Front Page > Issues > 2003 > August

Nurses strike for better patient care

Given a choice, most people would prefer to never have to go to the hospital. It seems even more unlikely that anyone would choose to be tended by nurses who are overworked, understaffed, and on the verge of burnout. The nurses at Providence Milwaukie Hospital who have been struggling to get a union contract for eighteen months, claim that these are exactly their working conditions.

In December 2001, the nurses voted to unionize under the Oregon Federation of Nurses and Health Professionals. A year later, after filing—and winning—an Unfair Labor Practice suit against Providence, the nurses still saw no improvement in the hospital’s staffing policies. Finally, on July 11, the nurses held a one-day strike in an attempt to get the hospital administration back to the bargaining table.

At the rally held in support of the strike, several hundred nurses and community members marched around the hospital grounds, garnering supportive honks and waves from passersby. Nurses from OHSU and other hospitals came out to show their support, as did representatives from Jobs with Justice and the AFL-CIO. Nurse Betty Fish-Fergusson estimated that only five workers crossed the picket line, out of a staff of 118 registered nurses (RNs).

The Providence nurses in attendance spoke of their frustration at the hospital’s staffing policies. While the stories varied from department to department, all the nurses claimed that Providence’s staffing policies are detrimental to both nurses and patients.

“I’ve watched [the hospital administration] systematically chop my feet out from under me,” said Barbara Cole, who has worked as a delivery room nurse for 20 years. “I don’t mind working hard, but you cut the nursing staff to a certain level and people start to die.”

A study published by the Journal of the American Medical Association supports this claim: the study found that each additional patient per nurse was associated with a 7 percent increase in the odds of the patient dying within 30 days. Each additional patient also increased the odds of a nurse “burnout” by 23 percent.

Tina Clark, an RN who works on the floor, related a typical experience at the hospital. One night, she was at home on call; meanwhile, the supervisor who was working felt that the floor was overstaffed and sent the nurse’s aide home. However, the nurses on the floor felt that they needed some back-up and asked the supervisor to call Clark in at 4 p.m. The supervisor refused. At 7:30, a new supervisor came on, and the charge nurse again asked that Clark be called in, and again the supervisor refused. In the meantime, two staff members had been injured, needy patients had gone without their bedpans being changed, the nurses themselves had been unable to eat or take bathroom breaks, and they were exhausted.

By 9 p.m., when Clark was finally called in, she said, “The nurses were so far behind, because they were doing the job of a nurse’s aide as well as their own. The hospital had someone scheduled to come in, and they cancelled. That’s against staffing guidelines.”

These sorts of problems arise because the hospital uses the number of patients to determine staffing, rather than the severity of the patients’ conditions. This was the part of the basis for the unfair labor practice suit the nurses filed. After the suit, the hospital temporarily reformed its staffing policies, in time for a survey done by the Joint Commission on Accreditation of Health-care Organizations, the association responsible for seeing that hospitals and other healthcare organizations meet certain standards. However, after the survey was over, the hospital implemented a new “staffing grid” that amounted to an increased patient load for every RN. Meanwhile, many nurses are seeing their hours cut back due to “mandatory days off.”

Nurses and labor representatives alike agreed that the hospital is being notably obstinate in its refusal to deal with the union. In Dec. 2001, the nurses voted almost unanimously in favor of unionizing. However, the hospital has been adamant in its refusal to consider a “closed shop,” in which all new nurses hired would be required to join the union.

Leslie Kochan, of the American Federation of State, County, and Municipal Employees (AFSCME), said, “I think it’s more of a power issue than a money issue. With a union, the nurses will have a voice in how the hospital is run.”

Those in attendance at the rally maintained that the struggle is much broader than simply improving the conditions at one hospital. Nursing as a profession is currently in jeopardy: the median age of a nurse is now 48, and not enough young people are entering the profession to replace the nurses who will retire in the next ten years. The shortage will probably hit hospitals particularly hard, as nurses are likely to prefer working in private doctors’ offices, where the patient load is more manageable.

Barbara Cole, whose 24 year old son is also an RN, said, “We’re at a pivotal time in history. We can leave the profession stronger for those who come after us ...but if nursing doesn’t change, there just won’t be nurses. They’ll go the way of the nuns.”

No one seemed to think that the one-day strike would be sufficient on its own to win the nurses their contract. Rather, the strike served to notify the Milwaukie community of the nurses’ issues and to gather support from community members. It also stood as a warning to the Providence administration, letting them know that the nurses meant business.

Brad Witt, Secretary Treasurer of the Oregon AFL-CIO, attended the rally to show the federation’s support for the Providence nurses. He noted that there are 180,000 AFL-CIO members in Oregon, representing a sizeable pool of potential patients for Oregon’s hospitals.

When asked what the union’s next move might be, he made clear their willingness to hit Providence where it will hurt the most: in the pocket book. “If the hospital forces our members out on the street, we may be forced to take Providence Hospital off our health care options for our members,” he said.

Jackie Ellenz of Jobs with Justice, also saw a long fight ahead. She said, “We are working hard to bring lots of unions in so it can be bigger than just the hospital. We need to broaden the struggle, because that’s how we win.”

Abby Sewell is a writer, Reed College student, and former Portland Alliance intern whose excellent reporting continues to appear frequently on the pages of the paper.