Why unions matter for nurses—and our patients
Longtime UNAC/UHCP President Kathy Sackman, RN, reflects on our union’s beginnings and its future in this wide-ranging interview
Question: What attracted you to the field of nursing?
Answer: Growing up I took care of my grandmother and my mother before she died. In the 1950s there wasn’t much to do for women other than nursing and teaching, and I really wanted to go into nursing.
I went to a “diploma school” in Pittsburgh, a three-year program where you lived at the hospital. Students rotated through all services. It was a great way to learn nursing. When I graduated, I worked in an emergency room in Pittsburgh and came to California when I got married. At Kaiser Fontana in 1964, I started in Med-Surg, and then opened up the first ICU.
In the ‘50s and ‘60s nursing was much different in the hospitals. We didn’t have the technology hospitals have today. You didn’t have a lot of physicians around so nurses provided a lot of hands-on treatment and used a lot of independent judgment. Patients stayed much longer and you got very close to the patient and the family. It was easier to show more compassion and caring. I remember individual patients I took care of in the ‘50s and ‘60s because I got to know them and their families so well.
Q: What made you see a union as the answer?
A: Very few nurses were in unions in Southern California at the time and RNs were forbidden from being in their own bargaining unit. Unions were not really thought of for nurses. They were for people like construction workers. When you graduated you were told to join the “professional association,” but the association at that time did not have collective bargaining rights for many nurses.
At Kaiser Fontana, the steelworkers’ union represented employees other than nurses. In the late ‘60s the union employees went on strike. At 6 a.m. on the day the strike started, my nursing colleagues and I were called at home and told to report to work immediately and plan to work 16 hour shifts. We were told if we didn’t show up and work the shifts, we wouldn’t have a job. Some of us were assigned patient care, but the rest of us were assigned the work of the strikers: scrubbing floors and toilets, folding laundry, stocking supplies. The strike lasted four days, and the strikers won something the nurses had been asking for: a dental plan. During those days, a small group of nurses would meet once a year with management and told what kind of raise—if any—we would get. We asked for a dental plan and were told we didn’t need it and, even if we did, the employer didn’t know how to put one together.
When the Steelworkers got the dental plan we were very angry with Kaiser. We got together for a meeting. We knew we should do something together, but we didn’t want a union, just a way to talk to the employer and have a voice in staffing and quality patient care. We formed our own group and called it an association. At that time I was six months pregnant with my son Michael. Pregnant nurses weren’t allowed to continue to work after their sixth month, so I was forced to take a leave and agreed to become the association’s secretary. I also knew how to type.
Q: How did UNAC get formed?
A: Our group interviewed a few unions, including the California Nurses Association (CNA). Two of the unions we interviewed didn’t understand nursing so we rejected them. CNA represented nurses, had contracts in Northern California, and it was trying to organize nurses in Southern California.
CNA demanded that we get 75 percent of the nurses in our association to sign union authorization cards. They also demanded one year's dues up front before CNA would meet with us. We did that. The National Labor Relations Act didn’t cover us, but the employer agreed to an election run by the state. We won the election, and we worked with CNA reps to get a bargaining proposal together.
We had four sessions with Kaiser Fontana management when the CNA rep serving as our chief negotiator was laid off. We were totally on our own.
We decided we could form our own organization. We met with nurses at four other facilities organizing with CNA (who had also lost their CNA staff rep). We told CNA we were no longer interested in them. That’s how UNAC was formed. After another election, we were certified as UNAC. We concluded our negotiations with Kaiser Fontana for our first contract.
From 1971, when we formed our association, through 1974, we had no office. We worked off the dining room tables in our homes, often with our kids running around us. In 1974, we rented a one-room office, and hired a part-time secretary. We continued organizing—and we grew. We hired our first full-time staff person in 1976. By 1977, we had organized 2,500 nurses.
Q: Why affiliate with AFSCME?
A: As we continued to grow, we started thinking about affiliating with an international union to build power. For a year and a half, members interviewed a lot of unions. We decided to go with National Union of Hospital and Health Care Employees (NUHHCE), which at the time was an autonomous affiliate of the AFL-CIO. With NUHHCE we could still maintain our autonomy and structure.
A year later, NUHHCE and our UNAC members voted to affiliate with the American Federation of State, County and Municipal Employees (AFSCME) to increase our power. The AFSCME international president committed to setting up a nursing committee for all of the AFSCME nurses, supporting our private-sector nurse organizing and having a much more robust presence in moving federal legislation. We have been very pleased with our NUHHCE/AFSCME affiliation.
