Last
year’s longest-running strike came to an end in early January
when nurses at St. Vincent Hospital in Worcester, Massachusetts,
overwhelmingly voted to ratify their new contract and return to work.
Seven
hundred nurses had walked out over dangerous staffing conditions last
March—ten months ago. (See
previous Labor
Notes
coverage
from last April
and August.)
In
a year of health care workers organizing amid Covid surges and
staffing shortages, St. Vincent nurses stood out for their
willingness to strike indefinitely and for the discipline the
strikers showed.
Open-ended
strikes are still a rarity in health care, and Tenet was a formidable
opponent: a massive for-profit health care corporation that owns 60
hospitals across the country and is valued at $8 billion.
The
strikers won improved requirements on staffing, a critical issue for
health care workers everywhere, and stood up to Tenet’s
creative attempts to break the union.
“[St.
Vincent] spent hundreds of millions of dollars on this strike,”
said Marie Ritacco, a longtime nurse at “St. V’s”
and the vice president of the Massachusetts Nurses (MNA). “It
would have taken a small portion of that to rectify the conditions in
the building and make sure we could give patients the care they
deserve.”
STAFFING
WINS
After
years of public outcry about poor staffing at the hospital, the new
contract includes a four- or five-patient cap for nurses on cardiac
post-surgical units and other floors where patients are preparing for
or recovering from surgery or require cardiac monitoring.
The
behavioral health unit will also see a cap of five patients per
nurse, down from six.
MNA
also won the use of a resource nurse—a floating nurse in
high-acuity units who will not be assigned patients, but will be
available to support other RNs and to help with arriving and
departing patients.
The
nurses reined in the administration’s practice of “flex
time.” Previously, staff could be flexed off—that is,
sent home mid-shift when there were not enough patients. But then an
uptick in patient arrivals later in the shift could mean dangerously
high numbers of patients per nurse. New contract language will limit
this practice by allowing each nurse two refusals to be flexed off
(up from one) in every four-week cycle.
The
strike also yielded much better health insurance premium coverage for
part-time nurses, and modest raises, lump-sum bonuses, and step
advancements across the board.
Health
care workers across the country are facing a worrisome surge in
workplace violence. The strikers won workplace safety demands,
including more security staff and metal detectors in the emergency
department. Nurses have been concerned that growing numbers of
patients and visitors are carrying concealed weapons. The new
contract also provides “assault pay” for nurses who take
workers’ compensation after a workplace attack, to restore any
sick or vacation time used for the injury.
‘WE
WON’T BUDGE’
This
was the longest nurse strike in state history. One advantage for the
union was that the strikers were able to pick up shifts at facilities
across the area—easy to do given the shortage of health care
workers during the pandemic. The union was still able to maintain a
picket line throughout the strike.
Nearly
all the components of the tentative agreement, including the improved
staffing, were settled over a few days in mid-August with a federal
mediator. However, in an effort to cow the union, the hospital had
earlier hired permanent replacements—and Tenet refused to
guarantee striking nurses their positions, shifts, or hours back. So
the strike continued.
MNA
argued in a press release at the time that accepting a deal without
these guarantees would be “unprecedented and punitive.”
For Ritacco, St. Vincent’s aim was “to pressure and
demean us. Embarrass us.”
“We
won’t budge,” she said in response to Tenet’s hard
line, “unless all strikers who want to go back are able to get
their positions back.”
Because
St. Vincent was already short on staff, the more than 100 nurses
hired as permanent replacements all have the option of remaining on
staff, though returning strikers will have seniority to return to
their jobs and shifts.
ACCUMULATION
OF PRESSURE
When
St. Vincent’s nurses went on strike in 2001 for 49 days, the
tentative agreement was mediated by Senator Ted Kennedy. He brought
both sides to negotiate at his Washington, D.C., office, and they
reached a favorable deal for the nurses.
Ritacco
and endoscopy nurse Bill Lahey, a member of the bargaining team, say
they don’t know exactly what the tipping point was for St.
Vincent this time, but they credit an accumulation of pressure
heightened by the pandemic.
