Why some healthcare unions are keeping strikes short

One-day strikes and other "fixed-duration strikes" — defined as those with a short duration and predetermined time limits — are common at hospitals.

While some healthcare unions have held longer or open-ended strikes, most have opted for shorter strikes in 2024. 

From 2021 to 2023, the majority of healthcare strikes were of a fixed duration rather than indefinite walkouts, Johnnie Kallas, PhD, an assistant professor at Champaign-based University of Illinois School of Labor and Employment Relations and project director of the Labor Action Tracker, told Becker's. The tracker, a collaboration between Ithaca, N.Y.-based Cornell University and the University of Illinois, serves as a strike activity database. 

More than 20 healthcare strikes have been reported by Becker's in 2024, with those lasting fewer than five days being the most common. For example, Honolulu-based Hawaii Pacific Health's Kapi'olani Medical Center for Women and Children experienced a one-day strike in September, and University Medical Center in New Orleans saw a similar strike in October.

Despite their brevity and predetermined endings, fixed-duration strikes still require health systems to activate contingency plans to ensure uninterrupted patient care. 

At University of California San Francisco, where healthcare workers held a 2-day strike in November, the system addressed maintaining operations in a statement.

"UCSF Health intends to continue regular operations, including emergency care, and expects to be able to maintain the majority of scheduled appointments and surgeries," the system said. "The health system is working to minimize impacts on patients, with plans in place to bring in qualified replacement staff. Despite these efforts, some procedures may need to be rescheduled. Patients whose appointments are affected will be contacted and the health system will prioritize rescheduling their care."

At Kaiser Permanente locations in Southern California, where mental health workers began an open-ended strike on Oct. 21, the system also highlighted care coordination.

In a statement to Becker's in October, Oakland, Calif.-based Kaiser Permanente said all its members "will continue to have timely access to individual therapy appointments during the strike. Patients have the opportunity to be seen by a professional in our extensive network of highly qualified, licensed therapists if their regular provider chooses to take part in the strike. Where necessary, we are contacting patients and offering options that meet their needs." 

Fixed-duration strikes may be particularly prominent in healthcare due to regulatory requirements mandating a 10-day notice of work stoppages, Dr. Kallas said.

"As part of that notice, they usually will indicate whether the strike will be for a certain amount of time, or will be indefinite in nature," he said. "So that legal apparatus or regulatory state that's unique to healthcare also influences the emergence of this type of strike."

Even short strikes can have significant financial consequences for hospitals, particularly as costs for temporary staffing replacements rise, Dr. Kallas added.

"That economic impact is stronger in the healthcare setting, especially amongst nurses, than it might be in other settings," he said.

Regarding their effect on reaching agreements, fixed-duration strikes do not often result in quick contract resolutions, Dr. Kallas noted.

"You're basically saying, 'At the end of this strike, we're going to return to our work with or without an agreement,' which generally means that it's very rare for these strikes to be immediately followed with a contract agreement," he said. "It usually takes at least a couple months, and in some cases it takes longer than that of continued negotiations until there's some sort of agreement reached."

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