**[This is the Introduction to this paper. For the full paper, please contact the author].
Linda Briskin
York University, Toronto
Paper presented at stream on “Worker Power and the Labor Process, Past and Present”at the
International Labour Process Conference, Rutgers University, March 2010
“It is time we stopped being ‘yes girls’ because of the 'Florence' pledge and stood on our own
feet, because we have been pushed enough.” A New Brunswick nurse with 25 years of experience
(Telegraph Journal -Saint John, 31 January 1975, quoted in Kealey 2008: 4).
“We're not doing this for the sake of money. If it was necessary to do it again, I'd do is again, for
the benefit of the health service … Anger at the way the nursing profession has been treated has
been building a long time. The profession must be valued and respected by the service for the
good of the service.” An Irish nurse on strike in 1999 (quoted in Clarke and O’Neill 2001: 354).
“This issue is really about the nursing shortage which ... has led to horrific and unsafe working
conditions and compromised patient care.... We are taking a stand for the people of
Saskatchewan: you, me, our families, our communities, as the caregivers and patient advocates
that we are.” Laurie Swift, a striking nurse in Saskatchewan (Regina Leader-Post 7 May 1999).
“The government [has] failed to take into account that most nurses are middle-aged women who
have plenty of life experience and aren't easily cowed ... If Mr. Romanow [premier of
Saskatchewan's NDP government] thinks these 8,000 women are going to back down, he had just
better take his testosterone hissy fit and stuff it. He's not giving women their due.” Debra
McPherson, the secretary-treasurer of the National Federation of Nurses' Unions about the
Saskatchewan nurses’ strike (The Star Phoenix 15 April 1999).
“‘We're not moving,’ said the bus driver to the nurse with the picket sign. ‘I'm in a union too.’ …
Two hundred nurses were defying the government and breaking the law. They were sitting in the
middle of the busiest Halifax intersection. Traffic was backed up for blocks. The bus driver at the
head of the jam wasn't moving. No passengers complained. The folks on the sidewalks cheered.
The cops just stood back and watched.” Nova Scotia nurses dispute, 2001 (quoted in Hambling
2002: 12).
“If it comes to losing my job, I’m not concerned. I didn’t sign on to nursing to do slave labour. I
didn’t sign on to lose my rights.” Fay MacNeil, a Nova Scotia cardiac nurse. (Times-Colonist
[Victoria, BC] 29 June 2001).
Popular and scholarly literature certainly suggests a certain fascination with nurses on strike.
From a commonsense point of view, the militancy of nurses seems counter intuitive to the major
themes in nursing around gender, professionalism and resistance to unionization. And yet this
study of nurses on strike reveals a somewhat hidden history of militancy, perhaps connected to
what Hayward and Fee refer to as nurses “unique place in the political economy of health care”
(1992: 397). It is timely to examine
nurses’ strikes at this historical conjuncture in which workers and communities are under
considerable attack: from privatization and public-private partnerships, the re-construction of
work and labour markets, the deepening exploitation of racial and gender differences by corporate
capital, and the neo-liberal invocation of patriarchal and individualistic values for workplaces and
This paper “Nurses on Strike: The Feminization of Militancy, the Politicization of Caring
Labour, and Union Revitalization” is part of a larger project on women’s labour militancies
which starts from the assumption that militancies are fluid, contextually located practices,
negotiated and re-negotiated in historical circumstances. It illuminates and interrogates the
practice of gender in an area where it has traditionally been opaque. I enter the study of nurses’
militancy then, from the point of view of women’s labour militancies rather than as a scholar of
nursing. This vantage point has both strengths and limitations.
Part Two considers the demographic transformations in work, the workforce, union density and
union membership in Canada which set the stage for the feminization of labour militancy, that is,
those involved in strikes are more likely to be women. This trajectory is particularly true in the
public sector. Part Two investigates the 105 strikes of Canadian nurses between 1960 and 2007
with reference to the statistical data on work stoppages from Human Resources and Social
Development Canada (HRSDC), and also explores the limits of the available data. It notes three
‘waves’ of nursing strikes in Canada: 18 strikes between 1980 and 82; 42 disputes between 1985
and 1991, and 18 strikes between 1998 and 1999. It also considers the relationship between
professional nurses’ associations, and unions of nurses, a relationship which informs nursing
struggles and strikes.
