- With no plans for another meeting between unionized nurses at Riverside Community Hospital in California and Nashville-based HCA Healthcare, both sides are gearing up for a strike Friday. It's expected to last through July 6 — a day before contract negotiations between HCA and the union are set to begin.
- Citing staffing and safety concerns, the union issued a 10-day strike notice on June 15 to the country's largest for-profit hospital chain. Recent job listings from HCA show it's been looking to hire backup nurses ahead of a potential work stoppage, along with new labor relations directors in Denver and Nashville, among other locations.
- Riverside Community Hospital argued that the motivation behind the union's strike notice "has very little to do with the best interest of their members and everything to do with contract negotiations." The system said it has plans to ensure appropriate staffing and continued services for any type of event, including a strike, but did not respond to repeated requests to elaborate.
It's unusual for a labor union to strike just days before its next shot at negotiating a better contract for workers. But that's what happening at Riverside Community Hospital, where the COVID-19 pandemic is exacerbating long-simmering staffing issues.
The staffing issues at RCH predate the pandemic, though in California COVID-19 cases are surging following lifted stay-at-home orders.
Insufficient personal protective equipment, inadequate safety measures and recycling of single-use PPE is another issue the nurses have brought attention to. A survey of the union's members found only 27% at HCA hospitals reported having access to N95 respirators in their unit, significantly lower than other hospitals surveyed.
Early last year at RCH, reportedly low staffing levels led unionized nurses to vote in favor of authorizing a strike. HCA responded by entering into a mediated settlement with those nurses, resulting in a yearlong improved staffing agreement that helped avert a work stoppage.
That agreement ended May 31, following several extensions and a refusal from HCA to continue the mediation process, a spokesperson from SEIU Local 121RN, the union representing the nurses, told Healthcare Dive.
But the union's authority to go on strike still stands. It's unclear exactly how many nurses out of RCH's nearly 1,200 plan to strike. One nurse estimated 800 and another said a majority. The vote to strike had 98% approval, the union said.
They are protesting the end of the staffing agreement and new conditions they say leave too few nurses caring for too many patients.
California's staffing law, Title 22, is the first in the country to enforce nurse-patient ratios. Unionized nurses in other states have pushed for the same mandates in recent years.
Kathy Montanino, an RCH nurse and union representative, told Healthcare Dive the hospital went without any known nurse-patient ratio infractions for the duration of the yearlong staffing agreement. Fewer than 14 days after the agreement expired, three units at RCH reported having inadequate nurse-patient ratios, Montanino said.
And this time around it doesn't look like a strike will be so easily averted. Four days after issuing the 10-day notice, the union sent HCA a final proposal to resolve the staffing issues "collaboratively, prior to resorting to regulatory, legal, and other permissible actions," according to the proposal letter. A union spokesperson said HCA responded but did not agree to honor those proposals.
Some of the terms proposed include ensuring HCA's compliance with statewide public health regulations, such as denying transfers into the hospital once staffed beds are at capacity.
The union also wants all units to be staffed with a designated charge nurse at all times, and for those nurses to not be included in nurse-patient ratios when engaged in activities other than direct patient care.