Striking nurses stand in front of a Kaiser Permanente building.

Citing concerns over lack of supplies and lack of staff, nurses at Kaiser Permanente Los Angeles Medical Center in Los Angeles (LAMC) strike on June 23, 2022.

(Photo: California Nurses Association)

Worker Militancy Has Fueled a Surge in Union Growth and Popularity

The labor movement is at a critical crossroads in the United States. We continue to face the extreme danger of reaction and attack, but we also have an enormous opportunity to fight back against those exploiting the working class and seeking to undermine our unity.

If there's one picture to summarize the growing militancy of many unions and workers, let's call it the picket sign. Behind that image is an important message as well–forceful challenges to big corporations benefit all working people and resonate with the broader public.

And, they are a key to winning improved living standards for the entire working class and to the growth of unions. For nurses, the strike has always been one of our most important tools for protecting patients from the health and safety damage created by corporate cost-cutting.

Strikes in the U.S. rose by nearly 50% in 2022, according to Cornell University's School of Industrial and Labor Relations. And the trend has continued this year, including a three-day strike by some 30,000 Los Angeles school teachers' aides, bus drivers, custodians, and other support staff in March.

Even when facing virulent retaliation from employers, workers were willing to engage in dynamic workplace actions, with growing support for unions.

Wall Street tycoons and their allies in elected office and the media have devoted decades to vilifying unions and the very notion of workers going on strike to better the lives of workers and the communities they live in. Yet 2022 also witnessed the largest rise in support for unions in half a century, up to 71% public approval.

The message seems clear: Even when facing virulent retaliation from employers, workers were willing to engage in dynamic workplace actions, with growing support for unions.

Workers engaged in direct resistance to employers and the corporate class, and it does not appear they are turning back. For union nurses and other workers, understanding what we've been able to achieve, and how our approach has served our patients, will help us confront the challenges that lie ahead.

Nurses, teachers, journalists, and baristas were among the thousands who walked picket lines, many winning substantial gains and demanding an end to dangerous workplace conditions during the pandemic and after years of corporate profiteering at the expense of working people.

Militancy was also an emphatic response to decades of far-right policies that created the largest wealth and income disparity since the Great Depression, especially for workers of color. At the bedside, nurses see every day how inequality and social injustice show up as widening health disparities in our communities and increasingly ill patients in our hospitals.

Union nurses have aligned ourselves with a long legacy of union militancy, in part to get to the root of these structural problems. Yet, there remain compromises in the labor movement that pose challenges to workers' collective power.

Worker upsurge in the 1930s–and a willingness to utilize a variety of innovative strategies from hunger marches to sit down strikes to general strikes–led to decades of rising union membership and improved standards.

Of course, many of these gains disproportionately benefited white workers, but the best of these militant upsurges demanded a better life, and more power, for the entire working class.

A Labor Retreat: Labor-Management Partnerships

Corporations and the right mounted a counterrevolution against unions and the broader struggles they were connected to. Nurses and the working people we've cared for endured the worst of a neoliberal agenda of tax breaks for corporations and the rich, austerity, and repressive anti-union policies aimed at rolling back union gains and eliminating labor rights and workplace protections.

Sadly, a number of unions concluded they had lost the ability to fight employers and that to survive they had to join them in "labor-management partnerships."

The partnerships accommodated corporate business plans, and, as a priority, curbed labor militancy, above all by restricting the strike weapon. As more unions pursued collaboration with employers, workplace actions plummeted. The 1990s saw an average of just 35 major strikes per year, a number that fell to just 13 in 2003.

LMPs entice workers to identify with "their" corporations at the expense of their unity with other workers

In the increasingly influential health-care industry, a key turning point came in the 1990s. Kaiser Permanente, one of the nation's leading health-care systems, and my employer, won backing from doctors and some other medical professionals to provide bonuses for pushing patients out of hospitals earlier as well as additional patient-care cuts.

My union, the California Nurses Association (CNA), was a major impediment. CNA and Kaiser RNs, like myself, fought against anti-worker and anti-patient concessions, preparing a strategy of action against Kaiser's injurious practices.

But on the first day of a strike in April 1997, Kaiser pulled out a major weapon–signing a sweeping Labor Management Partnership (LMP) with its biggest unions to divide the workers and disrupt Kaiser union solidarity.

The LMP promised to limit its union partners from some of Kaiser's most severe cost cutting. But it exempted restructuring plans already developed–including hospital closures, cuts in patient services it deemed not profitable enough, and reductions in employee pay and benefits–and even allowed Kaiser to move forward on future harmful plans to patients and workers.

Further, the LMP prohibited participants from public criticism of its damaging practices, required support for its legislative goals such as opposition to workplace and patient safety, and turned the unions into sales agents for the company.

Our union refused to join the Kaiser LMP because we knew then, as we know now, which side we were on. Our partnership is always with our patients, our communities, and the working class, not our employers.

Instead, we mobilized the energy of our then 7,500 RNs in 47 Kaiser facilities for over a year and half. It wasn't easy, but we generated widespread public support and, in the end, CNA nurses forced Kaiser to withdraw its concession demands. And we won significant gains, including a stronger voice for nurses in patient-care decisions.

Within the next few years, through our public and patient advocacy, we also forced Kaiser to rescind its plan to close three hospitals in diverse, working-class communities, continued to expose and block some other patient-care cuts, and continued to win gains for our members and patients. All without signing onto the LMP.

LMPs entice workers to identify with "their" corporations at the expense of their unity with other workers, strengthening corporations, prioritizing profits and inherently undermining the antagonism against the exploitation that unions were developed to challenge. This partnership approach has not created more union jobs in this country, and, for nurses, it has proved detrimental to worker safety and patient care.

For us, this means advancing social justice unionism premised on benefiting the entire working class and fighting for worker rights, economic justice, racial/gender/LGBTQ+ justice, climate justice, Medicare for All, and a strong commitment to strengthened democracy in the workplace and beyond.

This stance is not only a matter of principle but increases our ability to fight and win—to build strong support from other workers, patients, and the public at the bargaining table and on the strike line.

Gains for Our Patients Without a Labor Management Partnership

CNA's militant approach to unionism, and the gains it has delivered over the years, has been key to our growth. We've shown that when we fight, we win—and when we win, more nurses want to join us in the fight. National Nurses United, which CNA helped found with other progressive nurses' unions, now represents 225,000 RNs and other direct care health-care workers from coast to coast.

In 2022, our union conducted more than two dozen strikes and hundreds of other workplace protests, pickets, candlelight vigils, press conferences, marches on the boss, and shift change actions from California to Florida to Maine.

Through these fights, we were not only able to win historic wage increases, but also compelled our employers to increase infectious disease control prevention measures for patient and worker safety in the face of the pandemic, adopt robust workplace violence prevention plans, and pledge to hire thousands of additional RNs to improve safe staffing.

Nationally, labor is at a critical crossroads.

For the first time, we've won contracts that include creation of a new regional Equity, Diversity, and Inclusion committee to address systemic racism with a commitment to securing a discrimination-free workplace and ending racial and ethnic disparities in health-care outcomes. And we put Kaiser, one of the nation's largest health insurers, on record that health care is a human right.

Nationally, labor is at a critical crossroads. We continue to face the extreme danger of reaction and attacks on our rights, our democracy, and our diverse communities that put our future as a people in jeopardy.

But we also have the opportunity to expand on the achievements for unions and workers in their fights for a healthy society, especially by vigorously challenging those who profit off labor and division among workers and prioritizing the united, class-based, social justice approach on behalf of union members and the working class as a whole.

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