January 11, 2019

Dennis Kosuth , a Chicago nurse currently working for the Chicago Public Schools and member of the Chicago Teachers Union and National Nurses United, draws out the lessons of a campaign demanding safe staffing in the public hospital where he used to work. This story is a contribution to the Socialists at Work series at SW that began with articles from the International Socialist Organization’s (ISO) Socialist at Work Toolkit , assembled by the ISO’s Labor Working Group. We asked readers to send their own stories and ideas about being a socialist at work. Please consider contributing about your experiences and the lessons you’ve drawn from them in an e-mail submission to SW — or just tell us what you liked, or didn’t, about this series.

SOME YEARS ago, I participated in organizing a safe-staffing campaign by nurses in the emergency room of a unionized hospital. Many of the lessons from that experience could be useful to others, regardless of if they are in a union or not.

Orient on the Rank and File

The first point is to focus activity on and around rank-and-file workers. While almost all of the activities outlined below were sanctioned by our union (some more openly than others), they were all mainly organized and executed in the workplace by rank-and-file workers. The union we happened to belong to is very progressive and supportive of most initiatives, and this made organizing much easier.

If you are a member of a union that is not as friendly to initiative, having as many people involved as possible will be key to bringing in union resources. As the socialist union activist Farrell Dobbs wrote, “The indicated tactic [is] to aim the workers’ fire straight at the employers and catch the union bureaucrats in the middle.”

The overall goal is to fight the boss, and sometimes this requires getting the union leadership on board. Usually, this should not require heavy lifting, but if it does, that would have to be the subject of a different article.

In a nonunion workplace, organizing with co-workers is the only resource you will have to depend on, unless you are actively organizing with a union. Some workplace actions are protected under the National Labor Relations Act, as briefly outlined here.

The National Labor Relations Board, which oversees this law, is a federal government body whose current leadership was appointed by Donald Trump, which should tell you all you need to know about how dependable it is as an advocate for workers.

We should not counterpose or downplay activity that is driven mainly by union staff, but we should understand that union staff are not the critical component of an effective workplace campaign. This goes to the heart of what socialists think about changing society — regular working people can and must be at the center of it.

Pick an Issue That Affects Many People

It’s important to pick an issue to organize around that affects as many workers as possible. The defining issue in the emergency room happened to be safe staffing. Not having enough nurses was a chronic problem which affected every aspect of the job, especially patient care.

The issue of staffing was not just a workplace issue, but a community health issue. Since this was a public hospital which served the poor and uninsured, this issue had significant political weight.

Series Socialists at work An SW series dedicated to discussing how to organize in your workplace. The ISO’s Labor Working Group has contributed how-to guides, and readers are adding their own experiences. Larry Bradshaw Being a socialist at work

From a socialist at work Finding another socialist at work

From a socialist at work A scene of shop-floor solidarity

Sean Petty Socialists and the rank-and-file strategy

Socialist at Work Toolkit How to support a picket line

Socialist at Work Toolkit Using Socialist Worker at work

Socialist at Work Toolkit Getting a union job

Ryan Roche Strong contracts come from the bottom up

Dennis Kosuth Organizing a workplace campaign

Pranav Jani Lessons in class consciousness from striking faculty

Kirstin Roberts How do you go back after you shut down a city?

A workplace issue that only directly affects one or two people, while significant to those involved, will not be as an effective rallying point as something that affects multiple parties.

Luckily for workplace activists, the boss will often be our best organizer — as they frequently engage in behavior that will provoke a widespread response. It’s important to keep in mind that when a broader victory is won, it gives more confidence to take on other issues in a unified way.

Related to this, it’s worth thinking through what victory will look like. Choosing to fight around an issue that can be realized is important. This is why constant conversation with a group of trusted co-workers about the goal and how you will collectively get there is key. These discussions will put people on solid footing about what they are struggling for and make it easier for them to talk to others about a path to success.

While the chronic understaffing issue was not something that we knew would be solved overnight, there were steps that could be taken to move in the right direction that management had not prioritized.

Utilize Tactics That Involve Lots of People and Pull Them Outside Their Comfort Zones



Organizing at work has become more popular in recent years, but is still not yet the norm. Most people don’t consider themselves activists, though they live in a time where they are aware of activism. Many more are open to the idea that united action can make a difference in people’s lives, as evidenced by the “red state” teachers rebellion.

