Seattle Nurses Report Illegal Lockouts at Swedish Hospitals As Strike Ends

Updated January 31, 2019

Union members say that Swedish Medical Center has illegally locked them out after participating in a 3-day strike against Providence Health. Nurses and healthcare workers throughout the Swedish Medical Center facilities say that they were turned away from their scheduled shifts after reporting back to work. Hundreds of Swedish employees received calls, voicemails, and texts from an outsourced HR company stating that they were temporarily replaced. 

A Swedish spokesperson told KOMO News that they hired workers to replace the strikers for 5-days and that they will be honoring those temporary contracts.

Swedish reported that they have to spend around $10 million on contract staff to work while their permanent staff strikes. 

"It's really hurtful to feel so replaceable," one Union Member told Nurse.org.

Picketers can still be spotted around Seattle with the words "locked out" strewn across their strike signs - many of which reading, "Safe Staffing, Saves Lives." The strikes forced the hospital to close multiple emergency departments throughout the city. 

The King County Executive, Dow Constantine wrote a letter to Swedish Medical Center's CEO, Guy Hudson, with questions about the potential of a lockout,

“I have learned that Swedish has not committed to returning all bargaining unit members to their positions at the end of the strike, January 31, at 7:30 a.m. Instead, workers have been told that they may or may not be called back to work during a ‘replacement period,’ which continues until February 2, 2020. Please immediately confirm that all striking workers will be returned to work at the end of the strike on their shift scheduled prior to the strike,” the letter reads. 

 

Originally Posted on Jan 25, 2019 

Members of SEIU Healthcare 1199NW at Swedish are planning to join over 13,000 total strikers throughout Washington State against the corporate giant, Providence Health and Services at 13 facilities.

Representing three unions, including UFCW 21 and the Washington State Nurses Association - the strike is being called the largest healthcare strike in recent history.

Strikes have been authorized throughout Washington State at multiple Providence facilities including, Sacred Heart Medical Center and Holy Family Hospital in Spokane.

Seven Seattle locations have submitted their intent to strike from January 28-30, 2020 

1. Swedish First Hill,
2. Swedish Cherry Hill,
3. Swedish Ballard,
4. Swedish Edmonds,
5. Swedish Issaquah,
6. Swedish ambulatory care center Mill-Creek,
7. Swedish ambulatory care center Redmond

Providence-Swedish Strike in Seattle 

SEIU Healthcare 1199NW represents nurses, CNAs, radiology techs, pharmacists, pharmacy techs and environmental services. They say that since being acquired by Providence, all seven Swedish Medical Center facilities have experienced dangerous understaffing - putting patient care at risk. 

Union members also say that wages are not aligned with the increasing cost of living in the Seattle market. However, in 2018, Providence Health System, which controls hospital facilities in 7 states - received $24 billion in revenue. In 2017, Providence CEO’s salary was over $10 million.

To date, bargaining has not led to an agreement between the two parties and the employee union has set a three-day window in which to officially strike: January 28-30. 

Nurses Speak Out Against Providence 

Nurse Whittney Powers is on the negotiating team that’s discussing a new contract between a union of about 8,000 Seattle-area hospital employees and the Providence Health & Services-owned Swedish Hospital healthcare system. 

The strike, which has been contentious at times, has many implications, including on patient care and employee futures. 

We caught up with Powers to ask her what led up to the strike, what happens next and how both parties might be affected. 

What is your role with the union?

I am a bargaining team member and part of the union. There are about 120 members of our bargaining team representing about 8,000 members in our union. 

How long have you been with the union?

I have been with the union for almost two years now. But I wasn’t involved at this level until June, which is when I joined the bargaining process. 

Prior to the negotiations, what was your day-to-day as a nurse?

That definitely changed throughout the two years I’ve been here. I’m an emergency department nurse and I have been for seven-and-a-half years. I was a travel nurse before I did this before I was here at Swedish. Prior to that, I started my nursing career in Alabama. So, I’ve seen all sorts of emergency department environments. 

But when I first got here, we were well staffed. We had appropriate ratios. But what I’ve seen since I’ve been here is a steep decline in our staffing levels. It’s gotten to the point that in the E.R., where we typically staff four-to-one, meaning we have typically four patients per one nurse max. But now it’s gotten to the point where nurses are forced into taking five-six patients. I’ve even seen people take seven patients at a time because we don’t have the appropriate staffing levels. 

What I’ve also seen is that in the emergency department, we’re no longer able to flex for need. For example, there was a time when I was at the [proper] ratio and I had four patients. However, I also had a critical patient, who ended up being intubated, which means he had to have a tube to help with breathing. Typically those kinds of patients are one-to-one, especially in the emergency room setting. However, at that time, I still had four patients. 

