At 6:00 a.m. on Monday, March 8, 800 nurses at St. Vincent Hospital in Worcester, Massachusetts began an open-ended strike. This is the first strike at the hospital in 20 years by nurses. They are members of the Massachusetts Nurses Association and have been working without a contract since 2019.
St. Vincent nurses are demanding improved staffing ratios because the current ratio of 5 patients to 1 nurse on medical-surgical floors is unsafe, leading to preventable complications, injuries and deaths. Nurses want the ratio set to 4 to 1. The staffing ratio has been their main concern since contract negotiations began in November 2019.
In order to meet this demand, Tenet Healthcare, the Dallas, Texas-based conglomerate that owns St. Vincent Hospital, would have to hire more permanent nurses. This would run counter to Tenet’s commitment to “maintaining a strong cash position,” even amidst a pandemic. Tenet posted a $414 million profit in 2020, and St. Vincent has made four times the average profit of other hospitals in Massachusetts. St. Vincent is the conglomerate’s most profitable facility.
On February 11, a day after nurses overwhelmingly voted to authorize the strike, St. Vincent management offered to improve ratios on two units—far short of nurses’ demands. Now, by spending millions of dollars on replacement nurses, who make twice as much as nurses normally do, Tenet has demonstrated its intent to continue exploiting its nurses and sacrificing patient outcomes. Nurses have described the replacement nurses as “mercenaries.”
As health care workers across the country have experienced throughout the pandemic, nurses at St. Vincent have been asked to take on duties and perform work that stretches their capacity to provide quality care and which goes beyond their training. Early in the pandemic, they had to operate respiratory machines without having the requisite training and monitor patients receiving high flow rates of oxygen, which was also beyond their scope of practice.
Nurses were forced to reuse disposable personal protective equipment, risking further transmission and their own exposure to COVID-19. To procure more masks or gowns, nurses had to request them from reticent managers, who kept them under lock and key.
Along with the number of nurses, the level of support staff, such as secretaries and personal care assistants [PCA], are also critical to patient care. As one nurse on the picket line described to the WSWS, she is not “above” answering the phone on the ward. But as St. Vincent’s profit margin was four times the state average, she wondered why “they can’t staff [enough] secretar[ies] to answer the phones. They can’t staff a PCA for 20 patients? It’s unreasonable.”
Ed Adamiak, a nurse of 42 years, told the WSWS how the scarcity of critical PPE has forced nurses tending to highly contagious patients to remain with those patients in order to not contaminate others. However, this meant less critical patients receiving less care, which could lead to preventable complications. This is what nurses want to avoid by instituting safe staffing ratios.
In spring 2020, when Massachusetts was undergoing the first major spread of the novel coronavirus and patients were flooding emergency rooms, St. Vincent installed a screening system to segregate patients with COVID-19 from those without it. Since then, the hospital has abandoned this practice, co-mingling all patients while awaiting test results. The obvious outcome of this is that staff and COVID-negative patients are unnecessarily exposed to the pathogen.
Without enough nurses and support staff, such as personal care assistants and patient observers, more patients are falling down and injuring themselves, developing bed sores, waiting hours at a time for time-sensitive medication and having to lie in their own waste.
Stretched as they are and after a year of the worst public health emergency in modern history, health care workers face a future of post-traumatic stress. Julie Pinkham, executive director of the Massachusetts Nurses Association, said nurses have “seen more people die than most of the military has. I don’t want to see anyone blown up, but I don’t want to see anyone ‘guppy breathing’ for hours on end either. … It’s like watching somebody drown before your eyes no matter what you do.”
Diane Waters, a nurse with more than 30 years experience, explained the reason for hospital policies that on face-value appear totally unreasonable. “Profit comes first—has always been that way.” When asked about the punitive management culture that has been reported by the local press, Waters described her manager as “by far one of the worst” and someone who is “very bullying and micromanages … she will just yell at you.”
As of this week, UFCW Local 1445, the union for support staff, secretaries and housekeeping workers at St. Vincent, let its contract expire without being renewed. The union has floated the idea of joining the MNA nurses in their strike. These workers represent a layer even more exploited than nurses, with many earning poverty wages.
To understand how nurses view their struggle within the greater context of the pandemic and the ruling class’ response to it, WSWS reporters asked nurses what they thought about the drives to reopen schools and the economy.
While nurses correctly referred to the aerosolized nature of the virus, some believed that a strict adherence to masks would be sufficient in suppressing transmission in reopened schools. In response, WSWS reporters cited the Columbia University study that found that the closure of New York City schools significantly reduced general transmission, and a Canadian study that found a strong correlation between in-person classes and community spread.
In fact, nurses and teachers face a common struggle in terms of workplace safety and the defense of their health and that of their patients and students under their care. However, the MNA’s strategy is not based on uniting workers and challenging the for-profit health care system exemplified by Tenet Healthcare, but on calling on their adversary to “do the right thing” by abandoning their vast resources. They have also welcomed the support of Democratic politicians like Senator Ed Markey, fostering illusions that they will defend them.
The nurses unions have a record in the pandemic of organizing isolated protests and limited strikes to blow off steam, while acceding to the demands of the health care conglomerates. The unions give hospitals advance warning of their strike dates, allowing the hospitals to prepare by bringing in traveling nurses as replacements as nurses walk the picket line. Strikes are then quickly settled with little changes to the conditions they face.
Nurses should reach out for support for their struggle, beginning with the support staff, secretaries and housekeeping workers in UFCW Local 1445 at St. Vincent. The large health care workforce in Massachusetts and beyond, along with teachers and other workers, must be mobilized behind the St. Vincent nurses.
Nurses and health care workers should organize rank-and-file safety committees, independent of the unions and the pro-corporate Democratic Party, to fight for safe conditions in hospitals to defend the rights and health of patients and health care workers alike. Leaving the response to the pandemic in the hands of the government and corporations like Tenet Healthcare has been a catastrophe, leading to more than 500,000 deaths in the US alone.
In contrast, the program of the Socialist Equality Party and its sister parties calls for an international response to the pandemic, the cessation of work in non-essential industries and the unification of all workers struggles. This program is based on socialism, not the profits of the financial oligarchy, and genuine socialized medicine. Join the Socialist Equality Party today to take forward this struggle.
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