SEIU 1021

San Francisco Department of Public Health Nurses to Vote Next Week to Authorize Strike
RNs at San Francisco’s public hospitals and community clinics say they need more than praise or pizza parties for National Nurses Week–they need safe staffing. 



Contact: Jennie Smith-Camejo,, (510) 710-0201; Ella Sogomonian,, (415) 686-5075

As National Nurses Week winds down, registered nurses and other frontline staff gathered outside Laguna Honda Hospital on Thursday afternoon. Even as they celebrated the critical role nurses and staff played in keeping the hospital open and moving it toward recertification with CMS, speakers struck a somber note – and a warning to SFDPH.

Nurses and other DPH staff who came out to support them marched with picket signs, chanted – and cheered as SFGH RN Chapter President Heather Bollinger announced that Tuesday through Friday of next week, members will vote to authorize a strike. 

Download video from the rally here.

The approximately 2200 SFDPH nurses represented by SEIU Local 1021 have been in contract negotiations since February. But so far, SF Department of Public Health management have rejected all of their staffing proposals. In fact, they seem to deny there’s even a staffing problem, citing an official 4% vacancy rate. They make this spurious claim even as they admit that in 2022-23, there were over 12,000 missed rest breaks alone, not counting missed lunches, due to understaffing. Further, there were 606,000 hours worked by per diem (temporary part-time) nurses in 22-23, representing about 291 missing full-time positions. And from July 1, 2022, to November 24, 2023, there were 245,000 hours of RN overtime.

The negotiations are currently in mediation, which will continue as nurses vote to authorize a strike.

At Laguna Honda specifically, an increase in falls due to short staffing has triggered a state investigation and could even jeopardize recertification. The City has already spent $125 million on the CMS recertification process, including some $40 million just on consultants who are not even licensed in California and who have implemented such policy changes as removing all the side rails from beds. Combine the lack of side rails and a staffing crisis that too often leaves only one person to turn patients in bed, and the result is a recipe for falls – which can be catastrophic and even fatal for medically fragile patients like Laguna Honda’s residents. 

Thanks to the heroic efforts of nurses and other frontline staff, Laguna Honda could soon be recertified, which means it could start admitting new patients. But nurses right now are already struggling to keep up with quality patient care as it is. They need more nurses to be able to properly care for their current residents – let alone a sudden influx of new ones. 

“Nurses and staff at Laguna Honda are deeply committed to our residents,” said Kathleen MacKerrow, an RN and clinical Clinical Nurse Specialist at Laguna Honda. “That’s exactly why we’re frankly terrified at the prospect of admitting new residents before we have adequate staffing. 

“Instead of wasting tens of millions of dollars on consultants who have done little to improve patient care, and in some cases have actually implemented non-evidence based practices, they could have provided us with the permanent, full-time nurses and ancillary staff we need to provide the quality of care our residents need and deserve,” said MacKerrow. “Nobody wants to go on strike, but if that’s what it takes to protect our residents from SFDPH’s poor choices, we’re ready to do that.”

“Chronic, dangerous understaffing of frontline caregivers across our entire system has led to working conditions which are unsafe for patients, increased violence in the workplace, and record high resignation rates in critical areas,” said Heather Bollinger, who has been an RN in the emergency department at SFGH for 16 years. “An overreliance on expensive registry staff takes permanent jobs away from local applicants. It also places patients at risk when those staff are not adequately trained and not aware of California state regulations. This is fiscally and clinically irresponsible. And it’s gross fiscal mismanagement of the budget evidenced by DPH’s 35% increase in expenditures on administrative positions compared to a pitiful 7% increase in spending on frontline caregivers.

“The City has had months to respond to many of these proposals and chose to wait until last week to deliver unilateral rejections to almost all of them with no explanation, no counter proposals, and often no discussion. This is not what we consider bargaining in good faith.

“Nurses have been vocal regarding our concerns for years. Pre-pandemic, we alerted the Health Commission to unsustainable conditions. We have presented evidence of over 16,000 missed breaks and over 1,400 assignment despite objection forms outlining unsafe conditions. Laguna Honda staff were ignored by DPH leadership for so long they had to bring in the state to get support for their vulnerable residents. We have delivered carefully developed staffing proposals to meet the needs of our patients. DPH has responded by rewarding its executives, increasing contracting out, mandating overtime, and stripping the front line of resources.

“The City has failed to listen to its staff members, participate meaningfully at the table and offer real solutions to the problems plaguing the Department of Health. This vote to strike is a direct result of their failures and proof of our continued commitment to advocate for quality patient care across San Francisco. We will strike for our patients.”