Patricia Schechter

The Labor of Caring

A History of the Oregon Nurses Association

THE OREGON NURSES ASSOCIATION (ONA) has its origins in the flurry of organizational activities undertaken by women in the United States at the turn of the twentieth century. A rapidly industrializing economy, momentous immigration and migration of peoples, and advances in transportation and communication fueled organizational energy. Many women sought a new public voice in education, civil rights, employment, health care, and government. Middle-class women in urban centers led efforts to consolidate local voluntary and religiously based community-betterment activities across the nation, and organizations such as the Young Women's Christian Association (YWCA), the General Federation of Women's Clubs, the National Association of Colored Women, the National Council of Jewish Women, and the Business and Professional Women's Clubs took shape. The massing of population in cities created both the need for and a supply of women in nursing. Trained nurses — that is, those formally educated — first banded together for mutual support in New York City in 1896; the group drew up its first bylaws at Baltimore in 1897. The organization grew and in 1911 took its modern name, the American Nurses Association (ANA).¹

Women in Oregon were also re-imagining their place in public life. One flashpoint in this effort was the Lewis and Clark Exposition of 1905, held in Portland, which offered both a chance to showcase women's accomplishments and an opportunity to exert influence over the tone and substance of the event.² A group of trained nurses staffed the Exposition's infirmary and as a result of their experience formed the Oregon State Association of Trained Nurses (OSATN). At first, the OSATN focused on mutual aid to members and benevolence to the needy poor more than on advancing the profession of nursing. In this, the group had much in common with the YWCA and women's organizations that developed their purpose and mission in deeply gendered terms—as help, service, and duty to others rather than self. Their agenda also points to the limited support for nurses in the marketplace, such as sick benefits or unemployment relief, either in private employment (called "private duty") or in hospital settings.

Facilities at the 1905 Lewis and Clark Exposition included this hospital, which was staffed by nurses who later formed the Oregon State Association of Trained Nurses.

OHS neg., OrHi 79836

Oregon's newly organized nurses attracted both encouragement and demands from the state's women's groups and clubs. In 1915, OSATN's board of directors had to delimit requests for scholarship funds, war work, and other benevolent activities made by women's organizations. These requests were "declined," the board minutes read; the organization "will stick to profession."³ Protecting professional standing was urgent, the OSATN believed. Like other employment groups, nurses sought to lock in advances in wages and standing made in wartime. Moreover, the massive military casualties brought by World War I and the influenza epidemic of 1918 put public health on the nation's agenda. With the passage of woman suffrage in 1919, organized women sought advances in a range of spheres, including education, employment, and the law. All of these factors shaped OSATN's protest letter, sent to the Portland city council in early 1920, with the criticism that "a position of Inspector in the Municipal Bureau of Public Health...has been filled by a woman of no particular training...."⁴ Though OSATN remained a member of the State Federation of Women's Clubs until 1960, the group emphasized regulating professionalism, very much in step with national trends in organized nursing.⁵

Before World War I, trained or "graduate" nursing in the United States took place in only a handful of centers for education and health care delivery. In Oregon, the first nursing "diploma" schools grew up alongside Portland's oldest hospitals, St. Vincent's (Catholic) and Good Samaritan (Episcopalian). These hospitals opened in the 1870s and formalized their nurse training schools in the early 1890s. In 1897, the Portland Sanitarium and Hospital (Seventh-day Adventist) opened, and the Multnomah County Hospital Training School opened in 1909. A Portland-based Visiting Nurses Association, founded by the wife of Rabbi Stephen Wise of Temple Beth Israel, began during this period, as did the University of Oregon's medical school and nurse training program.⁶

Whether public or religiously based, hospitals took advantage of their nursing students. Hospitals and doctors viewed student nurses, who usually lived in hospital housing, as a captive and exploitable labor force, and they rarely hired the nurses they trained and credentialed. Until about 1940, most graduate nurses worked in private duty, employed by individuals and families. Private duty even extended to employment within hospitals as paid nurses (called "specials") hired by wealthy patients. Poor working conditions characterized the lot of both student and graduate nurses; they worked long hours and, in the case of students, received little or no pay (often only room and board). Nurses and nurse advocates struggled to bring higher status, better education, improved recognition, and decent working conditions to trained nurses; and the ANA became the national voice for that agenda.⁷

Most women citizens in the U.S. lacked the vote before World War I, but the ANA and its state affiliates sought government help in advancing the profession of nursing by exercising the right of petition and appealing to the bar of public opinion. Nursing's main instrument was a regulatory mechanism — the passage of state-level Nurse Practice Acts (NPA), the earliest of which passed in New York State in 1903 — and the establishment of state boards of nursing to oversee credentialing and licensure. Nurses who passed state tests were "registered" with their state and acquired the right to call themselves a registered nurse (RN). By bounding who officially counted as a nurse and under what criteria he or she could be legally employed as an RN, the new regulations reshaped the conditions of nurses training and employment through the NPA. Nursing's official link to the state anchored the RN's identity as a defender of the public interest, health, and safety; it also lodged politics near the center of the profession's activities.

In 1906, Oregon nurses reorganized as the Oregon State Graduate Nurses Association (OSGNA) with the goal of securing an NPA for Oregon. In 1909, the OSGNA gained admission to the ANA and in January 1911 secured incorporation under the state of Oregon. That same year, Oregon's NPA went on the books, and the Oregon State Board of Nurse Examiners (OSBNE) was established to oversee the law's provisions. The OSBNE had authority over the examination and registration of nurses; it also set standards and inspected Oregon's schools of nursing and took some initiative over working conditions, such as limiting hospital shift hours. Oregon was an important laboratory for workplace issues for nurses. In 1903, for example, the legislature passed an hours law that withstood legal challenge all the way to the U.S. Supreme Court in the landmark case Muller v. Oregon in 1908.⁸ Portland laundry operator Curt Muller objected to this law, which restricted women's employment in "any mechanical establishment, or factory, or laundry in the State more than 10 hours during any one day." Oregon's Ten Hour Law was not the first but remains the most-cited example of protective legislation for certain groups of employed women who were targeted by unionists and social reformers for relief from unhealthful and exploitative working conditions.⁹

St. Vincent's hospital, pictured here in 1910, is one of Portland's oldest hospitals and one of the first schools to give diplomas for nursing.

