HPAE locals at Cooper Hospital University Medical Center in Camden and Meadowlands Hospital in Secaucus won agreements that made advances on their issues. In May, hundreds of nurses and healthcare workers from the remaining locals rallied in support of contract negotiations, which ended on May 31 and June 1. Members at each of the hospitals voted to authorize a strike if the key issues were not resolved. All but one hospital agreed to the contract demands of One Voice. On June 2, the nurses and health professionals at Bergen Regional Medical Center in Paramus went on strike. (See related story.)

The community has supported the nurses’ efforts throughout the campaign. That support has strengthened the union’s resolve to move toward the goal of One Voice, which is ultimately about giving a voice to everyone: the healthcare workers and the patients they serve.

“When we raise the standards for our members and for union hospitals, we are raising the standards for everyone,” says Twomey. “All healthcare workers will indirectly benefit from the gains we make in our contracts as hospitals are forced to raise rates to stay competitive. And, everyone will benefit if we can get our bills passed in the Legislature.”

One Voice is not a one-time event, says Twomey. “We intend this to be an ongoing campaign—giving voice to our health professionals and maximizing that voice through our coordinated efforts to establish standards for healthcare throughout the entire state. Of course, our goal is to make our voice louder and stronger by organizing new members.”