In Canada and elsewhere, three reference points dominate the discussion of nursing:
professionalism, patriarchy, and proletarianization. These deeply-entangled trajectories have had
a significant impact on the work, consciousness and militancy of nurses; and have shaped
occupation-specific forms of resistance. The goals of professionalism, and in particular the
commitment to service, resistance to patriarchal practices and gendered subordination, the
challenge of proletarianization, and the confrontation with neoliberal health care restructuring all
inform the militancy of nurses in Canada, and in many other countries. It is the argument of Part
Three that each strand produces solidaristic alliances – in the first instance among nurses; in the
second with the community-based and union movements of women, with nurses based on gender,
and potentially with other women workers; and in the third with workers in the health care sector
and other public sectors, the labour movement, and other progressive movements. These
overlapping solidarities have supported, indeed promoted, militancy among nurses, despite the
multiple forces arrayed against them.
The professional commitments of nurses to the provision of care have confronted health care
restructuring and gendered hierarchies with a militant discourse around the public interest, and a
reconstitution and reclamation of ‘caring’. Part Four notes the emergence, in the last three
decades, of this new discourse and practice. Nurses’ dedication to caring work may encourage
rather than prevent them from going on strike, a shift that I call the politicization of caring. The
discursive frames focussed on the public interest and the politicization of caring have also
provided a basis for nurses to build alliances with other unions, the community, the public, and
women's and other progressive organizations, and in fact, many nurses' strikes have been
characterized by strong popular support, mapped in the concluding section of Part Four.
The final part of this paper considers the relationship between nursing militancy and union
The militancy of nurses, and indeed of health care workers suggests new sources of leverage and
worker power. Their capacity to mobilise public support offers direction for envisioning union
The militancy of nurses speaks to many of the strategic threads in the union renewal project. In
considering the militancy of women, this discussion genders the union renewal debate. At the
same time, it broadens the focus of the women and unions scholarship from issues of
representation and leadership, constituency and cross-constituency organizing, and equity policy
and bargaining. The discussion of union renewal in Part Five touches upon four themes:
women’s militancy, rank and file militancy, coalition building and community outreach, and
professionals in the labour movement. The capacity of union movements to re-invent themselves
in these critical times might well rest on what can be learned from militant nurses, and public
sector workers.
Crossing Methodologies
Undoubtedly the most illuminating studies of nurse militancy may be in-depth accounts of
particular struggles, which capture what Johnston calls “messy multidimensionality” (1994: 216).
In his study of strikes, he also concludes that, given that “no case is typical”: “[W]e can only
generalize from these cases at the level of theory -- through the conceptual tools used to grasp
their histories, rather than through those histories themselves” (213). This paper embraces a level
of generalities in order to map the militancies of nurses, and draws on examples from Canada, the
UK, Australia, Japan, New Zealand, Israel, Ireland, the US, Denmark, Sweden, Finland, Poland,
and Portugal. Undoubtedly certain risks attend such generalizations. Although the paper is
suggestive and exploratory, the rich picture of nursing militancy which emerges using this
approach, in my view, justifies the crossing of context. As Phelan points out, researchers need to
resist both “the temptations to cloak crucial differences with the cloak of universality and to deny
generalities for fear of essentialism” (1993: 786).
In the attempt to map nurse militancy, this paper is trans-disciplinary (drawing on sociology,
women’s studies, history, and industrial relations), and multi-methodological (using qualitative
material and quantitative data, statistical and theoretical approaches, narrative and documentary
strategies). It includes statistical data from Human Resources and Social Development Canada
(HRSDC) on the 24,475 strikes and lockouts in Canada between 1960 and 2007, and particularly
on the 105 Canadian nurses’ strikes in this period; newspaper accounts of nurses’ strikes which
represent a vital primary source to highlight the voices of striking nurses (Briskin 2010a);
documents from nurses’ unions where available; and references to the popular and scholarly
literature on nursing militancy in Canada and elsewhere. Using a trans-disciplinary methodology,
and both qualitative material and quantitative data provides a layered and complex presentation of
nursing militancy.
