LABOR RIGHTS ACTIVISM AT DUKE HEALTH

The Pre-Union Era

In the 1960s, Duke University and Duke University Medical Center stood as a testament to the intersection of philanthropy, medical innovation, and industrial expansion in the American South. However, beneath its prestigious guise, the workforce composition revealed a nuanced reality. While Duke's medical complex symbolized progress in American medicine, the workforce composition highlighted challenges, particularly regarding gender and racial dynamics.

Between the late 1960's to mid-1980's minority workers, distinctly Black women, comprised a significant proportion of hourly workers for Duke Medical Center. Workers' roles within the hospital ecosystem were multifaceted, encompassing a spectrum of technical, clerical, and service-oriented tasks crucial for the operation of the health system. However, prevailing societal norms of the time often overlooked the various challenges faced by these workers, particularly those stemming from racial disparities. For example, Black janitors were often instructed to address white undergraduates as Mister and Miss, a very demeaning requirement. One such Black custodian (a later prominent figure in unionization efforts), Oliver Harvey, stated '"We were treated like subhumans until we started organizing… It was a segregated institution… Now we cooked the food, served in the dining hall and daggone it, can't eat in the dining hall " describing the power imbalance experienced by Black workers (Sacks, p 40). Another such service worker, Mrs. Johnstone once noted, "my head nurse told me to apply for the [nurse's] aide job… Mrs. Smith there said 'I'm sure you are qualified for this job, but there are no openings.' I knew it was because of my race” (Sacks, p 44). Despite these challenges, there existed an inherent sense of vocation among the workers and a dedication to the noble cause of healing and caregiving that transcended the confines of their employment. Women, in particular, exhibited a remarkable degree of solidarity and leadership within the workforce.

While Duke Medical Center thrived on the contributions of its diverse workforce, disparities in pay, job opportunities, and workplace conditions persisted, disproportionately affecting female and Black workers. Minority workers often faced unfair treatment, evidenced by their assignment to more physically demanding roles, reduced job security, few opportunities for promotion, and encounters with discrimination during the hiring process. One faculty member once stated "One of the janitors at Duke University, a very close personal friend of mine… because of the fact he is a negro, his job opportunities have always been limited including limitations imposed by Duke University" (Sacks, p 47). These practices hindered their career advancement opportunities, particularly affecting Black people in service worker positions, who felt constrained from upward mobility. Additionally, Black employees endured heavier workloads, heightened supervision, and punitive measures aimed at pushing them to exert more effort, resembling a factory-style approach to work. Once overworked service worker Mrs. Sarah Moore stated: "We would see from seventy five, eighty, to a hundred people in the morning. My poor little legs was about to drop off because each doctor was truing to see how many patients they could see" (Sacks, p 28). As a whole, working conditions for these groups highlighted the need for unionization.

Early Unionization Processes and Duke University Campus

Oliver Harvey, a Black service worker employed by Duke, began various campaigns for justice through the end of the 1950s. Under the leadership of Harvey, who had participated in the Greensboro sit-ins, a Duke Employees Benevolent Association was formed by 1965. The subsequent assasination of Dr. Martin Luther King, Jr., in a workers strike, added fire to the flame of workers conditions. Following this, 1500-2000 students made a vigil at the home of Duke President Douglas Knight demanding wages for non-academic employees be raised to $1.60 an hour and that Knight speak out and denounce racism (Sacks, p 52). As a whole, the civil rights movement in Durham served as a catalyst for unionization efforts. Subsequently, a strike of custodians and dining workers ensured for about two weeks following this. After feeling the compounded effect of these events, the university service employees connected with the American Federation of State, County and Municipal Employees (AFSCME), a union interested in organizing Black workers. An election was held in January 1972; the union won it by a vote of 491 to 10, instating AFSCME Local 77 on campus (Dunbar, p 5). A prominent comment made by this group was that "without a union, workers could only quit or 'meekly submit' when they were insulted, abused, or cheated."