OHS neg., CN 005981

Between World War I and World War II, OSGNA built professional identity and solidarity through yearbooks, directories, and, in 1931, a monthly journal called The Oregon Nurse. A particular high point came with the appointment of Oregon's own Elnora Thomson as president of the ANA, where she served from 1930 to 1934. Yet, membership growth was relatively slow, with only about half the state's trained nurses as members at any time during this period — some 874 nurses in 1935.¹⁰ To foster professionalism, ONA began a scholarship fund aimed at training graduate nurses in administration and public health, which were key New Deal issues.¹¹ Adding to student nurse rolls was less an issue during this decade, since Depression-era trained nurses already faced underemployment. ONA also fretted over the so-called foreign nurse problem and established a committee charged with investigating the potential undercutting of their marketshare by nurses from Canada.¹²

Like the ANA and many other state associations, OSGNA sought the benefits of professionalization in terms of status and pay for its members, as it battled the overproduction and underemployment of trained nurses caused by the hospital-affiliated nursing school system, a situation only worsened by the Great Depression. The organization pressed hard to have nurse training migrate into colleges and universities, a movement clinched by both the structural changes in health care during the Depression and additional advocacy by the National League for Nursing Education, the voice of nurse educators since the 1890s. New academic programs helped nurse educators consolidate their authority over who could be a nurse and determine a nurse's competencies — a trend alternately fought or lamented by doctors and hospital associations. "Why Aren't Nurses Our Allies Any More?" ran a typical physician's complaint at mid-century.¹³ With the ascendancy of formal schooling for nurses and the practical disappearance of the apprenticed or home-trained nurse, the OSGNA changed its name to the Oregon State Nurses Association (OSNA) in 1936. The last hospital-affiliated diploma program in Oregon — the Good Samaritan Hospital and Medical School of Nursing in Northwest Portland — closed in 1985, having trained nearly four thousand nurses in its ninety-five-year history.¹⁴ Linfield College in McMinnville adopted the program into a four-year Bachelor of Science program.

During the 1930s, unionization received a strong push across a variety of job sectors in the U.S. economy, helped enormously by the Wagner Act of 1935, which gave legal sanction to collective bargaining. The ANA rejected trade unionism, however, and instead stressed nursing's distinctive character as duty and service. Nurse leaders held nursing to be a "womanly vocation" rather than a matter of self-interest or money. Upon graduation from nursing programs, new nurses took the Florence Nightingale Pledge, affirming duty and deference to authority: "With loyalty will I endeavor to aid the physician in his work and devote myself to the welfare of those committed to my care." Oregon nurse leaders viewed pressure by unions as an opportunity to demand higher wages from employers, a position that advanced their identity as professionals while playing on hospital administrations' general distaste for unions. Still, rank-and-file nurses demanded both the right to care and the right to fair wages, and feisty nurses in the western states were among the first to break into the world of negotiated contracts to protect and further their rights as workers. California nurses came before the War Labor Board in 1941 and proceeded to implement an economic program for members of their state association.¹⁵

ELNORA E. THOMSON

1875–1957
Born in Illinois in 1875, Elnora E. Thomson was an Oregonian for most of her professional life as a nurse, nurse educator, and health-care advocate. In Chicago, she trained for nursing at Presbyterian Hospital and for social work at the Chicago School of Civics and Philanthropy. She then served with the Red Cross in Italy during World War I, moving to Portland after the war. From 1920 to 1944, Thomson directed and taught in the department of nursing for the University of Oregon medical school. She was also active with the American Child Health Association and the Oregon Public Health Association. In 1937, Governor Charles L. Martin appointed her to the State Board of Nursing; and during World War II, Thomson was in charge of recruiting in Oregon for the U.S. Cadet Nurse Corps.
She was active in ONA and served as president of the American Nurses Association from 1930 to 1934. In the trying times of the Great Depression, Thomson warned against "neglecting the art" of nursing, lobbied tirelessly for nurses to keep hold of the leadership of their field, and exhorted ANA members to "have faith to believe that we shall press forward to even greater accomplishments" in the nursing profession. ONA helped commission a portrait of Thomson, which hangs in the University of Oregon medical school in commemoration of her service. She died in San Francisco in 1957.

SOURCES:

Brief Biographies of Candidates for OSNA, 1943–1945," Oregon Nurse (June 1943), 7.

William Levin, The Oregon Public Health Association: A Quarter Century of Progress, 1944–1969 (Oregon Public Health Association, 1969), 192.

"Obituary: Famous Nurse Dies," Oregonian April 25, 1957.

Elnora E. Thomson, ANA Presidential Addresses, "Nursing Comes of Age" and "Relationships," reprinted in Lyndia Flanagan, One Strong Voice: The Story of the American Nurses' Association (Kansas City, Mo.: The Lowell Press, 1976), 456–65.

Photo courtesy of the OHSU Archives

An additional incentive for change came from the corrosive effects of the Great Depression on private duty nursing. Struggling to find employment during those years, many trained nurses undersold themselves to hospitals, working for the cheap wages — or even just room and board — usually given to students in hospital-based nursing schools. At the same time, hospitals cut costs by hiring some of the older, trained nurses, many of whom were attached to homes or families of their own. Finally, insurance plans introduced in the 1930s eased some of hospitals' historic payment shortfalls, and federal relief programs offered funds for both health care and the clinics to dispense it. All of these factors strongly shifted the nursing market away from private duty and into hospital and public-sector employment.¹⁶

Oregon responded somewhat slowly to these national trends. The state's rural economy mitigated some of the Depression's extremes found in heavily industrialized or high-finance state economies. Private duty still paid well compared to hospital work, and during the 1930s OSNA began a Nurses Official Registry to more efficiently place nurses in home-care positions, though it restricted its services to RNs only. Yet, the hospital market beckoned, and the 1935 state nurses' convention featured a presentation on "How to Make Staff [Hospital] Nursing Attractive." The next year, nurses and the Oregon Hospital Association staged a joint meeting to find solutions to hospital staffing problems. The question of unionization was aired among Oregon nurses at their state convention in 1937, and the ANA commissioned a study on the subject.¹⁷ During this period of uncertainty and social crisis, however, the comfort of idealized gender roles took center stage among nurses. In 1936, White Angel, a sympathetic feature film on Florence Nightingale, reinforced the image of self-sacrificing femininity as the nursing ideal. Oregon nurses showed the film as a fundraiser that year.¹⁸

World War II both accelerated and redirected the trends toward hospital nursing and unionization. The nursing shortage brought down barriers against "untrained" nurses in a range of employment sectors. The OSNA worked with the State Nursing Council for War Services to secure adequate nursing services for the war effort, and many Oregon nurses employed in office settings or private duty were reassigned to hospitals. As the U.S. Army Corps enlisted married women under the age of forty, the state re-examined its restriction against married women in nursing schools. As an example of one of the many painful ironies of Japanese internment, young educated Nisei women in the camps found themselves sought after as potential military nurses even as they and their families were incarcerated under suspicion of "espionage" and "sabotage" according to President Franklin Roosevelt's Executive Order 9066.¹⁹ OSNA endorsed the idea of allowing nurses' aides to take more Red Cross assignments and hospital work, freeing RNs for more prestigious military service — though the prospect of a nurse draft seemed to raise more anxiety than patriotism among Oregonians.²⁰

The possibility of a nurse draft arose late in the war and came within one Senate vote of passing into law. The responsiveness of volunteers — some ten thousand nurses during 1945 — answered the need. War and military nursing meant danger, but it also meant excitement. Squeaking into the Nurse Cadet Corps just at the age limit of seventeen and a half, Lois Sidell Miller of Pedee, Oregon, recalled both the thrill and the strain presented by wartime nursing:

... between '43 and '45 they educated 124,000 nurses in the United States. Which is amazing.... it was a very rigid program.... you ha[d] to be working 1,000 days in three years plus going to school. So you would work and go to school. Our morning started with chapel at six o'clock and we worked even as a probie [probationer] in the first few weeks. We worked till seven o'clock at night.... And it was just an interesting time and it's no wonder that we came away with a sense of camaraderie with all the other students because we lived together. Literally, forced together.... And the major just carried staff in[to] the hospital because the hospitals were bereft; even the hospital's administrator was drafted. So the assistant administrator, a woman, was running the hospital. It was an interesting time.²¹

Years later, Oregon RNs admitted that the "practical nurse" — that is, the apprenticed or informally trained nurse caregiver — became "our arms and feet" for the duration of the war.²² RNs generally viewed aides and practical nurses as competitors, and, according to the OSNA board, "control of subsidiary workers" was the key to maintaining RNs' authority in the workplace and in the health care labor market.²³ How to manage and regulate this expanded sector of nurses became a pressing issue after the armistice. Oregon partly resolved the issue in 1948, with the Oregon Licensed Practical Nurse law, a relatively permissive law regulating the title but not practice, with licensure optional.²⁴ In other words, the state assured an ample sector of less regulated health care workers to meet the shifting and uncertain needs of hospitals and care providers in the aftermath of war.

