(This article has been updated to incorporate additional reporting.)

Nurses at Providence St. Vincent Medical Center in Portland have overwhelmingly rejected a tentative agreement with the hospital’s management. 

The development means a strike of the 1,600 nurses at the hospital is now much more likely.

“Today’s vote results are overwhelming and undeniable,” said Jessica Lobell, registered nurse and vice president of ONA’s nurse bargaining team at Providence St. Vincent, in the union’s Thursday press conference. “The frontline nurses at Providence St. Vincent have rejected the tentative agreement by more than a 4-to-1 margin. Put simply, hundreds of experienced frontline ONA nurses looked at Providence’s offer and said it’s not good enough. It’s not good enough for  our patients. It’s not good enough for frontline nurses and it’s not good enough for our community. This vote is a flashing red light that tells Providence that nurses have had enough. ”

The vote is big news because the hospital is the largest of three Providence-affiliated hospitals in Oregon with nurses who voted in the last two months to authorize a strike if a deal cannot be reached. The outcome puts pressure on the hospital as negotiations continue with the threat of a strike hanging over the bargaining table.

“​​If nurses vote not to ratify, the ONA nurse bargaining team at Providence St. Vincent may return to negotiations or move towards a strike,” according to a June 22 ONA announcement of the press conference.

In a memo to hospital staff, Jennifer Burrows, a registered nurse and chief executive at Providence St. Vincent, pledged to return to the bargaining table.

“We hope to quickly work through our differences to draft a contract the represented nurses of Providence St. Vincent will approve,” the memo said.  “Over the past eight months, Providence St. Vincent Medical Center has been working with ONA to deliver a fair pay and benefits package to our nurses. We are committed to ensuring our valued nurses receive a fair pay and benefits package.”

From the start, the tentative agreement was hotly contested, with a vocal group of nurses at the hospital organizing to oppose the negotiated contract terms as not good enough. Lobell echoed that sentiment too, saying the hospital’s offer didn’t do enough to address Providence’s growing staffing crisis and position the facility to retain and recruit skilled nurses.

The vote at Providence St. Vincent to authorize a strike happened in May. In early June, nurses at the other two hospitals voted to authorize a strike: Providence Willamette Falls in Oregon City, which has 233 nurses; and Providence Milwaukie, which has 239 nurses.

Nurses at each of the three hospitals have separate contracts with Providence and cast separate votes to authorize a strike. This means the bargaining – and any decision to strike – could vary from one hospital to another.

According to the union release, “ONA nurses have volunteered their time to meet with paid Providence managers more than 50 times over the last eight months to bargain multiple contracts at Providence’s Oregon hospitals.​​”

Up to this point, none of the hospitals’ nurses have gone on strike. And Providence St. Vincent Medical Center is the only one of the three where a tentative agreement has been announced. 

Other Nurses Speak Out

Amy McRae-Brownlee, a registered nurse in the  emergency department at Providence Milwaukie, said at the union’s press conference that working conditions have deteriorated during her 15 years at the hospital. 

“We have a staffing problem,” McRae-Brownlee said. “In order to make budget, nurses are sent home from their shifts early. This leads to fewer nurses caring for more and sicker patients which leads to increased injuries and infections, more expensive interventions, longer hospital stays and worse outcomes for the patients. For nurses it leads to workplace injuries, burnout, moral injury, and the constant stress of knowing we’re not able to provide the care our patients deserve.”

She also pointed to differences between bonuses for new nurses and existing staff. A new nurse can get a $10,000 hiring bonus, while existing staff received a $1,000 bonus, McRae-Brownlee said.

Another nurse and union leader said Providence has “lost its way,” despite its roots as a non-profit faith-based provider.

“For all the crosses and mission statements we walk by in the hospital halls, it’s clear to every nurse that Providence isn’t run by the nuns anymore,” said Virginia Smith, an acute-care charge nurse and executive committee president at Providence Willamette Falls Medical Center in Oregon City. “It’s a multi-billion dollar business run by corporate executives. And Providence’s corporate executives care more about their bottom line than the people working on the frontlines.”

Sticking points at the bargaining table included stronger patient safety standards to reduce COVID-19 outbreaks, increased nurse staffing, lower  health care costs for employees and higher wages, the union has said.

The union’s bargaining team had earlier recommended that nurses vote to approve the tentative agreement. Its terms included:

• Improved access to appropriate personal protective equipment to prevent future COVID-19 outbreaks and uphold high standards of care.
• Improved nurse staffing that puts safe staffing standards into the contract. Providence also makes a stronger commitment to meet established daily safe staffing standards, the union said. This includes posting and filling vacancies quickly and a task force to monitor the issue.
• Health care costs for nurses are kept in check, with health benefit costs with limited increases in premiums and locked-in costs.
• An increase in wages of up to 14% during the next two years.

However, the proposal drew immediate resistance from some rank-and-file nurses, who voiced concerns about the deal to The Lund Report and on social media. 

“The (offer) may look good on the news for Providence but the majority of us are uniting together to vote it down,” Angela Knapp, a registered nurse at the hospital, said in a message to The Lund Report at the time. “We don’t feel Providence has bargained fairly. This is the first time they made any significant movement on anything. It’s a good start, but after seven months of negotiations, it shouldn’t be the first time they moved and they haven’t even come close to addressing the real concerns.”

Next Steps 

Providence officials have said management has a plan in place in the event of a strike and labor negotiations would halt during a strike to focus on patients.

In order for any of the hospitals to go on strike, the union would first need to give the hospital a 10-day notice of when it will do so. That gives the hospital time to prepare with temporary staff and puts pressure at the bargaining table to avert a strike with a deadline. 

None of the hospitals so far have provided that notice as they continue to bargain.  At this time, Providence St. Vincent’s doesn’t have a date scheduled for its next round of negotiations.

Even as both sides pledge their commitment to continue bargaining, preparations are underway for a potential strike. 

In the union’s notice to nurses about the vote outcome, it says  “Providence and our ONA Bargaining Team will return to negotiations.” The memo also puts out a call for volunteers for strike training.

As part of the next steps, labeled “expedient strike preparation,” the union’s memo says: 

“As our bargaining team heads back to the table, they will also announce more information about next steps as soon as we have them. In the meantime, please commit to serving as a Picket Captain.”

According to the sign-up form, picket captains “coordinate with ONA elected leaders and staff to manage day-to-day operations on the picket line during a strike.”

Virtual strike trainings on Zoom are scheduled from Monday, June 27 until July 8, the memo says.

You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.