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Only the Rank and File Can Save Us Now

Dispatches from the Frontlines of Care

April 15, 2020

We are proud to have a strong analytical focus on social reproduction at Spectre. The current pandemic is tragically proving that which social reproduction theorists have long emphasized: that work needed to sustain life and life-making, such as nursing, teaching, cleaning – in other words, care work – is essential for any society to function. Indeed, it is care work that makes all other work possible.

A social reproduction focus, however, is not simply a philosophical position. It is simultaneously a political project. This is why during this time of crisis, we want our readers to hear the voices of workers fighting on the frontlines of care. The work of nurses, refuse workers, teachers, and farmworkers, among others, is sustaining us through this crisis. Our series Dispatches from the Frontlines of Care is designed to remind ourselves that it is the stockbroker and the corporate executive who are disposable, and we want a world where they remain so.

If you have story for us please write to the series editor Tithi Bhattacharya at


I’m a nurse working in the ICU at one of the largest, highest-grossing healthcare systems in New York City. There, I’m a shop steward and member of the New York State Nurses’ Association (NYSNA). I’m also a revolutionary socialist and part of the Left Voice editorial board.

Last year, I was deeply involved in my union’s multi-facility contract fight that brought 10,000 nurses on the verge of striking at Montefiore, New York Presbyterian, and Mount Sinai. The powerful battle for safe staffing ratios devolved in the hands of a bureaucratic leadership that responded to members’ demands for strike action with delay and inaction. When bargaining committees touted a tentative agreement that left out our primary demand of nurse-to-patient ratios, I helped organize a rank-and-file opposition (“vote no”) at my hospital, out of which consolidated a core of militant shop stewards dedicated to democratizing the union and advancing shop-floor struggles. Despite members’ outcry, union officers were able to pass a contract and shut down strike action. It is difficult, now, not to dwell on the fact that a strike then might have better prepared us for this disaster with more nurses already integrated into our units when the crisis hit.

Soon after the contract was signed, I became pregnant. I gave birth in January and planned to take leave for several months to adjust to parenting and revel in my baby’s firsts. However, in early March, it became quickly clear that the Covid-19 virus would not spare the center of imperialism. After some deliberation, I started picking up shifts in the ICU and taking my 11-week-old to the city’s childcare for emergency frontline workers. My 14-bed ICU expanded to fit double the number of patients. Today it is an entirely Covid-19 unit, with newly-constructed negative pressure doors and whirring isolation motors in every room.

The United States is now the country with the most deaths due to coronavirus and we’re still not past the peak. The federal government’s response has been disastrous. After several weeks of denial, the White House changed its rhetoric, but never launched an effective, nationally-coordinated response. The scarcity of tests precluded the rapid containment of community spread. State governments were left to decide whether to implement restrictions on activity. Protective equipment and ventilators purportedly coordinated by the federal government were funneled through private vendors who, true to their speculative natures, are selling N95 masks and life-saving supplies to the highest bidders.

At the pandemic’s epicenter, millionaire Governor Andrew Cuomo has emerged as a sort of people’s champion. In widely televised news briefings, he’s displayed at the helm with Trump on speed dial. He swings from reprimanding to beseeching New Yorkers with hollow mantras like, “Do your part,” and, “We need to come together,” throwing chips to frontline workers. The crisis unfolding in New York can not be divorced from the profit-first, neoliberal policies Cuomo’s administration has rammed through since he took office in 2011. Even in the throes of a public health crisis hitting poor, immigrant, working-class and Black and Brown people the hardest, Cuomo insists on a $2.5 billion cut to Medicaid in New York State; he insists on moving forward with the cut when it means forgoing $6.7 billion in federal aid.

Back in the ICU, I immediately felt the toll the pandemic was taking on nurses. We’re being drained by the constant donning-on and donning-off of protective gear, by the desperate calls from family members who can’t visit, by the shortage of monitoring equipment and trained staff, by the harsh rationing of ventilators, by the wrapping bodies to send off to freezer-truck morgues.

We’re being drained by the constant donning-on and donning-off of protective gear, by the desperate calls from family members who can’t visit, by the shortage of monitoring equipment and trained staff, by the harsh rationing of ventilators, by the wrapping bodies to send off to freezer-truck morgues.

In low voices, we pass along news of coworkers who are sick at home with fever and shortness of breath, those who have themselves become ICU patients. The anxiety of catching the virus and passing it to our elderly parents, children, and partners bears down on all of us.

The wildly unchecked viral spread paired with supply and personnel shortages have pushed unsafe working conditions to new heights. Days after spending a single shift inadequately protected, any paramedic, nurse, doctor, or aide can end up in respiratory failure on a vent. We all heard of Kious Kelly, a 48-year-old-nurse who died after working when we were being denied even minimal personal protective equipment (PPE). We all hear of the dozens of MTA workers succumbing to Covid-19.

