THE RESURGENT STRIKE: UNION REVITALIZATION THROUGH MILITANT IDENTITY A Thesis Presented to the Faculty of the Graduate School of Cornell University In Partial Fulfillment of the Requirements for the Degree of Master of Science by John Stephan Kallas August 2020 © 2020 John Stephan Kallas ABSTRACT After decades of decline, strikes have re-emerged across the United States since 2018. Much of the literature on union revitalization has bypassed the role of strikes, arguing that labor’s traditional weapon is ineffective in the twenty-first century. In this thesis, the author argues that strikes remain an important component of union revitalization. He answers three related questions regarding strikes as a source of union revitalization and the factors that lead to strike activity through a case study of a militant nurse union in California. In the major campaign analyzed, nurses struck nine times over a two-year period to preserve their collective bargaining agreement against nearly 100 proposed concessions. The role of leadership and identity emerged as important factors in strike incidence and sustaining militancy over time. BIOGRAPHICAL SKETCH John Kallas is a M.S./Ph.D. student in the Labor Relations, Law, and History department at Cornell University’s School of Industrial and Labor Relations. His research focuses on union strategies and labor militancy in the U.S. healthcare and education sectors. He is also interested in non-institutional forms of workplace unrest. He received a B.A. in Politics (High-Honors) and History from Oberlin College in 2014. He then worked as a labor organizer for multiple unions in healthcare before beginning graduate school at Cornell University. iii ACKNOWLEDGMENTS I want to first thank everyone I spoke with at the California Nurses Association. I promised to maintain confidentiality in this thesis, but I greatly appreciate the nurses and staff who took time out of their incredibly busy schedules to talk with me. At Cornell, I especially thank Alex Colvin and Rose Batt. Alex provided generous funding for travel to California. He also spent numerous meetings helping me flesh out my ideas and questions while maintaining a broader research focus. Rose provided very helpful advice on how to conduct interviews and invaluable feedback on multiple drafts that made this thesis considerably stronger. I also want to thank Dave Blatter, Laura Carver, Virginia Doellgast, Matt Fischer-Daly, Eli Friedman, Shannon Gleeson, Nick Krachler, Chad Rosenbloom, Katherine Sender, Dana Trentalange, and Ethan Whitener for providing helpful and thoughtful comments throughout this process. I close with a special thanks and love to my family. Everything that brought me to this first tangible step in an academic journey would not have been possible without them. iv TABLE OF CONTENTS Biographical Sketch………………………………………………………………………………iii Acknowledgements……………………………………………………………………………….iv Introduction…………..…………………………………………………………………………....1 Strikes in the United States ………….…………………………………………………………....3 The Sources of Strikes and Labor Militancy……………………………………………………...6 Strikes and Union Revitalization …………………………………………………………6 External Determinants of Labor Militancy………………………………………………..9 Internal Determinants of Labor Militancy…………………………………………….....15 Leadership, Union Identity, and the Formation of Labor Militancy………………...…...20 Methods………………………………………………………………………………………......21 Case Selection and Background………………………………………………………….21 Access…………………………………………………………………………………....22 Sampling………………………………………………………………………………....23 Data Analysis…………………………………………………………………………….24 CNA and a Militant Union Identity: “One Enemy and It’s Capitalism”………………………...24 CNA Background……………………………………………………………………......24 The Construction of a Militant Identity………………………………………………….27 Employer Relations……………………………………………………………………...29 Strikes as “Political Education” ………………………………………………………...31 Extra-Workplace Campaigns…………………………………………………………....32 Nine Strikes: The Alta Bates Summit Contract Campaign, 2011-2013…………………………33 Background………………………………………………………………………..……..33 External Determinants……………………………………………………………..…….35 Internal Determinants……………………………………………………………..……..37 Strikes as a Source of Union Revitalization? Case Comparison…………………………….….41 Alta Bates Summit: “Cold War Status” ………………………………………….……..41 Roseville: Revitalization…………………………………………………………….…..43 2020 Onward………………………………………………………………………….....45 Discussion and Conclusion……………………………………………………………………..46 List of Interviews…………………………………………………………………………….…51 References……………………………………………………………………………………....52 v Introduction Following decades of de-unionization and decline in strike rates, labor militancy began to rise in 2018 across the United States (U.S.). While Bureau of Labor Statistics (BLS) data only cover strikes with more than 1,000 employees, these data show that more workers went on strike or were involved in work stoppages in 2018 and 2019 than any year since 1986 (BLS, 2020). In 2018, nearly 90% of striking workers were employed in the education or healthcare industries (BLS, 2019). Wildcat strikes by teachers and other public-school personnel in West Virginia, Oklahoma, and Arizona—that is, those strikes not sanctioned by union leadership—accounted for much of this activity. With the covid-19 crisis in the spring, 2020, more wildcat strikes by ‘essential’ and frontline service workers occurred (Elk, 2020), though a debate has emerged on whether some of these actions constitute strike activity (Brooks, 2020). Despite the fact that employers have outsourced work and decentralized production to undermine union power (Bernhardt, Appelbaum, Houseman, & Batt, 2016), strikes have nonetheless increased. The loss of union density and power in both the manufacturing and service sectors make the re-emergence of the strike relatively surprising after such a long decline. Despite representing the most direct source of worker power—the ability to withhold labor and stop production—strikes remain understudied in contemporary social science research for three main reasons. First, it is difficult to define and measure a strike. Virtually all labor scholars and activists in the U.S. would recognize a work stoppage by a union in response to a contract impasse and employer unfair labor practices as a strike, but not all conflict fits neatly under this definition. Second, the BLS only collects data for work stoppages that involve 1,000 or more employees and last a full shift (Shierholz and Poydock, 2020). Nearly 60% of private sector workers today are employed by firms with less than 1,000 workers. Also, because 1 bargaining units are often at the workplace level and multiple units sometimes exist at a single firm, many strikes are excluded from official data unless the number of strikers reaches 1,000 or more. Important workplace actions like the walkouts over Google’s sexual harassment policies did not last a full shift and are excluded from BLS data (Telford and Dwoskin, 2019). Third, the decline in research on strikes itself reflects decreasing unionization and strike rates. Social science research on collective bargaining and labor relations has turned towards different issues. In terms of union revitalization, scholars have focused on the development of social movement unionism, which encompasses the implementation of strategic campaigns, community coalitions, and non-institutional forms of collective representation instead of the role of strikes (Milkman and Voss, 2004; Fine, 2006; Turner and Cornfield, 2007). In this thesis, I return to the central industrial relations question of how workers and their unions mobilize strike action. I answer three related questions. First, why do strikes occur? Second, how do workers and their unions sustain militancy beyond temporary episodes of unrest? Third, do strikes serve as a source of union revitalization? I explore these questions through an analysis of a series of strikes as part of contract campaigns by the California Nurses Association (CNA) at Sutter Health (Sutter) between 2011 and 2015. Through 18 interviews as well as the examination of contracts, secondary sources, and other archival data, I analyze the factors that allowed CNA nurses to sustain strike activity over this time period. From this research approach, the role of a militant union identity emerged as a critical factor that explained the union’s ability to sustain nine strikes during a two-year contract campaign at Alta Bates Summit Medical Center (Alta Bates Summit) in Oakland and Berkeley, CA. By militant, I mean a strategic and ideologically confrontational approach to labor relations that prioritizes the strike weapon, but also encompasses other adversarial tactics. I also use a comparison between the nine 2 strikes at Alta Bates Summit and a single strike as part of a contract campaign at Sutter Roseville Medical Center (Sutter Roseville) in Roseville, CA, to show that labor militancy serves as a vital source of union revitalization. Strikes in the United States The history of strike activity in the U.S. is important for contextualizing the strike wave in the current period. Prior to the passage of the National Labor Relations Act (NLRA)1 in 1935, strikes in the U.S. were particularly violent. The federal, state, and local governments actively repressed labor conflict, as strikers experienced more arrests, injuries, and deaths than any other industrialized country (Forbath, 1989). The decentralized nature of the U.S. government and the active role of the courts in repressing union organizing empowered corporations to curtail labor unrest. Strikes occurred unevenly in this hostile climate, as the 1916-1922 strike wave—the largest in U.S. history at the time—consisted of radical demands by workers but resulted in no encompassing political institutions (Montgomery, 1987). The Great Depression and the election of President Roosevelt in 1932 created the opportunity for the national recognition of union rights, as workers led another strike wave that resulted in the institutionalization of a labor relations system in 1935. However, unions never achieved the same level of political incorporation as in many European countries, and strike rates increased at multiple junctures after World War II (Korpi and Shalev, 1979). 1 The NLRA excludes agricultural workers, domestic workers, and independent contractors, among others. The Act also excludes public sector workers, who are regulated by individual states, and those transportation workers covered under the Railway Labor Act (RLA). These exclusions lead to a wide range of rules and regulations covering strikes in the United States. Sanes and Schmitt (2014) explain how states vary in their regulation of public sector strikes. For example, some states (e.g. Illinois) may permit teacher strikes but restrict strikes by police officers, while other states (e.g. West Virginia) prohibit work stoppages by both teachers and police officers. In the case of teachers, as of 2014, 12 states permit teachers the right to strike, albeit under different circumstances, 35 states prohibit teacher strikes, and three states lack statutes or case law regulating educator work stoppages. The curtailment of the right to strike does not necessarily prevent work stoppages, as teachers in West Virginia struck in defiance of state law in both 2018 and 2019. Only Hawaii and Ohio permitted strikes by police officers as of 2014. 3 As indicated in the first figure below, strikes rates proceeded unevenly after World War II. In 1946, 4.6 million workers went on strike in the largest strike wave in U.S. history (Brecher, 1997). While industrial unrest in the 1930s led to labor law reform that facilitated unionization, a newly-elected Republican Congress responded to the 1946 strike wave by overriding President Truman’s veto and passing the Taft-Hartley amendments to the NLRA, which weakened sympathy strike rights and prohibited secondary boycotts, among other restrictions (Wallace, Rubin, & Smith, 1988). Strikes declined in the mid-1950s and 1960s, bottoming out at around 500,000 employees in 1963, until workers began revolting against both business and labor leaders in the late-1960s and early-1970s (Wallace, 1989). This strike wave reached a peak of about 2.5 million workers in both 1970 and 1971. Relative to the level of unrest evident from the 1940s through the 1970s, strikes virtually disappeared by the mid-1980s. Workers lost grueling strikes reminiscent of the pre-NLRA days during this decade (Rosenblum, 1995; Getman, 1998). Since 1983, the number of strikers has not exceeded 538,000 in any year. While traditional collective bargaining and strikes deteriorated, some unions and other labor organizations began experimenting with innovative strategies to organize and represent workers (Waldinger, Erickson, Milkman, Mitchell, Valenzuela, Wong, & Zeitlin, 1998; Juravich and Bronfenbrenner, 1999; Fine, 2006; Milkman and Ott, 2014). The wildcat educator movement in 2018 led partially by nonunion workers (Blanc, 2019) and one- day strikes utilized by the Fight for Fifteen campaign (Rhomberg, 2018) serve as prominent examples of labor militancy in the twenty-first century. Large work stoppages in 2018 involved more workers than any year since 1986, but do not approach the level of conflict evident in the 30 years following World War II. 4 Figure 1.1: From Campbell, 2019. Figure 1.2: From Buchholz, 2019. 