From the Bedside to the Picket Line

Jason E. Kaplan
The picket line at Providence Portland Medical Center in Northeast Portland

This summer has seen a flashpoint of labor activity among Oregon health care workers.

Share this article!

It’s shaping up to be a hot summer for labor activity in health care. 

Nurses at Providence Health Systems in Portland and Seaside held a five-day strike. Nurses at St. Charles medical center in Bend voted to strike but reached an agreement with the hospital system before the strike was to begin. Nurses at Oregon Health & Science University held informational pickets in Portland, Astoria and Hillsboro, and nurses at PeaceHealth held similar pickets in Eugene and Springfield. 

And — with the exception of the St. Charles strike vote, which happened in late May — that’s just June.

While this summer has so far shaped up to be an exceptional one when it comes to labor activity in health care, it’s not coming out of nowhere. 

First, though the numbers tell a more complicated story, it’s true that there’s more awareness of and support for labor unions in general — and more workers organizing and raising awareness of labor issues. Nationally, the rate of union membership is at an all-time low, with just 10.1% of American workers belonging to a union in 2022, according to Bureau of Labor Statistics data. Oregon tends to have a higher rate of union membership than the nation as a whole, with 15.7% of Oregon’s workers belonging to a union, per the same dataset. But the absolute number of Americans in unions has grown in recent years, and the number of union petitions filed with the National Labor Relations Board was 53% higher in 2022 than it was in 2021.  The number of strikes rose by 52% in 2022 versus 2021, according to Cornell University’s Labor Action Tracker report. The absolute number of work stoppages — 417 strikes and seven lockouts —  is far lower than it was in past decades, though support for unions is at an all-time high, per Gallup polls. 

Much of that increase in activity was driven by the pandemic, which inspired frontline workers — including retail and warehouse workers — to raise awareness about their compensation and benefits, but also about safety amid the pandemic, access to personal protective equipment and paid time off. 

Health care workers, of course, were in the thick of that. And while public health officials have declared an end to the COVID-19 public health emergency, nurses say they’re still struggling. Recent labor activity has focused less on compensation and more on working conditions, though during actions like the Providence strike, nurses have asked for more compensation in the form of more paid time off and increased access to mental health services.  

“The pandemic for the past two years has only highlighted what has been in existence for decades,” says Anne Tan Piazza, executive director of the Oregon Nurses Association. “The fracture the inequities, the structural barriers in our health care system, our nurses. It’s more than nurses, it’s caregivers and other health care workers who are absolutely at a breaking point. We are frustrated, we’re angry, we’re exhausted, we’re burnt out.”

Chris Rompala, chair of the bargaining team for the two PeaceHealth facilities in the Eugene area and a PeaceHealth staff nurse, told OB nurses were picketing in front of PeaceHealth Sacred Heart Medical Center in Springfield because they had 25 failed negotiation sessions for nurses to get fair wages and safe staffing conditions. 

Tamie Cline, ONA’s president and a nurse at Good Shepherd in Hermiston, speaks at the Southeast Portland headquarters of AFL-CIO. Photo by Jason E. Kaplan

Tamie Cline, ONA’s president and a nurse at Good Shepherd in Hermiston, said the union is asking for PeaceHealth for the same ratios the House Bill 2697 would require. (These ratios vary depending on the department but are one-to-one in departments like the emergency room and one-to-four in departments like telemetry and postnatal care.) But the hospital system had said they would only adopt the required staffing ratio if the law passes. 

Cline spoke with OB before the legislative session reconvened after a six-week walkout and passed HB 2697. That bill does not take effect until next summer, however. 

Cline says some hospitals in the state have already achieved the staffing levels recommended in the bill, but that PeaceHealth was unwilling to consider such a move unless required to by law. A spokesperson for PeaceHealth did not respond directly to a question about that claim about negotiations, but did say the hospital system would comply with the law.

“PeaceHealth remains committed to reaching agreements on contracts that our Home and Community and Sacred Heart Medical Center nurses can be proud of and support. We continue to make progress at the table and are hopeful we can reach agreements with ONA soon so that our nurses may benefit from the improvements these new contracts would provide,” said a written statement from PeaceHealth spokesperson Stefanie Valentino. 

“We are committed to making sure we remain an employer of choice so our caregivers want to continue their career here with us. In terms of staffing, this topic is of utmost importance and a priority for everyone. That is why we are also in the process of recruiting over 300 RNs to RiverBend/Sacred Heart. In addition PeaceHealth is committed to following any applicable local, state and federal law,” Valentino added.

“Our nurses need a change to provide the care they know they can provide,” Rompala says.

Kyle Cook, a registered nurse at Providence and member of the ONA bargaining team, told OB during the strike that Providence refused to come to the table for the 10 days between the strike vote and the strike. 

Cook says nurses bargained with Providence for eight months before deciding to strike.

“I don’t feel they were making meaningful movement, and we were,” he says.

The strike had a five-day limit and ended as expected. 

Cook says that for many years there has been a “rising wave against union work.” During the past 3.5 years of the pandemic, “working conditions were morally and ethically unjust,” and nurses have suffered moral injury — a term for mental health distress in response to witnessing or participating in events that go against one’s values. 

Travis Nelson, State Representative for House District 44 and a registered nurse, speaks at an ONA Providence press conference. Photo by Jason E. Kaplan

After the Providence strike wrapped, the ONA wrote a letter asking Attorney General Ellen Rosenblum to investigate the hospital system’s handling of the strike, specifically in hiring nurses from U.S. Nursing to ensure patient care while nurses struck.

Providence sent a letter to Rosenblum asking her office to deny ONA’s request, writing, “In the interest of public safety, it is imperative that Providence’s ministries be able to continue caring for patients in the event of a strike.”

Tan Piazza says the problem is not that the hospital hired substitute workers during the strike but that U.S. Nursing has an explicit mission of strikebreaking, which places the hospital in violation of state law against hiring strikebreakers. (Providence has also described that law as outdated.) 

U.S. Nursing’s website says, “Since 1989, U.S. Nursing has been working with healthcare facilities and professionals to provide turn-key staffing solutions during labor disputes.”

Tan Piazza says there are alternative nursing agencies that allow hospitals to hire nurses on contract that don’t advertise in quite the way U.S. Nursing does. 

Looking ahead, Tan Piazza says ONA will continue to bargain and fight on behalf of caregivers — including not just nurses but physicians, physical therapists and others who have begun to organize as well.

“Our members — our nurses and caregivers — know what the actual patient needs are in their hospitals, in their care settings. They will continue to come up in our collective bargaining to advocate for standards that are appropriate and needed for their specific population at that particular hospital or care setting,” Tan Piazza says. “I would say that the continued discussion and conversations around recruitment and retention and respect keep coming back to the same themes. The staffing law, we believe, will make a significant difference in providing a baseline in terms of improving working conditions for nurses. But again, there are specific things that are unique to each care setting and unique to each hospital. That is going to be bargained over.”

Click here to subscribe to Oregon Business.