Originally Published at HR Pulse
Is the act of crossing a picket line morally right or wrong? It’s an ethical assessment contingent upon the person’s values, beliefs and labor perspectives. The “right” or “wrong” perception is predicated on the intricate and diverse opinions regarding effective ways to support workers’ rights while upholding fair labor practices. There are always unique circumstances of each strike situation where opinions are formed — and more often than not, the scales are tipped toward a negative impression of those who cross a picket line, i.e., “scabs.”
The term “scab” evokes various opinions and heated debates across social media platforms, workplaces and even traditional media outlets. Some individuals within these vocal areas perceive working during a strike as an act of betrayal, while others view it as an essential role, especially when it concerns the healthcare industry. Given the fact that healthcare strikes are often emotionally charged and those who cross picket lines are automatically labeled “scabs,” it’s vital that we reframe the narrative in these situations.
Healthcare facilities are constantly negotiating with organizations such as the Nurses Association (NA) regarding expiring contracts. Often, a mutual agreement cannot be achieved, and nurses vote to strike. The vote to strike creates an instant staffing shortage that needs to be addressed quickly to ensure the proper level of patient care as well as other services such as nursery, pediatric and labor and delivery.
Nurses who fill in during strikes are not “scabs.” They are not a short-term solution, masking an underlying problem. Instead, they are dedicated, compassionate healthcare experts who step forward to guarantee that patients continue to receive vital care when regular nurses are advocating for improved working conditions. These invaluable healthcare professionals serve as a crucial link, assisting hospitals and healthcare institutions in ensuring uninterrupted patient care during some of the most demanding and intricate circumstances.
It is important to note that a nurse’s union cannot unilaterally declare a strike; instead, most nurses within a given hospital must vote in favor of striking. The facility must also be notified in advance of the impending strike. This notification halts the intake of new patients and allows the facility time to transfer existing patients. It also allows the hospital to contract with strike nurses to cover during the strike.
Morally correct, publicly shamed
Mireya Bustamante, a temporary nurse who chose to provide healthcare services during a strike, was recently profiled by Becker’s Hospital Review. The publication wrote about how Bustamante faced significant criticism when she posted a TikTok video of her experiences working during a nursing strike. Via the social media platform, she chronicled traveling to the strike location, hotel stays and her onboarding nursing session. Bustamante quickly received backlash from the TikTok community in the form of anger for choosing to cross the healthcare picket line while her fellow nurses were negotiating their job conditions.
The online community accused Bustamante of betrayal and lacking solidarity with her comrades, even going as far as portraying her as a “scab” and a “bootlicker.” Despite the harsh labels, some video commenters defended her and expressed gratitude for her commitment to patient care. Other commenters acknowledged the hospital’s financial aspects and questioned the labor negotiation’s overall impact.
Bustamante also faced undue criticism because of misinformation about nursing strikes, including the misconception that they occur when “nurses disagree with their union,” when, in fact, they typically happen when healthcare facilities and nursing unions fail to reach a consensus during negotiations. However, the Bustamante/TikTok incident sets a precedent for a clear case of changing the “scab” narrative for temporary nurses crossing a picket line to one of gratitude.
When nurses go on strike
As previously mentioned, healthcare facilities must provide a reasonable standard of care and navigate legal compliance during strikes. These facilities must provide emergency services guided by ethical principles emphasizing patient well-being and dignity. However, depending on factors such as strike duration, preparation and the healthcare facility’s response, there’s always a potential risk to patient care.
Healthcare organizations understand the gravity of their responsibilities to the community during a strike and take it very seriously. In the event of a strike the hospital, or hospitals, must fulfill as many of the vacated staffing requirements as possible to continue providing care to the community. If a nursing strike occurs, there is a complex set of dynamics at play:
- Duty of Care: Healthcare facilities must provide a reasonable standard of care and ensure qualified staff are available to meet patients’ needs. When nurses are on strike, healthcare institutions must find effective ways to fulfill this duty and maintain the quality of care.
- Legal Compliance: Intricate laws and regulations govern patient care, labor relations, and healthcare operations. These legal requirements remain in effect during a strike, and facilities must adhere to these laws.
- Emergency Services: Healthcare facilities are legally obligated to provide emergency medical services, irrespective of labor disputes. These services include emergency room care and life-saving interventions. Hospitals must ensure these services are readily available and staffed appropriately during a strike.
- Mitigating Harm: In a nursing strike, healthcare facilities must take reasonable measures to reduce patient harm. These measures include performing actions such as bringing in temporary or replacement workers.
The role of staffing agencies
Nurses’ strikes can have an impact on patient care. Still, healthcare facilities are committed to upholding legal and ethical obligations to safeguard patient safety and maintaining essential services during such labor events. Ethical considerations, underpinned by adherence to professional standards and principles, play a pivotal role in navigating these complex situations. Those temporary nurses who choose to cross picket lines should not be viewed as “scabs” but rather as individuals who help healthcare facilities uphold their legal obligations and ethical standards — their image and overall situational narrative must reflect the positive aspect of their actions.
In addition to temporary nurses, the narrative needs to change for the staffing agencies offering these services. Staffing agencies are instrumental in providing the highest quality nursing personnel available. They implement rigorous screening and credentialing processes that select only certified, licensed, and well-trained nurses capable of performing effectively during a strike. Moreover, these organizations excel in efficiently onboarding their nursing staff in alignment with customer expectations and strict compliance with state and federal guidelines.
Staffing agencies recognize that managing a strike extends beyond the nursing staff alone; it entails having a proficient management team to oversee operations and ensure a seamless transition. This collaborative approach involves close coordination with facility leaders to deliver comprehensive staffing solutions tailored to unique requirements during challenging periods.
Often, the only way to ensure continued patient care for a hospital experiencing a strike is through the support and dedication of a staffing agency. Staffing agencies enable healthcare organizations to fulfill their mission — even in challenging circumstances. Any healthcare worker electing to conduct services through a staffing agency or personal choice should not be viewed as a tyrant.
Mireya Bustamante’s public video diary is a testimony to her healthcare dedication, and nursing professionalism in the face of an improper characterization of valiant healthcare efforts. She may not have taken the Hippocratic Oath (not required for graduating nurses), still nurses are often aligned with the Nightingale pledge, a document written in 1893 and named in honor of the founder of modern nursing, Florence Nightingale. Perhaps there will be more brave individuals who put treatment above turmoil and share their experiences to help reshape the striking nurse narrative to be overwhelmingly positive.