5 The Sources of Strikes and Labor Militancy Many theories on strikes exist, though empirical work on strikes and labor militancy in recent years remains limited. Prior research is often divided according to specific perspectives, such as the economic versus the organizational/political approach (Franzosi, 1989). While useful, these approaches do not provide the depth needed to distinguish between trends in recent industrial relations and social movements research. Instead of analyzing the causes of strikes according to the various approaches, I distinguish between external and internal determinants of labor militancy that cut across the economic and the organizational/political perspectives. External factors create the conditions under which workers decide to strike. Examples include labor market conditions, collective bargaining institutions, employer strategies, and the political environment. Internal factors refer to building the capacity for workers to strike and engage in militant action. Examples include leadership, organizational power resources, and union identity. Prior research shows that both external and internal factors influence the formation and maintenance of labor militancy (Godard, 1992). Before diving into the causes of labor militancy, I first examine the role of strikes in union revitalization research. Strikes and Union Revitalization As union membership and strike rates continued to decline in the late-twentieth century, some unions began experimenting with innovative strategies to organize nonunion workers. A burgeoning literature on union revitalization developed in the 1990s and 2000s to identify the range of tactics used in these campaigns. Much of this literature focused on how unions build power outside of the workplace through multifaceted campaigns, community coalitions, and political action to support organizing and collective bargaining (Clawson, 2003; Katz, Batt, & 6 Keefe, 2003; Milkman, 2006). Traditional strategies of building power through strikes are no longer effective in isolation as corporate decision-makers operate beyond the workplace (Juravich and Bronfenbrenner, 1999). These scholars redefined the concept of activism away from the strike to focus on innovative and multifaceted organizing campaigns. For example, Frege and Kelly’s (2003) six major strategies for union revitalization included organizing, organizational restructuring, coalition building, partnerships with employers, political action, and international links. None of these strategies focus on strikes or labor militancy. In Voss and Sherman’s (2000) influential article on organizational transformation and union revitalization, strikes were not considered a tool of revitalization. The closest category to strikes, “disruptive direct action,” included “civil disobedience, large demonstrations, arrest actions, and regular picketing” (2000: 318). The union revitalization literature also emphasized organizing outside of the traditional National Labor Relations Board (NLRB) model. With the immense difficulties of winning an NLRB organizing campaign and negotiating a first contract (Ferguson, 2008) and a rise in employer opposition during these campaigns (Bronfenbrenner, 2009), unions began utilizing alternative means. Unions face considerably less employer opposition when organizing through card check procedures and neutrality agreements, leading them to win campaigns and achieve first contracts at higher rates (Eaton and Kriesky, 2001). The decline in unionization and already existing exclusions of agricultural workers, domestic workers, front line supervisors, and independent contractors from federal labor law protections have led to a proliferation of organizations that operate in the ‘alternative labor’ (alt- labor) sphere. Alt-labor refers to the collection of organizations that organize and represent workers often excluded from the institutions that regulate collective bargaining (Eidelson, 2013). 7 Worker centers and living wage campaigns offer important examples. Worker centers, which provide servicing and organizing support for workers with limited access to unions, gradually emerged in the 1990s before a large increase after 2000 (Fine, Narro, & Barnes, 2018). The Fight for Fifteen began making use of one-day strikes at targeted sites to pressure fast food companies and politicians to raise pay, which helped lead to wage gains across the country (Rhomberg, 2018). The few scholars who analyzed strikes have done so as a means to make a broader argument about union revitalization, rather than specifically about labor militancy. Milkman’s (2006) account of four immigrant worker struggles in Los Angeles emphasized the need for a combination of “bottom-up” and “top-down” tactics for successful campaigns. The 1992 drywallers’ strike succeeded because the union supported strikers with legal aid and a media campaign, whereas the 1996 port truckers’ strike failed because it lacked a comprehensive campaign to bring the employer to the table. Strikes remain important, but social movement unionism needs to encompass more than traditional workplace militancy (Lopez, 2004). Some exceptions exist to the trend in union revitalization research to bypass the importance of strikes. A critique that union leaders in both major American labor federations favor partnerships instead of rank-and-file activism has emerged (Moody, 2007). This perspective generally prioritizes rank-and-file militancy in union revitalization, distinguishing between top-down mobilizing and deep organizing. Many of the unions allocating resources to new organizing rely too heavily on union staff and media campaigns and only mobilize a small subgroup of workers, as opposed to advancing majority strikes (McAlevey, 2016). In some cases, strike activity leads directly to union revitalization through membership gain. Evidence from the United Kingdom suggests that between 2007 and 2013, membership in the British 8 Public and Commercial Services Union (PCS) increased during months with higher strike activity (Hodder, Williams, Kelly, & McCarthy, 2017). External Determinants of Labor Militancy While the union revitalization literature has often ignored strikes or viewed labor militancy as an ineffective tool in the face of employer opposition and globalization, workers have long relied on conflict at the point of production as their main source of leverage. Workers and their organizations make the decision to strike, but external factors—like labor market conditions, institutions, and employer tactics—frame this choice. Asymmetric Information and Labor Market Conditions The neoclassical perspective on strikes, derived mostly from economists throughout the twentieth century, paid little attention to the state and the development of worker organizations. This approach emphasized the importance of asymmetric information and labor market conditions on strike frequency. The misinformation hypothesis, as developed by Hicks (1932), posits that unions, or groups in unions, have access to different information than does management. Subsequent research expanded on this perspective by more clearly articulating union membership as the source of strikes (Ashenfelter and Johnson, 1969). Union members, operating with misinformation about the firm’s economic reality, may push leaders to strike even when they have minimal chance of making wage improvements. A union’s lack of knowledge about a firm’s financial situation also leads to higher strike rates (Tracy, 1987). The neoclassical perspective also highlighted the effect of macroeconomic conditions, especially unemployment and inflation rates, on strike incidence. Strikes in the manufacturing sector in the 1970s were closely tied to inflation rates—emphasizing the cyclical nature of work stoppages (Kaufman, 1981). A low unemployment rate may lead to higher strike incidence as 9 workers can easily find replacement employment if the strike fails or if they are fired for organizing a work stoppage. The recent wave of educator strikes in 2018 and 2019 occurred in the context of very low unemployment (Shierholz and Poydock, 2020). However, until 2018, strikes declined for several decades regardless of macroeconomic conditions, indicating that the business cycle alone does not easily predict labor unrest (Rosenfeld, 2014). Political Economy and Historical Legacies Much of the industrial relations, political economy, and sociological literature on strikes considers the role of institutions—sectoral bargaining relationships, state policy, the degree to which organized labor is incorporated politically—in managing or constraining labor militancy. The body of literature discussed below focuses primarily on advanced capitalist countries and assumes that capitalist development inherently produced some level of labor unrest, which national states responded to by creating labor relations systems that institutionalized conflict management. In the U.S., the federal government responded to labor unrest in the 1930s by passing the NLRA in 1935 that regulated the framework for organizing into unions and striking. Institutionalization is an ongoing process, as Congress responded to a surge in postwar labor activism by passing the Taft-Hartley amendments in 1947 over President Truman’s veto, which scaled back gains won by organized labor (Wallace et al, 1988). According to political economists, the degree of unionization and political incorporation of organized labor in a country largely determined the level of industrial conflict through much of the twentieth century. Higher degrees of mobilization and incorporation led to less conflict in the postwar years. Lower levels of mobilization and incorporation resulted in conflict of a longer duration (Korpi, 1983). For example, Sweden had a very high level of class conflict in the mid- 1930s before organized labor aligned with the Social Democratic Party and won political control. 1 0 Employers then organized into associations and helped develop corporatist institutions in which unions, employers, and the state mutually recognized each other’s legitimacy. Industrial conflict plummeted, and countries like Norway and Austria with similar institutions experienced nearly identical patterns. In countries with low levels of political incorporation and unionization, conflict continued to occur in waves. In the U.S., Canada, and Ireland, the working-class failed to translate labor militancy in the early-twentieth century into high levels of national political power (Korpi and Shalev, 1979). Recent evidence indicates a general decline of industrial conflict across advanced capitalist countries, pointing to both a breakdown of national institutions that previously supported workplace organization and a decline in strike rates (Baccaro and Howell, 2017). Local, or subnational, variations in political economy and labor relations may lead to different expressions of labor militancy and class relations. For example, class and institutional legacies in two Italian cities shaped the extent of labor unrest in the automobile industry during a period of economic restructuring (Locke, 1992). In thin institutional contexts like the U.S., local variation in employer power helps to explain divergent union outcomes. Healthcare unions struggled to expand in Rochester, NY, a company town in which corporate headquartered firms long dominated local institutions and organized at the city-level against unionization. In nearby Buffalo, NY, unions built on a strong blue-collar identity and legacies of labor-management cooperation to organize both major health systems (Batt, Kallas, & Appelbaum, 2020). Institutions and Conflict Unlike political economists, American industrial relations theorists in the mid-twentieth century argued that the construction of an industrial relations system around a shared ideology, rather than encompassing political institutions, would effectively limit workplace conflict. 