At the same time, pressure for collective bargaining increased to sort out the new labor market environment of both more nurses and more people needing care. ANA acceded to the principle of collective bargaining in its 1946 convention, with an important caveat: a no-strike policy. This policy reflected the long-standing service ethic of the ANA and a distancing of RNs as professionals from the modes and tactics of other unionized working people. The idea of OSNA as bargaining agent for RNs in Oregon circulated at the convention in 1946 and a program for bargaining rights was started, with an emphasis on education.²⁵ Like many state associations during those years, OSNA continued to collaborate with hospitals for workplace changes. In concert with the Oregon Association of Hospitals (OAH), OSNA achieved hours regulation and minimum salaries for RNs. But OAH held the line on key demands, such as formal grievance procedures, and the union movement pressed in on nursing. "There is a strong feeling that if nurses are not anchored securely to their organization they will be targets for an ever increasing assault by the labor unions" Portland-based nurses reported to the OSNA board in the early 1950s.²⁶ As for anti-union sentiment in the state, The Oregon Nurse proclaimed: "Fear not the 'red herring' that is being floated ... that Oregon nurses are being 'union-minded.' This is the day when social justice predominates!"²⁷ As the association slowly embraced bargaining, the leadership accented justice, fairness, and professionalism rather that more contentious class-tinged or labor-management frameworks for navigating power dynamics in Oregon's health care settings.

OSNA proceeded with measured optimism about collective bargaining and a wary eye toward non-RN competitors. As it embraced the world of labor contracts, ANA also ratcheted up its professionalization profile, issuing a new Code for Professional Nurses. Locally, OSNA launched an Economic Security Program, whose title and program muted the potentially confrontational tone of collective bargaining and instead echoed the anxious rhetoric of the cold war and atomic age. Oregon's nearly thousand practical nurses took matters into their own hands and organized a Practical Nurses Association. Nationally, civil rights agitation by African American nurses resulted in the integration of the National Association of Colored Graduate Nurses into the ANA in 1951.²⁸ On the one hand, then, professional nursing became more integrated and better organized; on the other, hierarchies along lines of race, credentialing, and status persisted amid the growing pains and controversy of expanded collective bargaining. In 1957, OSNA dropped "state" from its title and became the Oregon Nurses Association (ONA).

ALICE Y. SUMIDA

B. 1923
Alice Y. Sumida (neé Kawasaki) was born in Portland, Oregon, in 1923, the daughter of Japanese immigrants from Okayama. Her father worked on the railroad; her parents had married in Japan. The couple settled in Portland, where her mother's brother was already established. Sumida's mother ran a successful restaurant in town, generating income that allowed Sumida to attend college.
Sumida was enrolled in the pre-nursing program at the University of Oregon when the executive order for the internment of all people of Japanese descent mandated the family's incarceration. Once at Camp Minidoka in Idaho, Sumida managed to leave through a job arranged by a friend who had taken employment through the War Manpower Commission. She worked as a caregiver in an Orthodox Jewish family in Chicago. With the help of the American Friends Society, Sumida enrolled in nursing school in Rochester, New York. She joined the Cadet Nurse Corps and signed a contract to stay in essential nursing services for the duration of World War II.
Donning the official uniform was a special point of pride for Sumida, and she proudly remembers the courtesy and respect she was given in public whenever she and her friends wore it. From 1947 to 1951, she worked at Genesee Hospital in Rochester. Sumida returned to Portland in 1951, took a position at Providence Hospital, and worked for many years as the assistant head nurse in the emergency department.
She still lives in Portland.

SOURCES:

Alice Y. Sumida interview with Mariko Hedges, March 5, 2004.

Photograph: Alice Y. Sumida sings at the Rochester YWCA on May 4, 1944. Used courtesy of the Bancroft Library

The ONA convention of 1959 officially approved collective bargaining; and during the 1960s, the organization diligently laid the groundwork for successful contract negotiations for nurses across the state. ONA staged a thorough educational campaign emphasizing democratic goals and a "purely professional manner" for engagement in collective bargaining.²⁹ The association reaffirmed the no-strike policy of ANA and advised keeping negotiating and grievance procedures "close to home" and friendly, ideally within each hospital's staff and administration.³⁰ ONA continued to distance itself from those health-care employees they termed "non professional workers" and followed ANA's "neutrality policy," which prohibited sympathy strikes with other unions. ONA positioned RNs as self-reliant professionals apart from other hospital staff even as it strove to make the image of the nurse as other-worldly "angels in white ... a thing of the past."³¹

In 1961, ONA scored a major victory with the passage of HB 1360, a collective bargaining bill for nurses that prevented their classification with "bargaining units with dissimilar functions, interests, and qualifications."³² With that action, Oregon became the first state to enact into law an employer-employee relations bill introduced by nurses for nurses.³³ As professionals engaged in collective bargaining, ONA believed its members to be "pioneers, early arrivers to the world of labor-management relations of the future."³⁴ The first contract was signed in October 1962 at Providence Hospital in Portland.³⁵

Other early contracts — at St. Mary and Columbia Hospitals in Astoria and at Pioneer Memorial in Prineville — tried to follow the ONA Minimum Employment Standards for General Duty Nurses. Provisions included the forty-hour work week, a basic minimum monthly salary, and a "no discrimination" clause against bias in hiring by "race, creed, color or sex."³⁶ Given both the competitive environment and the wide variety of workers engaged in nursing in Oregon, however, pressure mounted to revise the NPA again, combining RN and LPN requirements into mandatory licensing (a change that remained almost another decade away). In an attempt to build membership and solidarity, the percentage of ONA members necessary to recognize a bargaining unit was revised upward from 51 to 75 percent. As a measure of nursing's growing public profile, Governor Mark O. Hatfield addressed the ONA convention in 1962 and declared the first week in October Oregon Professional Nurse Week.³⁷

Despite — or perhaps because of — steady progress in achieving contracts for nurses across the state, a number of challenges to ONA authority emerged. ONA opposed health industry efforts to liberalize the NPA for foreign-trained nurses and to relieve the governor of the requirement to make State Board of Nursing appointments from a recommended list generated by ONA; these amendments narrowly went down to defeat.³⁸ In 1966, ONA declined to re-open the NPA, fearing pressure from powerful hospital employers to loosen requirements on "state and foreign applicants" for licensure.³⁹ As nurses relied on the legislature to protect their interests, nursing inevitably became more political, tied to trends ranging from federal immigration policy to state-level party patronage. In 1968, ONA hired its first full-time lobbyist in Salem, McMinnville native Paula McNeil, who went on to longtime leadership in the organization, including executive director from 1978 to 1992. And, when public employees gained the right to unionize in these years, ONA found union competitors in health-care workplaces such as the Veterans Administration (VA) hospital, the state mental institution, and county clinics.