A Materialist Social Construction Approach
This research assumes that women's experiences are socially constituted, that is, grounded in and
emerging from the material experiences of their lives rather than from any narrow biological
imperatives. Such an approach recognizes that women enter unions differently than men because
of their workplace locations and their household/family responsibilities; women's work bridges
the public and the private, and each impacts on the other; and the pervasive discrimination and
violence women experience in both public and private spaces influence workplace, family and
union experience, and also women's political strategies. Without reference to essentialist ideas
that women are, for example, more nurturing, relational, or emotional by nature, this approach
recognizes that women may identify different issues as salient, as well as organize, resist and lead
in distinct ways. This project, then, assumes that it is possible to reject both an essentialist reading
of the militancies of nurses, and a gender-neutral frame, in favour of a contextual understanding
of the gender-specific patterns of militancy among nurses.
Given the fact that any discussion which focuses on gender specificity can resonate with
essentialism, in this research, I do not talk about female or feminine militancy or resistance. Such
language can unproblematically invoke biologistic and stereotypical thinking. Rather my focus is
on the militancy of women, and specifically in this paper, on the militancy of nurses.
Narratives of Militancy
Before turning to a thematic analysis of the strike patterns of nurses and their implications for
union revitalization, this paper shares some short narratives of a few key strikes by Canadian
nurses, and of an occupation-specific tactic: mass resignations. The themes of gendered
discrimination, professionalism and neo-liberal health restructuring are all visible in these
Canadian Nurses on Strike
In 1988, more than 11,000 staff nurses in Alberta went on illegal strike for 19 days and faced
very serious retaliatory measures by both employers and the state. In reference to this strike, the
organization Edmonton Working Women commented, “They defied the law to defend their own
democratic rights, and to oppose the erosion of workers’ rights on all fronts ... [and to] fight for
patients’ rights to quality publicly funded health care” (quoted in Coulter 1993: 56). In 1999,
Alberta nurses reached a settlement on the brink of what would have been another illegal strike.
In 1999, the first strike in 20 years by nurses in Newfoundland ended after nine days when the
provincial government passed back-to-work legislation. Also in 1999, two days of wildcat strikes
by 47,500 Quebec nurses, who had previously went on a week-long strike in 1989, set the stage
for a lengthy illegal strike. The nurses faced two draconian pieces of legislation which Michele
Biscay, vice-president of the Quebec Federation of Nurses, thought the government was using to
try to “kill the union” (Globe and Mail 6 July 1999). The nurses resisted the intimidation of both
Bill 160, which levied fines (more than $10 million by the end of the strike), withheld union dues
and docked two days of pay for each day off the job (costing individual nurses around $7,000),
and Bill 72, back-to-work legislation that targeted the union leadership. Five days after the
passage of Bill 72, 93 per cent of nurses voted to continue the illegal strike. One week later, an
agreement in principle was reached, which the membership later turned down by 75 per cent. The
nurses continued to use “local guerrilla” tactics, including working to rule, insisting on overtime
pay, and filing grievances for all breaches of the collective agreement (Globe and Mail 26 July
Following strikes in 1988 and 1991, Saskatchewan nurses defied back-to-work legislation for ten
days in 1999. Saskatchewan nurse Nancy Syles spoke to the convention of the Canadian Labour
Congress: “There were nurses on the picket line who told me, ‘I’ve never even had a speeding
ticket.’ But you know they never flinched. They were willing to stay on that picket line and
maybe even be sent to jail.. All we want to do as nurses is to deliver safe, excellent nursing care..
We cannot do this in the working conditions we have now” (Globe and Mail 13 July 1999).
Laurie Swift, a nurse in Regina, wrote in a letter to the Editor of the Regina Leader-Post (7 May
1999), “This issue is really about the nursing shortage which ... has led to horrific and unsafe
working conditions and compromised patient care.... We are taking a stand for the people of
Saskatchewan: you, me, our families, our communities, as the caregivers and patient advocates
that we are.”
Debra McPherson, the secretary-treasurer of the National Federation of Nurses' Unions was
interviewed in The Star Phoenix (15 April 1999): “The government [has] failed to take into
account that most nurses are middle-aged women who have plenty of life experience and aren't
easily cowed... If Mr. Romanow [premier of Saskatchewan's NDP government] thinks these
8,000 women are going to back down, he had just better take his testosterone hissy fit and stuff it.