So, in between taking care of my most critical patient, I was left trying to explain to my other patients why it took me an hour to get them to the restroom, why it took me 45 minutes to get the pain medicine knowing that they had a fracture. That’s the kind of environment I’m working in now. 

Why did the union decide to go on strike?

I do want to emphasize that our union is nurses, CNAs, radiology techs, pharmacists, pharmacy techs and environmental services. We’re really proud that we represent all of the different job classifications and we bargain together. 

• Nurse staffing ratios: The reason we are on strike is that Providence-Swedish has failed to address our staffing concerns, and that’s for nurses and across the board. Social workers, EVS, others.
• Wages: We’re also working to get affordable wages for all of us. At this time, 40% of employees at Swedish are below the salary necessary to afford an average one-bedroom apartment in the Seattle-area. Seattle is now the third most expensive city in the country and yet our wages fall behind less expensive cities like Portland. We’ve actually surpassed L.A. as one of the most expensive cities. As we know, California wages much better and California also has patient ratio standards. What we’ve seen here is that we’re competing in a national market and whenever nurses feel unsafe with their license and also feel like they’re not afforded to live in the area, they leave. That’s one of the retention issues we face now and the same goes for our recruitment.
• Workplace safety: As of right now, none of the Swedish facilities have simple measures like metal detectors. We don’t have dedicated security for emergency departments or our behavioral health units. Those are all things that we want to introduce into our system.

Do nurses feel professionally safe at Swedish hospitals?

Absolutely not. I’ve heard testimonies from nurses that feel that they come to work and they really don’t know if they’re going to make it home to their families because of the lack of security and the lack of security measures. 

We’ve found patients with guns and knives. I even have a nurse who said she was triaging a patient for 10 minutes and a machete fell out of his bag. We serve a population that has a high rate of mental illness and a high rate of drug addiction. So, we definitely don’t feel safe and when we are assaulted by patients, because of the low staffing for security, it often takes them a while to come to help us with combative patients. 

What are the current staffing ratios at Swedish Medical Center and why are they a cause for concern?

Right now, the Swedish/Providence hospitals aren’t abiding by any ratio [specifications]. 

I do believe the units on the floor are a bit better about maintaining ratio [standards]. Typically, they follow California State ratios. However, we have seen on the floors that their ratios are starting to increase. For example, typically a unit is either one-to-one or one-to-two depending on how critical the patient is. But we’ve seen several instances where ICU nurses were taking three patients at a time. 

In the emergency room is, I think, where we see the staffing ratios suffer the most. The reason is that when the hospital is full - and by full, I mean there is no more staffing and/or beds for patients - what happens is that they stay in the emergency department to board. Emergency department nurses are expected to maintain that patient load on top of our average patient load. 

It’s a concern because research has shown that nurse staffing has a direct effect on patient outcomes. A higher patient load has been associated with higher rates of complications, falls, infections and readmission rates.

What are the biggest impediments to a resolution with Providence-Swedish?

In my opinion, Swedish has just failed to make any concrete commitments. They prefer to promise us committee work that we’ve seen in the past hasn’t made improvements in the areas we’re seeking, such as, 

• Safety: Our primary concern has always been staffing and patient safety, as well as employee safety. Providence-Swedish has refused to make any concrete commitment to staffing ratios or on workplace safety. Essentially, they are trying to satisfy us with committee work that we’ve seen in previous contracts. We were also given promises of committees to improve these areas and yet we’ve seen committees either be disbanded or their concerns and suggestions were outright ignored.
• Staffing ratios: Right now, we’re looking for a concrete, meaningful commitment to patient ratios, to having concrete plans on how we’ll reduce workplace violence, how we increase employee safety.
• Environmental services: We’ve also sought commitments on workload limits and increased staffing for our environmental services. We see a pretty high rate of injuries with our EVS workers. They’re expected to push around carts with linens that often weigh about 1,000 pounds, without additional equipment. People feel like corners are having to be cut by EVS in order to maintain the load that they do have. Because, ultimately, EVS, they’re the gatekeepers to the hospital. Without them, our patients don’t have safe, clean, comfortable rooms. Without appropriate resources for EVS, we see higher infection rates.
• Wages: They’ve also failed to offer wages that retain and recruit staff and we’ve seen that this year they attempted to actually take away and slash medical benefits for employees. 

Is there an official strike day set? How has Providence-Swedish responded?

Our official strike dates are January 28-January 30.

However, Providence-Swedish has sent out emails informing us that employees that participate in the strike will not be allowed to come back on Friday and Saturday [January 31st and February 1st]. Essentially, they said they’re not letting us come back on Friday and Saturday if we participate in the strike. However, they have said it is not a “lockout.” So, this leaves our membership confused as to why we’re not allowed to come back on Friday and Saturday. 

