Striking a Balance: Worker’s Rights and Employer Retaliation in Hawaii’s Nursing Negotiations

In October 2024, Administrative Law Judge Anita Baman Tracy found Hawai’i Pacific Health and Kapi’olani Medical Center for Women & Children guilty of implementing coercive rules, in which the hospital engaged in unfair labor practices by enforcing a dress code policy that prohibited wearing logos in patient care areas. Hospital administration forced employees to remove union solidarity stickers and pins from their badges and uniforms in patient care areas. The Hawai’i Nurses Association (HNA) OPEIU Local 50 Union filed numerous charges on November 15, 2023, alleging bad faith bargaining, repudiation and modification of contract, and coercive rules. Due to this ruling, all HPH hospitals had to rescind any disciplinary actions against employees for violating this unlawful dress code and propagate official notices to employees by the National Labor Relations Board. This notice stated that the respective hospitals had violated federal labor law. It reassured employees of their federal rights, including the right to unionize, bargain collectively, and participate in protected activities. While this ruling did not find Kapi’olani Hospital guilty of bad faith bargaining or modification of contract, it did find that they attempted to suppress unionization or solidarity with the union.

This case emerged amid tensions over the approaching expiration of Kapi’olani nurses’ contracts and shared frustrations about the hospital's resistance to contract modifications. The October 22, 2024 ruling turned attention to the broader implications of Kapi’olani Hospital’s actions, which highlight a disregard for workers' federally protected rights. This case underscores the need to uphold labor laws that safeguard employees' ability to advocate for improved working conditions and union representation without fear of retaliation or suppression.

The legal protections afforded to unionized workers under the 1935 National Labor Relations Act (NLRA) must be respected to defend nurses’ rights during efficient and reasonable negotiations conducted in good faith by the employer hospitals. Collective bargaining and the right to strike are essential mechanisms for healthcare workers, especially nurses, to demand better working conditions under the NLRA, where employees are granted the right to “engage in other concerted activities for collective bargaining or other mutual aid or protection.” This protects workers' right to join or support labor unions, enabling unionized healthcare professionals to collectively address unfair labor practices, substandard working conditions, and insufficient wages. Kapi’olani’s striking nurses argued that improving these conditions is not just in the interest of healthcare staff, but is essential for ensuring safe, high-quality, and sustainable healthcare for Hawaii’s residents.

Hawaii’s hospitals are notorious for being slow and ineffective in their negotiations with healthcare workers, leading to prolonged contract delays. Kapi’olani Medical Center repeatedly attempted to delay contract negotiations, forcing nurses to continue working without an official contract under the conditions sought to improve. At Kapi’olani, the nursing staff have felt a lack of transparency and trust in their employers, making it difficult to reach collaborative solutions. In response, they organized strikes with the assistance of the HNA to amplify their voices and put pressure on their employers for more substantial progress.

Kapi'olani nurses had worked without a contract since December 2023 and began negotiations in September 2023. During these negotiations, nurses reported a fear of retaliation when voicing concerns about working conditions. Hospital officials have denied these claims, asserting they have always encouraged open communication. However, their actions against striking nurses validate the staff's concerns about a lack of support and transparency. Consequently, the Hawai’i Nurses Association (HNA) strengthened its demands to include a wage raise proportional to the cost of living and safer staffing ratios in response to the decreased workforce. Hawaii's long-standing nursing shortage is exacerbated by the state's high cost of living and the aftermath of the COVID-19 pandemic. This crisis has resulted in high nursing turnover rates, placing an even greater burden on the remaining staff, who are often required to work extended hours and frequently forgo meal breaks. Altogether, these concerns increase the potential for error, decrease individualized attention for patients, and hinder quality care. As a result of their disappointment with negotiations, the HNA held a series of informational pickets a weeklong strike beginning on January 21, 2024. Almost eight months later, they held another strike on September 13, 2024.