Pushback from Duke

Throughout various unionization efforts at Duke campus and medical center, administration responded with a series of concerted efforts aimed at impeding the organizing drive and maintaining its authority over the workforce. It is significant to note that largely, though at the time run by the fairly moderate President Terry Sanford, a large reason for harsh anti-union efforts was due to funds. At the time, a hospital wing was being constructed, which cost over $92 million, (as well as the sum needed to pay the several new employees required to staff it) (Dunbar, p. 7). This monetary concern was a potent concern of Duke administration's pervasive anti-union pushback.

Throughout the progression of unionization, there continued a constant struggle between workers seeking empowerment and an institution aiming to maintain control and uphold the status quo. Tactics such as intimidation, coercion, and harassment were employed to deter workers from engaging in union activities. The pushback also included enlisting the services of Modern Management Methods (3M) throughout the various drives for unionization, a consulting firm known for its anti-union stance. Under the direction of 3M, supervisors became actively involved in anti-union activities, further exacerbating tensions within the workplace. In addition to integrating management into the anti-union campaign, 3M spread antiunion propaganda, such as suggesting that employees might lose their jobs if they voted in favor of the union, and that the union would go on strike, leaving workers without employment or access to benefits.

The administration, with the assistance of 3M, also circulated literature that portrayed the union as "an alien force that would disrupt the previously congenial relations between the workers and Duke's management". Additionally, the administration emphasized the possibility that employees might lose existing benefits and pay if they voted in favor of the union. These tactics were designed to create a sense of fear and insecurity among the employees, ultimately influencing the outcome of the union election. Overall, their actions fostered an atmosphere of apprehension and suspicion among workers, eroding the sense of camaraderie and trust that had previously characterized the work environment. As a result, open dialogue and collaboration became increasingly difficult, hindering the progress of the unionization efforts. Employees advocating for unionization often faced disciplinary actions, including threats of job loss, in an effort to suppress dissent and maintain control.

At the forefront of Duke University's efforts to maintain dominance in its power dynamic with workers were specific direct tactics used on employees aimed at perpetuating control. For example, management often undermined workers' ability to effectively train others, by denying senior employees the necessary authority and resources to effectively train new workers. This lack of support made it difficult for senior employees to pass along their understanding of the job to new workers. Furthermore, the lack of recognition and compensation for the substantial energy invested by senior employees into training newcomers was demoralizing, leading to a sense of devaluation and frustration. As a result, their capacity to conduct comprehensive training programs was limited, hindering the transfer of vital skills and perpetuating a reliance on institutional training initiatives. Separately, Duke implemented stringent educational and certification requirements for certain positions, especially impacting Black women, in order to reshape the workforce composition and consolidate control over hiring practices. Following the success with Duke campus, attempts of unionization followed for the medical center.

The First Drive:

In the autumn of 1974, Local 77 launched its inaugural drive to unionize Duke Medical Center, amidst a backdrop of rising activism and favorable political conditions in the late 1960s and early 1970s. This period saw significant mobilization efforts, including a notable walkout staged by DTO's in May 1974. With the hiring of Howard Fuller as its business agent, Local 77 gained substantial momentum. A pivotal development came with a 1974 National Labor Relations Board decision, which provided a substantial boost to organizing efforts by granting workers the right to petition for a union election.

By November 1974, an organizing committee of Local 77 was established, marking a visible manifestation of worker solidarity. Duke's attempts to curtail worker wages further galvanized the movement, culminating in a collective show of strength dubbed the "paycheck ripoff." The campaign overall centered on two core principles: bolstering union strength among workers and publicly showcasing the benefits of organizing, utilizing grievance procedures instituted by public walkouts. The formidable network among workers, spearheaded by figures like Rose Gattis, proved instrumental in garnering support for the cause. Despite financial constraints and lack of support from the international union, Local 77 amassed enough show of interest by June 1975 to petition for a union election with a bargaining unit of between 900-1000 workers, encompassing a broader spectrum of workers (Sacks, p 109).

