Protests erupted at 15 HCA Healthcare hospitals nationwide last week as nurses demonstrated their anger over the company’s planned layoffs and furloughs as well as severe shortages of personal protective equipment (PPE) to combat the coronavirus pandemic.
These protests are erupting under conditions where hospitals and health clinics across the country have already laid off or plan to lay off thousands of health care workers to circumvent budget shortfalls. The central and most persistent problem raised by nurses since the pandemic’s start, and which has fueled health care workers’ anger, is the absence of N-95 masks to protect staff from the deadly COVID-19 virus.
One protesting nurse from an HCA hospital in Brooksville, Florida told a local news station that the pay cuts “are especially disgraceful and a slap in the face while we have struggled, often without adequate protective support from HCA, to protect our patients, keep ourselves and our families safe, and limit the spread of the virus in the face of this dangerous pandemic.”
The protests, which were officially called by the National Nurses United (NNU) union, took place on Thursday and Friday in six different states: Florida, California, Nevada, Missouri, Kansas and Texas. NNU affiliates participating in the protests hold the contracts for an estimated 10,000 registered nurses at for-profit HCA Healthcare, the largest hospital chain in the country. Based in Nashville, Tennessee, in 2019 HCA managed 185 hospitals and 119 freestanding surgery centers in the US and UK.
In a statement on the NNU website, the union cited the workplace “risk due to inadequate provision of optimal personal protective equipment in the face of a still-raging pandemic.” Union Vice President Malinda Markowitz said, “It defies belief that HCA, which has widely failed to provide the protection nurses need, wants to further punish them with layoffs and other cuts.”
Despite such statements, the reality is that it has been the long collaboration of the NNU and other health care worker unions with austerity measures imposed by corporations and both big business parties that has left nurses and other health care workers particularly vulnerable in the current crisis.
Evidence of hospital neglect and dangerous working conditions is mounting for health care staff on the frontlines fighting COVID-19. A survey released by the NNU earlier this month found that a staggering 87 percent of American nurses have been forced to reuse protective equipment while working. In the survey, one researcher said that “dangerous health care workplace conditions have become the norm.” Lack of PPE has been a central contributor to the rising death toll among nurses, which stands at more than 100 since the pandemic began. Nearly 65,000 health care workers have become infected with the novel coronavirus.
Health care workers have sharply rebuked hospital policies that have encouraged wearing reused and/or decontaminated N-95 respiratory masks that has placed thousands of lives at risk. Experts in the medical community have repeatedly noted that there is no valid or scientifically driven evidence that wearing reused or decontaminated N-95 masks is a safe alternative to daily replacements for preventing exposure to the virus. Evidence-based techniques that were standard practice before the pandemic have been swiftly discarded in many health care facilities.
This policy of criminal endangerment has been approved by both the Centers for Disease Control and Prevention (CDC) and the National Institute for Occupational Safety and Health (NIOSH). In early April, the CDC passed guidelines that gave health care employers the green light to force workers to reuse surgical equipment. NIOSH also moved to safeguard employers against any liability for infections and deaths of staff. The organization gave assurances that health care conglomerates would not be cited for violating respiratory protection rules that placed their workers’ lives at risk if they followed CDC guidelines.
Even though tens of thousands of hospital workers have been infected with COVID-19, these numbers are still a vast underestimation of the full weight of the health crisis. Hundreds of thousands of potentially exposed people are still deprived of testing. In the same NNU survey, 84 percent of respondents indicated that they had not been tested for the virus. Among the 23,000 nurses surveyed who stated they received a test for the virus, 500 tested positive while another 500 had their results pending.
Although these conditions are documented in the majority of hospital settings, HCA has become one of the most notorious chains working systematically to deny workers protective equipment and implement a wave of layoffs to boost company profits.
In addition to laying off workers, HCA is planning to implement further wage freezes and other pay cuts through reduced hours, which will inevitably reduce the incomes of hundreds and send workers and their families into acute financial strain. The claim that the conglomerate has no money to dispense PPE or stop layoffs, wage freezes or other pay cuts is belied by the fact that it acquired a multibillion-dollar federal bailout package from the CARES Act in April.
Nurses have emphatically pointed out that HCA is using the pandemic and losses of company revenue as a pretext for cutting costs and further enriching itself. The HCA received $700 million in bailout funds from the federal government and has amassed another $4 billion in Medicare loans. In the past decade alone, HCA has accumulated more than $25 billion in profits.
