Oregon’s largest hospital strike ever is scheduled to launch Friday at 6 a.m. — despite rhetoric from both sides claiming continued willingness to bargain.
More than 4,000 providers, most of them nurses, are expected to walk out across eight Oregon hospitals and several clinics.
Previous limited-duration strikes against Providence were intended to give the hospital system an incentive to come back to the table and compromise. But this one is billed as open-ended, and both sides say they are resolute.
Whether that holds true remains to be seen. In any strike, the runup is marked by positioning, with both sides claiming to have the best interest of workers and the public in mind. Experts say that, in part, that’s because public opinion can provide an edge at the bargaining table.
How the strike will impact patients across the state is also unclear. Providence says it is bringing 2,000 temps, who will be working more shifts and more days per week than many of the nurses going on strike had been working. It’s also shifting specialists to fill in for about 70 physicians going on strike at St. Vincent’s Medical Center.
However, to help ease the load, as the strike neared Providence has sought to lower its patient count by discouraging new admissions and transferring patients elsewhere, and that means more pressure on other hospitals in Oregon as well as other parts of the health care system.
On January 7, hospitals in the region including Portland reported 88% of their staffed, adult, non-intensive care beds were occupied, according to a dashboard maintained by the Oregon Health Authority. But some health system employees said that figure seems lower than the reality, and state officials could not provide historical background on how the figure has changed in recent weeks.
Area hospitals including Oregon Health & Science University have been planning how to handle transfers during the strike, according to Sara Hottman, a university spokesperson. OHSU is home to the Oregon Medical Coordination Center and is also tabbed by the state to help coordinate during surges in hospital bed demand.
This, however, may not be a silver bullet.
Oregon health leaders in decades past took pride in Oregon’s low number of hospital beds, which accompanied low coverall costs compared to other states. Local experts credited a focus on cost-effective primary care and a provider culture that resisted the incentives in the health care system that lead patients to receive care that's more expensive than they need.
Now, however, the situation shows Oregon needs more beds, hospital representatives say. Elements of the health care industry have long chafed at the state's system for curbing health care costs, which requires proposed new faciliites such as hospitals show evidence of need to be approved.
“Oregon has the second lowest number of hospital beds per capita in the country, so it is a significant concern any time that hospital capacity is constrained, no matter the reason,” said Lisa Goodman, a vice-president of communications for the Hospital Association of Oregon, said in a statement. “We saw during the pandemic the devastating consequences when hospital capacity could not meet community needs. So we know this strike will impact community health and patient access to care, especially in the Portland metro area.”
Many other sectors have placed the pandemic in the rear view, but providers say some Oregon hospitals are overflowing with patients, with some treated in hallways and converted supply closets. Providers say some health systems shunt sick patients to clinics ill-suited to provide the care that makes the most sense.
During the pandemic, hospital executives, providers and state officials said some patients died because of hospital overcrowding and lack of capacity. The deaths stemmed from the inability to shift patients from smaller or rural hospitals to larger facilities equipped for complex or specialized care, they said.
I was extremely fortunate to have my surgery scheduled for January 7, discharged January 8. I would not want to be a patient being cared for by overworked scabs.
The nurses who took care of me seemed resigned to the need to strike. I wish them a short strike and success in future negotiations.