1 1 Instead of viewing unions, employers, and the state as independent entities, Dunlop (1958) proposed a theory of industrial relations systems that highlighted the complexities and interrelationships among these three actors and the shared ideology they produce. Initial labor unrest was motivated by political purposes and not economic development (Kerr, Dunlop, Harbison, & Myers, 1964). A shared ideology around industrialization would unite workers and management across advanced capitalist countries and end labor unrest. The rise in labor militancy in the late-1960s refuted the end-of-conflict hypothesis and led to the re-emergence of a Marxist tradition in industrial relations research. With workers reliant on a wage for their livelihood and employers determined to maintain control over the production process, capitalism inherently creates the conditions for workplace conflict (Hyman, 1975). Despite vastly different political and economic contexts, labor unrest in the automobile industry followed similar patterns across the globe throughout the twentieth century (Silver, 2003). Labor militancy persists despite institutionalization and union co-optation and takes a variety of forms. A helpful distinction is made between ‘token demonstration’ and ‘trials of strength’ strikes (Hyman, 1989). The former signals a threat to employers and becomes more common after institutionalization, whereas the latter represents a long-term struggle. Spontaneous conflict occurs despite institutions of collective bargaining and formalized grievance procedures, but also remains constrained by these very factors. Based on ethnographic research at worksites in both the manufacturing and service sectors, for example, Fantasia (1988) showed how “cultures of solidarity” form through direct action: "industrial action embodies a transformative potential when it can achieve a degree of independence from the institutional structures designed to contain it" (Fantasia, 1988: 19). Workers observed at a manufacturing plant did not plan a strike in the days leading up to the event and did not take a strike vote 1 2 through traditional union procedures. The work stoppage openly defied the employer, the union, and the existing collective bargaining agreement. However, these structures confined militancy to a spontaneous and temporary state. The legal constraints in both traditional and wildcat strike settings underscore the importance of the state in constructing the framework under which industrial conflict occurs. A case study of a contract fight by a group of non-RN healthcare workers at a Vermont hospital highlights how workers struggled to win a first contract because of existing labor law (Fantasia, 1988). The workers undertook a ‘trial of strength’ conflict that lasted eleven months. The employer made use of permanent replacements and decertification procedures to bust the strike and the union, showing how labor law constrains militancy. A recent ruling by the Trump NLRB found that Walmart workers aligned with the labor organization OUR Walmart engaged in ‘intermittent strikes’ in 2013 and upheld the termination of these employees (NLRB, 2019). This ruling further restricts the short duration strikes often used in the low-wage service and healthcare industries. These regulations also change overtime and speak to conflict within institutions, as Trump’s appointments led to the ruling. Employer Tactics Employer tactics represent another external source that frames the decision of workers and unions to strike. Strategic choice remains important, as management and unions have the capacity to change their strategies and priorities (Kochan, Katz, & McKersie, 1986). Management began to take a hard line towards union demands in the 1970s and 1980s because corporations faced a ‘profit squeeze’ and shareholder demands for higher returns. The rise of the ‘shareholder value’ ideology shifted employer priorities towards maximizing profits at all costs—especially union contracts (Appelbaum and Batt, 2014). Deindustrialization and the threat 1 3 of global competition in the 1980s also fueled anti-union animus. Data show that employer opposition continued to hinder union organizing drives in the late-twentieth and early-twenty- first century (Bronfenbrenner, 2009). These union suppression tactics by employers resulted in drawn out and unsuccessful strikes in the 1980s and led industrial conflict to become relatively dormant by the 2000s (Godard, 2011). The suppression of several high-profile strikes reflected the more aggressive tactics by employers formalized in the 1980s. Multiple accounts (Nordlund, 1998; McCartin, 2011) point to President Reagan’s termination of air traffic controllers in 1981 as a turning point that sent a signal to employers across the economy to openly bust unions. Ironically, PATCO—the union of air traffic controllers—endorsed Reagan’s presidential campaign in 1980. The proliferation of anti-union consulting firms in the 1970s and 1980s to prevent unionization drives and defeat strikes provides further proof of the rise in union avoidance and suppression tactics (Levitt and Conrow, 1993; Logan, 2006). While Reagan’s firing of the air traffic controllers represented a considerable shift in American labor relations, the transformation in the private sector occurred at Phelps Dodge in 1983. In the midst of several years of losses, the company demanded an end to regular cost-of- living adjustments, which prompted the local union to strike. Instead of giving in to the union demands, the employer relied on consultants, who advised hiring permanent replacements to resume work at the plant. After months of bitter conflict, including violent outbursts between strikers and replacement ‘scabs,’ Arizona called in the national guard to protect the facilities and nonunion workers. The union was decertified soon thereafter. Phelps Dodge completely changed the rules of American labor relations, as the company adopted an aggressive anti-union approach 1 4 to bust the union and upend the relatively harmonious relations that existed in the industry (Rosenblum, 1995). The defeat of the strike and union at Phelps Dodge did not occur in a vacuum, as other unions lost battles with employers that recast the trajectory of workplace relations. International Paper’s (IP) defeat of a seventeen-month strike by Local 14 of the United Paperworkers’ International Union (UPIU) did not only occur because of disputes between the local and international union, but also because of IP’s insistence on concessionary bargaining and use of permanent replacements (Getman, 1998). The strategic choices by management—centered around the uniquely American phenomenon that gives employers the power to permanently replace strikers with other workers (Rhomberg, 2012; Colvin, 2016)—connect the union defeats at Phelps Dodge and IP. Diffusion from other Social Movements The diffusion of activism from other social movements also influences strike incidence. The U.S. civil rights movement of the 1960s led to more shop floor militancy in the public sector, indicating the importance of both social movement diffusion and institutional context (Isaac and Christiansen, 2002). This was also true in healthcare, as 1199—then affiliated with Retail, Wholesale, and Department Store Union (RWDSU)—built on the legacies of the civil rights movement to foster in an era of militant organizing and strikes in the late-1950s and 1960s (Fink and Greenberg, 2009). The influx of activists from newer social movements helps to revitalize older social movements, as in the case of the labor movement in the late-twentieth century (Voss and Sherman, 2000). Internal Determinants of Labor Militancy 1 5 While external factors create the conditions under which strikes occur, workers need to develop the capacity to strike in the first place. Internal determinants enable workers to engage in militant action. Whereas industrial relations scholars have traditionally focused more heavily on external factors—like the institutions of job regulation—social movement scholars are more concerned with the internal factors that build capacity and lead to mobilization (Tapia, Elfström, & Roca-Servat, 2018). An integration of these two approaches is required for a more complete understanding of the internal causes of strikes and labor militancy, with an emphasis on the role of leadership, power resources, and union identity. Leadership, Networks, and Status Leadership plays a critical role in the formation of labor militancy. Union organizers build campaigns around leadership identification, as they try to discover and win over the natural leaders in a work unit to help organize other co-workers (Fink and Greenberg, 2009). Leaders translate dissatisfaction into injustice and organize other workers around this frame (Kelly, 1998). Union leaders at higher levels of the organization also play a determinative role. For example, the United Farm Workers (UFW) developed a greater strategic capacity than the Agricultural Workers Organizing Committee (AWOC) by relying on the networks and resourcefulness of its leaders, even though the AWOC had more material resources (Ganz, 2000). The agitator theory of strikes, which advances the role of left activists in promoting labor militancy, is another example of leadership in this process (Darlington, 2006). Communists held formal and informal leadership positions in many Congress of Industrial Organization (CIO) unions in the 1930s and 1940s and won contracts that more directly challenged management’s control over the production process (Stepan-Norris and Zeitlin, 1991). Recent evidence suggests 1 6 that a small group of militant teachers in West Virginia spurred the wildcat educator movement in 2018 (Blanc, 2019). Networks and social identities also shape strike participation. Workers do not only organize in response to grievances, but also as a result of identities formed outside of the workplace that cannot be separated from their union or workplace identities. In a campus worker strike at The Ohio State University, strike involvement largely depended on status and race (Dixon and Roscigno, 2003). African American workers in lower-paid jobs participated in the strike at higher levels than whites and/or employees with higher status. Beyond these identities, networks at the point of production served to mobilize workers before and during the strike. It is impossible to completely distinguish between leadership and networks, as small groups of leaders in each unit often encouraged other workers to strike. The combination of formal organization through unions with the presence of informal networks among workers leads to higher strike frequency. A useful conceptualization is to identify workplaces as contentious, cohesive, or unorganized, as Roscigno and Hodson (2004) did in their analysis of 82 workplace ethnographies. They found that union presence, high levels of solidarity, and historical legacies of conflictual employer relations unsurprisingly led to more strikes. When examined independently, unionization and high levels of solidarity have little predictive value of strike frequency. Therefore, organizational level-phenomenon in the form of unionization and the presence of strong networks through a history of collective action combine to produce greater levels of militancy (Dixon, Roscigno, & Hodson, 2004). Power Resources Strikes are often built upon leadership and social networks, but workers and their organizations utilize a range of power resources available in a given campaign. The two 1 7 traditional types of power resources include structural and associational power (Wright, 2000). Workers develop structural power based on their position in the economy, such as through tight labor markets or employment in certain sectors. They derive associational power by collective organization, most commonly through unionization. These power resources are not automatically deployed in a given campaign, so the operationalization of power resources requires special attention. For example, workers in positions with high structural power, such as nurses or transport workers, develop the capacity for more disruptive and effective strikes (Connolly and Darlington, 2012; McAlevey, 2018). Recent literature has expanded beyond traditional forms of power resources to discuss noneconomic forms of power—for example, ideological. Workers and their organizations often make use of symbolic politics to organize fellow workers and win over public support during campaigns (Chun, 2009). In healthcare, unions often succeed when framing organizing campaigns around patient advocacy, rather than just economic benefits (Reich, 