On Saturday, Health Professionals and Allied Employees (HPAE), a healthcare union in New Jersey, announced a “historic tentative agreement” for approximately 800 nurses and other workers at Palisades Medical Center in North Bergen, located just across the Hudson River from Manhattan. Union officials kept the workers on the job without a contract for more than a week despite a strike authorization vote of more than 90 percent by rank-and-file workers. Workers will not be able to review the tentative agreement until the day of the vote, which is scheduled for Wednesday, June 12.
These actions are flagrant violations of workers’ democratic rights. After blocking strike action, HPAE officials are attempting to pressure the nurses into ratifying a contract that they have not had time to study. In doing so, the HPAE leadership is collaborating with administrators from Hackensack Meridian Health, the network that operates Palisades Medical Center, which after a series of mergers is now the largest health care provider in New Jersey.
Nurses should reject the tentative agreement on principle and organize an independent rank-and-file committee immediately to prepare strike action. The workers’ central demands—for safe staffing levels—can only be attained through an intransigent struggle against the profit-driven healthcare system and the Democrats, Republicans and trade union bureaucrats who defend it.
The contract for the Palisades nurses expired on June 1. On the same day, contracts expired for 1,500 nurses at Cooper University Health Care in Camden and 800 nurses at Englewood Hospital in Englewood. Nurses at all three hospitals are members of HPAE. They all cast nearly unanimous votes to authorize a strike for safe staffing.
Safe staffing is essential to providing patients with the best care and to maintaining reasonable workloads for nurses. Understaffing, which has been the main reason for the current international wave of healthcare strikes, has been associated with increased risk of medication errors, worse patient outcomes, overwork and burnout.
Hours before the contracts expired, HPAE announced tentative agreements with Cooper University Health Care and Englewood Hospital. The union thus left the nurses at Palisades isolated and in a weaker position. Instead of submitting 10 days’ strike notice to Palisades management, HPAE continued negotiating and prevented the strike that the workers had authorized.
The HPAE apparatus has a history of dividing its members, even when they work for the same company. In 2020, union leadership kept the nurses at Southern Ocean Medical Center in Stafford Township separate from those at Jersey Shore University Medical Center in Neptune when their contracts expired simultaneously. The HPAE’s tactic helped management impose contracts that did not provide adequate personal protective equipment or eliminate floating nurses.
Last week, HPAE officials claimed that the agreements with Cooper University Health Care and Englewood Hospital included “substantial wage increases.” But it has not provided any details about the raises to date. If the wage increases were truly substantial, then HPAE would be crowing about them at every opportunity.
The Englewood contract establishes a ratio of one nurse to five patients, and the Cooper University contract a ratio of one nurse to four to five patients. Critical care units will have a ratio of one nurse to two patients at both hospitals. But nurses will have no means of enforcing these ratios and instead these life-and-death issues will be tossed into the largely toothless grievance and arbitration processes. The Englewood contract supposedly provides “expedited arbitration” for staffing grievances.
Hospitals routinely violate contractually mandated staffing ratios. Contracts such as those at Cooper University and Englewood Hospital put the onus on nurses, who are already overburdened with paperwork, to file grievances when a shift is understaffed. On the rare occasions when a decision is made in the nurses’ favor, the hospital does not face a significant penalty, and the nurses are not adequately compensated.
At Mount Sinai Hospital in New York, for example, nurses in the neonatal intensive care unit received little more than a day’s pay for having endured three months of understaffing. In any case, nurses do not want to be paid “bonuses” for enduring exhausting and unsafe conditions, they want them eliminated.
On June 6, HPAE proclaimed that “an overwhelming number” of nurses at Englewood Hospital and Cooper University had ratified the new contracts. It did not provide any vote totals at either facility. If this is true, it is only a measure of the fact that nurses have no confidence HPAE officials would bring back anything better if they voted down the first deals.
HPAE later announced that a federal mediator had become involved in negotiations at Palisades. Federal mediators are far from neutral arbiters. They use the power of the state to enforce the interests of the corporations and banks. The involvement of a federal mediator is another clear sign that a betrayal of the Palisades nurses is being prepared.
HPAE’s brief statement about the tentative agreement mentions “safe staffing improvements and wage increases” without elaborating on either point. The Palisades workers have a right to know the details of the tentative agreement, but the union refuses to reveal them until the day of the vote. The only reason that the union would keep the details hidden until the last minute is because they know it does not meet workers’ demands. Fearing an explosion of anger and opposition, the union officials want to rush through a vote before workers can talk to each other and organize to defeat this sellout.
Like other unions, HPAE is encouraging workers to appeal to Democratic lawmakers to pass legislation that would supposedly ensure safe staffing levels. Union officals are promoting the “Patient Protection and Safe Staffing Act,” a bill the Democrats claim that would mandate safe patient-to-staff ratios in New Jersey hospitals. The HPAE has brought nurses to Trenton, the state capital, for rallies to urge legislators to pass this bill.
But similar bills have been proposed in the state legislature every year for the past 20 years. These bills have been stillborn; never making it out of committee. Moreover, in states such as Massachusetts, California and Oregon, which have passed safe staffing laws, the hospitals routinely ignore them without facing meaningful consequences.
The overriding priority of the Democratic Party is not to protect healthcare workers and patients or any other section of the working class. It is funding war. This includes the continued support for Israel’s genocide in Gaza and escalating the proxy war against Russia in Ukraine, even at the risk of inciting a nuclear war. Despite the intense factional fighting between the Democrats and Republicans, these parties are united on the agenda of global war, which requires attacks on the working class.
As an affiliate of the American Federation of Teachers (whose president, Randi Weingarten, is an active promoter of imperialist war), HPAE is determined to keep workers from breaking with the Democratic Party and waging an independent fight. The nurses at Palisades will not be able to win safe staffing, adequate raises and the best care for their patients if their struggle remains within the straitjacket of the union bureaucracy and appeals to either capitalist party.
To prevent the HPAE from betraying them, Palisades workers should reject the tentative agreement. To wage a genuine fight for safe staffing and better pay, the nurses will need to form a rank-and-file committee that they themselves control democratically. This fight is inseparable from the struggle to eliminate the profit motive from the healthcare system and establish a socialist system of medicine.
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