There wasn’t an existing tradition of organizing in the emergency room, and this was prior to the current nationwide uptick in workplace activity. We started very modestly in 2011 by having nurses sign a petition demanding better staffing. We started with the more confident nurses first, and once critical mass was reached, everyone wanted to sign on.

We took advantage of knowing that the publicly run hospital had open committee meetings, and gathered a delegation of nurses to present the petitions to the hospital’s “safety committee.”

There was one nurse in particular who didn’t think her English was good enough to play this role. It took some convincing to get her on board, but it was important to take the time to do this.

She took it very seriously, wrote her speech out word for word, practiced at home to family, presented powerful testimony, and has since become a stalwart advocate. There is no shortcut to building people’s confidence in themselves as leaders — these lessons will last a lifetime.

By demonstrating that this was a patient safety concern that almost all the ER nurses were concerned about, upper management responded by temporarily lifting the annual overtime limit.

While this didn’t solve the underlying problem of not having enough nurses on staff, it provided some immediate relief. It provided a direct experience for nurses that collective action can make a difference.

Progressively Escalate Actions

The boss can always be depended upon to repeat stupid mistakes, and by March 2012, staffing in the ER was again terrible. We drew up another petition, and this time, we went to the elected officials who oversee the financing of the hospital, even if they aren’t responsible for its day-to-day operation.

This was more of an ask for nurses, as it required them to come downtown on a day off to sit in a meeting for several hours before testifying. With the success of the previous year, it wasn’t difficult to collect signatures and get a half dozen nurses to take time away from families, and publicly testify.

As luck would have it, the CEO of the hospital happened to be there — and was not happy that we were reporting on bad news when he wanted to provide good news. The very next morning as I was charting on a patient, I felt a hand tap my shoulder as the CEO wanted to meet and discuss our concerns.

Because we had organized this campaign broadly, it was easy to immediately gather several nurses together talk with him. He informed us that the overtime limit would be lifted again, and that he was looking into more long-term solutions.

Needless to say, without struggle, there is no progress, and by the summer of 2013, we were again in the same boat. This time nurses decided that instead of asking for the overtime ban to be lifted, what if we didn’t do any overtime at all?

It took several weeks of conversation and planning, and when the sign-up sheet for overtime went up for the first week in September, not one of the 130 ER nurses signed up. The ER operates because of overtime, and it can be lucrative for nurses who work two or three extra shifts a pay period. It was a significant thing for nurses to take a pay cut to fight for something bigger.

The impact of the action was significant, a third of ER had to be shut down. It also went on bypass for heart attacks and strokes. To put this in perspective, on an annual basis, there are between 120,000 and 150,000 visits in this ER, making it one of the top 20 busiest in the country.

Patient care was impacted, and was the result of a chronic problem that had been ignored by the boss. Management went from confusion to stonewalling and finally agreed to meet to discuss terms by the end of the second day, where they agreed to expedite hiring.

The action in itself didn’t produce immediate staffing relief, so by those standards, it wasn’t successful. However, it did clearly demonstrate to all of the ER staff the power of collective action. The more general lesson is that success can breed confidence, which can in turn lead to more daring action.

Additionally, because it was an action that was not “officially” organized by the union, it provided some buffer to retribution, as nurses were exercising their legally protected right to refuse overtime.

Openly Fight against Divisions in the Workplace

When the Black abolitionist Frederick Douglass wrote “they divided both to conquer each,” he was referring to poor whites and Blacks, but this idea is applicable to other circumstances as well.

In the ER, nurses come from many different backgrounds, and of the 130, the number of white nurses could be counted on one or two hands. Unfortunately, ethnic and racial divisions persist despite the diversity.

When organizing for the action, ridiculous stereotypes were thrown up as excuses for why it wouldn’t work: “Those Indian nurses are made to work overtime by their husbands, and they won’t go against them.” “Those Filipino nurses work so many hours because they’re greedy, you really think they’ll go for this?” “The Nigerians are each supporting 10 families back home, they need the money too much to go along.”

As people organized and talked to each other, it was clear that these ideas had nothing to do with reality but were a reflection of their own doubts. When we did talk openly about it, it was clear that the first idea of not doing overtime for a couple days was too conservative, and people thought we needed to set the goal of one week.