2012). In a particularly relevant case for this study, Gastón (2017) argues that the impetus for utilizing economic action to advance patient advocacy sometimes occurs from the rank-and-file. Focusing on the historical development of CNA, he shows how nurses in the Bay Area repudiated the distinction between professionalization and collective bargaining through much of the twentieth century. Beginning in the 1960s, staff nurses undertook the “moralization of the strike” (Gastón, 2017: 25) and utilized strikes to uphold their duty as patient care advocates. Union Organizational Identity Particularly militant organizations reproduce strike activity through the development of a union identity—a foundational structure that conditions the organization towards particular objectives and strategies. Organizational theorists emphasize the durability of this identity, with 1 8 Whetten (2006: 22) describing organizational identity as “the central and enduring attributes of an organization that distinguish it from other organizations.” The tensions in unions between rank-and-file members and leaders complicate this notion of organizational identity. Gumbrell- McCormick (2013: 242) defines union identity as “the relatively stable characteristics and orientations of an organization, tending to persist regardless of changes in personnel, which have both an internal dimension (assuring members, activists and officials what the union is and does) and an external one (proclaiming the nature of the union in the broader industrial relations and public sphere).” This definition grounds identity as a characteristic of the union, rather than individual members. Union identity thus serves as a “root structure” (Hodder and Edwards, 2015: 847) derived from a multitude of factors, including geography and industry (Smale, 2020). Unions have long diverged based on identity and approaches to unionism. In the U.S., labor organizations exhibited a variety of approaches to unionism in the early-twentieth century (Hoxie, 1923). Many unions adopted ‘business unionism’ by the mid-twentieth century, an approach to labor representation dominant in North America that prioritizes servicing existing membership and rejects political advocacy (Perlman, 1928). Hyman (2001) presents a typology of union identity by focusing on the three main faces of trade unionism—towards market, class, and society. Market refers to the regulation of labor market conditions, similar to the business unionism described above; class describes militant unionism and the prioritization of class struggle; and society encompasses social integration and political advocacy. Unions operate somewhere in this triangle, and often orient themselves towards two of the three typologies. The class-focused identity emerges as particularly important for facilitating militant action and strikes. Militancy is often counterposed against cooperation in defining a union’s identity. These two approaches, or identities, encompass more than just competing ideological 1 9 perspectives on how to best approach employer relations. They consist of contrasting goals, methods, and resources (Kelly, 1996). Militancy also extends beyond strikes. A commitment to confrontational tactics—in both the workplace and political arenas—emerge as important aspects of a militant identity (Gall, 2003). For example, members of the International Longshore and Warehouse Union (ILWU) do not only utilize strikes to improve workplace conditions, but to advance a radical political consciousness (Kimeldorf, 1988). While I have defined union identity largely as an organizational construct, a militant identity necessitates an active membership. Strikes and other confrontational actions require high levels of membership participation. Unions may build a more active membership through a network of left activists at all levels of the organization (Darlington, 2009) or the use of structure tests to gradually escalate towards more militant activity (McAlevey, 2016). The very act of lived struggle inherent to strikes and other confrontational action further cements a militant identity at the membership level (Fantasia, 1988). Leadership, Union Identity, and the Formation of Labor Militancy I have distinguished between external and internal determinants of militancy largely for conceptual purposes. Connections exist between and within these categories. The relationship between leadership and union identity is especially important. Leaders strongly influence union identity and help to sustain it over time. Stepan-Norris and Zeitlin highlighted the role of leadership in sustaining identity during early industrial organizing by the CIO: “both Communist leadership and rank-and-file democracy tended to create and sustain a sense of common identity among the membership and transform the union into a close-knit working-class political community” (2002: 267). In the mid-twentieth century, leaders continued to shape the orientation and approach of many unions. The distinct leadership 2 0 style and ideology of Harry Bridges of the ILWU and James R. Hoffa of the Teamsters help to explain the militant social movement approach of the former and the business unionism of the latter (Levi, 2005). The interrelated roles of leadership and identity in sustaining action extends to other national contexts as well. Emphasizing the importance of union leaders in developing members’ union identity to facilitate transnational activism at General Motors in Europe, Greer and Hauptmeier make a connection between union identity and sustained collective action: “the identity work of union leaders is crucial for understanding how collective action is sustained” (2012: 276). Existing research suggests that identity and leadership often converge with other factors to shape militant action by labor organizations. For example, a comparison of two rail unions in the United Kingdom and France showed that the structural power of transportation workers and the left identity fostered by union leadership contributed to the success of militant unionism in both cases (Connolly and Darlington, 2012). Especially in the case of the British RMT, union leadership at all levels of the organization played a key role in reproducing a militant identity. This identity has led to repeated strike mobilization and serves as an important source of union renewal (Darlington, 2009). My research draws on these organizational level analyses to explain how internal determinants, like the formation of a militant union identity, and external determinants, like institutional legacies, lead to strikes and other confrontational action. Methods Case Selection and Background To examine the determinants of labor militancy and the role of strikes as a source of union revitalization, I analyze the California Nurses Association (CNA) and a series of strikes as part of contract campaigns at Sutter Health (Sutter) hospitals between 2011 and 2015. CNA 2 1 represents approximately 85,000 nurses across California in a variety of health systems, including, but not limited to, Kaiser Permanente (Kaiser), Dignity Health, and Sutter. The relationship between CNA and Sutter is especially contentious, as nurses have struck at several Sutter facilities multiple times, with the largest series of strikes occurring during contract campaigns from 2007-2008 and 2011-2015. Sutter representatives claimed that CNA organized 150 strikes over a five-year period from 2010-2015 (TeSelle, 2015). Because CNA nurses do not have a master contract that covers all Sutter facilities, like they do at Kaiser in Northern California, many of these strikes occurred unevenly across hospitals. The union recently achieved a common expiration date for all Sutter contracts (Interview 10, November 2019). This paper focuses on a contract campaign that included nine strikes between 2011 and 2013 at Alta Bates Summit Medical Center (Alta Bates Summit), a three-hospital campus in Oakland and Berkeley, CA. Most CNA members at this medical center work at either Alta Bates hospital in Berkeley or Summit hospital in Oakland. I then introduce a comparison by examining a one-day strike as part of a contract campaign in 2015 at Sutter Roseville Medical Center (Sutter Roseville), a hospital in Roseville, CA. Strikes by CNA nurses also occurred during multiple other contract campaigns at Sutter hospitals in this time frame, including nine strikes each at Sutter Solano Medical Center, Sutter Delta Medical Center, and Eden Medical Center. I focus here on Alta Bates Summit because several interviewees identified it as the most contentious case, due to its history as the union’s longest standing agreement and the number of concessions Sutter attempted to extract during negotiations. I then compare the contract campaigns at Alta Bates Summit and Sutter Roseville to evaluate strikes as a source of union revitalization. Access 2 2 The heightened pressures faced by unions make gaining access to labor organizations increasingly difficult. My prior work experience with CNA, in addition to other union experience, facilitated my access for this research. I worked at CNA for six months from August 2016 to February 2017 and left the organization on good terms. This experience ultimately shaped my work as a researcher in a positive way. To distance myself from personal experience, I gained access to a part of the organization I had not worked with during my employment. My prior work exposed me to the fact that the organization is very ideologically driven, but I relied on existing literature to frame and define this phenomenon. My experience helped lead me to this research idea and enhanced my understanding of unionism in healthcare without compromising my analytical work or judgement. Sampling I relied on two forms of sampling to gain access to a diverse range of interviewees. First, the organization set me up with a point person who helped coordinate initial interviews. This contact enabled me to reach a reasonable number of people in a limited time period. Second, I relied on snowball sampling to make sure I accessed informants independent of who the organization set me up to speak with. This sampling procedure allowed me to follow a more inductive approach (Glaser and Strauss, 1967), pursuing key issues that informants raised by asking them directly who else I should interview to provide more information on a particular topic. In late-2019, I conducted 18 semi-structured interviews of union leaders, staff, and rank- and-file members in under two weeks on a research trip in Northern California. Interviews lasted from 30 minutes to two hours in length. I used a semi-structured approach, with several core questions across all interviews, but I adapted my questionnaire depending on what I learned from 2 3 previous informants. I planned to collect more data in Northern California, but the covid-19 crisis has delayed that trip. Data Analysis I drew out emergent themes and a case comparison through coding and memo-writing. I coded and wrote individual memos for all 18 interviews. I relied extensively on writing memos to identify and elaborate on emergent themes (Charmaz, 2002). Three themes emerged from the interviews. I then wrote memos on each of the three themes, which provided the foundation for my findings section. The process of free writing during this memo process allowed me to identify themes and comparisons I did not recognize before (Becker, 2007). I drew out a comparison between two strikes from this memo-writing process, as I realized that strikes led to different outcomes in two separate hospitals, enabling me to analyze strikes as a source of union revitalization. I plan to collect more data in Northern California at the conclusion of the ongoing pandemic. CNA and a Militant Union Identity: “One Enemy and It’s Capitalism” CNA Background Nurses in the Bay Area have long utilized economic action to improve workplace conditions and enhance patient advocacy. California nurses first organized as a state-level affiliate of the American Nurses Association (ANA), forming CNA in 1903. Nurse managers and educators dominated leadership positions in ANA and oriented the organization towards an emphasis on professional advocacy. ANA viewed unionization and collective bargaining as antithetical to the nursing profession for the first part of the twentieth century (Gastón, 2017: 40- 41). 