Local hospitals already facing a shrinking pool of qualified workers, growing numbers of patients and reimbursement delays are now being subjected to some of the most aggressive union organizing drives in recent history.

An estimated 5,000 nurses and other hospital employees have joined the California Nurses Association and the Service Employees Union International in recent months. Both unions are planning to reach out to thousands of others in the future and many of these workers are receptive to their overtures, to the displeasure of hospital officials.

“Changes in health care demand that health care employees stand up and do something,” said Lisa Hubbard, a spokeswoman for SEIU, which represents about 35,000 nurses in California.

SEIU members last week protested against staffing shortages and what they consider to be excessive patient loads by delivering worn-down nurses shoes to the Los Angeles office of the Healthcare Association of Southern California, a hospital industry group with nearly 200 members in the area. The event was one of several protests held throughout the nation during National Nurses Week.

“This week, nurses aren’t saying, ‘We want more candy,'” said SEIU spokesman Steve Trossman. “They’re saying, ‘We want more staffing.'”

Managed care blamed

The unions contend that managed health care has led hospitals to put profits before care, leaving too few workers to deal with an expanding population of increasingly sick patients.

Increasing staffing levels, of course, would lead to a corresponding increase in labor costs. And that would squeeze health care companies’ margins, unless those costs could be passed along to other parties. Ultimately, the lion’s share of the burden would likely fall to employers and other group purchasers of health care.

But hospitals say they are understaffed because there is a shortage of health care workers.

“It’s not a question of money. We’ve got the money. It’s a question of supply, simple and pure,” said Jim Lott, a spokesman for the hospital industry group. “The unions pointing the finger at hospitals is specious, unfounded and, we think, disingenuous.”

But others say greed is the problem.

“A small number of people are making a killing, literally and figuratively,” said CNA spokesman Charles Idelson, referring to health care corporations and their executives. “They have diverted resources that should be spent on providing direct care for patients to their own personal profit and corporate expansion.”

The unions’ intensive organizing efforts are causing friction between the parties.

The National Labor Relations Board is set to hold a hearing this summer on a complaint that arose from a CNA campaign conducted at Long Beach Memorial Hospital last year. When union supporters lost their bid to organize by 11 votes, the nurses’ association filed a complaint with the board, accusing hospital officials of illegally pressuring nurses.

Health care workers often face harassment when trying to join a union, said the SEIU’s Trossman.

“Hospitals traditionally fight very hard when their employees try to gain a voice,” he said. “It’s hard for us to get people to join the unions because of the pressure that’s put on by hospitals.”

He accused management of trying to halt unionization by doing everything from hiring anti-union consultants to firing employees. He said that the SEIU has fought back by filing “hundreds and hundreds” of unfair labor practices complaints.

Both CNA and SEIU are vying to organize workers at St. Mary Medical Center in Long Beach and other hospitals throughout the area.

“It’s not a question of us targeting the hospitals,” Trossman said. “Nurses call us all the time.”

Myrna Valmeo-Ogilvie, a nurse who has been at Glendale Memorial for 12 years, said co-workers invited CNA to organize employees at the hospital.

“We’ve had a lot of concerns inside the hospital and one of them is short staffing,” she said. “It has been brought up several times many, many times to the management level but it seemed like nothing had been done about it.”

‘Enlightened’ approach

But Trossman said some hospitals have recently begun taking a “more enlightened” approach to dealing with unions.

California Healthcare West, which has 12 hospitals in the Greater Los Angeles area, earlier this year signed agreements with CNA and SEIU that broke down some of the barriers to unionization for its employees.

“We’re hoping to take as much of the tension out of that whole process,” said Marilyn Morrish, vice president of labor and employee relations for CHW. Campaigns at CHW facilities have gone smoothly and the union has not filed any complaints since signing a pact with the hospital chain, he said.

The nurses’ union, which has some 37,000 members, has not given up on its efforts at Long Beach Memorial, which is not affiliated with CHW.

“We are not abandoning those nurses,” Idelson said. “We absolutely intend to have another election there.”

Not surprisingly, union officials said that hospitals and employees both stand to gain from organization.

Lott disagreed.

“It’s like interrupting a family situation,” he said. “That’s why we make every attempt we can to retain the family relationship.”

The hospital industry spokesman believes the unions are simply looking to increase their income.

“It’s the same reason why bank robbers rob banks. That’s where the money is,” Lott said.

He blames many of the hospital industry’s woes on rising health care costs and delayed reimbursements from health management organizations and state and federal programs, such as Medi-Cal and Medicare.

The Office of State Health Planning and Development reported that 37 percent of California hospitals surveyed in 1999 showed losses, up from 35 percent in 1998. At the same time, the average number of patients treated by each hospital grew to 8,157, up from 7,884 in 1998.

CHW reported a loss of $47 million in 2000 vs. a loss of $90 million in 1999, said company spokeswoman Lori Aldrete.

As hospitals worry about keeping their doors open, unions are finding that tough conditions leave the doors open to organization.

The unionizing trend isn’t surprising to Lott.

“If you’re an employee and you feel pressured or stressed, you look for a savior and unions present themselves as saviors, so, why not?” he said.