Eight nurses have been fired for exposing appalling working and patient safety conditions at St. Vincent Hospital in Worcester, Massachusetts. The nurses were fired after being named in a lawsuit brought by the Massachusetts Nursing Association (MNA) against Tenet Healthcare, the hospital’s owner.
The nurses—Katherine Antos, Jacqueline Charron, Alicia Dagle-Metz, Rachel Denapoli, Megan Fikucki, Kayla Gill, Dominique Muldoon and Christina Nester—were all terminated after reporting safety violations to hospital administrators. The Massachusetts Hospital Accrediting Agency (Joint Commission) verified the nurses’ complaints.
Leaders of the MNA have ruled out a strike to compel Tenet to rehire the nurses, address understaffing or unsafe nurse-to-patient ratios. According to the Worcester Telegram-Gazette, union negotiator Marlena Pellegrino says a strike is out of the question to fight for the jobs of the fired nurses or to fight for safe staffing, telling the newspaper, “That’s not something we want to even think about now.”
Instead, the union has resorted to handing a toothless petition with hundreds of signatures to Tenet management. Tenet has predictably ignored it and accused the union of fabricating the entire situation in relation to staffing and patient care. It has also accused workers of “spreading false rumors” and have claimed that the nurse-driven investigations into the conditions at St. Vincent are a “publicity stunt” by the union.
The worsening conditions are not imagined and have only gotten worse since the strike at the hospital from March 2021 to January 2022—a total of 301 days—the longest healthcare strike in Massachusetts history. One of the nurses’ main demands was for safe nurse-to-patient ratios, which have only worsened in the more than two years since the strike’s end, exposing the rotten character of the contract pushed through by the MNA to end the strike.
Tenet Healthcare, a Dallas, Texas-based for-profit corporation that owns hospitals across the country, has been taken to court in other states and has lost lawsuits over the termination of whistleblowers. Two cardiologists at Tenet-owned Detroit Medical Center were awarded $10.6 million in February 2021 after being fired for reporting safety violations.
St. Vincent is severely understaffed, according to over 600 complaints to Massachusetts regulatory agencies made by nurses at the hospital over the last six months. Nurses frequently have been forced to care for six or more patients at once, despite the contract specifying a maximum of four to five patients per nurse.
This staffing shortage has resulted in patients being left alone for long periods, unable to receive any response when attempting to alert nurses. Patients have missed medications, and patients unable to leave their beds often have been left lying in their own urine and feces for extended periods. Patients have regularly suffered preventable falls.
One pregnant woman was forced to wait five hours for a C-section. According to the union, there have also been preventable deaths directly attributable to understaffing.
Tenet hauled in over $15.9 billion in revenue in 2022, and St. Vincent is Tenet’s most profitable hospital. Chronic understaffing and unworkable nurse-to-patient ratios have been a persistent problem at St. Vincent for years. The nursing staff has dropped from 800 to 500 in recent years, with hundreds more vacancies expected in the near future.
Tenet has been the subject of a patient and work safety investigation by the Massachusetts Department of Public Health since January 31. Although Tenet’s CEO dishonestly claimed in a statement that the hospital received “no negative findings for staffing and quality of care” from the investigation, the agency itself reports that its investigation is ongoing and that it is too early to draw conclusions.
The contract finally pushed through by the MNA at St. Vincent in 2022 provided for only 2 percent wage increases in each of the five years of the contract, far below the 6.8 percent rate of inflation of the time. The deal also entrenched the hated tiered wage structure. Nurses were beaten down over the course of the strike, with many forced to find other jobs. Tenet spent over $40 million on replacement nurses, and the Worcester police force was at one point paid $30,000 per day to allow strikebreaking nurses to pass through. Hospital management has also installed two surveillance towers to monitor the entrances, in an effort at further intimidation.
Presented by the union as a victory, the staffing provisions within the contract have set the stage for the hospital’s current staffing crisis. Better staffing was agreed to only under certain conditions and in certain units, which failed to meet nurses’ demands for a strict 4-to-1 patient-to-nurse ratio in all units. Only a few months after the strike ended, Tenet was forcing many nurses to work 12-hour shifts, rather than the 8-hour shifts many had worked before the strike.
Rather than mobilizing its 23,000 members at 51 hospitals across Massachusetts or linking the struggle of St. Vincent nurses with those of workers throughout the United States, the MNA isolated the nurses and left them to fight alone. The MNA, the third largest nurses’ union in the country, did not even pay strike pay to its dues-paying nurses, despite union officials raking in six-figure salaries.
Rather, the MNA demanded that nurses apply for access to minimal financial assistance through the union’s ad hoc relief fund. The union also advised nurses on seeking “alternative work” elsewhere to make ends meet.
It is critical that nurses draw lessons from the intentional isolation and consequent failure of the strike two years ago to ameliorate conditions at St. Vincent. It is not for lack of sacrifice or militancy among rank-and-file nurses that the strike dragged on for nearly a year, resolved nothing and now has left Tenet confident in the union’s refusal and inability to fight for any real change in the deteriorating conditions at the hospital.
The MNA bureaucracy and their counterparts in other industries have worked to sabotage the growing wave of strikes among healthcare workers, autoworkers, railway workers and others.
During the St. Vincent strike, Democratic Party politicians like Senators Elizabeth Warren and Ed Markey were paraded before nurses on the picket line as champions of labor. The MNA is also now pushing for passage of Massachusetts legislation that would mandate safe staffing ratios in hospitals, under conditions where similar laws passed in other states, particularly California, are routinely ignored by healthcare systems with no consequences.
St. Vincent workers must demand that the eight fired workers be returned to their jobs with full back pay and that a serious fight be waged against the deplorable conditions facing nurses and patients. But this requires that nurses break free from the straitjacket of the union apparatus and build a rank-and-file committee of nurses and other workers at St. Vincent that is independent of both the union and its Democratic Party patrons.
Only by linking nurses’ struggles with those of the wider working class can workers bring to bear the power necessary to break the hold of for-profit healthcare and wage a fight for genuine socialized medicine that guarantees good working conditions and high-quality medical care.