Massachusetts nurses vote to strike for safe staffing ratios

The nurses at St. Vincent Hospital in Worcester, Massachusetts, have been working since November 2019 without a contract. On February 10, they gave their overwhelming approval for strike action for safer working conditions and patient outcomes, with 89 percent of 800 voting in favor.

When negotiations resumed on February 11, management left the table after five minutes. Since that time, the nurses have been left in limbo. There has been no indication that the Massachusetts Nurses Association (MNA) is preparing to call a strike. The MNA would be contractually required to issue a 10-day strike notice to the hospital.

The nurses’ chief concern is that more nurses must be hired to staff the medical-surgical floor. Medical-surgical nurses attend to patients who have the highest needs and morbidity after patients in intensive care. The medical-surgical patient-to-nurse ratio at St. Vincent Hospital is currently five-to-one. Nurses want it lowered to four-to-one. While the industry standard typically falls between four and five, mandated ratios of four-to-one have been proven to result in thousands fewer patient deaths.

Saint Vincent Hospital, Worcester, Massachusetts (Credit: Terageorge~commonswiki)

Catharine Mysliviec, a nurse of 14 years who works on the medical-surgical unit at UMass Memorial Medical Center, wrote a letter to the Worcester Telegram & Gazette on Friday supporting the St. Vincent’s nurses. She explained that ratios are critical because nurses spend more time with patients than any other provider during their hospitalization. Every second a nurse spends with a sick patient is potentially the difference between life or death.

She wrote, “We are there to monitor your condition minute by minute so we can spot any change in your condition and take immediate steps to initiate actions that can mitigate a preventable downturn in your status, or even save your life.”

US hospitals universally refuse to prioritize health care professionals’ time with their patients because it negatively affects their bottom line. However, health care systems across the country have been profiting off of the pandemic. They have received millions in bailouts through the CARES Act, while health care workers are forced into unsafe conditions and overworked, with thousands contracting the deadly coronavirus.

On the day St. Vincent nurses voted overwhelmingly to authorize a strike, the owner Tenet Healthcare, which is based in Dallas, Texas, announced profits of $414 million for 2020. On February 1, 2021, just days after management made its “last, best, and final offer” to the nurses, shares of Tenet rose to $49, from $31 on February 1 of last year.

Funds totaling $3 billion from the CARES Act, along with nurse furloughs, layoffs of essential support staff and unsafe staffing levels have helped Tenet improve its “cash position” during the greatest public health emergency in over a century.

In the event of a strike, management says the “hospital will remain fully operational and ... continue to provide excellent patient care uninterrupted.” Although it will be costly, to avoid a long-term investment in more permanent nurses, Tenet and CEO Carolyn Jackson will expend large amounts of money on traveling nurses in order to break the strike and secure future profits.

Well before COVID-19 began to spread in Massachusetts in early 2020, St. Vincent nurses were caring for more patients than was safe. In February, 70 percent signed a petition calling for safer staffing levels and an end to a punitive management culture. Weeks before the first surge, more than 200 nurses from every unit of the hospital joined negotiations to testify on the impact staffing levels were having on patient care. They spoke of numerous falls, of the abandonment of suicidal patients and of the onset of preventable complications and death.

When the novel coronavirus was unleashed, it exposed inadequate stocks of personal protective equipment, leaving nurses ill-equipped for the influx of diseased and highly contagious patients. Contrary to the needs of its workforce amidst a pandemic and in order to maintain its balance sheet after halting elective procedures, the hospital furloughed nurses and began flexing staff, a practice that amounts to operating a skeleton crew. Nurses responded by passing a vote of “no confidence” in CEO Jackson, but management did nothing to address their concerns.

Throughout the course of the pandemic, the nurses have filed over 500 official reports documenting cases of what they deemed unsafe conditions. In the month of January alone, the country’s deadliest month of the pandemic, they filed 76 such reports.

Nurses who spoke to the Boston Herald described conditions that kept them up at night: patients waiting hours to be fed or given pain medication, developing preventable bedsores and soiling themselves when bathroom assistance was not available.

Jackson maintains that the hospital is able to provide safe and excellent care, but nurse Marlena Pellegrino, co-chair of the MNA bargaining committee, describes the situation differently: “Our COVID floors right now are drowning. Our emergency rooms are drowning. Our ICUs are drowning.”

Dominique Muldoon, who has been at St. Vincent’s for over 23 years, told the Herald, “I’ve just never seen it so bad. The staffing and everything [have] just deteriorated to the point where we don’t feel safe doing our jobs.”

For months now, nurses have made great sacrifices. They have been exposed to and infected by the novel coronavirus, and they have lived in quarantine away from their families. They have gone beyond their scope of practice to serve as grief counselors and conduits for dying patients isolated from their loved ones; and they have demonstrated their resolve to improve their working conditions. And following the policy of their union, they have filed hundreds of safety complaints and have approached hospital management with their concerns, to no avail.

In December at the beginning of the holiday surge in cases, more than 400 nurses held an informational picket to call for improved staffing. Since January, they have been holding daily pickets to generate support. Some 100 nurses have had enough, leaving for hospitals that take better care of their workers and patients. Those that remain, describe the decision to authorize the strike as “heart-wrenching.”

Over recent decades, the MNA has been working to achieve their goal of safer patient limits through legislative efforts. This is in keeping with the union’s perspective. The Massachusetts Nurses Association, which describes itself as “the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public” (emphasis added).

Conspicuously absent from these principles is any intention of fighting to defend its membership through mobilizing nurses, in alliance with health care workers in Massachusetts and beyond, in a political struggle against the mega-hospital chains and the two big business parties that represent their interests.

On Thursday, Democratic Senator Ed Markey joined picketing nurses, saying, “I join you in your frustration, and I raise my voice with you. You deserve better working conditions, better staffing, so you can continue to do God’s work here on Earth and in the hospital, so you can give your absolute best in patient care to every single person who needs it in Worcester.”

Through Marlena Pellegrino, the union replied, “We are thrilled that Senator Markey is taking the time to join us ... as we continue our daily effort to educate the public to help us convince our employer to finally put a concern for our patients and community over Tenet’s concern for profits.”

David Schildmeier, MNA director of public communications, told the Telegram & Gazette that the union hopes that St. Vincent management and Tenet Healthcare will hear the message and aid nurses. It is a foregone conclusion that the MNA’s slavish appeals to the health care behemoth, which has profited off of mass suffering and death in the pandemic, will fall on deaf ears.

As the pandemic persists and capitalism profits from the exploitation of workers and mass death, it is critical that health care workers, who have witnessed the worst and bear the scars to prove it, enter the struggle for a society organized on the basis of social need, not private profit.

The World Socialist Web Site and the Socialist Equality Party call on St. Vincent nurses to form an independent rank-and-file committee to link their fight up with nurses and health care workers across the country and internationally who are demanding better working conditions and patient care. This struggle must be organized independently of the unions and the Democratic Party. Sign up for the WSWS Health Care Workers Newsletter to find out how to carry forward these policies.