Organizers say it's the biggest nurses' strike in U.S. history: involving two hospital chains - Kaiser Permanente and Sutter Health - and two unions - the National Union of Healthcare Workers and the California Nurses Association.
Today, some 23,000 people walk off the job for a day. Yesterday, 2,500 took to the picket lines in Southern California.
LA Bureau Chief Krissy Clark reports.
Krissy Clark: Outside a Kaiser hospital in Los Angeles, hundreds of nurses, psychiatrists, and other health care professionals marched in scrubs or red union T-shirts. They've been in heated contract negotiations with their employer for months now. Nurse Maggie Lazo says Kaiser is asking people like her to sacrifice too much.
Maggie Lazo: I don't know what's going on with them, because they want us to cut, cut, cut, cut everywhere: cut our retirement, cut our education benefits, cut our health benefits.
Clark: Ironic though it may be -- that a healthcare worker is worried about her own health care benefits -- it's an issue that's erupting in contract negotiations at hospitals across California.
Employers are pushing to raise co-pays and employee contributions. Another issue driving the strikes is staffing levels. The more patients you're assigned, the less care they get, says nurse LaNeta Fitzhugh.
LaNeta Fitzhugh: I feel unsafe being here, even as a patient. And that's mainly why we're out here.
Clark: Fitzhugh is represented by the National Union of Health Care Workers. Vice President John Borsos was also on the picket lines outside Kaiser.
John Borsos: They pay their CEO $8 million a year, even though it's a not-for-profit. While at the same time, they're trying to achieve unprecedented takeaways for the caregivers, while denying them a voice in how the facilities are staffed.
John Nelson: Well, we're disappointed by the union's reaction to bargaining.
Clark: John Nelson is a spokesman for Kaiser. He says big health care facilities like his need to pay senior management enough to attract the best leadership. And when it comes to the reductions in health benefits that Kaiser is pushing on its workers...
Nelson: Just as everyone else in the world's economy and certainly our nation's economy is experiencing, the rise in cost of healthcare benefits continues to go up and we're trying to find ways to address those.
Clark: The hospitals targeted by this week's walk outs will remain open, with contract nurses and nurse managers filling in. But Jan Emerson-Shea, with the California Hospital Association, says all the same, the strikes across California will be disruptive.
Jan Emerson-Shea: We don't understand how taking more than 20,000 nurses away from caring for patients -- and having them walk a picket line -- improves and advances quality patient care.
Clark: In fact, a study (PDF) that came out last year found that patient mortality rates do go up during strikes at hospitals. Joanne Spetz, a health care economist with UCSF, says while management points the finger at the striking nurses...
Joanne Spetz: A nurse might say in response to that, 'yeah, it's a short term risk, but what we're trying to do is prevent bigger harm in the long term.'
Clark: The strikes across the state will conclude by the end of the day tomorrow.
The California Report's intern Bridget Bodner contributed to this report.