Strike Nursing: The Ethics of Crossing the Picket Line

• With over 300,000 views, a nurse’s viral TikTok on being a strike nurse opens up the conversation of what it means to cross the picket line.
• History of the word scab and what it represents to different industries and their own unions.
• The financial benefits of being a strike nurse, and how those benefits allow healthcare facilities to pit nurses against one another.

Following national attention on nursing strikes, one nurse went viral for her “Day in the Life as a Strike Nurse” TikTok. Mireya Bustamante RN BSN has amassed over 50,000 followers for her nurse lifestyle content.

However, this viral video stoked the flames online with swarms of comments such as “appreciate your help in perpetrating corporate healthcare greed. there are 1000 of ways to make money as a nurse. you picked one that harms RNs” and “that you don’t feel shame in posting this is insane. undermining staffing standards for the sake of a buck.”

These comments reflect common sentiments about workers who “cross the picket line” by working during a labor strike and earn them the title of “scab.” But does crossing the picket line as a nurse have the same ramifications as it does in other industries?

Travel Nurse vs Strike Nurse

Traditional assignments for travel nurses are often for several months with the nurses being given six to eight weeks of notice. These assignments are typically for things like maternity leave or seasonal spikes in population.

In cases where nurses are needed on shorter notice, the assignments are filled by rapid-response nurses. These nurses are essential in emergency situations where a facility may otherwise be overwhelmed. Rapid response assignments can be given as little as two days’ notice. 

Strike nurses, as the name implies, are another subsection of travel nurses that work during labor strikes. Hospitals are typically given at least a week’s notice of when their staff is striking in order to contract temporary nurses to fill in during that time. Strike nurses are also some of the highest–paid nurses due to the hospital’s desperation during union negotiations.

Strike nursing is also one of the more stressful assignments, as there will likely be chaos and disorganization in the facility due to a lack of typical staff. Strike nurses bear the burden of a patient’s care but are not always given the tools to succeed by a facility’s management. This can lead to patient suffering such as mothers being made to labor without anesthesia.

What is a Scab?

The term “scab” comes from the 1800s to use against someone who chooses to work with a company during a labor strike. It pulls from its early usage to describe someone with a low moral character. These workers are also known as “strikebreakers” and are often used to undermine a union’s bargaining power during a strike.

In other unions like the Writers Guild of America (WGA) and the Screen Actors Guild (SAG) they’ve instated mandatory reporting for scabs during the current strike. Union members found working with struck production companies can be expelled from the union and non-union members are barred from ever joining the union itself. To most unions scabbing showcases a callous lack of care for the union’s efforts to better the working conditions for everyone.

Crossing the Picket Line

Nursing unions are different. The care they give to patients is essential and cannot be interrupted without catastrophic consequences. However, that doesn’t mean nurses are barred from striking.

A nurse’s union cannot call for a strike itself. Instead, a majority of the nurses in a given hospital must vote to strike. The facility must be given notice of the strike. This notice is meant to stop the intake of new patients and allow the facility time to transfer patients. It also gives the hospital time to contract with strike nurses to fill in during the strike.

This notice does not stop healthcare facilities from attempting to undermine striking nurses with temporary strike nurses. Nurses are naturally empathetic to the struggles of patients and a hospital may use that to their advantage by claiming they need strike nurses to ensure their patients are safe, when in reality their lack of care for patient endangerment is often what incites the strike itself. It pits nurses against one another while absolving the facility of their capability to stop the strike at any time.

Strike contracts are another way healthcare facilities can undermine the value of a nurse’s work, even for the temporary nurses working during the strike. Strike contracts can require up to six 12-hour shifts a week or require working 72 hours in a single week. These assignments are also open-ended meaning that a strike nurse may be working in these conditions for months at a time.

The proposed benefits of a strike contract for nurses are that the high costs of hiring strike nurses put financial stress on the institution. For example, the 2016 strikes against Allina Health cost the system $149 across its five hospitals.

Strike nurses are typically paid up to $100 an hour, while the average nurse is paid $39 an hour. That hourly pay does not take into account the billing percentage travel nursing agencies take out of the nurse’s wage, which made one staffing firm over $1.1 billion dollars in 2021. 

The TikTok Strike Nurse

In the case of Mireya Bustamante, there is no clear answer to what she should have done.

The nurse attended school in Austin and worked in Ascension hospitals for years, although she seemingly left before the nurses at Ascension unionized in September of 2022.

Strike nurses are a necessary part of the system that allows nurses, as essential workers, to strike. Strike nurses, especially those with public influencer platforms, have the opportunity to not only broaden a strike’s audience but also speak on the issues at hospitals as a sign of solidarity towards their community.

What brought people’s negativity to Bustamante was her misinformation regarding nursing strikes, like claiming they occur when “nurses disagree with their union” rather than occurring when a healthcare facility and nursing union fail to reach a consensus during negotiations. Her attitude around working a strike as a “bucket-list item” felt tone-deaf compared to the reality of the nursing staff shortage and the lives it costs.

Following her two videos on being a strike nurse she released a follow-up to the “nurse bullying” after many comments repeatedly questioning how she presented working the strike. Unfortunately, this did little to rehabilitate her online reputation. The follow-up video did not contain any information about the strike, or why strike nurses may be necessary.

Influences like Bustamante are in a unique position as they are often not prepared to be educators despite creating content that positions them as such.

The Bottom Line

Strike nurses are not the enemy, they are nurses who deserve the same recognition and sustainable working conditions that unionized nurses are fighting for.

That doesn’t make strike nurses a safe or sustainable option for healthcare facilities facing a strike. A study across 20 years found that in-hospital mortality increased by 19.4% during a strike with no improvement in hospitals that had hired temporary strike nurses compared to those had didn’t.

Strikes emphasize the disparity between a facility‘s claims to value its nursing staff and the lived reality of working nurses. One healthcare economist points out that “there is no economic incentive, right now, for hospitals to invest in adequate nurse staffing, pay nurses well, or provide a good working environment for nurses.” Until hospitals are able to come to an agreement with unions, or the federal government mandates working conditions for nurses, there are likely going to be more strikes and more strike nurses. 

Read More