2 4 Staff nurses in CNA began to problematize the distinction between professionalization and collective bargaining, recognizing that they could strengthen themselves as professionals and patient advocates through economic action. In 1946, the Alameda County Nurses Association (ACNA) threatened to disaffiliate from CNA-ANA over the issue of collective bargaining with hospitals before CNA leaders established the Economic Security Program—later called the Commission on Economic and General Welfare—which served as the collective bargaining arm for the state-level organization. CNA then signed the first collective bargaining agreements for nurses in the country in 1946 that included a contract at Alta Bates hospital. CNA won agreements at 18 hospitals in the Bay Area by 1948 (Gastón, 2017: 45-46). Tensions continued to exist between the collective bargaining arm of CNA and ANA leadership, which remained ambivalent towards collective bargaining and strikes during the latter part of the twentieth century. Staff nurses pushed CNA to eliminate a ban on striking in 1966. ANA followed suit in 1968 (Gastón, 2017: 59-60). Nurses began what Gastón (2017: 25) refers to as the “moralization of the strike,” meaning that they viewed striking and economic action as enhancing, rather than hindering, their professional and moral obligations as patient care advocates. CNA staff nurses engaged in several high profile strikes after 1966, including a three- week strike at 42 Northern California hospitals in 1974, a largely unsuccessful three-month strike by nearly 1,200 nurses in San Jose in 1982, a month-long strike involving approximately 2,000 nurses in San Francisco in 1988, and a six-week strike in solidarity with other healthcare workers at Summit hospital in Oakland in 1992 (Johnston, 1994: 130-134; Silver, 2013: 145). Changes in healthcare delivery and several high-profile strikes led to a staff nurse revolt and takeover by an insurgent left leadership in 1993 and CNA’s formal disaffiliation from ANA in 1995. Healthcare delivery rapidly consolidated in California in the 1980s, as smaller 2 5 community hospitals merged into larger health systems that sought cost containment strategies in the form of reduced labor costs (Johnston, 1994: 120-122; Gastón, 2017: 127-130). This led to attacks on collective bargaining agreements at newly consolidated facilities and corresponding strikes, such as the six-week strike at Summit hospital in 1992 (Silver, 2013: 134). Tensions in CNA exploded during the aftermath of the 1992 Summit strike, as the CNA- ANA affiliated leadership remained concerned about increasingly militant union staff members and nurse solidarity with non-professional healthcare workers throughout the strike. In response, CNA leaders fired the 13 union staff members in the collective bargaining division in December 1992, including future executive director RoseAnn DeMoro, though the staff members won their jobs back through a court injunction in March 1993 (Silver, 2013: 146). The staff nurse contingency then won an election in 1993 that took over the CNA board of directors, wrestling control away from nurse managers and educators affiliated with ANA (Interview 4; Interview 9, November 2019). Nurses ushered in an insurgent left leadership by naming DeMoro executive director of the organization. The combination of the long-held tensions between CNA staff nurses and ANA leadership, the changes in healthcare delivery that precipitated the strikes of the late-1980s and early-1990s, and the union staff firings in 1992 all led to the staff nurse takeover in 1993 and formal disaffiliation in 1995. The staff nurse revolt in 1993 led to a newfound emphasis on organizing and expansion, as CNA quintupled its membership from approximately 19,000 in the early-1990s to just under 100,000 as of 2018 (Garofoli, 2018). CNA also spearheaded the formation of National Nurses United (NNU), a coalition of nurse unions that currently includes the Minnesota Nurses Association, the District of Columbia Nurses Association, and several other state affiliates 2 6 (National Nurses United, 2020). NNU currently represents approximately 150,000 members across the U.S. CNA’s collective bargaining program is organized internally by divisions according to the different health systems in which they represent nurses. The master agreement with Kaiser, which covers 19,000 nurses at 21 hospitals in Northern California, is considered the gold standard. Important provisions include no mandatory overtime and wages ranging from $61/hour to $92/hour for staff nurses as of 2017, with differences in pay largely dependent on seniority (Kaiser Contract, 2014). No master agreement exists with Sutter, though certain individual contracts approach the pay and benefits achieved in the Kaiser master contract. For example, the Alta Bates Summit agreement includes wages ranging from $55/hour to $85/hour for staff nurses as of 2017 (Sutter Contract, 2016). The Construction of a Militant Identity The left leadership that assumed power in 1993 cemented the legacy of economic action by rank-and-file nurses in the Bay Area into a militant union identity, which extended to both the collective bargaining and political advocacy divisions of the organization. The staff nurse revolt in 1993 marked a turning point because an insurgent left leadership began to reproduce rank-and- file militancy at the organizational level. Interviewees referred to the disaffiliation as “the revolution” (Interview 4, November 2019), highlighting the importance of the event to the organization. Since the staff nurse revolt, CNA has cultivated a strong hierarchy led by left leaders. DeMoro assumed leadership in 1993 and held her position as executive director until retiring in 2018. DeMoro, who never worked as a nurse, developed a radical ideology long before her ascension to leadership of CNA. She arrived in California as a doctoral student in Sociology at 2 7 the University of California at Santa Barbara, before dropping out to organize with the Teamsters and CNA (Enzinna, 2018). Upon assuming leadership, DeMoro began to orient the organization towards more forceful positions on electoral politics and public policy (Draper, 2019). One interviewee remarked that the disaffiliation from ANA restored power in the union from nurse managers to staff nurses, but union staff has since consolidated control over the organization. This led to strong positions on issues like Medicare for All but resulted in a clear hierarchy that constrains union democracy (Interview 9, November 2019). The new left leadership directed the militant tradition of California nurses into activism both at and beyond the workplace. Examples include CNA’s fierce opposition to labor- management partnership and a longstanding and uncompromising support for a single-payer healthcare system—both in opposition to ANA’s perspective on employer relations and healthcare policy. At the heart of CNA’s identity is a belief that problems facing nurses and consumers in healthcare stem from systemic issues, leading one union leader to assert that there exists “one enemy and it’s capitalism” (Interview 14, 2019). This anti-capitalist identity permeates the current organizing work of union staff and rank-and-file activists. Several interviewees identified capitalism and the for-profit health system as the causes of workplace antagonism and inequities in healthcare delivery (Interviews 3; 10; 13; 14; 16, November 2019). A central message that CNA staff emphasize is that corporate greed drives the U.S. healthcare system. Instead of focusing on particular corporations, CNA draws attention to the broader system. One interviewee stated that: “The difference here is that we are very focused and disciplined in how we approach capitalism. We are fighting capitalism on a day to day basis…it’s a core part of who we are” (Interview 10, November 2019). 2 8 Situating capitalism as the primary enemy of nurses reinforces a fierce opposition to labor- management cooperation. This does not mean that CNA representatives ignore differences between employers. They just argue that all employers reflect the tendencies of the private healthcare system to a certain extent, with Sutter representing a particularly egregious example (Interview 5; Interview 16, November 2019). Employer Relations The left identity has led to a more confrontational approach towards employer relations. CNA is fiercely against the idea of labor-management cooperation, specifically labor- management partnerships. DeMoro has frequently criticized labor-management partnerships— for example, commenting for a news article just before her retirement that “I never gave up on conflict” and “we’re in a class war in this country” (Garofoli, 2018). Interviewees also used strong language in response to questions about cooperation. One remarked that “any nurse who embraces the cloak of management is not really one of us anymore” (Interview 4, November 2019). Another replied, “CNA is not in bed at all with the employer” (Interview 17, November 2019). CNA’s proximity to the largest formalized labor-management partnership in the country, the Kaiser Permanente Labor Management Partnership, likely fuels some of this disdain. Formed in 1997, the partnership includes many of the unions representing the non-professional staff at Kaiser hospitals in Northern California and both professional and non-professional staff in other locations across the country. The noticeable exception is CNA, which refused to join the partnership, engaged in a series of strikes at Kaiser in 1997-1998, and has remained steadfast in its opposition (Moore Jr., 1998; Kochan, Eaton, McKersie, & Adler, 2009). CNA’s approach to employer relations extends beyond an opposition to labor- management partnerships. Labor representatives and nurse leaders routinely build confrontation 2 9 into organizing activities at their worksites. Boss delegations, or ‘marches on the boss,’ serve as the most obvious example of these non-strike militant tactics and are part of the “master plan” of the union (Interview 12, November 2019). These actions are confrontational in nature, as they generally involve a group of workers collectively marching to a manager or administrator’s office to deliver a petition and/or force a discussion on workplace issues. Such confrontational tactics help reproduce CNA leadership’s militant identity at the membership level. Many of the union staff and nurses I spoke with had utilized marches on the boss in issues-based campaign between contracts at their facilities (Interview 1; 2; 3; 6; 8; 10; 11; 12; 13; 14; 17, November 2019). For example, nurses in one hospital engaged in two marches on the boss to confront management about reduced staffing in the emergency department. These confrontational workplace tactics, in combination with a broader campaign, led to the posting of new positions in the department (Interview 2, November 2019). CNA staff also utilize marches on the boss as structure tests to build power in preparation for contract negotiations and potential strikes. The connection between routine, workplace-based confrontational tactics and building power is essential, as one interviewee stated: “We want to make sure that we are not simply escalating for the sake of escalating but in a way that develops and engages more nurses in the department…the point is to figure out ways to increase organizational power in the hospital…when we are engaging in these offensive campaigns we are also using them as a structure test” (Interview 3, November 2019). Marches on the boss often occur as part of a strategic plan in an organizing drive, a contract campaign, or an issues-based campaign between contracts. This tactic allows nurses to confront management in a way rivaled only by the most direct form of workplace action—the strike. 