In this cartoon, titled "Pulled in Many Directions," originally published in the Oregon Nurse, September 1965, a head nurse is besieged in an ominous and confusing bargaining environment, with armored "management" on the left wielding a "budget," the "profession" on the right grasping its "standards," and a ghoulish dollar and coins floating away with "her own economic security."

Courtesy of the Oregon Nurses Association

In December 1967, for example, twenty-three public health nurses walked off the job in Marion County and engaged in an "arduous four days" of negotiations with officials over wages. The next year, ONA became the nurses' representative and signed its first agreement with a public employer in Oregon.⁴⁰ Pressure heated up at the VA hospital in Portland in 1970, where federal budget cuts whipsawed against increased patient needs in the middle of the war in Vietnam. In November 1970, ONA staged a "Heal-In" at the VA, picketing in the interest of better patient care and redress of the facility's nursing shortage. Led by ONA president Lee Killam, ONA nurses also offered several hours of free volunteer nursing on the wards, in a show of solidarity with the VA nurses who were then organized under the American Federation of Government Employees Union. These efforts went a long way toward a decertification vote by VA nurses and the victory of ONA as their new bargaining representative.⁴¹

Oregon nurses pressed their case across the state with high spirits and solid organizing. Bargaining units cleverly subverted the no-strike provisions in their contracts by instituting mass resignations — a tactic upheld by the Public Employee Relations Board and one that proved decisive in securing a contract in 1972 at the University of Oregon Medical School Hospital.⁴² By the mid 1970s, ONA could boast that more than two out of three hospitals and virtually all major health departments in the state of Oregon were under collective bargaining, making RNs covered by ONA contracts the highest paid in the state (outside of the VA). Nationally, the question was asked, "Is Nursing Ready for a 'George Meany'?"⁴³

Opposition to ONA gathered as the organization tallied up successes. Corporations such as American Medicore began buying up Oregon hospitals, effectively displacing the "close to home" relationships with administrators that had been long nurtured and prized by nurses. A decisive incident occurred at Portland's Woodland Park Hospital in May 1975, where, according to the nurses, the administration refused to bargain in good faith. Before the National Labor Relations Board (NLRB) could rule, the hospital administration forced a decertification election to remove ONA and then essentially starved out striking nurses.⁴⁴ Union-busting became profitable. West Coast Industrial Relations Association of California — a "management services company" specializing in "non-union campaigns and counsel" — was marketed to hospitals through an Oregon-based business. ONA leadership was "astonished" that a local company would disrupt carefully tended heath care relationships for profit.⁴⁵

In 1970, the ONA staged a "Heal In" to bring attention to nursing shortages at the Portland VA hospital.

Courtesy of the Oregon Nurses Association

ONA's surprise indicated more than naïveté or sour grapes. Strong face-to-face relationships historically characterized health care settings, especially in rural Oregon; and the neighborly quality of those relationships actually fostered rather than impeded organizing. In such settings, nurses, doctors, and administrators frequently shared a basic vocabulary of justice and a history of positive social interaction. These dynamics enabled consensus more easily than in larger, more anonymous or socially stratified settings. As ONA labor organizer Diane Hedrick described for nurses in Bend and Baker,

... the benefit of a small town, small hospital is that nurses and doctors can actually socialize together and can be friends. A lot of times just because it is a small community, they can be neighbors and there aren't a lot of those, sort of, barriers that [can make] doctors ... off limits to talk to. I mean everybody's referred to by their first names. Because your kids may go to school together, you are in the same parent-school activities....⁴⁶

Of course, small-town relations could also lead to bitter conflict. Paula McNeil described both the power and costs of strikes in Hood River:

.... everybody knew everybody and the nurses went out on strike and ultimately were successful in getting a better a contract as a result of it but I think that it was something of a wounding experience. And I'll never forget the reaction of mourning almost that those nurses went through on their one year anniversary of the strike. It is very difficult I think even today for nurses to make a decision to go out on strike. It was very difficult. They were in kind of the forefront of the collective bargaining movement.⁴⁷

Hedrick is particularly proud of the high rates of ONA membership and contracts for nurses in Oregon and the state's recognition by national bodies: "I also enjoy the role that Oregon plays in the whole thing, too, because you know, Oregon has such a huge influence at ANA convention. . . . other states look to us to see what we're going to do. And people will actually vote according to how the folks in Oregon do. We have a lot of influence."⁴⁸

ELIZABETH WASHINGTON

B. 1928
Elizabeth Washington dedicated her entire thirty-year nursing career to Oregon Health Sciences University (OHSU) Hospital. She began working as a teen in the kitchen when the institution was still Multnomah County Hospital. After a few years, she was transferred to transportation and pursued LPN training while continuing to work fulltime. While an LPN, a supervisor noticed Washington's ability and urged her to further her training. She attended Clark College, completed her ADN, and became an RN in 1962. She worked in the psychiatric ward at OHSU in a new crisis unit for more than a dozen years, much of that as head nurse. She was in the first "returning RN" class at the OHSU School of Nursing, where she finished her BSN in 1980. She credits her husband and a nurse colleague as especially supportive of her efforts to complete her education.
Washington was very active in ONA and took a leadership role on ONA's Affirmative Action and Human Rights Committee in the 1970s. In 1977, Washington was appointed to the Oregon State Board of Nurse Examiners, one of the first women of color ever to serve. While at OHSU, Washington participated in collective bargaining, an experience she describes "really, really an eye-opener." In addition to nurse professionalism, she was committed to collective bargaining, supported activism in nursing school, and championed the ERA. "I learned very early in life to say whatever was on my mind, and so, I didn't hesitate but to give my little two cents worth," she notes. In 2005, Washington received a meritorious service award from ONA.

SOURCES:

Elizabeth Washington interview with Maye Thompson July 2, 2003, ONAA.

Photograph: Elizabeth Washington stands at the ceremony in Salem where she was sworn in to serve on the Oregon State Board of Nurse Examiners in 1976. Used courtesy of the Oregon Nurses Association

In Oregon, however, ONA could do little to stem the market forces that were raising the stakes in strike situations, and in the 1970s the organization focused on politics. In 1974, the organization established N-PAC, the Nurse Political Action Committee, in order to deepen and extend its effectiveness in the electoral realm. This mobilization included backing political candidates and mobilizing "nurse voters" as a political force, a force some state elected officials called a "sleeping giant."⁴⁹ Oregon voters elected their first woman nurse legislator to the state house of representatives, Donna Zajonc, in 1978.⁵⁰ As a measure of RNs' political standing in the state, Governor Vic Atiyeh declared May 12, 1981, the Day of the Nurse.⁵¹

As in the 1930s and 1950s, the 1970s entailed another round of nursing's professional consolidation and fracturing. Successful labor organization, political assertiveness, civil rights initiatives, and feminist energy made a heady brew in the late 1970s; Oregon nurses called it "nurse power." "The role of doctor's handmaiden has yielded to professionalism," The Oregon Nurse explained, and "emancipation" now struck a key note. "Nurse power requires the unified political action of our entire organization adequately funded by the membership."⁵² The ONA opposed Ballot Measure 7, for example, which called for limiting abortion availability, and the association broadcast its hope that the old-fashioned "cake sale approach to funding [nurse politicians] should ... become extinct with the enactment of the ERA."⁵³ After intense lobbying, the first nurse practitioner, Karla Jagow, was certified in 1977, marking a new realm of professional autonomy for nurses.

