May 10, 2011

Bay Area Permanente nurses first in California to stage work action

A Permanente nurse tends to a child patient in Oakland in 1960. Kaiser Permanente Heritage Resources archives photo.

Contributed by Lincoln Cushing, Archivist and Historian

In May 1966, nurses from Kaiser Permanente facilities in Vallejo, Richmond and Napa became the first nurses in California history to conduct a work action. Little did these registered nurses know that their bold stance would force society to review their status and ultimately elevate the nursing profession for all time.

The 85 registered nurses, represented by the California Nurses Association (CNA), voted to picket the facilities when negotiations broke down over salary. The nurses were asking for a $50 per month raise, bringing the regular nurse salary from $480 to $530 per month and from $520 to $570 for head nurses.

CNA rejected a Permanente offer of a $35 per month raise and on May 17 authorized the nurses to demonstrate. At the time, CNA had a no-strike clause in its agreement with Permanente and was not yet an official collective bargaining agent for Kaiser Permanente nurses. The nurses investigated joining another union, the Office and Technical Workers, Local 29, Oakland, according to an article in the Oakland Tribune, May 6, 1966.

During this breakdown in negotiations, CNA spokesman Ralph Hartley told the papers that X-ray technicians, who were not required to be formally trained, were making $466 to $532 a month, about the same as the nurses. He added: “We take the view that registered nurses are next to doctors in patient care and should be recognized accordingly.”

Nurse protests spread to Oakland and across Bay Area

The dispute intensified when the nurses expanded their picketing activities to Oakland on June 6 and aroused interest in their cause from a broader base of Kaiser Permanente nurses. Meanwhile, 91 out of 107 staff registered nurses at Eden Hospital in Castro Valley threatened to resign their positions if their salary demands were not met.

Eden nurses complained that gardeners at their hospital were making more than a staff nurse. Eden nurse spokesperson Wilma McCarthy told the Tribune that nurse duties had expanded in recent years to include intravenous feeding, blood pressure readings, cardiac resuscitation and drug administration. “These are very important functions, and (a nurse) often must perform them through 2 straight shifts, yet she makes less than the hospital gardener.”

Permanente nurses with doctor 1967.
Permanente nurses with doctor 1967. Kaiser Permanente Heritage Resources archive photo.

On July 10, the Eden nurses made good their promise to resign and walked out en masse, staying out from Sunday until Wednesday, July 14, when their hospital board agreed to entertain their salary demands. “They’ve been kicked around so long in every way that nobody thought they’d do this,” said CNA agent Ralph Hartley. “It’s a revolution.” Hartley said he believed this was the first time in labor history that nurses had abandoned their posts over salary or working conditions.

Meanwhile, the CNA was urging its growing number of Bay Area members to submit resignations as a technique to pressure their employers to meet their wage demand. By the time Eden settled its impasse, more than 2,000 nurses employed by Bay Area hospitals had threatened to resign as well. A spokesman for the hospitals told the Oakland Tribune the employers were considering seeking a court injunction to halt the resignations. The hospital owners saw mass resignations as a de facto violation of the no-strike clause in their agreements with nurses.

On July 11, about 700 Kaiser Permanente registered nurses met in San Francisco and voted to resign if CNA’s salary demands on their behalf weren’t met. Soon after, CNA put in a petition to represent all KP registered nurses in facilities north of the Tehachapi. On July 18, the CNA turned down an offer for a 20% increase to be spread over a three-year period. On July 21, KP hospitals board raised the salary of all staff nurses by $60 a month, bringing the pay range up to $500 to $570. CNA negotiators did not accept the $60 as sufficient and actually increased their demands up to a range of $600 to $720 per month. Most Bay Area hospitals granted an across-the-board increase of $50 or $60 to their nurses, but in most cases the nurses considered it too little too late.

Nurse mass resignations spawn governor’s fact-finding committee, 1966

Oakland Permanente nurses at work in the cardiac care unit in 1967.
Oakland Permanente nurses at work in the cardiac care unit in 1967. Kaiser Permanente Heritage Resources archive photo.

The hospital administrators stuck together during this critical period, which ended up being truly ground-breaking for the nursing profession. On July 29, 1966, the hospitals placed an almost full-page ad in the Oakland Tribune pleading their case and showing a comparison between the hospitals’ offers and CNA demands. They proposed asking Gov. Edmund G. “Pat” Brown to appoint a fact-finding committee to study the issue and make recommendations. By this time, about 2,275 nurses had threatened to resign. The hospitals titled their ad “A solution to the hospitals-nurses dispute.”  Twenty-one East Bay and San Francisco hospitals, as well as the Kaiser Permanente hospitals of Northern California, were listed as signatories.

Hospital representatives reasoned that submitting the issues to a fact-finding panel could avert the crisis inherent in mass nurse resignations. “We will expect the Fact-Finders to explore fully the area of nursing salaries and fringe benefits. We will expect them to study the relationship of nurses’ pay to their experience and tenure, to their position in the entire hospital wage structure, and to nurses’ salaries in other comparable areas,” the hospitals’ statement said.

After some haggling over nurses’ interim pay, both sides agreed to put their faith in the independent panel charged with resolving the conflict. Brown appointed the Rev. Leo C. Brown, S.J., a research associate at the University of Cambridge Center for Social Studies, as panel chairman, along with Adolph M. Koven, a San Francisco attorney, and Howard Durham, professor of industrial relations at the College of San Mateo. Undoubtedly, the panel’s conclusions shocked everyone.

Panel urges 40% salary increase for Bay Area registered nurses

In announcing the panel’s recommendation for a 40% salary increase for Bay Area registered nurses, Father Brown acknowledged the dramatic increase would be a bitter pill for hospitals — and patients — to swallow. He said the panel “is fully aware that its recommendation will have a far-reaching effect on the cost of hospitalization and that the public will ultimately pay more for medical care. Raising the salaries of experienced nurses to $700 per month and beginning nurses to $600 per month was estimated to cost Bay Area hospitals about $7 million more per year beginning in 1967 when the raises were fully implemented. Hospitals spokesman Laurence P. Corbett said agreement was reached among the hospitals “after bloody meetings on both sides of the Bay.” He said the increase will upgrade the professionalism of nurses and that hospitals were already finding ways to relieve nurses of non-skilled duties.

Panelist Adolph M. Koven told the Tribune: “The whole picture of the nurse as a self-sacrificing Florence Nightingale is going to be changed to a professional Florence Nightingale adequately compensated. Hospitals and nurses throughout the country will look to this settlement as a framework for further bargaining. An inescapable result will be higher standards of patient care.” Predictions that other hospital workers would demand higher pay as well came true almost immediately. In December 1966 Kaiser Permanente negotiated agreements with Local 250 of the Hospital and Institutional Workers for raises ranging from $5 to $105 per month for 2,200 hospital workers, including licensed vocational nurses who got the biggest raises, from $397 per month to $500 for LVNs with 4 or more years’ experience.  Other hospitals in the area negotiated similar increases for their workers.