3 0 Strikes as “Political Education” Strikes embody CNA’s approach to employer relations. CNA leaders view strikes as both ideological and strategic. Multiple staff members and nurses referred to strikes as the greatest form of “political education” (Interview 7; Interview 13, November 2019) and as “part of the culture of the union” (Interview 3, November 2019). Nurses directly confront both the for-profit healthcare system and the nature of power in their workplace through strikes and these actions reproduce the organization’s militant identity at the membership level: “Striking is quintessential political education for our members. It is the key piece where people have learned more about relationship between people and capital than any other way. You can’t demonstrate any more than actually living through it…real shift in terms of taking power and control” (Interview 13, November 2019). This Fantasia-like analysis underscores the importance of lived struggle in creating solidarity and a militant identity among workers. Unlike Fantasia’s account, which emphasizes grassroots militancy in defiance of formal union structures, union leadership facilitates strikes at CNA. CNA leadership’s ideological view of labor militancy is partially mediated by strategic concerns. Strikes, and strike threats, are used to build power in a facility and win concessions from the employer. A nurse leader spoke about how they openly discussed strikes with co- workers in front of managers as the unit built towards a first contract campaign (Interview 6, November 2019). Strikes also revitalize a stagnant membership, leading to more sustained activism and militancy beyond the strike itself (Interview 17, November 2019). While CNA leaders help facilitate these strikes, they also appear to regulate conflict to a certain extent. A large portion of the strikes studied for this paper lasted one-day, with the longest strike occurring for seven-days. CNA leaders and nurses have utilized one-day strikes since they struck Kaiser 3 1 facilities in the late-1990s, and they point to some level of control and coordination over labor militancy. Other nurse unions also organize these short duration strikes (McAlevey, 2018). Extra-Workplace Campaigns Since the departure from ANA, CNA leaders have advocated for policy positions and organized grassroots campaigns indicative of its left identity. The union proved instrumental in implementing the first, and still only, statewide mandate on nurse to patient staffing ratios in the country. The campaign for ratios began in 1992 and was signed into law in 1999. It still had to pass several obstacles, including newly elected Governor Schwarzenegger’s opposition in early- 2004, before implementation began later that same year (Silver, 2013). The ratios provide for a mandatory level of licensed nurse staffing per patient on various units in acute-care hospitals. CNA leaders and nurses have also advocated on the issue of single-payer healthcare. They first pushed for a single-payer healthcare system in California in 1994 and have remained a national leader on Medicare for All ever since (Draper, 2019). Union leaders also reject any sort of allegiance to the Democratic Party, with DeMoro once describing some unions as being “toadies of the Democratic Party” (Garofoli, 2018). At the local and state levels, CNA has strongly opposed Democrats who refuse to support Medicare for All legislation (Siders, 2017). The union is also notable for its strong support of left presidential campaigns, including the general election campaign of Ralph Nader in 2000 and the Democratic primary candidacy of Bernie Sanders in 2016 and 2020. In addition to statewide and national political efforts, CNA has organized opposition to the closure of hospitals, especially at Sutter facilities. These campaigns often involve the formation of community coalitions. The best example is the successful effort to prevent the closure of St. Luke’s Hospital in San Francisco, which Sutter announced it would close in 2007. 3 2 CNA leaders and nurses helped organize a strong community coalition in conjunction with San Francisco’s local Jobs with Justice chapter to prevent the closure of the hospital (Interview 14, November 2019). St. Luke’s has since integrated with two other hospitals to form Sutter’s new California Pacific Medical Center (CPMC) Van Ness Campus in 2019. CNA is currently engaged in a similar effort to prevent the closure of Alta Bates in Berkeley, which Sutter leadership intends to close before 2030 (Interview 1; Interview 5, November 2019). Nine Strikes: The Alta Bates Summit Contract Campaign, 2011-2013 Background CNA has represented nurses at many hospitals currently owned and operated by Sutter long before the Sacramento-based organization entered the Bay Area. The modern-day version of Sutter originated in the Sacramento area, before expanding to the Bay Area by merging with California Healthcare System in 1996 (Sutter Health, 2020). CNA now represents nurses at 16 of Sutter’s 24 hospitals, though the union organized nurses at most of the Bay Area hospitals before Sutter began expanding in the 1990s. For example, the collective bargaining agreement at Alta Bates Summit is CNA’s longest contract and one of its strongest, dating back to 1946. Contentious relations between CNA and Sutter existed prior to the series of strikes from 2011 to 2013. The 1992 Summit strike occurred before Sutter acquired the hospital, but CNA engaged in sympathy strikes with SEIU 250 at Sutter hospitals in 2004 and a series of strikes during contract campaigns in 2007-2008 (Rauber, 2005; Rauber, 2007; Interview 4, November 2019). CNA staff have also attempted unionization drives at several Sutter facilities outside of the Bay Area since the 1990s, including successful campaigns at Sutter Roseville in 1997 and Sutter Tracy Community Hospital in Tracy, CA in 2012 and an unsuccessful organizing drive at Memorial Medical Center in Modesto, CA in 2015 (Interview 17, November 2019). 3 3 CNA and Sutter have a particularly contentious relationship, highlighted by contract campaigns that included a series of strikes at multiple hospitals between 2011 and 2015. Strikes occurred at several Sutter facilities as part of contract campaigns during this time period. CNA and Sutter representatives reached agreement after strikes at CPMC hospitals in San Francisco, CA and Mills-Peninsula in Burlingame, CA, but took longer to settle at four East Bay hospitals (Interviews 13; 16, November 2019). Nine strikes occurred at Sutter Solano Medical Center, Sutter Delta Medical Center, and Eden Medical Center, though I focus here on Alta Bates Summit because CNA interviewees referred to it as the most contentious case. After negotiations in which Sutter demanded approximately 100 concessions in 2011, CNA nurses struck Alta Bates Summit hospital nine times as part of a contract campaign to preserve its collective bargaining agreement. Nurses at Alta Bates Summit first struck in September 2011 and the final strike—which lasted seven days—occurred in May 2013. Little movement in contract negotiations materialized between the strikes as the sides stopped meeting with a federal mediator in July 2012 (Rauber, 2013). When the sides finally settled in October 2013, CNA nurses had fended off nearly all 100+ concessions that Sutter management remained adamant on extracting for over two years. Nurses only won a 1-1% pay increase during the two- year agreement but laid the foundation for considerable wage gains in the following contract negotiations in 2015-2016. Various factors led nurses to sustain nine strikes as part of a contract campaign and preserve the Alta Bates Summit contract. Both external and internal determinants converged to produce high levels of militancy during this time period. I argue that the existence of a militant union identity emerged as especially crucial in leading to sustained strike activity, instead of just a temporary outburst of labor unrest. 3 4 External Determinants Employer Tactics Sutter management’s bargaining strategy represented the most obvious and immediate trigger of strike activity. Sutter representatives proposed concessions across all contract negotiations with CNA in 2011, but none as substantial as the approximately 100 takeaways demanded at Alta Bates Summit, which both sides recognized as the strongest contract. Sutter management felt that weakening the union’s stronghold could lead to substantial concessions at all hospitals (Interview 18, 2019). The proposed concessions touched every nurse represented by CNA (Interview 7, November 2019). Many CNA interviewees believe that Sutter management overplayed its hand by trying to destroy the contract and unintentionally became one of the union’s biggest organizers. Drawing on a militant identity and strike history, CNA leaders turned Sutter management’s bargaining approach into an organizing tactic. Even anti-union nurses showed up to the picket line: “When someone comes up to you with 100 takeaways and wants to take the contract apart, even my charge nurse who was anti-union showed up on the picket line...the company went too far to demoralize the nurses and treated the nurses as though they were not valued, which is what got people out to the picket line” (Interview 5, November 2019). Sutter management’s decision to “pick a fight and wage war” (Interview 16, November 2019) unintentionally made them one of the union’s biggest organizers. Historical and Institutional Legacies Both the institutional environment of Northern California and labor law peculiar to strikes in healthcare shaped the union’s capacity to sustain nine strikes. The Bay Area is known 3 5 for its militant left history and as a longtime union stronghold. In particular, much radical political activity originated in the East Bay, such as the Oakland General Strike of 1946 and the founding of the Black Panther Party in 1966 (Rhomberg, 1995). The legacy of this militancy still exists in the twenty-first century, as evident in Occupy’s May Day strikes in Oakland in 2012 and a seven-day strike by Oakland teachers in 2019 (Mahler, 2012; Paret, 2016). In terms of unionization, observers have often recognized a difference between the union-friendly Bay Area and Los Angeles (Milkman, 2006). While organizing campaigns in Los Angeles since the 1990s narrowed the gap between the two areas in terms of total union density, the Bay Area still maintained a 25% unionization rate in healthcare, higher than the rest of California at the turn of the century (Milkman and Rooks, 2003). While a history of militant organizing and relatively high unionization rate in the Bay Area influenced CNA’s ability to sustain nine strikes, they were not necessarily determinative of this outcome. Recall that the largest formalized labor-management partnership in the country is headquartered at Kaiser in Oakland and is employed in various hospitals across the region. The Bay Area’s unique political environment enables various forms of unionism, though it does not necessarily determine the specific approach taken. Federal labor law places unique restrictions on healthcare workers designed to limit labor militancy. As a result of the 1974 amendments to the NLRA, all healthcare workers need to provide a 10-day notice of any strike. This provision allows hospitals to staff up with temporary replacements, but also enables the employer to persuade workers not to walk out. Sutter management took advantage of these 10-day notices to run campaigns prior to the strikes (Interview 13, November 2019). On the other hand, CNA representatives filed several ULP charges alleging bad faith bargaining during negotiations. These charges, in combination with 3 6 the nature of short duration strikes, prevented Sutter management from relying on permanent replacements in the same way as employers had during many labor conflicts in the past. Labor law only partially constrained CNA leaders and nurses in this case. Internal Determinants Collective Bargaining Legacies The threat of losing substantial provisions in the organization’s oldest contract played a large role in the sustained resistance in this case. As the oldest contract, the Alta Bates Summit collective bargaining agreement holds much symbolic importance to CNA leadership (Interview 4; Interview 5, 2019). It is also the strongest contract in the Sutter division, if not at all of CNA, which helps explain why both sides went to such dramatic lengths to attack and protect the contract. One nurse commented that Sutter management tried to take on the Alta Bates Summit agreement because “it’s the best contract of them all and would have created a domino effect throughout the whole system” (Interview 18, November 2019). Because no master contract covering CNA nurses exists at Sutter hospitals, unlike at Kaiser, Sutter leadership believed it could weaken other contracts by going the hardest after the strongest and most symbolically important agreement. Previous episodes of labor militancy at Alta Bates Summit helped lay the foundation for the series of strikes from 2011 to 2013. The 1992 Summit strike involved 1,700 workers represented by CNA and four other unions that refused to give up the right to honor each other’s picket lines. Some of the nurses who participated in the 1992 strike helped lead the strikes in 2011-2013 (Interview 9, November 2019). CNA nurses struck Sutter hospitals several times in the 2000s, including sympathy strikes with SEIU 250 in 2004 (Rauber, 2005) and a series of strikes in 2007-2008 (Rauber, 2007). 