In 1979, ONA became one of eighteen organizations in the state to join the Women's Rights Coalition, an activist umbrella group in support of the Equal Rights Amendment (passed in Oregon twice, once in 1973 and reaffirmed in 1977).⁵⁴ During the ANA's national convention in 1978 in Washington, D.C., Oregon delegates joined their nurse colleagues in marching on the capitol, joining thousands gathered in support of extending the deadline for ERA ratification that summer. In those same years, internal fracture lines in nursing, especially around race and status, reached a new breakpoint. In the 1970s, RNs in Oregon were 95 percent white.⁵⁵ A new ONA Committee on Affirmative Action, chaired by Elizabeth Washington, took up a wide range of issues, including investigations of complaints of discrimination from nurses, better involvement in ONA by minority nurses, and curriculum reform to train nurses for the care of minority patients.⁵⁶ In 1978, the committee organized a workshop on "Meeting the Psychosocial Needs of Ethnic People of Color," and the ONA gave the first Harriet Tubman Award to honor the contributions of black women in nursing.⁵⁷

ONA struggled to remedy long-standing patterns of racial exclusion in nursing. The organization briefly affiliated with the Urban League during the 1970s, and Elizabeth Washington's committee worked hard to advocate more inclusive hiring policies, particularly within the association staff itself.⁵⁸ The board of directors did include one African American woman in the mid-1970s, but ONA was unable to create a staff position on affirmative action, a proposal that came from the rank-and-file. As late as the 1990s, nurses such as Dominga López identified and attempted to close the distance between minority nurses and the ONA mainstream. Consistent with national trends, nurses of color in Oregon developed their own organizations while maintaining state and national memberships. López and her colleagues, most of them based in Portland, organized a chapter of the National Association of Hispanic Nurses in 1998.⁵⁹

As a measure of both nurses' determination and the strength of a gathering backlash, ONA began to rethink the use of the strike. ANA rescinded its no-strike policy in 1968 and in 1970 withdrew its neutrality policy regarding sympathy strikes.⁶⁰ As in most industries, strikes were an expensive, emotionally draining, high-risk tactic. In 1980, nurses at Sacred Heart Hospital in Eugene won an unprecedented two-month strike with the help of a federal mediator.⁶¹ ONA carefully tracked and publicized its strike activity across the state, highlighting the support of community and family during labor conflicts and underscoring how many nurses were the sole supports for their families.⁶² In this shifting social and political landscape, ONA tested new alliances and tactics such as sympathy strikes. In 1980, ONA nurses joined with Local 88 of AFSCME to strike Multnomah County when the officials rejected the results of a fact-finder to break contract negotiation impasse.⁶³

KARLA JAGOW

1936–2006
Karla Jagow was Oregon's first licensed nurse practitioner, certified in 1977. She got married during the same week that she graduated from the diploma program at Emanuel Hospital School of Nursing in Portland and went to work right away in a rural clinic near Boring, Oregon. Jagow did intensive, hands-on nursing for a number of years.
When her husband was killed in a racing accident, she needed a better paying job in order to care for her three children. She took a practical course in health care administration at Portland State University and ran a nursing home for a number of years. As her family expenses mounted, she decided to advance her education further and became interested in becoming a nurse practitioner. A physician mentor in Oregon City sponsored her through Brigham Young University in Provo, Utah, then the nearest degree-granting program, and she worked with him for more than fifteen years.
Jagow was committed to the caring side of health care, and actually dropped out of OHSU medical school in disgust "after the first lecture." She became a tireless advocate for nurse practitioners, addressing nurses, doctors, and legislators throughout the state in the 1960s and 1970s. Karla Jagow credited her dedication to improving rural health care and her success at politicking to her parents' example of grassroots activism. She died in Mulino, Oregon, in 2006.

SOURCE:

Karla Jagow interview with Maye Thompson, August 29, 2003, ONAA.

Photograph: Karla Jagow addresses a group in about 1978. Used courtesy of the Oregon Nurses Association

Organizing and strikes placed a financial and political strain on ONA. The association had trouble matching the high pressure, hands-on tactics of the Teamsters, who were available to meet monthly with their units and boasted a strike fund — neither of which ONA could deliver during those years.⁶⁴ The demands brought AFL-CIO affiliation to the fore. Start-up AFL-CIO unions, such as the new Oregon Federation of Nurses (which had the Oregon Federation of Teachers as parent), challenged ONA at Portland's Bess Kaiser Hospital in 1979, seeking and losing a decertification vote.⁶⁵ Affiliation could offer resources and expertise to ONA, but nurse delegates rejected affiliation at their 1981 convention — strongly guided by ANA president Barbara Nichols, who urged nurses to close ranks against outside unions and to maintain their autonomy.⁶⁶ Though ONA for decades served as the voice of Oregon RNs, historically the organization only claimed actual membership of around 50 percent—about three thousand nurses in 1990. This left many health care workplaces open to "raids" by rival unions as well as to encroachments on nursing practice by doctors intent on circumventing the RNs' growing autonomy. One such attempt in the 1990s was the creation of Registered Care Technicians, yet another new category of health care workers who would be more fully subordinate to doctors' authority in institutional settings, especially nursing homes, a booming market in health care during this period.

Nationally, nurses steadily gained collective bargaining rights and increased their effectiveness in politics. By 1999, slightly more than 19 percent of the nation's 20.7 million registered nurses were covered under collective bargaining, a figure that compared favorably with other unionized sectors of the U.S. labor force.⁶⁷ Contract battles seemed to get larger and more protracted, however, both locally and nationally. ONA nurses struck for eighty-six days at McKenzie–Willamette Memorial Hospital in Springfield in 1981.⁶⁸ Oregon hospital administrators admitted that "both [sides] have had experience and are better organized, so they're standing firm."⁶⁹ The largest nurses' strike in the nation took place in Minnesota in 1984, when some six thousand nurses in the state association struck for five weeks.

Nurses from the McKenzie–Willamette Hospital near Springfield, Oregon, strike in 1981.

Courtesy of the Oregon Nurses Association

Changes in the labor market and the new scale of hospital economics also shaped nursing labor relations in the 1980s and 1990s. Companies specializing in placing nurses in short-term, temporary, and disaster or emergency relief employment also emerged during this period.⁷⁰ These companies took advantage of the late twentieth century's so-called nursing shortage, a situation frequently fanned by the underemployment of RNs by hospitals. By marshalling a reserve pool of labor, placement agencies underwrote the desire of hospitals and other care facilities for a more flexible nursing workforce, relieving the employers of committing long term to a larger, fixed pool of relatively high-paid workers on site. Though the cost of these temporary workers was high — in some cases twice the rate as regular nurse employees — employers seemed willing to pay for the ability to hire and fire at will.

