Portside

On Monday, Nov. 8,  the historic St. Vincent Hospital nurses strike will reach the eight-month mark,  another sad milestone in their struggle against Dallas-based Tenet Healthcare, a for-profit corporation that has spent more than $100 million and engaged in a number of unfair labor practices to retaliate against the nurses for exercising their right to advocate for safer patient care. The strike is the longest nurses strike in state history, and one of the longest of several strikes by workers across the nation, who are standing up to corporate greed and the devaluation of essential workers in the wake of the COVID-19 pandemic. 

The strike has caught the attention of labor and social justice advocacy organizations from across the nation, after Tenet has pursued an aggressive campaign to undermine the nurses’ union rights, and to permanently replace the nurses, what some in the labor movement have called a “PATCO moment,” referring to efforts by the Reagan administration to replace air traffic controllers following their strike in the early 1980s.  In the St. Vincent nurses case, the effort has already had a dramatically negative impact on the care delivered to patients served by the hospital, as the nurses have received reports from numerous staff members inside the hospital as well as recent patients, of serious medical lapses and errors by ill-prepared and/or incompetent replacements, including the nurses own experiences encountering and providing care to compromised indigent patients being dumped outside the hospital’s emergency department by Tenet.

“After eight long months, sadly, it is clear that Tenet was never interested in a good faith effort to negotiate an equitable contract, but their ultimate goal is to destroy our union to prevent us from exercising our legally protected right to protect our patients and our community.  We will not let that happen,” said Marlena Pellegrino, RN, a longtime nurse at the hospital and co-chair of the nurses local bargaining unit of the Massachusetts Nurses Association. “Our nurses want nothing more than to be back at the bedside to provide our patients with the dignity and expert care they expect and deserve from this, their community hospital.  Unfortunately, Tenet has refused an agreement that would allow that to happen, choosing instead to spend millions to keep us out, to pursue illegal practices to punish us for our advocacy.  Tragically, it is our patients who are ultimately paying the price for these reprehensible practices.”

The strike by the St. Vincent nurses, which began on March 8, followed more than 18 months of negotiations and advocacy by the nurses to convince their CEO Carolyn Jackson that conditions for patients were patently unsafe and needed to be improved to protect their patients and stem the mass exodus of nurses, after more than 100 nurses left the facility largely due to the deplorable working conditions.  The strike followed a year of great sacrifice and courageous service by the nurses during the pandemic, as they worked tirelessly to care for patients with inadequate staffing conditions and the required personal protective equipment (some nurses resorted to wearing trash bags after Tenet failed to provide appropriate protective gowns), resulting in hundreds of the nurses becoming infected with the virus themselves. 

Back in August, after four days of negotiations, the nurses had agreed to staffing improvements negotiated throughout the strike and were ready to return to work to provide care, particularly during the current surge caused by the Delta variant, yet a final agreement was scuttled by Tenet when they demanded the nurses accept an unprecedented and punitive back to work provision that is not only unfair to nurses, but its replacement of highly skilled nurses with lesser qualified staff, would undermine all the patient safety gains the parties had negotiated. The hospital’s proposal also called for the nurses to retract all the unfair labor practice charges, opening the door for Tenet to continue its efforts to retaliate against the striking nurses.

In October, Tenet declared an impasse in the negotiations and proceeded to implement their last offer for the replacement nurses inside the hospital.  The nurses maintain that Tenet’s attempt to declare an impasse implementing their last offer was illegal and made in bad faith as it is compromised by its inclusion of an illegal bonus for replacement nurses, and by one or more of the unfair labor practices involving their actions regarding the return of nurses to work. 

As the strike continues, the nurses continue their effort to hold Tenet accountable for their actions and have filed a total of eleven unfair labor practices against the corporation for its actions prior to and throughout the strike including making unlawful threats against striking nurses, retaliation and discrimination towards striking nurses, promises of benefits to non-strikers, and bad faith bargaining tactics, all designed to break the strike and to remove MNA as the nurses’ bargaining agent. 

The nurses are clear that any negotiated Return to Work Agreement must also include a negotiated resolution of any and all unfair labor practice charges the nurses have filed.

Steve Striffler, a professor of anthropology and director of the Labor Resource Center at the University of Massachusetts Boston, commenting on Tenet’s refusal to grant nurses a return to their previous positions in a recent news report said, “Its unheard of for two sides to come to an agreement, after a really contentious strike, and for them, the employer, to say, 'No, we aren’t going to guarantee you can come back to the job you’ve been in.'”

In the last two weeks, the nurses have been buoyed by a growing chorus of voices coming from all sectors of the community in recent days, On Oct. 20,  the entire Massachusetts Congressional delegation signed a letter to Tenet’s CEO calling out Tenet for its attack on the nurses and its endangerment of the community, demanding that Sutaria come to Worcester to ensure an equitable end to the crisis that Tenet has created. 

“We are alarmed and dismayed by Tenet’s efforts to prolong this crisis with their demand that nurses be denied a return to the positions they held, many of them for decades, prior to the strike. Tenet’s approach violates long-accepted standards for the conclusion of a work stoppage and jeopardizes the safety of the patients who will be subject to care from more inexperienced replacement staff,” the lawmakers wrote. “Of more concern is Tenet’s decision to purposefully close desperately needed beds and eliminate services as a punitive ploy to force the nurses to end their strike, using patients and our communities as pawns in their anti-union strategy.”

