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On Monday, 15,000 nurses in Minnesota will be voting on whether to authorize a strike. The nurses work at hospitals and health systems in the Twin Cities and Duluth, Minnesota, including Allina, Fairview Health, HealthPartners, Children’s Minnesota, North Memorial Health, St. Luke’s and Essentia Health.

The Minnesota Nurses Association (MNA) is calling the strike vote after keeping nurses on the job without a contract for more than two months in the Twin Cities, and since July 1 in Duluth. The union has strung out contract negotiations for months, despite the obvious intransigence of hospital executives and their insulting wage offers. Allina, for example, stated that it had proposed a raise of just 10.25 percent over three years, which would amount to a nearly 15 percent cut in real pay at the current rate of inflation (8.5 percent).

In keeping nurses on the job without a contract, the MNA has worked to block a coordinated and serious struggle to address the burning issues facing nurses, including safe staffing ratios and raises to overcome soaring inflation and years of wage stagnation. If the MNA has called a strike vote now, it is only to save face, and out of concern that the growing frustration and sentiment for action among nurses will erupt outside their control.

Nurses are growing increasingly angry with the conduct of the unions, including the MNA, which has negotiated multiple sellout deals over the previous years. In 2016, the MNA worked to isolate 5,000 Allina Health nurses by ratifying contracts at every other hospital system in the Twin Cities beforehand so the hospital system could force its demand to remove employer-sponsored health care from them.

A real fight is both possible and necessary. The WSWS Health Care Workers Newsletter urges nurses to vote to authorize a strike by the largest possible margin Monday. To win their fight, however, nurses will have to take matters into their own hands, through the formation of rank-and-file committees. Such committees will provide the means for nurses to draw up a list of demands based on what they actually need, and not what the hospital executives claim is “affordable” or “realistic.” They will also provide nurses with the ability to coordinate their struggle with the growing movement of health care workers throughout the US and beyond.

The strike vote comes amid a surge of militancy among the working class internationally. Health care workers including nurses have been at the forefront of the fight against the pandemic, which has been exacerbated by the policies of the Democratic and Republican Parties, to which the MNA is subordinating nurses. The explicit policy to “let it rip” concerning COVID-19 and now monkeypox has been furthered by the US Centers for Disease Control and Prevention (CDC) removing quarantine guidelines for those exposed. This policy, alongside the general attacks on the working class and rising inflation, has led to intolerable conditions for health care workers across the nation.

These conditions have generated an eruption of opposition from nurses. In Michigan, roughly 6,200 Michigan Medicine nurses are determined to carry out a struggle against the university hospital system for safe staffing levels, higher wages, benefits and workplace safety. They have been kept on the job since their contracts expired at the end of June, however, by the Michigan Nurses Association and the affiliated University of Michigan Professional Nurse Council (UMPNC) unions. The Michigan Nurses Association and the UMPNC instead have made impotent appeals to Michigan billionaires such as Denise Ilitch, while subordinating the struggle of nurses to their maneuvers with the Democratic Party.

In California, 2,000 Kaiser Permanente mental health therapists are set to go on their first indefinite strike ever starting Monday. The contracts for tens of thousands of Kaiser nurses and other health care workers have expired or are about to. California health care workers have been fighting for the same issues as their counterparts across the country: adequate staffing levels to address the grueling conditions; wages that match productivity and combat inflation; and mental health care for patients to address patient safety. Their struggle, however, has been repeatedly sabotaged by the National Union of Healthcare Workers, which has only called limited strikes that have not produced any results in their fight.

In Buffalo, New York, the Communications Workers of America and the Service Employees International Union Local 1199 have called a one-day “informational picket” at two hospitals on Thursday. The unions have kept 7,000 nurses on the job through contract extensions and other stalling.

Health care workers and nurses are fighting giant hospital systems and big-business politicians, which defend the for-profit health care system. At the same time they are fighting the MNA and other unions, which are determined to keep the common struggle of health care workers across the country from coalescing into a powerful, unified struggle. This is part of the union bureaucracy’s strategy of subordinating nurses to the Democratic Party, which has been carrying out the attacks on nurses’ living conditions alongside the Republican Party.

While health care professionals who are committed to saving lives are denied adequate resources, the Democratic Party is pouring unlimited sums into its military confrontations with Russia and China, which threaten to erupt into a nuclear war and the end of civilization.

The opposition of nurses and the working class in general cuts across such plans. Nurses, however, must not wait for the MNA to bring them contract agreements that do not meet their demands. They must organize rank-and-file committees immediately to take the initiative into their own hands.

The building of rank-and-file committees is necessary to link the struggles of Minnesota nurses with health care workers. The struggle must be expanded to include teachers, manufacturing workers and service workers confronting the same attacks on their wages and working conditions. As part of establishing these democratically controlled committees, nurses must make explicit demands to enforce staffing levels, reduce workloads and hours, raise wages to meet and exceed inflation levels and decades of stagnating wages, including for new hires.

These demands should be coupled with the demand to hire thousands of new nurses and health care workers to cement nurse-to-patient ratios that are sustainable. Such a fight must be fused with the building of a powerful movement of the working class to take profit out of medicine and establish a socialist medical system that works to improve the health of society.