Let me tell you a story about a group of nursing home workers in Connecticut and their union, District 1199 New England, or 1199NE as it’s often called. While many unions in recent times have adopted approaches focused on political deals or partnership with employers, the story of 1199NE is one of sticking to an older path. Their belief is simple yet powerful: the workers are the union.

They don’t see the union as a third party coming in to fix things, but rather as a collective force built by the workers themselves. Their entire approach is built for class struggle, not the kind of “class snuggle” that seeks cozy deals with management. This means their organizers work closely to find and mentor organic leaders among the workers – those trusted by their peers – and then help these leaders build a powerful organization from the ground up, aiming for a strong majority.

What truly sets 1199NE apart and is central to their story is their unwavering willingness to use the strike weapon. They view striking not just as a last resort, but as a critical “structure test” – the ultimate way for workers to prove their collective power and readiness to fight for a better life. They talk about striking early in the organizing process and routinely run majority strikes, understanding that this “strike muscle” must be kept strong.

This commitment to building power and engaging in struggle, even famously telling the national union “Go fuck yourselves” when presented with a partnership deal that would compromise worker rights, has allowed 1199NE to achieve the highest nursing home wage, benefit, and workplace standards anywhere in the United States, winning life-changing gains like real pensions and the right to strike at the end of contracts. Their story is a testament to the idea that when workers build their own power and are prepared to use it, they can truly transform “lousy jobs into fairly decent ones”.

Ready to Transform Your Workplace?

For Certified Nursing Assistants (CNAs) and other workers seeking to organize a nursing home, understanding effective strategies is crucial. Drawing on insights from Jane F. McAlevey’s book, No Shortcuts: Organizing for Power in the New Gilded Age, particularly its examination of nursing home unionization, we can identify a powerful approach rooted in the collective strength of the workers themselves. The book contrasts a less effective “mobilizing” or “advocacy” model with a deep, participatory organizing model that is presented as key to achieving significant victories.

Here is a step-by-step guide explaining the best way to organize a nursing home as a CNA, based on the principles outlined in No Shortcuts:

Organizing a nursing home effectively as a CNA involves building real power among ordinary people. This approach, rooted in a deep, participatory organizing model exemplified by unions like District 1199 New England (1199NE), contrasts with less effective advocacy or mobilizing models. It’s about the workers themselves being the union, not relying on a third party.

Here is a breakdown of the key steps involved:

1. Conduct a Deep Power Analysis (Including Your Own Power): Before you start, systematically dissect the power structures, not just of the employer, but also among the ordinary people who are or could be involved in the fight. This involves meticulously mapping social networks and understanding who can influence whom and why. Understanding “what you have” – the power of the workers themselves – is essential for developing strategy.
2. Identify and Develop Organic Leaders: Look for individuals who have natural influence among their peers, even if they don’t have official titles or self-identify as activists. Getting close to the workers is crucial for this. The focus should be on recruiting and coaching these organic leaders, as they start with a base of followers and are key to reaching scale. A guiding principle is “Don’t do for workers what they can do”.
3. Build to a Majority (Aim for a Supermajority): The goal is to build a specific, quantifiable majority of workers supporting the organizing effort within the bounded constituency of the nursing home staff. This requires targeting and planning to reach each and every person, not just those already interested.
4. Engage in Purposeful Conversations: Understand that conversations are the primary vehicle for moving the plan forward. Each conversation should have a clear purpose: roughly 70% listening/discovery where the worker speaks, and 30% presenting the union as the solution to shift the worker’s attitude, belief, and commitment.
5. Master the Semantics: Workers Are the Union: Pay careful attention to language. Frame the fight as having two sides – the boss and the workers (who are the union) – directly countering the employer’s message of the union being a “third party”.
6. Frame the “Hard Choice”: Engage organic leaders in a critical conversation where you help them understand that their self-interest (like winning significant benefits such as pensions or sick pay) can only be realized through collective action (a union), which involves taking a risk. Be prepared for the “long uncomfortable silence” as they contemplate this choice, respecting the gravity of their decision to fight the employer. Good organizing conversations make everyone a little uncomfortable.
7. Conduct Structure Tests: Regularly implement actions that measure the power of the workers’ organization and their willingness to fight. These are agency tests. Examples include majority petitions, majority photo posters, majority sticker days, and majority T-shirt days. These tests help gauge commitment levels and assess the strength of organic leaders.
8. Be Ready to Strike: Readiness to strike should be discussed from the opening conversations with the organizing committee. Strikes are highlighted as the “hardest of structure tests” and the mechanism through which workers can win significant, life-changing contract standards like better pay, healthcare, and pensions. Preparing patient families beforehand is part of this process to allow workers to strike for better conditions for both patients and themselves [The source mentions preparing patient families step-by-step, linking it to the ability to strike [implied from nursing home context and strike discussion]]. Winning and maintaining the right to strike in contracts is crucial, as surrendering it can lead to marginal gains.
9. Integrate Workplace and Community Organizing: Recognize that nursing home workers are part of a broader community (families, neighborhoods, churches). Building power in the community requires the same meticulous approach as in the workplace, starting with identifying organic community leaders. This “whole worker organizing” approach acknowledges the importance of non-workplace issues to workers’ lives.
10. Build for Struggle, Not “Class Snuggle”: Understand that achieving significant improvements and challenging power inequality requires a willingness to struggle against the employer, not seek partnership or “class snuggle”. Your union should be built for this struggle, with workers understanding that their power comes from getting everyone together to fight for a better life.

This high-participation, high-risk, structure-based organizing model, rooted in the collective power and agency of the workers themselves, is presented as the most effective path to achieving meaningful and lasting change in nursing homes.

For more information, check out these resources for organizing.