These discussions and the action taught people that despite our different backgrounds, when we come together as one, our power is substantial. All the racist garbage that people hear and internalize had to be confronted before any unified action was possible. While it didn’t make all the backward ideas disappear forever, it demonstrated how these ideas were a hindrance to improving our working conditions.

Another division that had to be confronted was between classifications of workers, specifically between registered nurses, licensed practical nurses and paramedics. All three groups are in different unions and under the stressful working conditions, are sometimes at odds with each other.

The unions representing these workers have also been in open battle. In the winter of 2008, concurrent decertification campaigns were run by the union representing nurses and the union representing paramedics. Thousands of dollars were wasted on each side, and nothing changed, while the bosses sat back and laughed at us all.

When the other workers learned about what the registered nurses were doing, they joined in, adding almost another 40 to those who were refusing to sign up for overtime. Dividing workers along racial, gender, sexual orientation, gender identity, job classification, etc., is the oldest trick in the bosses bag.

These garbage ideas are reflected in many aspects of our society and must be consciously fought against. One effective arena to break them down is through workplace struggles, because it is a concrete place where one can learn who our true enemies and actual allies are.

Be a Responsible Organizer



Bargaining for a new contract began in December 2012 and lasted until July 2015 — spanning over two and a half years. Staffing in the ER became terrible again in April 2015, and my co-workers were frustrated at the apparent lack of progress on negotiating a contract. To many of them, the next logical step was to organize a sick-out, and my first instinct was to support this.

As organizing something like this was out of my own comfort zone, I talked to other socialists who are experienced with unions as well as a veteran union organizer who had direct knowledge about such actions. The main questions I was confronted with that I didn’t have answers for were: how do you negotiate your demands, and was what was the plan if the boss fired everyone?

One important part of being a leader is knowing what you don’t know and getting help from others. When stakes are higher, there is no point in reinventing the wheel, as a bad failure could set organizing and confidence back significantly.

It’s one thing to have a poorly organized meeting that doesn’t go the way you wanted; if people’s jobs are going to be put at risk, there better be a common understanding of this risk and a plan to take them on.

Since having a meeting at work about an illegal strike wasn’t prudent, we organized conference calls to catch nurses on the different shifts. The main focus of the conversations were a discussion of what such an action would entail, and in the end it was evident that this was beyond what people were ready to do.

The upshot of this, however, was that the sentiment of the emergency room was reported to the rest of the bargaining committee, which helped us organize a strike vote of the entire membership, which was overwhelmingly positive.

In the end, no strike was ever organized, because while the union generally has no problems striking hospitals elsewhere, it was against striking this hospital, and had successfully convinced a majority of the bargaining team on this position.

Regarding staffing, we did win new language in the contract that lifts the ban on overtime when staffing is short. This was a partial victory, as it didn’t solve the underlying problem and furthers enables the reliance on overtime by the employer.

Build Collaborative Leadership with a Common Political Outlook

The best leader is one who aims to replicate their method of organizing in others. We should constantly be pushing others forward to take a lead, as well as helping to guide others who are already leaders. Out of this campaign, several more nurses became and remain active with the union.

We all have co-workers who are leading others in many directions, whether consciously or not. Some ideas about how to improve situations are more effective than others. The way our bosses teach us to deal with workplace problems is to either ignore them or to run and tell a supervisor — and these are dead-end solutions.

There are real problems in every workplaces, and the vast majority of them are due to capitalism. As socialists, we should help identify how the underlying cause of the stress and conflict in a workplace isn’t due to a co-worker who has a bad attitude or poor work ethic, but that profit driven system constantly drives to have workers do more for less, and the boss’s job is to uphold that system.

My co-workers knew I was a socialist because I talked about politics with them all the time and distributed a socialist newspaper. During this years-long campaign, one co-worker felt the need to tell me that while she didn’t agree with socialism, it didn’t bother her that I was a socialist because I was a good organizer.

I told her I was a good organizer because I was a socialist, which she thought was hilarious — but it was given in all honesty.

We should start with the premise that regular working people both have the interest and capability of changing society through collective action. We must be part of learning alongside others about how to bring this set of politics into realization through organizing workplace struggles.

We may not win all of our co-workers to a socialist outlook, but we should aim to win as many as possible. We should also aim to win an even wider layer of people to this idea: a union is simply an organized group of workers who use all means at their disposal to fight for something better — and that we can make it happen ourselves.