Editor’s note: This story has been updated to reflect a tentative contract agreement announced Saturday at one of three Providence hospitals where nurses have voted to authorize strikes.
Nurses at Providence Health System hospitals in Milwaukie and Oregon City have voted to authorize a strike.
They briefly joined nurses at Providence St. Vincent Medical Center in Portland, who authorized a strike last month, although the St. Vincent nurses announced a tentative contract agreement Saturday morning that appears to have averted a strike there.
The votes empower their union, the Oregon Nurses Association, to decide if — and when — to strike. ONA is required to give Providence 10 days notice.
A coordinated strike across the three hospitals had the potential to involve 2,000 nurses, or roughly a third of Providence’s nurse workforce statewide. With a potential St. Vincent strike now called off, about 470 nurses could still strike at the Milwaukie and Oregon City hospitals.
The votes come at a time when Providence is already struggling to keep its hospitals fully staffed.
Providence recently reported a $510 million dollar loss in the first quarter of 2022, and said the health care labor crisis and an increasing reliance on “premium labor and agency staffing” during the omicron surge have driven up costs.
Nurses say they are negotiating for higher wages, lower health plan costs, and better coverage for meal breaks during their twelve-hour shifts.
In a press release issued Saturday, the Oregon Nurses Association said Providence’s agreement with its St. Vincent Medical Center nursing staff takes critical steps toward addressing many of their concerns. The tentative agreement would improve access to personal protective equipment, update safety standards used to set daily staffing level, commits to a 14% increase in wages over the next two years, and limit how much health benefit costs can climb during the contract period.
The 1,600 Providence St. Vincent nurses covered by the contract will be asked to vote on the agreement in the coming weeks, and if it is approved it will go into effect immediately.
At Providence’s Milwaukie and Oregon City hospitals, meanwhile, nurses have said management’s proposal — starting with a 6.5% raise this year — doesn’t compensate for inflation and how far Providence nurses’ wages have fallen behind Oregon Health & Science University and Kaiser.
Poor compensation is making it harder for Providence to retain and recruit, they said.
“I train a lot of the new nurses who come into the hospital and they are very much aware of,” the wage discrepancy said Sarah Bea, a nurse and union leader at Providence Milwaukie Hospital. “We were not their first choice and a place to work based solely on that.”
The union also wants Providence to hire more nurses. At the current level of staffing, nurses often struggle to find someone to care for their patients during their mandated meal breaks, according to ONA.
“When a nurse I am working with wants to take a break, I assume care of her patients. And that can leave me looking after eight patients on a day shift for as long as 45 minutes at a time,” said Jay Formick, a nurse at Willamette Falls Medical Center in Oregon City. “Eight patients is a lot of work just to make sure they’re safe,”
Formick said that, as a result, nurses skip breaks to avoid imposing on their colleagues.
Leadership at one of the hospitals involved in the contract negotiations pushed back on the idea that they do not provide adequate coverage for meal breaks.
Some Providence hospitals, like Providence Milwaukie, do employ a “resource nurse,” whose responsibilities include helping other nurses take their scheduled breaks.
But the pandemic has created tremendous strain on staffing, with higher patient volumes due to COVID-19, and nurses calling out sick more frequently. That means the resource nurse may get pulled away to cover staffing shortages in the emergency department or elsewhere.
“We have to continuously juggle the schedule around to make sure that our patients get covered,” said Victor Carrasco, chief executive for Providence Milwaukie Hospital.
Formick, who has worked at Providence for 11 years, said he used to feel the nonprofit was driven by a Catholic mission of public service.
That sense of purpose has shifted as the health system has merged with others and pursued greater profits and growth, and the nuns who once ran the health system have played a reduced role, he said.
“Suddenly, it became very cutthroat. The whole ethic of the Sisters of Providence, the nuns who started Providence just seemed to be tossed right out the window,” Formick said.
Carrasco disagrees, and says the care Providence Milwaukie Hospital has provided during the COVID-19 pandemic is a prime example of public service.
“We’re here to serve, We’re here to serve the vulnerable, we’re here to serve the poor,” he said. “That is our mission.”
Providence is the largest health system in the Pacific Northwest and among the wealthiest nonprofits in the region, with its own venture capital fund.
In Oregon it manages eight hospitals and more than 90 clinics. The system employs more than 5,000 nurses.
In response to the strike authorizations, a Providence spokesperson said the company is disappointed by the votes and eager to continue a dialogue.
OPB digital editor Courtney Sherwood contributed to this story.