Over late 1998 and the first half of 1999, nurses in various hospitals across Sweden have been quitting their jobs, in a kind of "contagious" mass action. The reasons for their resignations are mostly dissatisfaction with salaries and aspects of working conditions.
Over late 1998 and the first half of 1999, some hundreds of nurses have either threatened to leave their jobs or have actually resigned, at a time when national unemployment remains relatively high. However, unemployment among nurses in Sweden is almost zero at present. Nurses can obtain other nursing jobs very quickly, either through their own contacts or through a temporary work agency. The market share of temporary nursing agencies is expanding rapidly.
The trend began in early autumn 1998 when 150 nurses at the thorax intensive care unit at the hospital in the university town of Umeå, in the north of Sweden, publicly advertised for new employers. The reason for doing this was apparently not really a wish to leave, but rather an attempt to apply pressure to keep their existing flexible work scheme. The employer, Norrbotten county council, finally gave in, but not before 26 of the nurses had left. A new local agreement maintaining the old regulations was concluded on 21 October 1998.
Resignation phenomenon spreads
A wave of similar actions started in February 1999 when 14 out of 45 nurses employed at the neurology intensive care unit in the university hospital in Lund, in the south of Sweden, handed in their notice. They claimed a SEK 1,500 per month pay increase in addition to the salary provided for in the relevant collective agreement. Another group of nurses from the Lund anaesthetic clinic also announced they were going to quit their jobs. Shortly after this, 50 nurses, half of all those employed in the northern town of Skellefteå, also resigned. They did so because they claimed that their working conditions were too arduous and that more nurses should be recruited. In April, 17 children's nurses handed in their notice at a hospital in Boden, a small town in the far north of Sweden. The nurses stated that their salaries were far too low, given their educational qualifications and, along with 30 nurses in Luleå, on the north coast, claimed monthly pay increases of SEK 3,000 to SEK 5,000. Furthermore, more nurses in Umeå, this time seven out of the 20 in geriatric care, announced that they would quit their jobs.
Another reason for the discontent among the nurses who resigned was that younger nurses were being employed at a higher salary than older nurses in clinics. In all, about 300 nurses have resigned in the current wave.
Pay increases for Sweden's 90,000 or so nurses, who form a relatively low-paid group of white-collar employees, have totalled only around 18% over the last five-year period. The median monthly salary for a nurse is at present is SEK 17,400 . The white-collar workers with the highest pay increases, those working in industry, have seen their pay rise by 21.8% over the same period.
Impossible pay rise
Many of the local employers have admitted that nurses are not very well paid on the whole, but claim that it is impossible to increase salaries for all nurses. The recent claims from the nurses vary from SEK 2,000 to SEK 5,000 per month, and a spokesperson for the Federation of Swedish County Councils (Landstingsförbundet) has stated that if every nurse were to receive a pay increase of SEK 2,500, it would cost the employers SEK 3 billion. Mats Björck, the chief negotiator at the Swedish Association of Health Professionals (Vårdförbundet), which represents nurses, questioned the reasoning of the employers, claiming that there was no risk of a "knock-on" effect on the pay of other groups as actual salaries and other working conditions are determined locally. However, there was a risk for union trade solidarity, which might weaken. "I do not like the way the nurses act, they use the wrong methods. But I personally understand their actions," Mr Björck stated.
Temporary work agencies
Temporary work agencies have seen a growth in their activities in the healthcare sector during the past two years. In 1998, the authorised companies had about 900 workers in this sector, most of them in Stockholm. The nurses' salaries paid by temporary work agencies, such as Mabicare, New Care, Proffice Care and Competence sköterskejouren, are SEK 2,000 per month higher than those offered by the hospitals. Representatives of the temporary agencies frequently state that in the future whole care units will be staffed by workers from such agencies. One of them, Proffice Care, recently announced that it was preparing to set up training programmes for nurses.
Neighbouring Norway offers considerable employment opportunities for Swedish nurses and doctors, and so far one or two Swedish agencies have been involved in the arrangements for their placement. However, temporary work agencies are currently forbidden in Norway (NO9904128N), and the Norwegian authorities are monitoring Swedish cross-border activities.
What happens now?
To give in one's notice is not an illegal action. Seen as a mass action, it might be, but none of the social partners have as yet taken the issue to the Labour Court. Therefore, the nurses' resignations are being handled in different ways at the local hospitals. In Umeå, as mentioned above, the intensive care nurses were able to keep their old flexible work scheme and the majority of them thus stayed on, though 26 nurses had already started new jobs before the agreement was reached. The intensive care nurses in Lund have all found new employment elsewhere. The management regrets this, but states that it can do nothing about it.
A group of nurses in the geriatric care unit in Umeå have been awarded a monthly pay rise of SEK 1,870, which was enough to persuade them to stay on. In Lund some 20 nurses from other clinics have left their jobs, and another 12 will leave in the beginning of summer, and those remaining have received an extra pay increase. In Skellefteå, 20 nurses in the geriatric care unit will leave their jobs in June, while 39 nurses have changed their minds since they received a promise of a reorganisation and a commitment that part-time workers would be given full time jobs in due course.
The children's nurses in Boden will leave their jobs in July 1999, and the 34 operating-theatre nurses in Luleå will probably do the same. These two towns in the far north of Sweden are situated in the county of Norrbotten. In April 1999, the county council came to a local agreement with the Association for Health Professionals, providing for a general pay rise of 3% for nurses from 1 April 1999. The county council publicly stated that it would not accept the claims of those nurses who had handed in their notice.
Commentary
it is important both for the employers and the trade union concerned that the claims from the nurses should be treated within the framework of the normal readjustment of salaries. Public opinion and the media have always sympathised with nurses, who traditionally belong to a low-paid group of professionals. "Going public" like this with a somewhat unconventional kind of action has proved to be an effective way for the nurses who have resigned to highlight their case.
There is a risk that the employers, supported by the union, will refuse to entertain their demands when nurses hand in their notice. In this event, however, this way of drawing attention to their claims does not involve many risks for the employees at present, as it is fairly easy for a nurse to find a new job, and even work in Norway or in Denmark. In both these countries, there is a shortage of nurses and doctors, and the salaries are better than in Sweden. (Annika Berg, Arbetslivsinstitutet)