3 7 Union Strategy The strikes allowed the union to control the timeline of the contract campaign and forced Sutter management to incur large publicity and financial costs for over two years. Unlike the drawn-out nature of many notable American strikes, an obvious feature of the strikes at Alta Bates Summit was their relatively short duration. These short duration strikes are not specific to this case, as other nurse unions make use of one and two-day strikes (McAlevey, 2018). At Alta Bates Summit, the union relied on a gradual escalation of strike length as a key component of the contract campaign. Instead of calling for open-ended conflict, the short duration strikes enabled the union to control the timeline and when to best utilize these tactics as part of the campaign. The strikes occurred nearly every two months and gradually increased in length, with the ninth strike lasting seven days and a final threat of a 10-day strike that ultimately brought Sutter leadership to the table. After the third strike, nurses gave the bargaining team the authority to call strikes without an official membership vote for strikes four through nine (Interview 7, November 2019). This development centralized strike authorization into the hands of CNA leadership, representing a considerable step in the internal deliberation process. CNA leaders now controlled the decision-making power to call strikes and maximize leverage in the contract campaign. While centralizing the decision to strike helped coordinate activity across Alta Bates Summit, union staff and nurse leaders took a unit-by-unit approach to ensure strong participation on the picket line. Staff implemented regular assessments of nurses on a name by name, unit by unit, and shift by shift basis (Interview 16, November 2019). Strike participation appeared very high but is ultimately difficult to ascertain considering divergent accounts from union and company sources. Disparities within units appeared to exist. For example, the Labor and Delivery unit honored the strike in very high numbers, with reportedly only one out of 150 3 8 crossing the picket line (Interview 9, November 2019). It is clear that a considerable number of nurses did not cross the picket line even if direct participation remains unknown. Structural and Symbolic Power of Nurses CNA leaders and nurses mobilized structural and symbolic power inherent to the nursing profession throughout the strikes, forcing Sutter management to incur substantial costs. Because nurses have specialized skills and replacements are difficult to find, hospitals often contract with temporary agencies to staff hospitals during work stoppages. These agencies generally staff workers on a five-day basis, so a one-day strike led Sutter management to lock out nurses for an additional four days. Sutter incurred high costs paying agencies and housing replacement nurses over the course of nine strikes (Interview 8, November 2019). CNA also mobilized around the symbolic power of nurses as America’s most trusted profession. This relationship with the public allows CNA leadership to pursue a more militant strategy, with one interviewee stating that “nurses are unique, beloved in public. Having nurses as spokespeople for what we do makes a huge difference” (Interview 10, November 2019). The union has long drawn on this symbolic power and it is intimately tied with the organization’s militant history, as nurses have repeatedly centered strikes around issues related to the moral economy of care, instead of just economic interests (Gastón, 2017). The intimate ties that nurses foster with patients and the public allow them to generate support from the community, especially in a progressive area like the East Bay. Nurses placed lawn signs and received support from local business and community leaders (Interview 16, November 2019). CNA representatives also made the connection between the strikes and patient care explicit: “Sutter is going to know publicly that we are nurses, the most respected profession…you are willing to let people die to make more money” (Interview 4, November 2019). 3 9 Militant Identity The left leadership and activists that led the internal ‘revolution’ and disaffiliated with the ANA in the mid-1990s maintained strong power at both the workplace and organizational levels in the 2011-2013 period. Many nurses from the 1992 Summit strike played leadership roles in the 2011-2013 strike wave (Interview 9, November 2019). Instead of shying away from strikes like much of the labor movement at this time, CNA leaders prioritized militancy: “CNA had an ideological point of view that the labor movement wasn’t using the strike tool enough and they were going to show its efficacy as a tool, which they did” (Interview 8, November 2019). The level of militancy that these strikes achieved remains an open question, though nurses clearly developed a heightened political consciousness through repeated strike activity. Some of the older nurses resisted the transition to short duration strikes. One interviewee recalls older nurses referring to these short duration strikes as “weak ass” and “fucking disgusting” because they only maintained a picket line from 7am-7pm, in contrast to the 24-7 line at the 1992 Summit strike (Interview 4, November 2019). However, the strikes appeared to foster a culture of militancy that sustained nurses through nearly two years without a contract and in constant conflict with their employer. Another interviewee recalled the story of a nurse who provided for multiple children and how, after the sixth strike, she struggled with the idea of continuing to walk out as it led to a loss of necessary income. Nonetheless, this nurse participated on every picket line with her children present, showing how CNA’s organizational identity is reproduced at the membership level (Interview 16, November 2019). This same interviewee emphasized the connection between striking and political consciousness: 4 0 “People in CNA reference that the best political education occurs on the strike line…nurses began to develop a rhythm with strike activity, especially strikes five through nine. Once they achieved the comfort of walking off the job and withholding their labor they broke through to a whole new level of political consciousness” (Interview 16, November 2019; Italics added by author). The strikes themselves cultivated a political consciousness that CNA leaders already prioritized historically and organizationally. This factor—a militant union identity created at the organizational level and reproduced by ‘cultures of solidarity’ (Fantasia, 1988) formed through direct struggle on the strike line—led to sustained, rather than temporary, opposition. Strikes as a Source of Union Revitalization? Case Comparison Because no master contract exists, strikes at Sutter from 2011 to 2015 had different impacts on bargaining relationships and membership activism in each facility. I draw out a comparison between the lasting legacies of strikes at Alta Bates Summit and Sutter Roseville, two facilities with very different histories. The nine strikes at Alta Bates Summit preserved the existing contract and eventually led to wage gains in the following agreement. The series of strikes led to more mixed results on membership activism. At Sutter Roseville, a one-day strike as part of a contract campaign in 2015 resulted in strong wage gains and increased membership activism, completely transforming the facility. Alta Bates Summit: “Cold War Status” As illustrated in the prior section, nurses at Alta Bates Summit launched nine strikes over two years to fight back approximately 100 concessions and reach a two-year agreement that preserved the existing collective bargaining agreement. Sutter representatives wasted no time implementing workplace restructuring plans that affected most nurses. Immediately after the 4 1 settlement, management at the local hospitals undertook a massive rebidding procedure legal under the contract. They eliminated 12-hour shifts and forced many nurses to alter their work schedules (Interview 16; Interview 18, November 2019). Despite the rebid procedure, local management did not fight the union during the next round of contract negotiations in 2015-2016 and nurses won strong wage gains. Instead of proposing largescale concessions, Sutter and CNA representatives agreed on a four-year agreement in 2016 that provided for a 3-5-5-6% wages increase across the board each year, partially making up for the 1-1% increase in the 2013 strike settlement (Sutter Contract, 2016). The series of nine strikes appeared to produce mixed results in terms of workplace activism. The union made considerable gains in the 2016 contract, though the threat to close Alta Bates hospital and an influx of new nurses with no strike experience have forced CNA staff and activists to prioritize membership re-engagement. Many current leaders in the facilities participated in the 2011-2013 strikes, but younger nurses have replaced much of the rank-and- file. The influx of new nurses is substantial, as approximately one out of three nurses working at Summit have started since 2016 (Interview 12, November 2019). These new nurses lack the history and experience of striking. The strikes may have resulted in a tiring effect on some older nurses (Interview 8; Interview 9, November 2019). Union activists at both Alta Bates and Summit are organizing campaigns to mobilize newer nurses in preparation for future contract negotiations and potential strikes. At Alta Bates, CNA leaders have invested organizational resources into creating a community coalition to prevent the hospital’s closure (Interview 5, November 2019; Interview 10, November 2019). Besides recruiting workers in this effort, activists are beginning to prioritize unit-by-unit organizing at Alta Bates, with specific attempts to energize departments previously considered 4 2 anti-union through marches on the boss around staffing concerns (Interview 1, November 2019). At Summit, leaders are rebuilding strength in the facility through card campaigns and marches on the boss, recently launching a new anti-harassment campaign (Interview 12, November 2019). The long war waged between CNA and Sutter at Alta Bates Summit from 2011 to 2013 reduced confrontational behavior on both sides. CNA won large wage increases in the 2016 contract, though the legacy of the nine strikes on militancy is mixed. The strikes arguably forced Sutter into a more consenting position, leading to large gains in the 2016 contract and a proposed extension of that agreement through mid-2021, as discussed in more detail later. One interviewee made a rather strong analogy on the post-strike state of labor relations with Sutter, most apparent at Alta Bates Summit: “The fight never really stopped; it just became more of a Cold War status. The strikes fundamentally shifted the earth underneath these hospitals…the cumulative militancy that floats around the Sutter division as a whole has not diminished. It has quieted down for the moment” (Interview 16, November 2019). Roseville: Revitalization A one-day strike at Sutter Roseville in 2015—a first in its history—provides support for strikes as a direct source of union revitalization. Organized by CNA in 1997, Sutter Roseville nurses lack the legacy of militant unionism and a progressive political climate as their counterparts in the East Bay. Operating in a more conservative area, CNA struck Sutter Roseville and four other facilities on April 30, 2015 (Lindelof, 2015). Nurses eventually ratified a contract agreement in December 2015 that defeated Sutter management’s outstanding demands on healthcare costs and provided for a 16.5% wage increase over four years (Locke, 2015). The 4 3 strike clearly had a revitalizing impact on Sutter Roseville’s membership, which became considerably more active post-strike. Similar to Alta Bates Summit in 2011, nurses at Roseville in 2015 felt disrespected by Sutter management’s approach to bargaining and demand for concessions. Roseville nurses previously organized an informational picket leading up to contract negotiations in 2010, but otherwise a noticeable difference existed between Roseville and the militant Bay Area (Interview 13, November 2019). The bargaining survey conducted prior to the 2014 contract negotiations highlighted this conservative legacy, as only 5% of respondents indicated they would strike as of May 2014 (Interview 17, November 2019). Leaders began opening up bargaining session information to members through meetings and a Facebook group. The negotiations in 2014-2015 showed rank-and-file nurses that Sutter leadership did not value them: “In nurses’ heads they were really important to Sutter, but then they realized they are just a number no matter how long they worked here for…a lot of it came with the healthcare package…when that came out it lit a big fire under people” (Interview 