This reserve pool of labor — and job options — emboldened both nurses and hospitals in strike situations. Nurses could walk out, having pre-arranged temporary employment, thus mitigating some of the hardship of going without pay. For their part, hospitals could brave a strike by planning to bring in replacement workers, though these came with a sometimes exorbitant price tag and hospitals sometimes faced NLRB sanction for hiring strikebreakers. New records for strike costs and combativeness were set at Stanford University Hospital in 2000 when 1,700 hospital nurses struck for 52 days. Stanford reported that its hospitals lost $31 million dollars in payments to replacement workers and in lost patient fees.⁷¹ Oregon nurses reasoned like many others: "Frankly what we've said is, 'If you're going to spend between three and five million dollars a week to try and break this strike, why don't you just pay these nurses and let's get it over with?' "⁷²

Though nurses frequently won these high-profile, mammoth strikes, sometimes the gains were far less than the goals. At Stanford, nurses settled for only slightly more than what the hospital offered before the strike. Although nurses were reasonably well paid workers, they still frequently only earned as much as a high-end secretary in the corporate sector (eighteen to twenty dollars per hour starting rate) in a job that demanded more education, responsibility, stress, and strain. And while a secretary might not expect much autonomy on the job, nurses were being asked to take more responsibility for caring for sicker patients and for monitoring increasingly complex machines and medicines. One of the mounting costs that led to under-employing nurses was the rising price of health insurance, which was itself tied to advances in medical treatment and technology. All of these factors raised the stakes in health-care conflicts for patients as well as providers. As a bulwark measure, ONA became an AFL/CIO affiliate in June 2001, joining some hundred thousand nurses nation wide.

DOMINGA LÓPEZ

B. 1952
Dominga López was born in 1952 in Baytown, Texas, one of twelve children in a devout Catholic family. "My mother was a folk healer, a curandera," she recalled in an interview. And "we always had other people in the house" seeking aid and comfort. Growing up, her family's deep faith and love for one another fostered an ethic of service in López. School was a hostile environment, however, where young Spanish-speaking students were literally beaten for not using English.
Pushed into vocational training—given the "option" to leave school for work half the day in high school—López became a nurses' aide and fell in love with nursing. A friendly supervisor noticed López's abilities and mentored her, helping her find scholarships for nurse training.
López has gone on to an outstanding career in health care, nursing across the western states and becoming active in state and national nursing associations. In the mid-1990s, her husband was hired by Oregon Health Sciences University, and OHSU helped find López a position in the hospital's Center for Women's Health. Oregon proved a politicizing experience, as OHSU was the first unionized workplace López had ever encountered (AFSCME struck OHSU just as she joined the staff). As working and patient care conditions at the hospital deteriorated in the late 1990s, she dedicated herself to establishing a chapter of the National Association of Hispanic Nurses and stepped up her participation in the Oregon Nurses Association and the OHSU union, organizing the major strike of 2001. López understands the power of health-care institutions to sometimes manipulate and marginalize disempowered nurses, especially minority nurses. Never afraid of a challenge, she embraced unionism and professionalism for nurses; as she notes, "very few nurses cared to do both."

SOURCES:

Dominga López interview with Trudy Flores, November 22, 2004, ONAA.
"Minority Issues: An Interview with Dominga López," Oregon Nurse, October 1998.

Photograph: Dominga López holds a banner, third from right, during the 2001 nurses strike at OHSU. Used courtesy of the Oregon Nurses Association

Many of these pressures came together at Portland's Oregon Health Sciences University (OHSU) that same year. Formerly Multnomah County Hospital, OHSU achieved autonomy from the state system of higher education in 1995, chary about shrinking state budgets and ambitious to compete in profitable health-care markets for advanced technology, biomedical, and education research. With a historic charity mission, University Hospital was the largest provider of indigent care in the state, a mission balanced against a need to bring in paying health care customers (or "covered lives," in health industry parlance). In this competitive environment, nurses found themselves squeezed. The press reported that hospitals in the state operated with 10 to 18 percent of their nursing positions unfilled, leaving the remaining, general duty floor nurses to pick up the slack and potentially compromising patient care. Nor was nurses' pay keeping up with rising cost-of-living and insurance prices. While OHSU offered some perks unavailable at other hospitals, like participation in the state's public employees retirement system (PERS), the high stress and low pay left many nurses frustrated.⁷³

ONA strikers march down the hill in front of OHSU in 2001.

Courtesy of the Oregon Nurses Association

Newly backed by AFL/CIO affiliation and with temporary jobs awaiting them, OHSU nurses voted to strike in late November, 2001, after the hospital rejected their proposal for a 30 percent wage increase over two years in their new contract. They walked out on December 17, 2001, and stayed out for fifty-six days. In the end, ONA moved OHSU up from its initial 5.5 percent offer to 7 percent per year, barely offsetting the new price tag on health insurance facing the nurses. "We don't want to leave the patients at the bedside," remarked one striking nurse. "It took a lot for us to do this. It's been hard times for a few years now and a lot of anger.... And we didn't want to do this."⁷⁴ Such were the thin margins of economics and high personal and professional stakes involved in the labor of caring as ONA entered the twenty-first century.

During its first century, the Oregon Nurses Association engaged many of the shaping tensions and possibilities in the world of work and politics in the U.S. The increasingly corporate — as opposed to public or charitable — structure and function of health care delivery in the United States is a critical context for nurses' shifting ability to negotiate fair conditions for work and protect patient care. As highly skilled workers, nurses strove to advance their status and power by fostering high educational standards, state credentialing, and self-regulation as a profession. Like teachers, another heavily and historically female employment group, nurses struggled to both preserve some of the gendered expectations in the field, like caring and service to others, while modifying others, like subordination to doctors and unfair forms self sacrifice conveyed by the angel of mercy stereotype.⁷⁵ Collective bargaining emerged in the post World War II period as a key tool for nurses to build solidarity, enabling them to contend for power in the electoral realm and on the shop floor. Regulating the boundaries of nursing both as a profession and via collective bargaining, however, by definition involved exclusion and hierarchy. Hierarchy by educational status — often keyed to race, class, ethnicity, or national origins — persistently marked ONA's efforts, as in other state associations and the national ANA. The only answer to these dilemmas within nursing or in its external relations, could be, in the words of long-time ONA union representative Connie Weimer, "don't agonize, organize."⁷⁶

Notes

The author acknowledges the support and encouragement of the Oregon Nurses Association Centennial History Committee in the preparation of this article. Special thanks to the committee's fearless leader, Elizabeth Washington, the unstoppable archivist Harold Warner, and interviewer par excellence Maye Thompson. This article focuses primarily on the situation of registered nurses and refers to this group throughout as "nurses" with the understanding that many caregivers contribute to the well being of patients in hospital (and other) settings.

^1. For a standard history of the ANA see, Lyndia Flanagan, One Strong Voice: The Story of the American Nurses' Association (Kansas City, Mo.: The Lowell Press for the American Nurses' Association, 1976).