Last week, the AFL-CIO, a federation of more than 57 national and internal labor unions representing more than 12.5 million working men and women also sent a letter to Tenet’s CEO registering the federation’s support for the St. Vincent nurses strike and calling on him to resolve the corporation’s unfair labor practices and negotiate an equitable end to the work stoppage. 

And last month, Mayor Joe Petty and City Councilor and Chair of Public Health Sarai Rivera held a press conference supporting the St. Vincent nurses’ position and calling out Tenet for their efforts to endanger the community, where the Mayor stated, “Tenet Healthcare is demanding that these nurses end this strike with no guarantee that they will retain their previous positions or a commitment that they can return to work without fear of retaliation. These demands are unprecedented and violate the standard practice in any and all strikes and the high labor standards that we expect from all employers in our city. The demand put upon them by the hospital's corporate owners is not only unjust, it is detrimental to the safe restoration of services for our community. I want Tenet to know that we will not allow Worcester to be a testing ground for the imposition of unprecedented labor practices that harm unions and all workers. And when it comes to our nurses, who have given so much to us for so many years, I want Tenet to know that we in Worcester believe that they are irreplaceable.”

How We Got Here  -- Background on 18-month Effort to Convince Tenet to Improve Care

As stated above, the nurses engaged in a long and concerted effort to convince Tenet to address their concerns about unsafe working conditions prior to going on strike.  Repeated appeals to improve conditions were ignored by Jackson and her leadership team, who responded to the crisis by furloughing staff, implementing daily staffing cuts, while the corporation bragged in the press of their plan to utilize billions in taxpayer pandemic funding to “maximize our cash position.”  Over the course of the last two years, the nurses went to great lengths to convince Tenet to address the growing patient safety crisis, including:

• the nurses filed more than 1,000 official real-time reports of unsafe conditions that threatened  the lives of their patients, with Tenet taking little or no action to address nurses’ concerns; 
• the nurses signed and delivered a petition to Jackson in March of 2020 demanding safer patient care conditions;
• the following month, more than 200 nurses attended a meeting with the hospital’s negotiating team providing harrowing testimony of unsafe conditions for patients on nearly every unit;
• in January of 2021 nurses began daily picketing outside the hospital to draw public attention to their cause, and finally;
• on February 10, 2021, the nurses cast an 89 percent vote in favor of the strike.  The same day, Tenet announced profits for the pandemic year of more than $400 million, profits made on the backs of their nurses and the suffering of their patients. 

“What is at stake in this situation is the ability of nurses to advocate for and to care for patients at the most vulnerable time in their lives,” said Marie Ritacco, RN, a member of the nurses negotiating committee and vice president of the MNA.  “CEOs come and go, but at the end of the day, nurses are the ones who answer the call light and make the split-second decisions that could save your life.  Our union provides us with a protected voice which allows us to fight for you, particularly when a for-profit corporation is willing to sacrifice your safety, as Tenet has done, to boost their stock price for their shareholders. 

“We were the nurses in the room with patients gasping their last breaths, holding up an iPad or cell phone to say their final goodbyes to loved ones last year, not anyone wearing a suit from Tenet in Worcester or Dallas,” Ritacco concluded. "We are appalled that they have chosen to deprive patients in this community of the care they need, and they are now threatening us with the loss of our ability to care for you purely out of spite.  It is beyond despicable.”

“As difficult as this has been for all of us, we take enormous comfort from the support we have received and continue to receive from all sectors of our local community and from around the world,” said Dominique Muldoon, RN, another longtime nurse at the hospital and co-chair of the nurses local bargaining unit.  “No matter what lies and misinformation our CEO puts out, the public understands the core message of our strike, as shown on one of our signs, which is ‘if nurses are out here, there is something wrong in there.’  The public understands the key role we play in their care, particularly after what we all went through last year, and they know we are doing this not for personal gain, but to keep them safe.”

Tenet’s propensity for questionable and unlawful behavior is well documented, as the corporation has been subject to fines and other judgements from courts and governmental agencies totaling more than $1.8 billion over the last 20 years alone. A listing of those decisions can be found here.  This includes the award in February of $10.6 million to two cardiologists at Tenet-owned Detroit Medical Center after a federal judge upheld an arbitrators’ decision that the hospital and Tenet acted with malice in firing them as retaliation for reporting violations at the facility.  Four nurses at a Tenet facility in June of 2020 have also filed a $25 million lawsuit against Tenet for alleged wrongful discharge, retaliation against whistleblowers, and intentional and/or reckless infliction of emotional distress, after the nurses reported preventable patient deaths in their emergency department due to understaffing during the height of the COVID crisis.  And in February of 2020, Tenet and one of its California hospitals agreed to pay $1.41 million to settle false claims allegations brought by the federal government for knowingly charging Medicare for implanting unnecessary cardiac monitors into patients.

While the nurses continue to picket outside the hospital, and the patients of Worcester go without needed care following Tenet’s decision to close desperately needed beds and services to prolong the strike, the corporation recently released an announcement of third-quarter profits in excess of $448 million and total revenues of more than $4 billion.  This largesse is in addition to the $197 million Tenet generated in the first two quarters of the year, which means that the Fortune 100 company has reaped profits in excess of $645 million throughout the nurses strike – a strike waged to encourage Tenet to invest a portion of its vast resources to ensure safer patient care.

Without an agreement, the strike will continue as the nurses continue to work with all responsible entities to find a way to move the process forward. 

For more background on the strike and the issues involved, click here to learn more.