HCA Healthcare operates 15 hospitals in its West Florida division along the Gulf Coast, its largest concentration in the state. A registered nurse at Largo medical center in St. Petersburg said, “They’re threatening to cut us, hours, positions,” while later emphasizing that the way forward is to take matters into workers’ hands. “They’re basically saying ‘if you don’t do this, then we will do this.’”
Nearly 2,000 of the 23,000 responses to the NNU national survey came from RNs in Florida, where nurses from eight hospitals rallied over the two-day period. Consistent with national rates, 83 percent of health care workers in Florida reported that they were compelled to reuse single-use disposable respirators or masks while treating a COVID-19 patient.
In addition, more than two-thirds of RNs in Florida cited having to work with exposed skin when caring for confirmed or potentially infected patients. A third of those surveyed said they were required to use “decontaminated” respirators with confirmed COVID-19 patients and well over 80 percent said they have not been tested for the virus.
In comments to local media, nurses highlighted that they have been on the frontlines helping the sickest COVID-19 patients and expressed outrage that the company was orchestrating plans for a wage freeze and attacks against their income. Barbara, a nurse at St. Petersburg General Hospital, said, “Now they’re saying that they’re going to either have layoffs or they’re going to cut hours when actually we don’t have enough help now.”
In response to widespread opposition, HCA Healthcare released a statement that amounted to a total repudiation of the demands being made by hospital staff. In its open letter to the protesting nurses, the corporation arrogantly stated, “It is surprising and frankly disappointing that unions would demand pay raises for their members and may reject the continuation of a generous pay program that is providing continued paychecks for more than 100,000 colleagues.”
The so-called pandemic “pay program” implemented by HCA in March and extended through June is not a show of generosity but is in effect a wage reduction and cost-cutting measure that has further impoverished already struggling health care workers. The program allows employees who are called out or affected by facility shutdowns and cannot be redeployed to receive 70 percent of their base pay. This amounts to a 30 percent pay cut, which is a large reduction of income for many.
Moreover, since pay cuts are not considered on an equal basis when determining a worker’s eligibility for unemployment insurance, most workers who are out of work but receive reduced pay may not even qualify for unemployment compensation. In many states, arbitrary and draconian provisions exist to deny benefits to workers receiving cuts of a certain rate.
HCA has placed more than 16,000 unionized health care workers on furlough at some point during the pandemic, despite that the fact that the wage-reduction provision is not even part of the contracts that have been officially put in place to determine employee compensation. The company is also touting a 30 percent pay cut by senior leadership and CEO Sam Hazen donating his pay for April and May to a company fundraiser. These are token measures that hardly affect the wealth of top executives, including Hazen, who receives a large portion of his wealth from shares in the company’s stock.
It is important to note that while the NNU called the protests against the hospital chain, the union has done everything in its power to handcuff workers behind the profit-driven mandates of the HCA executives and the company’s wealthiest shareholders. The NNU is following the same tried and tested script of systematically suppressing all upsurges of health care worker opposition while ensuring that concessions are imposed on nurses.
In early April when the pandemic was beginning to make its ferocious spread across the country and was overwhelming scores of hospitals, the NNU called a measly two-day protest as a tactic to let workers blow off steam and quell the anger over the lack of preparedness and PPE for the brewing pandemic. Now the union has tried the same method, but this time is now working side by side with HCA to impose a worthless concessions deal.
HCA is demanding that the nurses choose between an indefinite number of layoffs and no 401(k) match for this year, or no layoffs and no nurse pay increases for the rest of 2020, according to an ABC affiliate. The track record of the NNU, which has forced one concessions contract after another over the past decade while refusing to organize its members for nationwide strike action to demand better pay and conditions, leaves little doubt that another betrayal is in the works.
No confidence should be placed in the pro-corporate health care unions. Workers should take the conduct of the struggle into their own hands. In every hospital, medical center and health clinic, nurses and other frontline health staff should form rank-and-file safety committees to demand full protective gear and equipment to combat the pandemic, full compensation to all staff, and the rehiring of all laid-off workers. This must be combined with a politically independent and socialist movement against the capitalist profit system, which includes the mobilization of the entire working class and nationalization of the health care industry.