Which hospitals are participating?

The Providence-Swedish strike is going to include seven campuses: 

• Swedish First Hill
• Swedish Cherry Hill
• Swedish Ballard 
• Swedish Edmonds
• Swedish Redmond 
• Swedish Mill Creek 
• Swedish Issaquah

Was the vote to strike unanimous?

It wasn’t 100% but it was a Super Majority. We were pretty close!

How might patients be affected?

Providence is hiring agency workers to cover staffing needs during the strike. And then, from what I hear, other hospitals are up-staffing during that time to be able to handle an influx of patients that may be diverted from Swedish. We’re confident that our patients will still be taken care of but we do look forward to coming back to work to be able to take care of them and ourselves. 

Ultimately, we’re doing this to make sure that the care at Swedish does continue to be extraordinary - which is how they market it. 

I’m thinking extemporaneously here, but it must be expensive for Swedish to fly in that staff? 

That one I can’t make a true comment on. Federally, we have to give a 10-day notice for a strike, as per the Healthcare Bill. So that hospitals are able to contract workers to make sure the patients are safe. So, ultimately, I can’t speak to what Providence is doing and how they’re doing it. I do know that it is going to be very expensive for them. 

I certainly hope that if Providence feels like they can’t find the staff to take care of patients and that they’re willing to come back to the bargaining table with us. We are, at any time, open to going back to bargaining with Providence. However, they have explicitly stated that after the 10-days, they will not meet with us to bargain. So, ultimately, it’s in their hands at this time. 

It is a company that made $700 million in profit in 2017. So, I feel like they can afford this staffing and a fair contract. But I certainly can’t speak for them.

How will nurses and other employees be affected?

We’ll be picketing outside of the hospitals during this three-day strike. This is definitely not extra time off for us. This is not a vacation. We’ll still be out there showing the community that we’re here for them. That we’re invested in their care. Whether we’re being paid for it or not, we’re going to be there for them. So, we’ll be out there picketing. 

Of course, we know that in order to financially survive, some nurses will have to work their second job during strike days. But many people have a set plan and a set time to come out and picket with us because we are all truly invested in this. 

Providence recently bought Swedish Medical Center. Have things changed as a result? 

Most definitely. I’ve been here for two years, I never got to experience Swedish as Swedish (before Providence.) I’ve heard stories from the people I work with and the relationships I’ve made, especially through the bargaining team about the times before Providence.

• Environmental services workload: Many of the stories are related to the staffing of environmental services (EVS.) One worker was saying that three workers used to split the load of 28 rooms and common areas to clean. Nowadays all that work is left up to one environmental service worker.
• Lower pay: I’ve talked to a Charge Nurse who said that her Charge Nurse pay is actually less now that they’re under Providence than it was with Swedish.
• Safety: What actually brought me to Swedish was that I heard about its reputation of safety and investing in their staff and what I’ve seen is that underneath Providence, conditions have declined.
• Layoffs and Outsourcing: They came in and closed employee health clinics. They disbanded committees or ignored committees. They had layoffs in 2019, as well. We’ve seen outsourcing of departments since Providence has come in, as well. Particularly, our H.R. has been outsourced to the Philippines.

We’ve seen Providence come in and try to cut costs yet still try to make money off of the Swedish brand and the Swedish reputation. 

What can other hospitals around the country learn from this moment? 

I think what hospitals across the country can learn from this moment is that the actual employees, the frontline caregivers, are the experts in what makes hospitals functional.

That it’s no longer appropriate for us to take the backseat when it comes to making decisions about how to best care for our patients. 

That sometimes it does take drastic measures to stand up for our patients but that is something that we can do and that our labor is valuable and our expertise is valuable and we should make sure that our administrators and our executives' value and respect that. 

What would you say to a hospital employee considering crossing the picket line?

What I specifically try to do is ask people who are thinking about crossing the picket line to envision Swedish four years from now if we do accept their current offers. 

I want people to consider whether they’ll still feel safe working there four years from now if Providence gets their way. And, frankly, if they’ll even be able to afford to live in the area at that time. 

So, I just try to encourage people to be forward-thinking and also to keep our patients in mind. Keep our everyday struggles in mind. 

What’s next?

This week we have been doing issue-specific marches. We’re making sure that our membership feels invested and involved in this movement. We’re only building momentum as we go on. 

The next step is going through the strike and staying strong. I wish I had a crystal ball to see how it turns out but I just know that my people are committed to this movement. 

We’ll continue to stand up to Providence. 

Stay up-to-date and donate to the solidarity fund here.