‘We will shame them:’ Providence, nurses vie for public's strike support

This article has been expanded to incorporate additional reporting.

The planned three-day strike by nurses at six Providence hospitals has “the goal of creating the most cost for Providence,” according to a recent text sent to members by Oregon Nurses Association staff representing them in the negotiations. If the multistate health system delays in letting the nurses go back to work afterward, the text continued, “we will shame them in the press.”

The June 7 message to nurses, as well as Providence’s decision Tuesday to make it public, shows how both the union and the system’s leadership are trying to position themselves publicly as the champion of patients as about 3,000 nurses prepare for the largest such strike in Oregon history.

The two sides’ dueling messages reflect a pattern that has become familiar to Oregonians as unions representing health care workers have increasingly sought better wages and working conditions while citing workplace practices that prioritize finances at the expense of care. The runup to the looming strike, however, features new variations on that pattern as well as implications for the future — including with the details of the planned strike and a possible lockout.

In June 7, following a drumbeat of press releases and updates sent to members, the nurses’ union announced the plan for a three-day strike starting June 18 at Providence St. Vincent north of Beaverton, Providence Willamette Falls in Oregon City, and the system’s hospitals in Hood River, Medford, Milwaukie and Newberg. The release portrayed Providence as intransigent and cited the union's focus on better staffing, “quality healthcare” and “market-competitive wages to retain talented nurses and recruit more to fill the many open shifts.”

Providence responded with a statement defending the system attributed to its top nursing executive in Oregon, Jennifer Burrows: “I look forward to the conclusion of this walkout so Providence’s bargaining teams can get back to work negotiating agreements that will benefit our caregivers and their families, and ultimately, our patients and the community.”

Public opinion a focus

The runup to the strike makes sense. Both sides in contract negotiations view it as important to “frame the issues” and win public support to pressure the other side for a better deal, according to Kate Bronfenbrenner, director of labor education research at Cornell University's School of Industrial and Labor Relations.

For rank and file nurses, the issue is less about public opinion and bargaining than it is a genuine desire to be paid what they are worth and to care for patients, she added.

Strikes are generally the last resort in a process around contract talks that often amounts to a game of chicken, observers and experts say.

Limited-duration strikes, meanwhile, are an effort to give the employer a taste of what a real strike would mean.

When it comes to strikes at hospitals, the public has only limited tolerance, which is why the issue of perception comes into play, Bronfenbrenner said.

“The issue is who is causing this strike, and is it management intransigence or is it workers’ unreasonable demands? And if the public feels that the workers demands are reasonable then they're going to be blaming the company, not the union.” 

Walkout tees up potential lockout

Last year, when the Oregon Nurses Association conducted a strike at Providence Portland Medical Center, Providence Seaside and workers at Providence Home Health and Hospice, it was limited to five days.

At the end of it, workers were not allowed back to work until 12 hours later, which Providence attributed to its need to sign five-day-minimum contracts in order to hire temps to replace the striking workers.

In this year's strike, the union decided to walk out for only three days. According to the June 7 text shared by a Providence spokesperson, the union planned the strike duration as a part of a plan to create the maximum financial cost to Providence as it relied on the expensive temps, while also inflicting public relations damage as well.

The text said, “Our RN bargaining team declared a 3 day strike starting 6/18 @ 6 am with the goal of creating the most cost for Providence – we know that scab contracts last 5 days. RNs will return to work 6/21 at 6am, if Prov chooses to lock us out for 2 days in order to save money, we will shame them in the press.”

On June 10, before Providence publicized the text, nurses union spokesperson Myrna Jensen said the decision to cut the walkout duration to three days was based in part on the desire to limit the impacts to members and patients.

The union’s members won’t draw wages during the strike, she said though some may qualify for the union’s hardship fund set up for the purpose.

But if the health system has a five-day contract for its temps, why would limiting the strike to three days mean less impact for its workers?

Jensen responded that the decision on when to bring back workers is up to Providence, adding that the nurses chose the three-day duration.

“They want Providence to feel it and Providence is going to feel it — especially if Providence is hiring (temporary) nurses for five days and they choose to lock their existing nurses out for those last two days. Financially it’s going to be a burden for them, but they could avoid the burden … they could make some significant movements (on the contract) and I bet it would be cheaper for them in the long run.”

Asked about the text, Jensen said the main goal of hoping to return after three days is that nurses “want to provide their patients with quality care,” adding that “They don’t want to go on strike, but they've been pushed to their limit.”

Asked why Providence wouldn't bring back workers when the strike ends, and whether doing so would provide better care, a Providence spokesperson did not respond.

Wages and patient care in the balance

Together, the hospitals where nurses plan to strike operate more than 850 patient beds.

