The continuing nurses' strike against Group Health Association, the largest health maintenance organization in the metropolitan area, reflects demands by women throughout the country for equality on the job at least as much as it does the nurses' specific demands for increases in salary and staffing.
Even though the number of men entering nursing has doubled in the last five years, it is still overwhelmingly viewed as quintessential women's work. Nurses traditionally have been considered handmaidens of doctors, most of them men. And as such, some nurses say, they're paid accordingly.
"The job we do goes largely unappreciated, except by our patients, who adore us," said Patricia Miller, a 15-year nursing veteran who has worked at GHA for the last five years specializing in internal medicine.
At GHA, average yearly salary for nurses is $16,977. Physicians' salaries range, approximately, between $45,000 and $80,000, according to Dr. Donald E. Mitchell, president of the Capital Alliance of Physicians, which represents non-management doctors at GHA. The fact that at least half of the 105 doctors at GHA have walked out in support of the strike indicates their conviction that the nurses are underpaid and overworked.
Mitchell termed the organization's salary offer "unrealistic" and said the nurses "have long been underpaid and are entitled to a parity wage."
With the two sides still wide apart on the wage issue, no end to the strike was in sight yesterday. GHA officials said they are still meeting the needs of 70 percent of their patients, but if the strike continues much longer it appears inevitable that a significant number would require treatment elsewhere--something GHA must provide under the terms of the prepaid health care program.
The GHA nurses are not arguing that they should be paid as much as physicians, whose professional preparation may be three times as long. But here and elsewhere in the country, nurses are demanding equal pay for equal background.
In San Jose, Cal., 1,300 nurses at four hospitals have been on strike since January. Salaries for those nurses range from $17,982 to $22,684. They're demanding increases to the same level as staff pharmacists, between $30,336 and $31,848.
"The strike in San Jose is about what the nurses call 'comparable worth,' " said William L. Kuehn, communications director of the American Nurses Association. "Nurses and pharmacists go through comparable training and their compensation should be comparable. But, of course, pharmacy is male-dominated."
Pharmacists receive their degree after four years of study, and, increasingly, so do nurses, although until recently many were certified after a three-year program.
Another strike by nurses has been in effect at Burbank Hospital in Fitchburg, Mass., since Feb. 26. According to Kuehn, who was interviewed by telephone at the association's headquarters in Kansas City, negotiations between the 233 nurses and the hospital's management are deadlocked.
In all of the ongoing strikes, the demands are virtually the same: higher pay, improved working conditions and what Kuehn termed "some voice in the decision-making process as it regards patient care. Nurses want to work on a team with doctors and other health care specialists. They no longer want the handmaiden role. But health care is still under physician domination."
The 80 nurses and five physical therapists on strike against GHA since April 1 express only gratitude and praise for the doctors who support their job action. Yet some indicate that their professionalism goes largely unrecognized.
The concept of nurses specializing, as physicians do, is gaining credence. "It used to be that nurses were only assistants to doctors," said Mary Beard, who works in obstetrics at the Pennsylvania Avenue GHA center. "More and more now, we're becoming coworkers with our own responsibilities to the patients."
As she waved a strike placard and strode along downtown K Street during a lunchtime rally last Friday, Beard added, "The doctors are concerned with illness. I'm more concerned with health."
Her work puts her in touch with "high-risk pregnancies," particularly teen-agers, "who often don't even understand how they got pregnant, let alone what childbirth is all about."
Despite some professional gains such as establishing specialties, nurses still consider themselves to be what Patricia Miller called "abundantly underpaid." Nationally, according to Kuehn, their salaries range from $13,000 to $20,000 a year, with the higher levels paid on the West Coast, in New York City, Chicago and some Sun Belt cities.
Even so, Kuehn said, a considerably higher proportion of the 1.4 million nurses in the United States--70 percent--remain in their profession than do women in other fields considered to be female-dominated, where 50 percent leave for new careers.
On the other hand, enrollments in nursing schools has declined 1 percent a year for the last two years and, Kuehn said, "we're worried about that."
Staying on in the face of what they consider poor pay and tough conditions seems to be almost second nature to some nurses. "I wanted to be a nurse from the time I was a 15-year-old in Schenectedy, and so did my twin sister," said one. "We're both still at it.
"I went into it for all the altruistic reasons that any 17- or 18-year-old always gives: to help people, to do something meaningful, to get into a profession you can stay in all your life. I still feel that way."