Oregon Providence health care workers announce strike

Thousands of health care workers at Providence hospitals and clinics in Oregon are planning to go on strike.

The Oregon Nurses Association announced Monday morning that the union could not come to an agreement with Providence, and an open-ended strike is set to begin on Jan. 10.

The scope of the strike is unprecedented for Providence. Around 5,000 nurses are planning to strike at all eight of Providence’s hospitals in Oregon, and they will be joined by some physicians 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 unionized hospitalists, physicians associates, and nurse practitioners are participating in the strike. Hospitalists are primary care doctors who manage day-to-day care.

At Providence’s six women’s clinics in the Portland metro area, 80 obstetrician-gynecologists, certified midwives, and nurse practitioners are also striking.

Providence executives say they will draw on their recent experience running hospitals with replacement nurses during two previous strikes to keep as much of their operation running as possible.

A strike staffing agency Providence has worked with in the past is currently advertising hundreds of temporary positions in Oregon for an estimated $100 per hour.

But there is no similar solution to replace the advanced practitioners planning to walk out.

Raymond Moreno, Chief Medical Officer at Providence St. Vincent, said replacing the striking hospitalists, or figuring out how to serve patients without them, is a difficult challenge and may require “adjustments.”

“This is new,” Moreno said. “Replacing physicians, midwives, practitioners - nobody has any experience with this.”

Moreno said Providence will communicate clearly with the public in the coming days if there are any changes to services.

Adding to the potential cost of the strike, Oregon’s nurse staffing law is still in effect during the walk-out, meaning Providence will have to adhere to standard staffing ratios.

Providence spokesman Gary Walker said their hospitals were providing care for about 1,200 patients in total on Monday, the day the strike notice arrived.

The nurses association said Monday’s decision came after a week of intensive bargaining, followed by a five-day cooling-off period and additional mediated discussions.

“The corporatization of healthcare has left many Providence employees frustrated and burnt out as they are being told to spend less and less time with patients and more time trying to drive up profits,” ONA said in the strike announcement.

Providence CEO Jennifer Burrows released a statement in response, saying that the union was not willing to compromise and sent mixed signals in response to the company’s proposals.

“Once again, our leadership teams’ attention 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, bargaining stops to support our priority of ensuring we continue to provide excellent patient care.”

Providence has accused the Oregon Nurses’ Association of working for months toward a system-wide strike, noting that 11 different bargaining units are involved. Some units, like those at Providence’s flagship St. Vincent hospital, have been bargaining for over a year, while other units' contracts expired more recently.

Fliers and social media posts from the union have referred to plans for a coordinated strike even as bargaining was underway, Moreno said.

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 out.

“I can’t afford to strike. And talking with my coworkers, they feel the same,” said Heather Medema, a labor and delivery nurse and chair of the Seaside bargaining unit.

Still, she said, calling a strike was necessary because Providence was unwilling to negotiate on two of her unit’s top priority issues: paid time off, and the high premiums and deductibles that nurses say they pay for their health insurance.

Medema said this fall, union members received a letter saying they would no longer have Providence insurance, and were being transferred to an Aetna plan instead.

“It’s not just about this contract. It’s also about Providence refusing to talk to us, and Providence refusing to discuss the things that are important to us,” she said.

Dr. Jahnavi Chandrashekar, a hospitalist on the bargaining team at St. Vincent, said that inadequate staffing is the critical issue that led negotiations to break down for her unit.

Hospital staff can’t cope with the growing population of sicker patients. While beds in the hospital are available, Chandrashekar said, patients who’ve been admitted remain stuck in the hall in the emergency department or in the waiting area, because there isn’t adequate staffing to move them up stairs.

“We’re expanding the hospital, but we’re not expanding the service of the providers fast enough to keep pace,” Chandrashekar said. “That’s a huge part of it.”

Chandrashekar said the physicians’ union has proposed language in the contract that would require a temporary pause in hospital admissions when the number of patients grows too high for the number of providers on a given shift.

Providence’s Moreno agreed that St. Vincent is dealing with larger numbers of patients who are older and sicker than they have been in the past.

But the solution, he said, needs to go beyond the scope of an agreement with the hospitalists, and is hard to solve in a contract.

“If there needs to be a pause, and the patients are still here, who else is going to pick up the baton for a little bit, who else is going to provide care?” Moreno said. That’s a really complex problem.”

The union said they remain open to negotiating over the next ten days, and would call off the strike in exchange for concessions from Providence. Providence has said it cannot spare its executive team to work on bargaining while they prepare for the walkout.