^2. For an important treatment of issues of race and nation at the Exposition, see Robert W. Rydell, All the World's A Fair: Visions of Empire at American International Expositions, 1876–1916 (Chicago: University of Chicago Press, 1984). For an overview of women and gender issues at the Chicago Columbian Exposition of 1896, see Jeanne Weimann, The Fair Women (Chicago: Academy Chicago, 1981).

^3. Board of Directors Minutes, November 23, 1915, in Oregon Nurses Association Archive, Tualatin, Oregon (hereafter cited as ONAA).

^4. Board of Directors Minutes, January 26, 1920, ONAA.

^5. See Barbara Melosh, "The Physician's Hand": Work Culture and Conflict in American Nursing (Philadelphia: Temple University Press, 1982); and Tom Olson and Eileen Walsh, Handling the Sick: The Women of St. Luke's and the Nature of Nursing, 1892–1937 (Columbus: Ohio State University Press, 2004).

^6. Barbara Conway Gaines, Oregon Health Sciences University School of Nursing: A History of the School, 1910–1996 (Portland, Or: Oregon Health Sciences University, [2002]), 5–11.

^7. See Flanagan, One Strong Voice.

^8. For more on Muller v. Oregon, see Nancy Woloch, Muller v. Oregon: A Brief History with Documents (Boston: Bedford Books of St. Martin's Press, c1996); Elaine Zahnd Johnson, "Protective legislation and Women's Work: Oregon's Ten-hour Law and the Muller v. Oregon case, 1900–1913," (Ph.D., University of Oregon, 1982); Janice L. Dilg, "By Proceeding in an Orderly and Lawful Manner": Protective Legislation, Working Women, and Progressive Politics 1913–1924" (MA Thesis, Portland State University, 2005).

^9. Miriam Theresa, Oregon Legislation for Women in Industry (Washington, D.C.: U.S. General Printing Office, 1931), 17, from http://pds.harvard.edu:8080/pdx/servlet/pds?id=2574470&n=24&s=4 , (accessed January 30, 2007). See also Woloch, Muller v. Oregon (1996). Across the country, state-level protective legislation focused on relatively advantaged women workers — usually white, urban, industrial workers — and excluded rural and domestic service employees, which were dominated by workers of color. Until 1913, the Oregon law excluded retail workers because of pressure by department store interests in the legislature. Nationally, protective legislation was not repealed or overturned until the 1970s.

^10. "Membership for 1935 — Oregon State Graduate Nurses' Association," The Oregon Nurse (February 1936), 7.

^11. "The Isabel Hampton Robb Memorial Fund," Oregon Nurse (April 1936), 2. ANA also had a scholarship fund in these years, named for Florence Nightingale.

^12. Board of Directors Minutes, April 18, 1935, January 10, 1936, and May 16, 1938, ONAA.

^13. Alfred P. Ingeigno, M.D., "Why Aren't Nurses Our Allies Any More?" Oregon Nurse (December January 1961–1962), 5. This particular doctor was being rhetorical and a bit ironic, as his short essay clearly identified reasons why nurses had turned elsewhere for support of their professional goals: low pay, low status, and low hopes for solidarity viz a viz hospital physicians.

^14. "Closure of Nursing Diploma Program Marks End of an Era," Oregon Nurse (April-May 1985), 19.

^15. Flanagan, One Strong Voice, 172; Board of Directors Minutes, April 18, 1935, January 10, 1936, and May 16, 1938, ONAA.

^16. Susan M. Reverby, Ordered to Care: The Dilemma of American Nursing, 1850–1945 (New York: Cambridge University Press, 1987), chapter 9.

^17. "Echoes from the Thirtieth Annual Convention," Oregon Nurse (June 1937), 1–2.

^18. Mary Loretta Sheasgreen, "The White Angel," Oregon Nurse (September 1936), 12.

^19. Susan McKay, "The 'Problem' of Student Nurses of Japanese Ancestry During World War II," Nursing History Review 10 (2002): 49–67.

^20. For criticism of the congressional bill to draft nurses, see Board of Directors Meeting Minutes, February 27, 1945, ONAA.

^21. Lois Sidell Miller interview by Laura Marie O'Neill, November 18, 2003, ONAA.

^22. Lee Killiam, "Nurses and the Oregon Law," Oregon Nurse (November 1972), 2.

^23. Board of Directors Meeting Minutes, April 26, 1940, ONAA.

^24. Viola M. Vreeland to District Presidents and Secretaries, February 27, 1949, ONAA.

^25. Helen F. Richardson, "Report on Collective Bargaining and its Implications for Professional Groups," Oregon Nurse (June 1946), 10–14.

^26. Annual Report for District #1, OSNA, June 1951-June 1952, ONAA. The AFL met with Good Samaritan nurses in the summer of 1948; Board of Director Meeting Minutes, July 17, 1948, ONAA.

^27. "To Stand Still is to Go Back," Oregon Nurse [newsletter] (September 1959), 1.

^28. For a full treatment of African American women in nursing in this period, see Darlene Clark Hine, Black Women in White: Racial Conflict and Cooperation in the Nursing Profession, 1890–1950 (Bloomington: Indiana University Press, 1989).

^29. "What do you mean 'Economic Security'?" Oregon Nurse (February-March 1960), 14.

^30. "Delegates Adopt Economic Security Resolutions," Oregon Nurse (October-November 1960), 5.

^31. Ibid., p. 8. See also Economic Security Council Meeting Minutes, Board of Directors Minutes, September 16, 1960, ONAA.

^32. "Collective Bargaining: A Challenge and an Opportunity for Nurses and Hospital Administrators," Oregon Nurse (April-May 1961), 3.

^33. Of critical importance in this bill were its specific provisions to include head nurses in the bargaining unit with general duty nurses (which was contested by the hospitals but upheld by the NLRB) and the provision that professional employees (i.e., RNs) shall not be included in the same bargaining unit with non-professional employees unless a majority of the professional employees desired that non-professional employees be in their bargaining unit.

^34.Oregon Nurse (October-November 1961), 15.

^35. "First Contract Under New Law," Oregon Nurse (October-November 1962), 24.

^36. "Fourth Contract Signed," Oregon Nurse (April-May 1963), 24.

^37.Oregon Nurse: ONA Convention Review (November 1962), 1. The first "National Nurse Week" was observed October 11–16, 1954. No federal action took place until Richard Nixon made a presidential proclamation in 1974.

^38. "What Happened to HB 1762?" Oregon Nurse (August 1967), 3.

^39. Board of Director minutes, September 8–9, 1966, ONAA, Catherine Ceniza Choy, Empire of Care: Nursing and Migration in Filipino American History (Durham, N.C.: Duke University Press, 2003). Choy notes the 1965 changes in immigration law as an important context for the migration of skilled workers and professionals from the Philippines to the United States in the 1960s. She emphasizes the legacy of U.S. colonialism in the creation of a Filipino nursing labor force as well as the complex individual, family, and community interests involved in the decision to migrate for work. See Chapter 3.

^40. Lois Brownell, "Crisis in Marion County," Oregon Nurse (December 1967), 2; "First Agreement with Public Employer Signed," Oregon Nurse (December 1968), 2.

