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by Maxim Ognev & Lucien Groll

More of us is better for everyone! - Hospital Strikes in NRW

by Maxim Ognev & Lucien Groll

In the German federal state of North Rhine Westphalia (NRW) a strike of historical proportion is happening. After the hard-won victory of the workers at the Charité and Vivantes hospitals in Berlin in 2021, currently the workers of the six university hospitals in NRW are fighting for a collective labour agreement regulating workloads (Tarifvertrag Entlastung) to ease the dire situation healthcare workers in most of Germany are confronted with. A 100-day ultimatum with the workers’ demands has been set and remained ignored by hospital managements. On May 1st, the ultimatum ran out, and 98.31% of the university hospital healthcare workers organized in a union – a massive majority – voted to strike indefinitely until their demands are met.

Working conditions in hospitals need to change

Such measures are long overdue. Situations like nurses having to manage an entire intensive care unit alone, not being able to adequately care for elderly or immobile patients, or nursing apprentices having to act as a fully trained nurse and having to do tasks only registered nurses legally allowed to do are commonplace. The problem lies not in the wages but primarily in having to work in these extremely mentally and physically taxing conditions. There is no shortage of nurses – nurses are fleeing the profession.

A recent study that surveyed 12.700 nurses in all of Germany who quit their job or reduced their work hours to part-time showed that for the overwhelming majority, the conditions they would need to return to nursing are an adequate amount of personnel and reliable working hours. This effect has become apparent in Berlin, where Vivantes advertises with the working conditions that the workers had to wrest from this very company itself. In the university hospital in Mainz, where a similar collective labour agreement is implemented, the executive administrator of the hospital even went on camera on national TV reporting of the hospital’s positive experience in hiring after implementing a workload-relieving collective labour agreement and stating that it is the best way to recruit new healthcare workers.

In concrete terms, such a workload-relieving collective labour agreement means mandatory safe staffing levels specific to the needs of different types of hospital wards and outpatient departments. If the employer fails to ensure safe staffing levels or the healthcare workers have to work under other especially demanding conditions, such as not being able to take a break in a workday, they get a so-called „strain point“. After a certain amount of strain points is reached, they can be used to get paid leave or, alternatively, financial compensation, if the worker chooses so. Furthermore, under such a labour agreement nursing apprentices are not counted as fully trained personnel and thus will no longer be confronted with having to handle tasks they are not yet prepared for on their own, without any supervision or training.

Already trained nurses who supervise nursing apprentices are also not counted in this minimum personnel number and therefore can take the time to teach the apprentices without being distracted by other tasks. In addition, a collective labour agreement like this does not only affect the specific hospitals in which it is implemented. Other hospitals are compelled to offer comparable working conditions if they want to keep their workers from switching to one of the hospitals with a workload-relieving labour agreement, and in this way a victory for only a few hospitals is a victory for all.


Success needs struggles

These conversations have to be had again and again, even if the hospital ward management tries to kick the organizers out, not only with the workers who are already aware of the need for change and ready to fight, but especially with those workers who are not yet convinced, or even opposed to striking. Meetings have to be organized and surveys for demands have to be evaluated. This is not a glamorous or quick process and may not sound as appealing to left-wing radical sensibilities as romantic imagery of workers uniting under red flags after listening to a single rousing speech and starting a revolution. But this is how the struggle in Berlin was won and this is how the healthcare workers in NRW will win. An intensive care unit nurse from Berlin who now is an organizer in the NRW campaign addressing the workers assembled for a strike preparatory meeting said:

„You are writing history here, because you are showing the reality of the nursing profession.“

This is what designing history means – to realize the present moment as history to be written and to act accordingly.

Some ADH cadres have been involved in the Berlin campaign as professional organizers and now also support the NRW campaign as professional organizers or volunteer supporters. We are glad to assist in these important achievements and to gather organizing experience for accelerating the class struggle. If you are in NRW, support the strikes and come visit the strike posts! Every person showing up and expressing support helps to keep up morale and show that those are not the demands of the healthcare workers alone, but a society-wide demand for better healthcare.

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