He's not giving women their due.” She explained that the resentment stemmed from the fact that
governments everywhere have shown no reluctance to cut or freeze the wages of public sector
employees, most of whom are women. “The public sector is constantly the brunt of wage
restraint. We have our federal government pushing back pay equity decisions from the courts.
But if they think they can keep women working for less, they are going to have to think again.
We're past that.”
These nurses’ strikes were characterized by strong popular support, and by backing from other
unions and the women’s movements. The 1999 illegal strike by Quebec nurses garnered massive
support from the Quebec public, 72 per cent of whom thought the nurses’ wage demands were
reasonable (Globe and Mail 28 June 1999), and brought out doctors, other unionized workers,
and members of the women’s rights federation to their picket lines. In reference to the 1999
Saskatchewan nurses’ strike, Barb Byers, then president of the Saskatchewan Federation of
Labour (SFL) said, “I’ve never seen a membership so solid and I’ve never seen this level of
support from the public.”i Byers told a demonstration in support of the nurses: “We've got to let
them know that women workers in this province are not going to be discriminated against”
(quoted in The Star Phoenix 12 April 1999). Byers thought the government had “underestimated
the nurses in a sexist and patronizing way.”ii A May 1, 1999 opinion piece in the Phoenix was
titled “Premier Faces Women's Fury.”
Mass Resignations and Non-Strike Tactics
Although this paper focuses largely on strikes, both legal and illegal, it does not assume that
strikes are the only form of workplace militancy. In his discussion of workplace conflict, Hebdon
(2005) distinguishes among covert collective actions (such as sick-outs, slow-downs and workto-rule), other collective actions such as claims of unfair labour practices, and individual forms of
militancy around grievances. Like other workers, nurses have engaged in multiple forms of
resistance over many decades. Some examples. In 1975 in New Brunswick, nurses booked off
sick to back their demand for contract reopening. The campaign was dubbed the “blue flu” as 700
nurses in 15 hospitals called in sick the first day (Kealey 2008: 10). In 1976, nurses in New South
Wales (Australia) instituted bans “such as those on overtime, non-nursing domestic and clerical
duties, and non-emergency surgery and admissions; they rallied, marched in the streets, burnt
their caps. and held stop-work meetings as a symbol of protest in pursuit of wage increases”
(Strachan 1997: 300). At a 2,000-bed hospital and trauma center in Southern California nurses
staged a two day sick out in 1987 (Kravitz, Leake and Zawacki 1992). In 1989 in British
Columbia, nurses refused “to perform ‘non-nursing duties’ (eg. cleaning, housekeeping,
portering, post-discharge charting) through a ban on overtime” (Haiven 1991: 18-19). Given bans
on striking, and essential and emergency service requirements, nurses have often been forced to
seek alternative forms of resistance and militancy.
Perhaps of most interest is what might be seen as an occupation-specific tactic: the long standing
use of mass resignations. Prior to access to collective bargaining rights, mass resignations offered
a collective vehicle of resistance (Hibberd 1992: 577). The earliest Canadian record I found is a
conflict in October 1950 at the Toronto General Hospital:
“73 graduate nurses from the hospital's seven floors, labour room, relief staff, and blood
bank submitted a petition to the superintendent and board of trustees of the TOH …
[which] promised that the 73 signatories would resign as of 23 November unless the
hospital met the nurses' demands. The 11-point program for change included specifications regarding the hours nurses could work, the number of patients they would be
required to attend, the number of staff on duty, length of holidays and daily rest periods,
and basic salary rates” (McPherson 1996: 243).
Even in cases where nurses did have the right to strike, the tactic of mass resignations continued
to be used, often with great success. Two Canadian examples are worth noting. In 1969 in the
province of New Brunswick, talks broke down between nurses and the hospital association.