During that period of change and growth at the national level, we continued to organize at home: Garden Grove, Fountain Valley, St. Francis, the remaining unorganized Kaisers, Sharp, and Tenet. AFSCME helped us with by providing staff, organizing and bargaining expertise, and financial resources. Medical professionals, such as physician assistants, began to join our ranks.
Q: What do nurses and medical professionals gain from their membership in UNAC?
A: It’s all about respect, better staffing, and more recognition professionally and economically.
The industry was, and still is, very paternalistic. Hospital administrators who were not nurses laid down edicts on how we were to do our jobs and what our hours and pay would be. Before the union, there was no recognition of longevity or seniority with pay or differentials. There was never any recognition or pay for additional education. It was just wrong. Now, with a union, nurses have a voice in staffing, wages, time off to take care of our families, and the policies that affect patient care.
Q: Looking back, what makes you most proud?
A: There are so many things we’re proud of. I’ve very proud of our union election at Sharp in 1996. The nurses there really wanted a voice for parity, equity, respect and improving patient care. The company ran an awful anti-union campaign. They even sent an anti-union video to everyone’s house. The organizing experts thought we were going to lose the election, but the nurses knew we’d win. And we did—by a large majority.
In 2001, the optometrists at Kaiser Permanente joined our union using the card-check process we negotiated in our Labor Management Partnership. A card check is different from traditional organizing because the employer agrees to recognize the employees’ desire for a union once a majority sign up to become union members. This is a fairer alternative than the broken union election process, which gives unscrupulous employers the opportunity to campaign against the union. This group of health care professionals hadn’t been in a union before, and they are non-nurses who are comfortable in our union because they see how together we could win a voice on the job and a strong contract. The optometrists are now one of our most active and involved units.
We’re proud of the staffing ratios at Kaiser Permanente that are better than the state minimum. We are still implementing that agreement and there’s a lot of work to be done, but it’s an important milestone.
Q: Who has inspired you in your work?
A: Nurses are the most wonderful people in the world to work with. And it is so exciting now to see younger nurses coming into the profession, to see young men coming into the profession, and to see the different opportunities and avenues for nurses and medical professionals available now.
Q: What can UNAC do for health care reform?
A: We have the power to help make genuine change happen that benefits our patients and society as well as nurses. We have always been involved in trying to achieve health care reform and access to health care for all. We have such a great chance to advance through political action around health care. But the only way that will happen is if nurses and all medical professionals stay involved with their union, which is our voice in Congress, Sacramento and city councils. Nurses are uniquely qualified to fight in the political and legislative arenas for reforming health care and making it accessible for everyone. We have the expertise and the credibility. Patient care is about more than taking care of our patients in our facilities. We need to stand with them where laws are made also.
1972 – RNs from several Southern California hospitals decided to form an independent organization in order to give working Staff Registered Nurses a say in the quality of the patient care they provided, an impact upon the conditions within which they provided that care, and a voice in the political arena where the legislation affecting their personal and professional lives was enacted. The United Nurses Associations of California (UNAC) was born. The basic philosophy of this newly created organization was – and continues to be – that RNs should represent RNs.
1974 – The Health Care Amendments to the National Labor Relations Act were passed by Congress, giving health care employees the right to organize. UNAC won many elections and membership grew.
1975 – UNAC began classes in labor-management relations for RNs. More than 50% of our members have attended classes, learning about collective bargaining and the vital role members play in keeping our union strong.
1980 – UNAC expanded its constitutional membership clause to include all medical professions as defined by the Supreme Court decision on hospital bargaining units.
1987 – UNAC affiliated with the National Union of Hospital and Health Care Employees (NUHHCE) to gain a greater voice on issues impacting health care workers nationally.
1989 – To attain an even stronger voice in our economic and professional lives, 25,000 NUHHCE members, including UNAC members, voted overwhelmingly to affiliate with the 1.3 million member American Federation of State, County and Municipal Employees (AFSCME). AFSCME is affiliated with the 13 million member AFL-CIO. Our affiliation with AFSCME, a powerful International Union, gave members a major voice on the national scene. Shortly after affiliation, our hope of a national organization for working nurses became a reality. United Nurses of America (UNA), an organization of working nurses within AFSCME, was created.
1999 – Members voted to change our union's name to the United Nurses Associations of California/Union of Health Care Professionals (UNAC/UHCP) to recognize that our union also represents non-RN medical professionals. RNs and medical professionals now have a major voice in all the decisions affecting their lives through UNAC/UHCP, NUHHCE, AFSCME, and UNA.
2000 – Kaiser affiliates reach an historic national agreement with the company. The agreement contained significant wage increases, pension enhancements and improved hospital staffing.
2003 – Tenet affiliates begin implementing new California-wide model agreement, which eliminates merit pay and provides for across-the-board wage increases, enhanced nurse participation in decisions, and union security.