There is growing rage and a will to fight back. Workers who once feared retaliation are talking to the press, protesting, and walking off their jobs, demanding PPE to reduce our chances of contracting or dying from Covid-19. The “war against the virus” is in fact a pitched battle within a longstanding war of classes: the ruling and the working.

In contrast, union leadership at my hospital painted management in glowing words, negotiating behind closed doors and without meaningful member input. In a Daily News op-ed completely out-of-tune with the moment and shifting consciousness, our hospital’s NYSNA president Robin Krinsky wrote, “Now is the time for labor, management, union, non-union, self-employed, non-employed and everyone in between to work together to make the best of this unprecedented situation. We are working together to resolve issues as quickly as possible. Communication is the key. Im asking my fellow nurses to escalate any issue to their supervisors or managers.” In a backhanded way, she blamed the nurses who were forced to DIY-our-way out of the PPE shortage: “You are not alone in this fight, but we cannot help if we do not know the issues taking place. Lack of communication at all levels led to nurses wearing plastic bags, not lack of supplies.” So there you have it. According to union officers, the inherently antagonistic relationship between bosses and workers could in fact be resolved by “communication” and “escalation.”

At the state level, we saw labor officials issue their routine statements and pleading letters to government officials. Unfortunately, the unions have not thrown themselves behind any city- or state-wide mobilizations for the monumental crisis of workers’ health and safety. Regardless, nurses began organizing actions throughout the city. For the most part, this was done by individuals and small groups with the resources and will to do so – with or without formal union support.

At my hospital, I got together with the core of militant shop stewards and rank-and-file nurses who organized the “vote no” last year. We formed the COVID-19 Frontline Workers Task Force at Mount Sinai that includes healthcare workers across trade and specialization. We based our decisions and power in the democratically-organized rank and file, with the belief that those of us directly caring for patients must be the ones who decide when conditions are safe or not.

Organizing, workplace action, and basic protective equipment is not a privilege. It is a necessity if we want to be able to contain Covid-19 and for saving the lives of nurses and patients.

We drafted a statement of purpose that presented our most pressing demands for PPE, staffing, testing, and quarantine. We pinned responsibility on the hospital corporations and executives, the state and federal government. Although we expected their ire, we still approached the union’s executive committee and argued for their support. The executive committee called the proposal for public actions “elitist,” saying, “How would it look [when we] have one of the best PPE policies in NYC right now?” But organizing, workplace action, and basic protective equipment is not a privilege. It is a necessity if we want to be able to contain Covid-19 and for saving the lives of nurses and patients.

The pandemic has shifted the parameters of what is possible and how we fight. Demands to cancel rent, freeze layoffs, and release all prisoners from jails and detention centers have gained traction. Medicare for All has become a foregone conclusion for many, and even more radical measures like the nationalization of the healthcare system and related industries are seen as increasingly popular, and necessary.

Union officialdom for the most part seems to be stuck in time, reproducing the same old, ineffective tactics as before. This is difficult to understand if we don’t analyze the social character of union officialdom and the incentives they have to behave the way they do. It’s wrong to write off these betrayals as individual corruption. Union officials, in particular those in the higher echelons, form a distinct layer of people whose material realities and relationship to the bosses differ markedly from those of the workers they pretend to represent. They aren’t subjected to the despotism of capitalist exploitation at their job on the daily; they usually aren’t in the shit, and when they are, they still squeeze as much prestige and privilege from their positions as they can.

In addition, union leaders often identify with and develop friendly relationships with management. Some union bureaucrats don’t even bother to conceal this, and publicly reproduce the insidious narrative of worker-management cooperation. Their role as representatives of labor holds inasmuch as they serve as interlocutors across the table from the bosses. Moreover, union leaders often have a special attachment to formal procedures and institutional channels – all of which take conflict off the shopfloor (and out of rank-and-file hands) – because that is what legitimizes their role as brokers between labor and management.

This kind of unionism dovetails with the traditional support for the Democratic Party and the lobbying of state and federal representatives – in the hope that this year, at long last, one tiny concession will fall into the hands of labor. Thus they are less prone to fight decisively for safe staffing ratios, a demand that is at the center of our burn-out working conditions and a major factor that has contributed to the current problem of overwhelmed NYC hospitals.

The antidote to this ill-fated strategy is the building of real rank-and-file power. We can force democracy into our unions and workplace organizing; we can advance a class-struggle orientation in which bosses are recognized as our enemies, collective action is preferred over grievances and filing complaints, and the most important decisions are determined democratically. An initial, although not minor step in this direction is to build a network of democratically-elected shop stewards in every bargaining unit. Shop stewards or combative representatives’ organisms must weigh on every measure the local leadership decides, and even set the course when the executive committee fails to react in a timely manner.

This sort of class-struggle unionism is necessarily complemented with a ruthless critique of pro-capitalist parties and their politicians. It is time for union leaders to drop their fruitless support of Governor Cuomo. At a time when neither of the parties that cyclically alternate in power can offer an alternative to sanitary, social, economic and climate catastrophe, it is time for unions in the U.S. to put their efforts in building a party of the working class, one that fights for socialism.



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