Strikes, while disruptive, are often a last resort when other efforts through negotiation and mediation have failed or stalled, and are a legal right of unionized workers fighting unfair labor practices. The U.S. Supreme Court case Mastro Plastics Corp. v. Labor Board (1956) provides an important legal precedent that supports this right of workers to strike against unfair labor practices, even when such strikes might contradict clauses within previous collective bargaining agreements that prohibit work stoppages. Employees at Mastro Plastics felt their employer implemented unfair labor practices and protested them via a strike. Mastro Plastics argued that the strike was illegal because it violated the no-strike clause of their collective bargaining agreement; however, the employees contended that their action was protected under the NLRA because it was in response to the employer’s alleged unfair labor practices. The employees alleged that Mastro Plastics attempted to undermine the union’s power by intimidating workers, interfering with the employee’s union activities, and bargaining in bad faith. Specifically, they justified their strike as a necessary defense of their worker’s rights of unionizing, striking, and collective bargaining. The court ruled in favor of the employees, retaining their right to strike. This ruling reinforced the principle that labor contracts cannot override fundamental worker protections guaranteed by the NLRA.

For nurses in Hawai’i, the NLRA and Mastro precedent protect their critical right to strike, even when it violates a previous collective bargaining agreement, as long as they are protesting unfair labor practices. Such rights ensure that these nurses and their respective labor organizations can pursue their demands, even when their employers are uncooperative, which is crucial in the high-stakes healthcare environment. Looking back to the lawsuit filed against Kapi’olani in 2023, they were found to be suppressing unionized support. Despite this lawsuit, they continued to quell support following the January and September 2024 strikes.

Furthermore, in Labor Board v. Washington Aluminum Co. (1962), the court protected employees’ right to walk out to protest unsafe working conditions without risk of losing their employment status. This case concerned a group of nonunion employees who individually complained that their shop was too cold to work in comfortably; yet, their concerns remained unaddressed. On an extremely cold workday, seven of these workers walked out of the shop and were fired for violating a rule that no one may leave during a workday without a supervisor's permission. It was determined that their termination was unlawful, as it violated their right to act in concert for mutual aid or protection under the NLRA. As a result, the court mandated immediate worker reinstatement with back pay.

Given this 1962 precedent, Kapi’olani’s lockout of all HNA-represented employees to suppress protests against working conditions is unlawful. Not only did they suppress the right to unionize and support the union by enforcing coercive workplace restrictions, but they also lacked justifiable cause to override the nurses' NLRA rights to engage in concerted activities or prevent their return to work. Furthermore, Kapi’olani hired temporary nurses to replace those locked out, which served as an additional intimidation tactic, signaling that they would not hesitate to replace nurses who continued to strike.

The 2024 strikes were held to bring greater attention to the pressing issues that Kapi’olani’s nurses felt needed to be addressed to improve their working conditions and overall patient care. Kapi’olani Hospital, although notified of the strikes within the proper time frame, instituted an indefinite lockout for all nurses represented by HNA, not just those who participated in the strikes. They even reported a temporary replacement nurse they hired to their employing agency for interacting with the striking nurses, who were ultimately fired. Kapi’olani argued that these actions were legal because the organized strikes were economic, even though the participating nurses stated numerous times that it wasn’t only about the money, making this the first lockout by a Hawai’i employer in 22 years. The staffing ratios and employee retention strategies were their main striking points, demonstrating yet another poor employment practice by Kapi’olani.

Given that precedent dating back to the 1950s has continuously protected worker's rights, Hawaii’s hospitals, especially Kapi’olani Medical Center, need to improve their working conditions for their employees and engage in better labor practices. One lawsuit out of Hawaii has parallels to historic cases, showing this is not a state or individual company issue, it is an issue of the American worker. These nurses, like any unionized group, have a legal right to remain unionized — as supported by Mastro Plastics Corp. v. Labor Board (1956) and Labor Board v. Washington Aluminum Co. (1962). The labor dispute between Kapi’olani Medical Center and their employees represented by HNA underscores the employer’s legal obligation to listen to their workers’ grievances and maintain their NLRA rights during negotiations. The systemic challenges faced by Hawaii’s nurses highlight the pattern of the violation of their NLRA rights and the necessity of their rights of collective bargaining and union support in combating these illegal acts. The ruling against Kapi’olani’s practices demonstrates that suppressing unionization efforts and retaliating against workers for lawful strikes are not only unjust but also unlawful actions that violate legal precedent.

Edited by Ananya Bhatia