CNA Bias Claims Against Sutter Health: Discrimination or Desperation?

The California Nurses Association has raised troubling accusations of ethnic discrimination against Sutter Health's California Pacific Medical Center and St. Luke's Hospital in San Francisco.

The union alleges that CPMC and St. Luke's Hospital are "engaged in systematic discrimination against the hiring of Filipino registered nurses." CNA leaders, flanked by Filipino community leaders, made the accusations during an Aug. 19 press conference.

CNA Co-president Zenei Cortez, RN, said that St. Luke's and CPMC RNs, many of them Filipino, have been outspoken in defense of their patients, and in opposition to Sutter and CPMC's plans to reduce services to the largely lower income, minority community depending on St. Luke's.

"Rather than respond to the concerns of the community, CPMC and Sutter have chosen instead to retaliate by carrying out a punitive, illegal, and immoral campaign of discrimination," Cortez said. "There can be no excuse for racial or ethnic discrimination. A hospital should be a center of therapeutic healing for patients, not a model of bigotry."

CNA on Aug. 18 filed a class-action grievance against Sutter and CPMC for contract violations in a "systematic policy of discrimination." CNA also called on Sutter Health to direct CPMC to end the discrimination. The union asked for an investigation by the San Francisco Human Rights Commission.  

CPMC CEO Warren Browner, MD, called the accusations "false and designed to cover up the union's own failure to win a contract despite three years of negotiations."
"We pride ourselves on our diverse hiring policies and our longstanding commitment to promoting equal opportunity employment," Browner said. "The allegations of discrimination made by the California Nurses Association are dishonest and without merit."
The CNA made its case in the court of public opinion with written statements from former employees. Chris Hanks, a former director of Critical Care Services at CPMC, alleged that Diana Karner, the Sutter West Bay vice president of nursing told him several times, "you are not to hire any Filipinos."

CNA said CPMC hiring data supports the accusations. "A review by CNA of active employee lists provided by CPMC demonstrates that in early 2008 there was a major demographic shift among the nurses being hired at St Luke's. Before February 2008, 65% of St Luke's RNs were Filipino. After February 2008, only 10% of RNs hired were Filipino," CNA said.

Browner said the hospital's data tells a different story. "In 2007, 63% of our nurses at St. Luke's were Asian. Today that number is 66%," he said. "We do not have any way of identifying what percentage of our nurses are Filipino because we don't break down these categories by ethnicity or country of origin."

The CNA's discrimination claims are questionable, however, owing to issues that the union must have known about but failed to mention.

First, the United States reportedly has a seven-year backlog of work visa applications from foreign-trained healthcare professionals, including Filipino nurses. Assuming that CNA's hiring data from St. Luke's is accurate, it seems highly likely that any decrease in the number of Filipino nurses hired is owing more to this backlog, which is well beyond the control of any hospital, than to discrimination.

Second, a big critic of extending work visas for foreign-educated nurses—including Filipinos—is the American Nurses Association, the nation's largest professional trade association for RNs, and a one-time affiliate with CNA.

In fairness to ANA, their opposition is not based on discrimination. "We need to be dealing with our domestic healthcare workforce problem. We shouldn't be using immigration as a means to address the nursing shortage," Cheryl Peterson, ANA's director of nursing practice and policies, told HealthLeaders Media. "That being said, we do believe that nurses and other healthcare workers have the right to migrate and we benefit when they migrate and work here."

The fact is, with the ongoing economic doldrums, Peterson said, "nobody is bringing nurses in. The whole recruiting of foreign-educated nurses is bolloxed up because of the economy and also because of the availability of visas."

As jurors in the court of public opinion, here is where we stand: CNA wants us to believe that two major hospitals in one of the most liberal, ethnically diverse, and politically correct cities in the United States are engaged in "systematic discrimination" against an ethnic minority because a subset of workers from that group allegedly criticized the hospital.

CPMC wants us to believe that the accusations are a red herring designed to distract rank-and-file members from the union leadership's failure in contract talks. One side is fabricating. Who sounds more believable?

If the CNA's accusations are shown to be true, they will raise serious questions about the judgment and fitness of the executive leadership at CPMC. If the accusations are shown to be false, they will raise serious questions about the judgment and fitness of the executive leadership at CNA.

Either way, heads should roll.