^41. "Portland VA Nurses Hold 'Heal In,'" Oregon Nurse (December 1970), 1, 8.

^42. "Nurses Sign Contract with U of O Medical School and TB Hospitals," Oregon Nurse (April 1972), 6.

^43.Oregon Nurse (December 1975), 1.

^44. "Woodland Park Nurses Strike May 9^th", Oregon Nurse (June 1975), 2; "Former Woodland Park Nurses that took Positive Action for Better Nursing Care to The Membership," letter to Oregon Nurse (Summer 1975), 3.

^45. "Hood River Nurses Vote to Strike," Oregon Nurse (December 1976), 4; William A. Lang, "A New Service Offered to Oregon Hospitals," Oregon Nurse (May-June 1977), 3.

^46. Diane Hedrick interview with Maye Thompson, August 25, 2004, ONAA.

^47. Paula McNeil interview with Dave Schmidli, December 10, 2003, ONAA. On struggles in Hood River, see "Hood River Re-Negotiations Completed," Oregon Nurse (June 1968), 3; "Unfair Labor Charges Upheld Against Hood River Memorial Hospital," Oregon Nurse (December 1977-January 1978), 4.

^48. Diane Hedrick interview with Maye Thompson, August 25, 2004, ONAA.

^49. Paula McNeil, "Let's Awaken 'The Sleeping Giant'" Oregon Nurse (October 1989), 2. According to McNeil, former Oregon Senate president Jason Boe began referring to nursing as a "sleeping giant" in politics in the mid-1970s.

^50. "Donna Zajonc Joins Legislature," Oregon Nurse (December 1978), 1. Lois Sidell Miller was appointed to fill out the term vacated by the unexpected death of state senator Mary Rieke in 1978. In 2004, nurse Laurie Monnes Anderson (D) was elected to the legislature from Gresham, Oregon.

^51.NEWS! ONA District #1 Newsletter (April-May 1980), 1.

^52. Marjorie Larsons, "Nurse-PAC decries Apathy," Oregon Nurse (May-June 1978), 7.

^53. Ibid.

^54. Board of Directors Meeting Minutes, August 30, 1977, ONAA; "Donna Zajonc Attended Houston Women's Meet," Oregon Nurse (December 1977-January 1978), 9.

^55. Queenie L. Samuel, "The Silent Minority: Who Are They?" Oregon Nurse (February 1979), 22. See also "Minority Issues: An Interview with Dominga López," Oregon Nurse (October 1998).

^56. "ONA Announces Affirmative Action Program," Oregon Nurse (December 1975), 4.

^57. See Oregon Nurse (December 1978), passim.

^58. See Board of Director Minutes, June 5, 1975, August 26, 1975, February 23, 1976, November 14, 1977, ONAA. See also letter from Elizabeth Washington to Peg Quan, February 7, 1978, ONAA.

^59. "Minority Issues: An Interview with Dominga López," Oregon Nurse (October 1998). That year, López successfully brought before the ONA a resolution affirming the organization's commitment to inclusiveness.

^60. Flanagan, One Strong Voice, 263–64.

^61. "Overwhelming Ratification Ends Sacred Heart Strike," Oregon Nurse (October-November 1980), 1. For a variety of materials on the strike, see Sacred Heart Strike binder in ONAA as well as news coverage in the summer of 1980; for example, "Strike Not Merely Pay Dispute: Sacred Heart's Union Nurses Seek Stronger Say in How Hospital is Run," (Eugene) Register-Guard, August 26, 1980, 1, 2A.

^62. "Two Year Contract Averts St. Vincent Strike"; "Families Give Strong Support"; "St. Charles Medical Center Nurses — A Model of Unity," all in ONA Collective Bargaining Newsletter, Oregon Nurse (August 1980), 16; "Turndown Forces Springfield Nurses Out Again," Oregon Nurse (April 1981), 3.

^63. "Unprecedented Alliance Unites Multnomah County Employees," Oregon Nurse (August-September 1980), 17–18.

^64. On Teamsters, see Board of Directors Minutes, August 29, 1977; on voting down a strike fund, see Board of Directors minutes, August 23, 1976, ONAA. A members-hungry Oregon Federation of Teachers went after nurses at Bess Kaiser Hospital in April 1979, painting ONA as elitist (because it supported BSN as entry into practice requirement) and as "management dominated" because it included head nurses in bargaining units.

^65. Board of Directors Meeting Minutes, April 20, 1979; May 18, 1979, ONAA.

^66. "Challenge Theme Draws 425 RNs to Medford Meeting," Oregon Nurse (June 1981), 1–2.

^67. Joe Rojas-Burke, "OHSU Nurses Getting Ready for Walk-Out as Talks Fail," the Oregonian, November 9, 2001.

^68. "Turndown forces Springfield nurses out again," Oregon Nurse (August 1981), 3; "Springfield Nurses return to work following longest nurses strike in Oregon History," Oregon Nurse, October, 1981, 4.

^69. Joe Johansen quoted in Debbie Selinsky, "Looking Back: Nurse Strike Differs from '79 Walk Out," Springfield News, August 6, 1981, 1.

^70. Some of these are Manpower Health Care, Kelly Health Care, Upjohn Healthcare Services, Staff Builders Health Care Services, and Western Medical Services.

^71. "Stanford Nurses Approve Contract, End Strike," AP 2000, CNN.com; July 28, 2000. http://archives.cnn.com/2000/us/07/28/stanford.nurse.ap (accessed December 16, 2004).

^72. Kathleen Sheridan quoted in Jeff Brady, "Nurses Refuse OHSU's Latest Offer," OPB News, November 29, 2001, http://www.publicbroadcasting.net/opb/news.newsmain?action=article&ARTICLE_ID=319435 , (Accessed May 1, 2006).

^73. "Cutting Loose," Oregonian January 23, 1995; "OHSU Braves the Real World of Managed Care," Oregonian, September 24, 1995.

^74. Gwyneth Paulson quoted in Jeff Brady, "OHSU Nurses on Strike," OPB News, December 18, 2001, http://www.publicbroadcasting.net/opb.news.newsmain?action=article&ARTICLE_ID=315272 (accessed May 1, 2006).

^75. See, for example, "ANA Commentary," in Board of Directors Minutes, December 1, 1966, ONAA. "The old story that 'angels of mercy' are above the needs of adequate compensation is no longer acceptable by nurses — nor, in fact, by anyone who takes note of nursing salaries." This stereotype about teachers also persists today. See New York Times editorial "Classroom Distinctions" in which the author criticizes popular films about teachers and students for their message that what schools and kids really need are "heroes" and martyrs, rather than teachers who receive adequate pay and security to get the job done. Tom Moore [editorial], "Classroom Distinctions," New York Times, January 19, 2007.

^76. Connie Weimer, interview with Maye Thompson, January 19, 2005, ONAA. See also Evelyn Nakano Glenn, "From Servitude to Service Work: Historical Continuities in the Racial Division of Paid Reproductive Labor," in Unequal Sisters: A Multicultural Reader in U.S. Women's History, ed. Vicki L. Ruiz and Ellen Carol DuBois (New York: Routledge, 2000), 436–65.

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