However, Duke's objections and delays, coupled with the National Labor Relations Board's (NLRB's) November 1975 ruling to expand the bargaining unit to include technical and clerical workers, prolonged the process. This expansion fundamentally altered the composition of the unit and diluted the union's focus by adding in a large group of "higher class" less pro-union workers, hampering its effectiveness. Throughout unionization efforts, the union failed to build on the potentially strong arguments of unified class and racial struggle. The election, delayed to the date of November 1976 after two years of intensive organizing as well as rampant infighting, resulted in a narrow defeat by 59 votes (Sacks, p 114).

Several factors contributed to this result, including supervisory responsibilities, last-minute changes to the bargaining unit, and a lack of unified determination among white workers compared to their Black counterparts. While the expanded bargaining unit represented a silver lining, the defeat proved demoralizing and led to a period of inactivity among previously active unionization efforts.

The Second Drive:

The second unionization drive at Duke Medical Center, spanning from 1977 to 1979, marked a significant departure from the grassroots character of its preceding movements. Despite facing continuing issues such as low wages, poor working conditions, and a lack of impartial grievance procedures, the campaign struggled to gain momentum. Reasons such as the shifting political economy (apoliticization to avoid infighting), struggles to contain costs in the post-war economic boom contributed generally to the slow momentum of the movement. Involvement of the Communist Workers' Party (CWP) in Local 77 also deterred a lot of support. In August of 1977, The Union Organizer reappeared announcing (separate from Local 77 and the CWP) that the medical center workers were seeking reeelction, led by Rose Gattis. Overall, as unionization activity dwindled, the unions strategy was to petition for election as soon as possible. On October 31st, 1976, they filed with the same bargaining unit certified by the NLRB in the first drive. The same issues within the bargaining unit were present as had previously been, with service workers having a long standing pro-union position but other higher level workers within the unit having more divisive union support. In ensuing unionization efforts, a large shift was made to specifically focus on the higher up secretaries and technical workers to garner pro union strength within these sections. This overall had a negative effect as it led to more powerful and central pro-union groups such as the Black women being ignored. The careful apolitical nature of this campaign, and lack of publicization of grievances of individual workers, led to the strongest and most politically based unionization supporters being taken for granted against the campaign. In addition to this, attitudes of core activists including centerwomen, were decreased due to many dropping out in early stages or some remaining distant and passive. Overall, due to a semblance of factors this second drive was characterized as an uphill battle to garner individual involvement compared to the first due to lack of mass mobilization efforts.

Finally, in February 1979, the union lost the election by more than two hundred votes, reflecting now incongruent support among disgruntled service workers and merely partial support by secretaries (Sacks, p 157). At the time, Rose Gattis summed up the reasons for the defeat stating that "We [they] didn't go to the people with rallies; the leaflets were slick but they didn't address the issues in the hospital…" (Sacks, p 158). This is indicative of the rather "careful" unionization approach taken throughout this second drive. In the end, Duke medical center was not unionized.

The End Result

Overall, a multitide of factors led to unionization efforts being in part, unsuccessful. At different instances, the movement took on different goals, perhaps at some instances concerned with racism and economic justice and others more concerned with class struggle among differing interests. In addition, the attempt to seek, at times, apolitical bases for unionization simply did not work. As a whole, though formal unionization efforts faced significant pushback at Duke University campus and medical center, and were only in part successful, the legacy of the movement extended beyond the immediate outcome. By mobilizing marginalized communities and amplifying their voices, namely Black women, the movement helped to highlight both civil rights and working class issues withing the workplace and community, informing the understanding of how to bring about real, palpable change. Ultimately, the unionization campaign at Duke exemplifies the collective, interactive process of effecting meaningful change, underscoring the importance of perseverance in addition to collaboration. One question remains: What avenues for change remain open today?

References

Duke University. Duke University Archives. Duke University Libraries. https://library.duke.edu/rubenstein/uarchives

Dunbar, T. (1979, November 1). The Old South Triumphs at duke. Southern Changes. https://southernchanges.digitalscholarship.emory.edu/sc01-9_001/sc01-9_004/

Sacks, K. B. (1988). Caring by the hour: Women, work, and organizing at Duke Medical Center. University of Illinois Press.