Thousands of health care workers at Oregon’s Providence hospitals and clinics are considering going on strike.
Providence St. Vincent Medical Center, in Portland, Oregon, August 2, 2023.
Kristyna Wentz-Graff / OPB
Oregon Nurses Association announced Monday morning, the union was unable to reach an agreement with Providence and an indefinite strike is scheduled to begin January 10.
The scale of the strike is unprecedented for Providence. About 5,000 nurses plan to strike at Oregon’s eight Providence hospitals, and they will be joined by some doctors and advanced practitioners, marking the first time in recent history that doctors have participated in a strike in Oregon, according to the union and Providence.
At St. Vincent, Providence’s largest hospital in the state, 70 union hospitalists, physician associates and nurse practitioners are participating in the strike. Hospitalists are primary care physicians who manage daily care.
At Providence’s six women’s clinics in the Portland metro area, 80 obstetrician-gynecologists, certified midwives and nurse practitioners are also on strike.
Providence leaders say they will draw on their recent experience running hospitals with replacement nurses during two previous strikes to maintain as many of their operations as possible.
A striking staffing agency that Providence has worked with in the past is currently advertising hundreds of temporary positions in Oregon for an estimated $100 an hour.
But there is no similar solution to replace advanced practitioners who are considering retirement.
Raymond Moreno, chief medical officer at Providence St. Vincent, said replacing striking hospitalists, or figuring out how to serve patients without them, is a difficult challenge and may require “adjustments.”
“It’s new,” Moreno said. “Replacing doctors, midwives, practitioners – no one has experience of that. »
Moreno said Providence will communicate clearly with the public in the coming days if any changes are made to services.
Adding to the potential cost of the strike, Oregon’s nursing staffing law is still in effect during the strike, meaning Providence will have to meet standard staffing ratios.
Providence spokesman Gary Walker said their hospitals were providing care to about 1,200 patients total Monday, the day the strike notice arrived.
The nurses’ association said Monday’s decision came after a week of intensive negotiations, followed by a five-day reflection period and additional mediated discussions.
“The corporatization of health care has left many Providence employees frustrated and exhausted, as they are told to spend less and less time with patients and more time trying to increase profits,” said the ONA in the strike announcement.
Providence CEO Jennifer Burrows released a statement in response, saying the union was unwilling to compromise and was sending mixed signals in response to the company’s proposals.
“Once again, the focus of our leadership teams will turn to caring for our community during this work stoppage,” Burrows said. “We have been transparent with union leaders that in the event of a work stoppage, negotiations stop to support our priority of ensuring we continue to provide excellent patient care.
Providence accused the Oregon Nurses Association of working toward a system-wide strike for months, noting that 11 different bargaining units are involved. Some units, like those at Providence’s flagship St. Vincent hospital, have been in negotiations for more than a year, while other units’ contracts expired more recently.
Flyers and union social media posts referenced plans for a coordinated strike even as negotiations were underway, Moreno said.
Image of a flyer, provided to OPB by a Providence spokesperson on December 30, 2024. Providence says the union plans to coordinate a strike at all eight Providence hospitals in Oregon to increase its bargaining power.
Providence
Members of the union’s bargaining teams disagreed and said it was Providence’s recent refusal to make concessions on their top priorities that led to the decision to walk away.
“I can’t afford to go on strike. And talking with my colleagues, they feel the same way,” said Heather Medema, labor and delivery nurse and president of the Seaside bargaining unit.
Still, she said, the strike call was necessary because Providence was unwilling to negotiate on two of her unit’s priority issues: paid leave and the high premiums and deductibles that nurses say they pay for their insurance. disease.
Medema said that this fall, union members received a letter informing them that they would no longer have Providence insurance and would instead be transferred to an Aetna plan.
Nurse Heather Medema, at ONA headquarters, December 30, 2024. Medema says poor health care benefits are one of the issues that pushed nurses to strike. “A lot of people think that if you work in health care, you’ll have great health insurance,” she said. “This has rarely been the case for me.”
Amelia Templeton / OPB
“It’s not just about this contract. It’s also about Providence’s refusal to talk to us and Providence’s refusal to discuss the things that are important to us,” she said.
Dr. Jahnavi Chandrashekar, a hospitalist on St. Vincent’s negotiating team, said understaffing is the critical issue that led to failed negotiations for her unit.
Dr. Jahnavi Chandrashekar, at the Oregon Nurses Association headquarters in Tualatin, OR on December 30, 2024. Chandrashekar says it is necessary to go on strike because the number and acuity of hospitalized patients is expected to increase take care of daily increases.
Amelia Templeton / OPB
Hospital staff cannot cope with the growing population of sicker patients. Although beds are available at the hospital, Chandrashekar said, admitted patients remain stuck in the emergency department corridor or in the waiting room because there are not enough staff to get them up to the hospital. the stairs.
“We’re expanding the hospital, but we’re not expanding provider services fast enough to keep up,” Chandrashekar said. “That’s a big part of it.”
Chandrashekar said the doctors’ union proposed a clause in the contract that would require a temporary pause in hospital admissions when the number of patients becomes too high for the number of providers on a given shift.
Moreno of Providence acknowledged that St. Vincent is dealing with more older and sicker patients than in the past.
But the solution, he said, must go beyond the scope of an agreement with hospitalists and is difficult to find in a contract.
“If we have to take a break and the patients are still there, who else is going to take over for a little while, who else is going to provide care? » said Moreno. It’s a really complex problem.
The union said it remained open to negotiations over the next ten days and would call off the strike in exchange for concessions from Providence. Providence said it couldn’t spare its management team from working on negotiations while it prepared for the walkout.