Given “nurses' inability to strike, nurses took direct action instead and resigned en masse”:
“Faced with starting salaries reputed to be the lowest in North America, loss of some
fringe benefits, and frustration that nurses' salaries did not reflect additional education
and training as well as the irritation of a constantly changing set of management
negotiators, the nurses charged that management was not bargaining in good faith and did
not take nurses' problems seriously. … Buoyed up by the Canadian Nurses' Association's
national campaign to improve nurses' salaries and address nurses' sense of frustration,
approximately 1400 or half of New Brunswick's registered nurses announced their
resignations at a news conference in Fredericton on 15 July. Threats that nurses would
lose their accumulated pension rights, sick leave, and seniority if they resigned only
strengthened the nurses' resolve. After nine days of negotiation the dispute was settled
and a master contract … ratified. Salaries were significantly improved and those with
additional educational qualifications received extra pay” (Kealey 2008: 9-10).
In June 2001, the issue of the right to strike for Nova Scotia health-care workers and nurses
became the centre of a contentious dispute. Health-care workers belonging to the Nova Scotia
Government Employees Union (NSGEU) were already walking the picket lines when the
provincial government passed a new law that took away their right to strike and threatened big
fines. In response, 1600 nurses who were due to go on strike within days signed up to resign. Fay
MacNeil, a cardiac nurse, said, “If it comes to losing my job, I’m not concerned. I didn’t sign on
to nursing to do slave labour. I didn’t sign on to lose my rights” (Times-Colonist [Victoria, BC]
29 June 2001).
“I was in a sweltering backroom at the NSGEU's strike headquarters packed with
passionate nurses, each one ready to resign, and each one deadly determined to risk their
careers for what was right … I was standing on the back of a flatbed truck parked beside
the doors of the legislature, helping nurses climb up to use big, black markers to sign
their names to their resignations in public for all the world to see. Many with trembling
hands and eyes full of tears. But all ready to do what needed to be done” (Hambling
2002: 13-4).
Amidst growing public support, “the government backed off and reached agreement with the
unions and the health employers to submit their disagreements to ‘final offer selection’. The
arbitrator opted for the unions’ proposal for registered nurses” (Haiven and Haiven 2002: 5), and
gave the nurses 70% more than originally offered (O’Brien 2002: 22).
The tactic of mass resignation of nurses has been used in many countries (for example, on the US
see Ketter 1997, and for Australia, see Strachan 1997). Perhaps the most successful recent use of
mass resignations was in the Finnish nurses’ mobilization. In October and November 2007,
considerable militancy erupted in Finland over salaries for nurses, as part of the on-going
struggles over pay levels for public health care employees. The Union of Health and Social Care
Services (TEHY) called for 24% increase to rectify unreasonably low pay for nurses, almost
twice what was being offered TEHY banned overtime, and announced that “13,000 nurses were
ready to hand in their resignations” (Jokivuori 2007). According to the Chair of TEHY, LaitinenPesola says the union had “to resort to the extreme threat of mass resignations in order to secure
the future of healthcare services and qualified personnel.”iii
In response, the government passed the unprecedented Patient Safety Act (16 November 2007)
which could order healthcare professionals to continue working at tasks considered essential for
patient safety even if they had resigned. The government also claimed that “each individual
would [be] criminally responsible if a patient became disabled or died because of the
resignations” (Jokivuori 2008a). In response to the passage of this Act, 4000 more nurses signed
onto the resignation campaign for a total of 16,000 nurses.iv
In the Finnish context, the strategy of mass resignation was used to prevent the invocation of
essential services policies which had previously undermined the ability of health care workers,
and nurses in particular, to make inroads on pay and working conditions. “The last time that a
labour dispute involving TEHY escalated to actual industrial action, the impact of the strike was
undermined by the requirement that the union allow a certain number of its members to maintain
a minimum level of staffing at hospitals. This time, TEHY has chosen the unusual strategy of a
mass resignation campaign, rather than a traditional strike.”v On November 19, the nurses
actually resigned. The Labour Court ruled that “the mass resignation by TEHY members on
permanent employment contracts was against the law.” The Court ordered the union to pay a
large fine, and gave the employer the right to start hiring replacement workers (Jokivuori 2008b).
Despite these many threats and reprisals, and the expert claims that TEHY would not succeed,vi
the nurses did not back down. On 19 November 2007, the date on which the first round of
resignations would go into effect, a new collective agreement was settled which gave the nurses
22-28% increase over the four year period of the agreement. This successful negotiation became a
reference point for the Danish and Swedish nurses’ strikes in 2008.
