Saint Vincent Hospital nurses end longest strike in Massachusetts history

Photo: Ariel Skelley/Getty Images

Nurses at Worcester, Massachusetts-based Saint Vincent Hospital ratified a new contract Monday ending the longest strike in Massachusetts history at 301 days, which clears the path for the hospital to begin recalling nurses to provide care to patients and fully reopen hospital beds to address the Omicron surge, according to the Massachusetts Nursing Association.

The contract provides 2% across-the-board increases each year of the three-year contract, commencing with the first increase retroactive to Jan. 1, 2021, and the last increase on June 30, 2025.

The secret ballot vote was held throughout the day on Monday, with nurses announcing the outcome at a press conference following the final vote count. The result was a final tally of 487–9 in favor of ratification. In all, 502 ballots were cast, with three ballots left blank and three contested ballots.

On Dec. 17, the 285th day of the strike, the nurses reached a tentative agreement with Dallas-based Tenet Healthcare that guarantees striking nurses the right to return to their original positions and provides the staffing improvements nurses said they needed to end the strike and re-enter the hospital to provide care to their community in the face of an emerging new surge of COVID-19 driven by the Omicron variant.

The agreement was reached after two weeks of discussions with federal mediators and finally settled at an in-person session, which was mediated by U.S. Secretary of Labor Marty Walsh. 

It came after two years of negotiations and more than 43 negotiating sessions, and followed what is now the longest nurses strike nationally in over 15 years and the longest nurses strike in Massachusetts history, with more than nine months of picketing, community rallies and marches, as well as support from federal, state and municipal public officials.

The strike also garnered the support of faith-based, social justice and labor organizations and their members.

The final component of the agreement reached at the final session was a "back to work" provision, which guarantees all nurses who went out on strike the right to return to work in the same position, hours and shift that they worked prior to the strike, while providing a process for the parties to follow in recalling the nurses back to work.

Under the agreement, the hospital will have 30 days following ratification to recall all nurses back to the hospital to provide care.

In a statement, Saint Vincent Hospital said the hospital will soon begin recalling nurses to work and scheduling them for reorientation, with all returning nurses expected to be back in the fold by Jan. 22. The hospital expects to reopen more beds after the nurses return and has already reopened 12 inpatient behavioral health beds that were closed in August due to staffing shortages exacerbated by the strike.

WHAT'S THE IMPACT?

The new contract includes improvements in staffing on a number of units sought by the nurses, including 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, according to MNA.

The contract also includes 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. Meanwhile, there will be no more than five patients assigned to each nurse in the behavioral health unit.

The agreement also includes improvements in the Resource Nurse assignment on many units. Resource nurses provide an additional nurse on the unit who is there to assist with the flow of patients on and off the unit, provide helping hands to a nurse with a complex patient or take on a patient assignment to ensure other nurses have a safer patient load.

The agreement also includes language that limits the hospital's ability to flex nurses, a controversial process in which a nurse can be sent home when the employer determines he or she is not needed.

One of the key improvements in the agreement is language regarding workplace violence against nurses, who, according to the MNA, are subject to assault on the job to the same degree as police officers and prison guards. 

The new 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 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 worker's 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.

Another key piece in the contract was the nurses' ability to obtain enhanced health insurance benefits 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 the previous 65% – which keeps pace with the benefit for nurses working at UMass Memorial Medical Center.

THE LARGER TREND

The agreement comes at a time when hospitals are strapped for staff and resources. The spread of variants such as Delta and Omicron is prolonging the shortage of workers across the healthcare industry, straining hospital profitability and adding to burnout rates, according to an October report from Moody's Investors Service.

Insufficient staffing in some regions of the U.S. has spread beyond clinical staff, such as nurses, respiratory therapists and technicians, to nonclinical workers, such as dietary and environmental services staff. This has led to hospitals suspending elective overnight surgeries.

In addition, the shortage of hospital workers has hampered recruitment and retention and driven up wages, which the report predicted will continue into this year. This will lead to a further decline in profit margins.

The scarcity of workers is likely to increase pressure on some issuers' margins in the near term but is unlikely to trigger any credit downgrades, Fitch Ratings found in November.

Multiple factors are contributing to labor pressures, including staff burnouts caused by the enduring COVID-19 pandemic and an overall shortage of qualified help, which has resulted in higher costs to hire temporary staff, as well as wage inflation.
 
Furthermore, the report noted that the lack of staff is forcing some in-patient behavioral health and senior housing operators to reduce admission rates.

ON THE RECORD

"I stand here tonight humbled beyond words by our journey, and we are overjoyed to report that our members have cast an overwhelming 'yes' vote to ratify an agreement that officially ends the historic St. Vincent Nurses Strike," said Marlena Pellegrino, RN, a 35-year nurse at the hospital and co-chair of the nurses' local bargaining unit of the Massachusetts Nurses Association. "For nearly 10 months, our nurses have walked the line for safer patient care, for the honor of our profession and for the right of all workers who make the difficult decision to engage in a lawful strike to return to their original positions. As we stand here tonight, we can proudly say we have achieved our goals."
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com