Ascension to Lock Nurses Out for Days After One-Day Strike
The hospital strikes back, but at what cost to patients?
Last Thursday, 900 unionized nurses at Ascension Seton announced a one-day strike for June 27, intentionally allowing enough time for Ascension to hire temp nurses to fill in. Ascension management responded by informing nurses that they would be locked out for an additional three days after the strike. National Nurses Organizing Committee/National Nurses United (NNOC/NNU), Seton's union, says this is a "deliberate ploy to intimidate nurses from speaking out and demanding action on the conditions they decided to strike over." Nurses fear it will create a potentially dangerous situation for patients at the hospital next week.
Since they unionized last fall, nurses have been organizing around a critical staffing shortage resulting in more patients for each nurse, which worsens the quality of care they can provide. Studies show that patients experience increased falls, complications from bed sores, and increased risk of death due to understaffing. Nurses at Seton say chemotherapy patients don't have a dedicated chemotherapy nurse, so nurses must leave their patients to administer treatment. There's been an increase in falls as patients try to get to the bathroom by themselves when nurses can't come fast enough. Six patients to a nurse "doesn't sound like a lot until you realize you have to see six patients in an hour," explains Monica Gonzalez, a neurology nurse who's been with Seton for nearly 20 years. (For comparison, California legally requires no more than two critical care patients to a single nurse, or five general patients to a nurse.) Lindsay Spinney, who works in the neonatal intensive care unit, says, "It's not uncommon for me to take care of three or four babies at a time. Everybody that's taken care of a baby knows how challenging one can be."
Now, they worry that Ascension's three-day lockout will only exacerbate those issues. Temporary contract nurses are paid much more than staff nurses to come on short notice, but don't know the hospital, where supplies are, or specific hospital policies and practices. Ascension "did not have to make this choice," stresses Taylor Critendon, an ICU nurse. "They are just looking for bodies. They are assuming that a nurse is a nurse. That's absolutely incorrect and very, very dangerous."
Especially for highly specialized units like the NICU, Spinney says, "everything matters. Because these tiny people can't tolerate mistakes. It's a safety issue. The community should be concerned that the hospital is willing to do that, rather than help us get to a good solution that's safe for everyone." Aside from the safety risk, nurses see the lockout as a union-busting tactic and have filed an Unfair Labor Practice complaint with the National Labor Relations Board (though the NLRB is currently facing an extreme backlog of these requests).
In a statement addressing the lockout decision, Ascension contends that it is "contractually required to commit to a minimum of four days of work" for temp nurses. (If Ascension is implying that they had no choice in the matter, that is questionable. Though they did not respond to specific Chronicle questions, presumably Ascension would have had a hand in writing any temp contract, or in picking an agency whose existing contract they preferred.) Ascension also calls the strike "disconcerting and disappointing, given that there have only been eight bargaining sessions" and an initial bargaining agreement "can take well over a year to complete." Nurses say management has been unwilling to budge on the main priority of comprehensive staffing, though they've conceded a couple of "small wins," including bonuses for certain units. "Every time I read that [Ascension statement], I get super angry," says Gonzalez. "They've had every opportunity to work on a contract that's mutually beneficial, and they haven't."
Seton on 38th is not the only hospital in the Ascension network experiencing these issues – nurses with NNU at two Ascension hospitals in Wichita, Kansas, reported similar staffing shortages and also authorized a strike for June 27. Nurses told the Chronicle that when Austin and Wichita nurses arrived at Ascension headquarters in St. Louis to deliver their strike notices, Ascension called security to block them from entering. In Austin, "Wes Tidwell, the CEO of our hospital, has continued to avoid us and actually hide from us when we've tried to deliver information to him or communicate with him," says Spinney.
The strike itself is unprecedented – it will be the largest nurses strike in Texas history and the first in an acute care setting, says NNU. Ascension also received national scrutiny after a New York Times investigation in December 2022 detailed the Catholic nonprofit's deep pockets and refusal to fund adequate staffing. They found that in 2021 Ascension had $18 billion in cash reserves and the CEO's salary was $13 million. Further, Mick Crowley, director of associate relations at Ascension, was formerly the executive vice president of a firm that explicitly specializes in "union avoidance," with the tagline: "Our services. Your union-free future."
NNU contends Ascension is contributing to a national trend of nurses choosing not to work in acute care settings due to stress. Hospitals have claimed there is simply a shortage of nurses, though NNU says that according to 2023 data from the U.S. Bureau of Labor Statistics and the National Council of State Boards of Nursing, there are more than 1 million RNs who choose not to work in acute care settings, citing low staffing levels and inadequate stock of medical supplies, among other things.
"I have thought about leaving," says Spinney, "because the conditions are not fair to the patients, and leaving work feeling terrible about the job you've done, because of the circumstances you're put in, is very demoralizing. It's been a lot of struggle for me internally." She says organizing is what convinced her to stay: "Solidarity is a real thing and it's very powerful. This is the first time where I felt like we would actually have a voice and actually be able to make change." Critendon agrees: "I will never work for a non-union hospital ever again."
Gonzalez says rather than discouraging nurses, the lockout has actually galvanized them. "They're trying to keep us from exercising our federally protected right of collective action. What I've seen it do is really, for lack of a better word, piss a lot of people off."