The association’s press release about the strike focused more on staffing than pay. It quoted Caroline Allison, a nurse at Providence Medford, accusing Providence of “systematically” undermining the state’s new minimum staffing law. The law went into effect five days before the union went public with its allegations a week ago.

Her statement added that “if a $28 billion dollar healthcare corporation isn’t going to fight for the community, our patients, and our nurses, then we will.”  

In response to her portrayal, a Providence spokesperson accused the union of “irresponsibly” misinterpreting the new staffing law in a way that hurts access to care.

The hospital system issued its own statement that focused on pay, quoting an executive saying its contract offer amounted to “approximately 10% increases in the first year of the contracts. Keep in mind that a typical nurse working a full-time schedule in our hospitals makes more than $100,000 per year.”

In 2023, federal data indicated Oregon’s nurses’ average pay ranks 19th in the country when adjusted for cost of living. A survey of 1,800 nurses late last year by the Oregon Center for Nursing pegged the average pay for nurses in Oregon at $114,694 annually, with those in hospitals averaging about $7,000 more than that. The survey did not differentiate between hospital nurse managers and staff nurses’ pay.

Last year, Providence managers defended the level of care at their facilities during the strike. But they also acknowledged it had an impact, with one calling it “challenging” as well as “very disruptive and emotional and expensive.” Some studies have concluded strikes substantially disrupt care, while others contend the short-term impact could lead to long-term improvement.

Jensen, the union spokesperson, said that when nurses returned from last year’s lockout, their coworkers reported “a sense of relief,”  adding “I think that says something.” In addition to addressing pay, the union is trying to amend the contract to incorporate aspects of the new state staffing law, she added.

Providence's website says it operates 51 hospitals and 1,000 clinics spread among Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Overall, the chain reported losting $1.2 billion last year but a profit in the first quarter of this year. 

It is currently under investigation in Oregon after state health officials estimated the system may have improperly billed more than 100,000 low-income Oregonians.

‘Smoke and mirrors’

Both sides are portraying themselves as strong and focused on patients. As it did last year, Providence is refusing to negotiate after the strike notice was issued, saying it needs to focus on preparing to keep patients safe after the staff nurses leave, while blaming the strike on the union.

The union, meanwhile, says it’s willing to negotiate anytime, blaming Providence for the strike.

Such tactics are not unusual, according to Bronfenbrenner, the Cornell University researcher.

A big part of the runup to labor actions is “smoke and mirrors” on both sides, she said, adding that “a very important part of bargaining is not just power, but perceived power — and the ability to convince the other side that you have more power than you have,” she said. “The employer will do that by making threats. The union does that by showing they have public support and membership support.”

In Oregon, the union has worked to shore up participation in the strike with encouraging messages about the union’s growing clout with Providence.

It also has distributed flyers to members defending the ethics of going on strike while caring for patients.

“Management and others supportive of the employer will attempt to spin this and say, ‘you are abandoning the patients and your community!’” the flyer reads. “This is the same language they use when they impose mandatory overtime or unsafe patient assignments on exhausted, overburdened staff.  … Oregon residents know the truth: nurses aren’t avoiding hard work. Nurses are advocating for their patients, their community, and themselves.”

Public opinion shifting

The latest surveys show that unions are growing in popularity even as corporations decline, according to Bronfenbrenner. She said that the public is also increasingly skeptical of nonprofits in health care, like Providence.

The propriety of health care strikes used to be a matter of significant debate.

“I think that the bar is definitely higher for health care workers than other workers because when they go on strike there is the question of whether the patients are at risk,” she said, but added that public opinion is starting to shift. 

She thinks the growing trend of incomes remaining flat for most people, while the rich get richer, plays a role.

“The public sentiment towards labor is very positive, including in health care strikes recently. So there’s really been a change,” she said.

Multi-hospital strike shows worker power

Jensen, the union spokesperson, said the decision for all six hospitals' nurses to strike together was an effort to maximize the impact of collective action to improve workplace conditions.

And that could happen more often, as health care workers' collective power in Oregon is growing. The nurses association has been expanding its reach rapidly, including going beyond nurses to include physicians and other hospital staff. 

Four new nurses association workplace bargaining units are currently negotiating their first contracts, including doctors, certified nurse midwives and nurse practitioners in Providence women’s clinics; nurses in the women’s clinics; and nurses, medical assistants and patient support specialists in immediate care clinics.

Meanwhile, the Pacific Northwest Hospital Medicine Association, which is affiliated with and staffed by the nurses association, has four other new bargaining units that are negotiating contracts, including emergency department providers in Medford; immediate care clinic providers; Providence St. Vincent hospitalists & nurse practitioners; and Providence cardiac advanced practice providers.