For their determination, courage, negotiating chops, and commitment to their patients and nursing excellence, this week surely belongs to the 700 nurses of St Vincent Hospital in Worcester, Massachusetts.
Our Nurses of the Week are ready to “come home” after successfully resolving the longest US nursing strike in 15 years – and the longest ever in Massachusetts history. St Vincent’s nurses, the MNA union, Tenet Healthcare, and St Vincent officials all sound relieved and ready to move past their epic 301-day fight. In a secret ballot on Monday, 487 out of 502 nurses voted to approve the new contract. This effectively puts an end to their marathon struggle for safer staffing ratios – and the subsequent fight to protect strikers from being penalized for taking action.
St Vincent seems to be rolling out the Welcome mat. Hospital officials are ready to recall strikers to their previous positions, are scheduling them for reorientation, and anticipate that everyone will be back at work by January 22.
Hospital spokesman Matt Clyburn stated, “We are ready to welcome back every nurse who chooses to return, and we have plans in place to make that process as smooth as possible.” He heralded the reconciliation and emphasized that both hospital and nurses are eager to “renew our focus on the values we share and the commitments we make to one another as colleagues. And we will work diligently to heal the wounds of the past year as we integrate striking nurses, nurses who have been taking great care of our patients during the strike, and the rest of our excellent staff.”
MNA celebrates “An enormous victory for our patients and our members”
Marlena Pellegrino, RN, a 35-year nurse at St Vincent and co-chair of the nurses local bargaining unit of the Massachusetts Nurses Association (MNA) union was jubilant and proud of the outcome. “This is an enormous victory for our patients and our members, and it is a testament to the grit and determination of every nurse who walked that line, day in and day out, through four seasons, 18 hours a day, in snow, pouring rain, through blazing heat and stifling humidity – all for the good of our community.”
Pellegrino described the mood of staff and management by saying, “Our eyes are focused on the future, on returning to our home and to the hospital bedside to do what we love the most – which is to provide the high-quality care our patients expect and deserve.”
Dominique Muldoon, RN, a nurse at the hospital and co-chair of the bargaining unit, agreed: “With this agreement, we can go back into that building with great pride not just in what we got in writing in the agreement, but for what we have built together as nurses who know they did everything they could for their patients and their community.”
A long, hard battle for better patient care
St Vincent nurses resorted to the strike after two years of deadlock with Tenet Healthcare. In November 2019, the nurses began campaigning for staff increases, contending that the staffing shortage was no mere workaday inconvenience. In their view – even before the pandemic – the lack of nurses had become unsustainable and endangered patient lives.
The calls for reform fell on deaf ears, though, even as Covid started cutting its way through the community. When Covid continued filling the hospital with unvaccinated prey, 700 St Vincent nurses opted for a more aggressive mode of treatment. Under the aegis of the Massachusetts Nurses Association union (MNA), they went on strike on March 8, 2021.
As the MNA account puts it, the St Vincent nurses’ March 2021 action initiated “the longest nurses strike in Massachusetts history, with more than nine months of picketing, community rallies and marches, tremendous support from federal, state, and municipal public officials who rallied to the nurses’ cause. The St Vincent strike also garnered the support of faith-based, social justice and labor organizations and their members not only from across the state but from across the world.”
Such support is not common during industrial strikes, and strikers often encounter violent opposition from all quarters. But when members of the most trusted profession strike, the public response can be more thoughtful and nuanced. One distinctive aspect of many nursing strikes is that patients are a vital part of the equation. When nurses are subjected to poor wages and dangerous working conditions, it has a direct impact on patient safety — and for most, being a nurse and caring for patients are virtually synonymous. So, a nursing strike can administer a salutary shock to the system. To quote one of the more popular picket signs, “If nurses are out HERE, something is wrong in THERE.”
Highlights of the St Vincent contract agreement
You can find more details on the MNA site, but here are the key points.
Safe staffing guidelines
- Agreed: a limit of four-patient assignments on the hospital’s cardiac post-surgical unit.
Prior to the strike, these nurses were often assigned five patients, with no ability to reduce an assignment based on the needs of the patients. - Agreed: there will be a mix of four- and five-patient assignments on the seven other medical-surgical and telemetry floors, including a limit of four patient assignments on the day and evening shift on the two cardiac telemetry floors.
Prior to the strike, these nurses were assigned five patients nearly every day and every shift, with no ability to reduce an assignment based on the needs of the patients. - Agreed: no more than five patients assigned to each nurse on the behavioral health unit.
Prior to the strike, these nurses including the resource nurse were regularly assigned six patients. - The agreement also includes language that limits the hospital’s ability to flex nurses, a controversial process where a nurse can be sent home when the employer determines he or she is not needed, which too often has left the nurses still working with unsafe patient assignments after an influx of admissions later in the shift.
However, the St Vincent nurses are very clear that work remains in other areas including the maternity unit as well as the emergency department. “We will now work to make progress in all areas inside the building and hope Tenet leadership commits to doing the same,” said Marie Ritacco, RN, a member of the nurses negotiating committee and vice president of the MNA.
Protections against workplace violence
- The new agreement includes language which the nurses have sought for a number of years regarding workplace violence. Nurses are subject to assault on the job to the same degree as police officers and prison guards.
- The added language provides two RN seats on the Hospital Workplace Safety Committee, adds new language committing the committee to work to monitor and address issues related to workplace violence, requires the hospital to staff and maintain a metal detector to screen all patients and visitors in the busy ED, and adds contractually enforceable additional staffing by a police detail during the night shift seven days a week and on all three shifts on weekends and holidays.
- The agreement also provides “assault pay,” for a nurse who is assaulted by a patient or visitor. A nurse who receives workers’ compensation and who uses sick or vacation pay as the result of a workplace assault for the first five days will have such time restored to their sick/vacation time off bank.
Wages and Benefits
One of the most important enhancements was the nurses’ ability to obtain significantly enhanced health insurance benefit for part-time nurses with all nurses who work 24-hours or more receiving a premium with Tenet paying 80% of the cost, up from 65% for 24-hour nurses previously, which keeps pace with the benefit for nurses working at UMass Memorial Medical Center.
As to wages, here are some highlights from the contract:
- 2% across the board increases each year of the contract, commencing with the first increase January 1, 2021 and the last increase June 30, 2025;
- Effective August 1, 2021 each nurse not at the max step advances one step (which results in nurses advancing 2 steps in 2021); 1% lump sum bonus for nurses at the top of the wage scale as of December 31, 2021.
- Nurses on the scale will see increases totaling 28% in combined annual across the board and annual step increases, and nurses at max will see 10% in across the board increases and an additional 1% lump sum on base wages based on pay rate on December 31 ,2021.
- Per Diem nurses will receive 3% increases each year of the contract, totaling 15% increases.
- Two options for a 3% lump sum bonus to be paid June 2022: Nurses can opt for a 3% lump sum of 2021 W2 wages, or 3% lump sum bonus based on 2020 W2 wages whichever is greater.
- If ratified the contract will run from Jan. 3, 2021– Dec. 31, 2025 and includes 2 years of retroactive pay (2020 and 2021).
“It feels like we’re going home”
After casting their ballots, the nurses celebrated their victory but mainly looked to the future.
Deb McCrohon, RN, said, “It felt amazing after such a long standout and thinking this day would never come. I’m looking forward to getting back in there and getting back to my patients.”
PACU (Post Anesthesia Care Unit) nurse Debbie Flagg, RN, a Daisy Award winner, added, “It feels like we’re going home. It’s been a long year.”
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