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This coverage sponsored by the SEIU. 

Tonight the SEIU nurses will hold a candlelight vigil.  Tomorrow they go back to work.  However, the people who locked them out are still going strong, ready to live and fight against unions another day.  That's only one reason it's so good to say goodbye to the 109th Congress and hello to Pelosi's 110th.  What comes along with it is a 5 day workweek.  Republicans are in shock.  But Democrats are going to fight for the middle class, baby, which means unions are back and The Employee Free Choice Act is in. We're blogging about it, with a terrific Kos diary, Tula's amazing input, Sirota, with something I wrote this morning here, with much more to come, including Senator-elect Sherrod Brown sending a message to BigPharma.

But the SEIU nurses in both Desert Spring and Valley Hospitals, both of which are run by Universal Health Services, will tell you their fight, at its heart, isn't about unions. It's not even about money.  It's about the patients they serve and providing the best patient care possible. There's just one catch. Universal Health Services in Las Vegas, run by David Bussone, which is a microcosm of the entire U.S. healthcare industry, has decided to make it about the union. This interview with Bussone is very telling and foreshadows the troubles to come. 

Enter the union-busters.

Enter Brent Yessin and Brent Yessin & Associates. He's also a former Vice President of the Burke Group, an anti-union firm. People at these anti-union firms are sometimes called "persuaders." Quaint, isn't it. In California, these "persuaders" have been used repeatedly to undermine the California Nurses Association. In California, nurses are made to attend mandatory meetings where they are lectured by these "persuaders," whose fees range from $118 - $210 per hour, with expenses going into the millions for these anti-union campaigns. Mr. Yessin has earned quite a reputation. He's a master of anti-union campaigns.

It had been brewing for years. Notorious union-busting consultant Brent Yessin was hired by VHS in January 2006, when the two hospitals' contracts with nurses gave up, but the union says agreements were made in the summer of 2005 to bring him in. In September of that year, 39 nurses at Desert Springs made news when they were suspended from work for wearing SEIU pins on their uniforms. In 2003, Desert Springs tried without success to rid themselves of the union, and in 1999, when SEIU was defying the medical field's historical resistance to unions, they and Valley led an unsuccessful charge to keep unions out of hospitals.

Caring for the Caretakers
Nurses and hospitals continue the war over union demands

I've learned a lot about David Bussone's Universal Health Services in a very short period of time. Brent Yessin comes as part of the package. They're fighting very hard and mean, but what they didn't count on was public support and the progressive blogosphere getting in the act.  As one person on the political end of the fight told me this week, but who didn't want to be identified: UHS miscalculated.  They're image has suffered a lot.  But when the blogosphere got involved, that's when everyone knew this was going to be big. Assembly speaker-elect Buckley and Commissioner Rory Reid (interviews with them here), among others, got UHS back to the bargaining table with SEIU, with two 30-day periods now in place to get a contract signed.

Now Bussone and UHS has a real image problem, not just with nurses and patients, but with the public at large. 

Unlike Bussone's Universal Health Services, Catholic Health Care West adopted specific nurse-to-patient ratios, which are enforceable through nurse contract; banned mandatory overtime; and ensured that nurses won't be floated to stations beyond her/his expertise.

Unlike Bussone's UHS, Hospital Corporation of America (Sunrise Hospital) also agreed to improve staffing levels by mid-contract, while also banning mandatory overtime, with "true partner floating."

Only Bussone's Universal Health Services refuses to bring Desert Springs and Valley hospitals up to standards already adopted by the other hospitals in Las Vegas. According to the SEIU, UHS has refused to make any guaranteed staffing improvements. To give you an idea of how understaffed UHS is regarding nursing care, they would have to hire 198 nurses to reach an equivalent staffing to Catholic Health Care West. UHS has also refused to ban mandatory overtime. In addition, UHS, through a contract loophole, allows nurses to float across the hospital, "including areas where they lack expertise," according to SEIU.

Feel safer, Las Vegas?

Well, I've got a news flash for you. This isn't just about Las Vegas. It's about what could happen across this country to U.S. healthcare once we try to make it accessible to everyone. If hospital conglomerates aren't made to understand that profit is important, but not nearly as important as patient care, we could all be looking at a situation like Las Vegas in every small town and big city across this country.

Brent Yessin came in to Las Vegas to help David Bussone keep control over UHS facilities. Evidently, Yessin and Bussone think they know best. Are they nurses? Do Yessin and Bussone know what it takes to care for patients? It's their business, but to SEIU nurses locked out in Las Vegas, it is their calling, their passion. What Yessin is doing for Bussone is intended to keep unions out of UHS hospitals, or break the unions when they do. Their threats are powerful and they back them up with actions. Don't like UHS policy? Tough. You're fired.

Special procedures nurse Christina Schofield, one of SEIU's nurses recently fired, says that Yessin tries to intimidate and oppress the nursing staff. She says:

"Six to eight months ago, the union-busters came in and started holding these mandatory meetings where they pulled nurses away from their patients and filled them with anti-union propaganda. Then they'd send around petitions for the nurses to deny allegiance to the union. Five of them in two weeks, each two hours long. They never let me attend them because I kept asking: ‘Who's taking care of the patients during these meetings?'

"Then they started with the one-on-one meetings, where they for instance would pull an international nurse inside, huddle around her, and ask her: ‘You like your visa? You want to keep it, don't you?'"

Schofield, who says she had never had a write-up prior to the "countless" formal reprimands she received this year ("for things like retrieving a Diet Coke from the ER"), says that management made an extra effort to suppress union literature, and posted their own propaganda every day with yellow fliers on the walls. Moreover, she says, she had to get used to security following her out on her breaks.

"The nurses are terrified now," she says. "They know this regime's threats are not empty, because, well, they fired me, didn't they?"

Caring for the Caretakers
Nurses and hospitals continue the war over union demands

One of the most important issues across this country is healthcare. Making healthcare accessible and affordable for every American, especially children, regardless of ability to pay is one of our priorities. But within this argument brews a much missed element of the story. What kind of healthcare will we receive for this universal coverage? If one nurse has to take care of 10 very sick patients, what kind of care do we each individually receive?

David Bussone's UHS lock-out of SEIU nurses in Las Vegas is just one part of this story; a microcosm of what could happen on a much larger scale as we move forward into the healthcare debate in this country. We had better pay attention to this fight and make certain the outcome is something we can all live with, because our lives could quite literally depend on it.