17, November 2019). This anger towards Sutter management’s proposed healthcare package led to widespread organizing in the facility. By April 2015, nearly all nurses authorized a strike. The activism generated by the strike extended beyond the contract agreement. While a one-day strike is far different than a series of nine strikes over two years, nurses felt energized by the picket line and Sutter management’s decision to lock them out for an additional four days. Nurses broke down the silos of their individual units through the strike and began a social media campaign they labeled a ‘strikecation,’ forming bonds over how they spent time as Sutter locked them out (Interview 13, November 2019). After agreeing to a contract in December 2015, several 4 4 noticeable changes took place. The Professional Performance Committee (PPC), a contractually bargained committee in which nurses independently elect representatives to address staffing concerns with management, reached maximum capacity and helped organize campaigns between contracts. Nurses from Sutter Roseville also attended CNA’s Joint Bargaining Council meetings more frequently, indicating greater involvement in the organization (Interview 17, November 2019). Leaders at Sutter Roseville undertook a campaign against health and safety threats that won several victories and exemplified the new level of activism at the facility. Prior to the campaign, nurses often took on responsibilities of a security guard, such as checking the personal belongings of incoming patients for weapons. They finally decided to run a card campaign to push back against these unsafe work responsibilities. After signing up hundreds of nurses demanding improvements like increased security guard staffing, they delivered the petitions by marching on the Chief Nursing Executive (CNE) and human resource managers (Interview 13, November 2019). Nurses also began reporting safety concerns more frequently, taking more ownership over the issue. They won several victories, including an increase of 10-plus security guards on campus at any time, locked doors after 9:00pm, and increased lighting in the parking lot (Interview 17, November 2019). The strike instilled nurses with a more militant identity and served as the foundation for this increased activism between contracts: “The facility is night and day since the one-day strike…nurses’ relationship with the union is completely different, even more conservative nurses who you would not think would be union activists are really strong activists” (Interview 13, November 2019). 2020 Onward 4 5 Before expiration in 2020, CNA and Sutter representatives agreed to an 18-month extension of all contracts in 2019. As all CNA agreements with Sutter now have a common expiration date, contracts at both Alta Bates Summit and Roseville fell under this extension. Interviewees were unsure why Sutter management proposed the extensions, though some speculated that recent lawsuits may have led Sutter leadership to avoid a fight with nurses (Interview 4, November 2019). Sutter agreed to pay $575 million in December 2019 to settle claims of monopolistic practices and anti-competitive behavior brought by California’s Attorney General and several unions and employers (Thomas, 2019). As for CNA, many nurses at first felt skeptical by Sutter’s offer to extend all existing contracts, though the current constraints imposed by a Trump-dominated NLRB made an extension appealing (Interview 10, November 2019; Interview 18, November 2019). While the 2016 settlement at Alta Bates Summit and the recent contract extension provide support for Sutter management consenting to CNA’s power at the hospitals, some interviewees still expect a strike when the contract expires (Interview 15; Interview 18, November 2019). Discussion and Conclusion I have attempted to show how strikes serve as a source of union revitalization and that CNA leadership has sustained militancy over time, pointing to the particularly important role of union identity in this process. Internal factors like leadership and union identity emerge as key factors, but external determinants also impact strike formation and activity. I have also expanded the conception of militancy beyond the strike. While strikes still serve as the most measurable and visible form of labor militancy, confrontational tactics such as marches on the boss and workplace campaigns between contracts are important manifestations of militant action. They are 4 6 also of strategic importance for the union to help develop a membership with the kind of militant identity that leaders espouse. Leadership and union identity sustain labor militancy beyond a temporary state of unrest. Through deep legacies of workplace conflict and the emergence of a left leadership in the early- mid 1990s, CNA developed a union identity that has sustained strike activity and other confrontational tactics over decades. The six-week long Summit strike in 1992 and the staff nurse revolt that resulted in CNA’s disaffiliation from ANA in 1995 emerged as particularly important, as they ushered in a new left leadership that strongly opposed labor-management collaboration, advocated for issues like Medicare for All, and viewed strikes through both a strategic and an ideological lens. Leaders then reproduced this militant identity at the membership level through strikes and other workplace actions. This process has occurred in other unions as well. The recent transformation of the New York State Nurses Association (NYSNA) provides a relevant example of how new leadership and organizational transformation results in more militant action. Following a similar trajectory as CNA nearly twenty years later, staff nurses took control of NYSNA’s board of directors in 2011 and inserted Jill Furillo—former CNA Government Relations Director—as executive director, leading to more militancy and staffing victories in subsequent contracts (Krachler, Auffenberg, & Wolf, 2020). Other organizational level analyses further emphasize the importance of left leaders in cultivating a union identity that sustains militancy (Stepan-Norris and Zeitlin, 2002; Levi, 2005; Darlington, 2009). A militant identity is one of several determinants that combine to influence strike activity. Other internal factors, like strategic decisions, contributed to CNA’s success in defending the Alta Bates Summit contract from 2011-2013. The nine strikes, which gradually escalated in 4 7 length from one-day to seven-days and a final ten-day strike threat, caused Sutter representatives to incur substantial costs by having to contract with temporary agencies to staff the hospitals. The structural power of nurses, observed through the difficulty and costliness in finding replacements for a high-skilled and essential profession, also enabled the union to sustain nine strikes. Striking does not occur in isolation, as external factors framed the decision of CNA leaders and nurses to strike nine times over two years. The most obvious example is employer strategy. Sutter management’s demand of approximately 100 concessions from nurses at Alta Bates Summit forced the union to strike multiple times as part of a contract campaign. Even anti- union nurses joined the picket line. Institutional legacies also mattered. Subnational differences in class identities and employer power may lead an observer to expect more strike activity by workers in Northern California. The legacies of unionism in Northern California likely facilitated CNA’s capacity to withstand nine strikes, but much disparity exists in the ideological orientation of major healthcare unions (Moody, 2014). The Bay Area headquarters the Kaiser partnership— the largest labor-management partnership in the country, which CNA fiercely opposes (Kochan et al, 2009). Employer strategy and institutional legacies both mattered in this case, but the union’s militant identity emerged as essential in its ability to sustain nine strikes. Militancy also encompasses more than just strikes. CNA leaders prioritize the use of confrontational tactics in campaigns between contracts. These campaigns show that militancy does not just occur at the end of contract negotiations but is embedded in the union’s internal membership program. ‘Marches on the boss’ represent an important example of these confrontational tactics and often serve as structure tests to prepare nurses for future actions (McAlevey, 2016). Groups of nurses that collectively address management create a form of 4 8 workplace solidarity perhaps matched only by the strike itself. Multiple interviewees stated how CNA leaders and staff incorporate these boss confrontations as part of the union’s organizing program. The successful staffing campaign mentioned earlier by emergency department nurses in one hospital provides a good example. The role of strikes and other confrontational tactics in union revitalization underscores the notion of militancy as an ongoing process. The distinct nature of strikes at Alta Bates Summit and Roseville between 2011 and 2015 resulted from marked differences in collective bargaining legacies. The strikes themselves had a longstanding impact on militancy in the years since. At Alta Bates Summit, the nine strikes followed a long tradition of militancy, featured by the six- week strike at Summit in 1992. The symbolic legacy of the Alta Bates Summit contract as the oldest agreement at CNA helped lead the union to sustain nine strikes in defense of this contract. While an influx of new nurses without strike experience now work at Alta Bates Summit, union leaders and staff are actively reorganizing and educating members to prepare for a strike, if necessary, in 2021. In Roseville, the one-day strike in 2015 provides a clearer example of revitalization, as the membership was fairly dormant pre-strike. From the standpoint of membership activism, the strike completely transformed the facility. Nurses built on the militant identity developed in 2015 to construct leadership through the PPC and launch a health and safety campaign that included multiple marches on the boss and won several victories. The outcomes from Alta Bates Summit and Roseville show that strikes serve as an important source of union revitalization, but too much conflict in a short period of time may result in a tiring effect on the membership. The contract extension proposed by Sutter management and agreed to by CNA nurses in 2019 highlights the role of institutions in constraining labor militancy. The Trump NLRB has 4 9 imposed considerable restrictions on union activity, including a more expansive definition of intermittent strikes (NLRB, 2019). This interpretation may prevent CNA from engaging in the sort of strikes that occurred between 2011 and 2015. Interviewees did not point to this ruling specifically as the reason for agreeing to the contract extension but spoke to the difficult bargaining context under the current NLRB (Interview 10, November 2019). Rule changes from the NLRB underscore the role of institutions in constraining labor militancy (Fantasia, 1988), though recent evidence suggests a rise in non-institutional forms of workplace activism and strikes in defiance of the law (Blanc, 2019). In conclusion, research on union revitalization needs to bring back a focus on labor militancy. Strikes serve as an important source of union revitalization. Much of the exciting non- institutional forms of labor unrest since 2018 have captured the public’s eye, but questions remain regarding the sustainability of these actions. Do they represent a new wave of strike activity, or a fleeting moment of temporary unrest? Will the activism surrounding the covid-19 pandemic generate a new era of persistent strikes and institutional remedies? The case of CNA provides important insight into the role of leadership and union identity in sustaining militancy over time. 5 0 List of Interviews2 Interview 1. Union Respondent. November 2019. Interview 2. Union Respondent. November 2019. Interview 3. Union Respondent. November 2019. Interview 4. Union Respondent. November 2019. Interview 5. Union Respondent. November 2019. Interview 6. Union Respondent. November 2019. Interview 7. Union Respondent. November 2019. Interview 8. Union Respondent. November 2019. Interview 9. Union Respondent. November 2019. Interview 10. Union Respondent. November 2019. Interview 11. Union Respondent. November 2019. Interview 12. Union Respondent. November 2019. Interview 13. Union Respondent. November 2019. Interview 14. Union Respondent. November 2019. Interview 15. Union Respondent. November 2019. Interview 16. Union Respondent. 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