REFERENCES [for Introduction only]
Briskin, Linda. (2010a forthcoming) “Beyond the Average and the Aggregate: Researching
Strikes in Canada.” In New Ways in Strike Research, eds. Sjaak van der Velden and Kurt
Vandaele. Amsterdam: Aksant.
Clarke, Jean and Catherine. O’Neill. (2001) “An Analysis of How the Irish Times Portrayed Irish
Nursing during the 1999 Strike.” Nursing Ethics, 8 (4): 350-359.
Coulter, Rebecca. (1993) "Alberta Nurses and the ‘Illegal’ Strike of 1988." In Women
Challenging Unions: Feminism, Democracy and Militancy, eds. Linda Briskin and Patricia
McDermott. University of Toronto Press, pp. 49-61.
Haiven, Larry. (1991) “The State and Nursing Industrial Relations: The Case of Four Western
Canadian Nurses’ Strikes.” unpublished paper.
Haiven, Larry and Judy Haiven. (2002) "The Right to Strike and the Provision of Emergency
Services in Canadian Health Care." Report frp, Canadian Centre for Policy Alternatives.
Hambling, Skip. (2002) “Hearts and Minds: A Response to Tom O’Brien’s ‘Targeting Tories’
Article.” Our Times, 21 (4): 12-14.
Hayward, Sarah and Elizabeth Fee. (1992) “More in Sorrow Than in Anger: The British Nurses’
Strike of 1988.” International Journal of Health Services, 22 (3): 397-415.
Hebdon, Robert. (2005) “Toward a Theory of Workplace Conflict: The Case of U.S. Municipal
Collective Bargaining.” Advances in Industrial and Labor Relations: Volume 14. D. Lewin and
B. Kaufman, eds. Amsterdam: Elsevier, pp. 33-65.
Hibberd, Judith M. (1992) “Strikes by Nurses.” In Canadian Nursing Faces the Future 2nd ed.
eds. Alice Baumart and Jenniece Larsen. St. Louis, Mo: Mosby, pp. 575-595.
Johnston, Paul. (1994) Success While Others Fail: Social Movement Unionism and the Public
Workplace. Ithaca: Cornell University Press.
Jokivuori, Pertti. (12 November 2007) “Nurses’ Union Rejects Pay Offer and Calls for Industrial
Action.” The European Industrial Relations Observatory (EIRO) Online
Jokivuori, Pertti. (14 January 2008a) “Controversy over Law Restricting Right to Strike in
Healthcare Sector.” The European Industrial Relations Observatory (EIRO) Online
Jokivuori, Pertti. (21 January 2008b) “Nurses’ Dispute in Settlement Talks.” The European
Industrial Relations Observatory (EIRO) Online
Kealey, Linda. (2008). “No More ‘Yes Girls’: Labour Activism among New Brunswick Nurses,
1964-1981.” Acadiensis, 37 (2): 3-7.
Ketter, Joni. (1997) “Nurses and Strikes: A Perspective from the United States.” Nursing Ethics,
4 (4): 323-329.
Kravitz, Richard, Barbara Leake, and Bruce Zawacki. (1992) “Nurses’ Views of a Public
Hospital Nurses’ Strike.” Western Journal of Nursing Research, 14 (5): 645- 661.
McPherson, Kathryn. (1996) Bedside Matters: The Transformation of Canadian Nursing, 19001990. Toronto: Oxford.
O'Brien, Tom. (2002) "Targeting Tories: How the Nova Scotia Nurses Won." Our Times, 21 (3):
Phelan, Shane. (1993) “(Be)Coming Out, Lesbian Identity and Politics.” Signs, 18 (4): 765-790.
Strachan, Glenda. (1997) “Not just a Labour of Love: Industrial Action by Nurses in Australia.”
Nursing Ethics, 4 (4): 294-302.
Quoted by Judy Rebick on CBC On-Line, 16 April 1999
“THEY announces Demands, Threatens Mass Resignations.” 9 Oct 2007 YLE: (Finnish Broadcasting
“Nurses Union Announces More Resignations.” 12 Nov 2007. YLE: (Finnish Broadcasting Company)
“Labour market experts doubt nurses will get pay hikes they want.” 22 Oct 2007.
Helsingin Sanomat (HS)