It was 90 degrees in Worcester, and instead of being inside an air-conditioned hospital, nurses stood outside holding signs that read, “If nurses are out here, something is wrong in there.”
For more than five months, 700 nurses at St. Vincent’s Hospital have been on strike. For two years the nurses have tried to convince the hospital’s parent company, Tenet Healthcare, to increase staffing at SVH to improve patient care and safety. It is currently the longest nurses strike in Massachusetts history.
Each day the picket lines are manned from 6 a.m. until midnight regardless of rain, sleet, snow, or heat waves. “It’s been the fight of our lives,” said Dominique Muldoon, a registered nurse and co-chair for the St. Vincent local bargaining unit. “It’s our career, our lives, our patients.”
Muldoon, 62, of Winchendon, has been a nurse for 19 years in the medical-surgical unit at SVH. She described the reward she feels seeing a patient’s recovery, “By the time they’re ready to go home or go to rehab you see a marked difference.” She feels stimulated by her work and loves the opportunity to meet people “from all walks of life, all different backgrounds.”
Issues with staffing began before the Covid-19 pandemic. “Covid was an anomaly. We’re not talking about Covid,” said Muldoon. She said a survey was sent out to the nurses and an overwhelming majority expressed safe staffing as their top concern.
A safe staffing ratio is one nurse to four patients, said Muldoon. One study from the Journal of the American Medical Association, says that for each patient a registered nurse has over four, the likelihood of patient death within 30 days increases by seven percent. With five patients, a nurse starts to become stretched thin. “It was like juggling balls up in the air, and every once in a while dropping one,” said Muldoon, “In their eyes it was productivity, but in our eyes we were putting out fires.”
Muldoon described a day she oversaw a patient who was confused and prone to falling out of bed. She had requested one-on-one observation by a nurse’s aide for the patient because of his condition, but was not provided support. She placed mats around his hospital bed as a precaution, but had to go check on her other patients periodically. At one point, she came back to his hospital room, and he had fallen out of bed. “To see that is horrifying,” she said, “you don’t know if that person is going to hit their head or break a bone.” Fortunately her patient was okay, but she said that type of event should be preventable.
In 2018, the ballot question to mandate staff-to-patient ratios in Massachusetts failed. “It was good legislation,” Muldoon said. “Hospitals really used a lot of fear tactics on people, saying that it would cost too much, but most of the literature says with better nursing care, people get better and go home earlier.” Currently, California is the only state to have mandated nurse to patient ratios that vary based on the hospital unit.
Muldoon was involved in campaigning for “Yes on 2” and would travel to speak at various town halls and events where both sides of the ballot question were discussed. “One of the things that the hospital administration would say is that there is a bit of a problem with safe staffing, but we feel that it’s not something that should be regulated,” said Muldoon. In response, the administration reiterated that they needed to work out this issue with the nurses without government involvement.
“The nurses and Tenet began negotiations for a new union contract in November of 2019. To date, 33 sessions have been held between the parties, with the last several involving a federal mediator,” said the Massachusetts Association of Nurses.
In May of 2020 there was a no-confidence vote after management implemented furloughs and staffing cuts, said the MNA, and in February of 2021 the nurses voted to strike.
A 6 a.m. on March 8, 2020 the nurses walked out of the hospital and were greeted by their fellow nurses on the lawn. Jessica Deyo, a medical surgical nurse at SVH for 15 years, recalled that morning, “It was totally packed,” she said as she waited for her friend on the lawn. She found her, pulled her into a hug and told her, “you did it” as her friend wept.
Deyo is a single mom of two young girls, ages 7 and 9. During the strike she faced financial hardship being out of work and experienced issues claiming unemployment. Finally, she received her first unemployment check 15 weeks after her initial claim. To provide for her family she had to visit local food banks, one of which she used to donate to as a child in Charlton.
Marcus Williams, Deyo’s boyfriend, filled water balloons for the children accompanying their parents to the picket line on Friday. He admits that he has enjoyed the extra quality time he has been able to spend with Deyo while she has been on strike. “But it’s stressful for her, she loves what she does and it’s her purpose,” he said, “She doesn’t want to go anywhere else.”
One day before the Covid-19 government shutdown, the nurses, committee members and hospital administration gathered to negotiate. “It was March 11, 2020 I’ll never forget it,” said Muldoon. Over 200 nurses rotated in to tell their stories of unsafe practices seen in the hospital. She recalled, only 25 nurses were allowed in the room at a time to be able to social distance. According to the MNA, “They described numerous patient falls, the onset of serious preventable complications, suicidal patients being left without one-on-one monitoring, and even preventable deaths directly attributable to inadequate staffing levels and unsafe nurse patient assignments.”
“We have to fight for what’s right,” said Deyo, “this is a community of love, and it needs to be better.”
Throughout the duration of the strike, the nurses have felt an outpouring of support from the community. Deyo said senators, congressmen, the teacher’s union, food banks, firefighters, teamsters and so many more have been supportive of the nurses’ cause.
“Nurses work hard to take care of us when it matters most, and I stand with them in this fight. It is time for Tenet to return to the bargaining table and conclude negotiations so St. Vincent nurses can go back to doing what they do best – caring for our community,” said Sen. Elizabeth Warren.
On Friday, Boston firefighters who volunteer with the non-profit Boston Sparks, were at the SVH strike headquarters serving the nurses and their supporters with a barbecue lunch. John Soares, union president of the Boston local 718 firefighters, said they were there “supporting labor and standing on the side of collective bargaining.” He was recently in the hospital for a lung condition, and says he has always had respect for the nursing profession.
Other unions have shown solidarity, including the Association of Flight Attendants, who rallied in front of Tenet headquarters in Dallas in July. “This fight is about our healthcare and care of our loved ones. We cannot allow Wall Street to take this away from us” said Sara Nelson, president of the AFA in a press release.
Muldoon’s days look a lot different now. She picks up three hour picketing shifts when she can, and has to be on-call in case the time comes to negotiate. The nurses have tried to keep up morale through events on the picket lines, said Muldoon, “We’re nurses, we kind of made lemonade out of lemons”. They celebrated Easter, held a Christmas in July event, and have themed days like “crazy leggings day.” However, this has not come without criticism.
Last week, five top doctors at SVH wrote a letter to Governor Baker urging intervention to bring the nurses back and criticizing their cause: “That is 157 days of the MNA not being there for our patients in our community, 157 days of the MNA striking during a pandemic, 157 days of the MNA throwing parties and events outside a hospital caring for sick patients, and 157 days of the MNA falsely claiming a need for ‘safe staffing’ at a hospital where multiple independent third parties have proven that its staffing is better than most hospitals in our state.”
“There has been criticism, but I’m explaining it from our philosophy,” said Muldoon. “We have to keep our spirits up,” noting that in the nursing profession, “we see so many problems, and death and bad things in a skewed proportion of the population.”
She described how in other professions, “you’re not going into a tractor trailer that has been turned into a morgue with shelves. You see that stuff and it affects you.”
Recently, Tenet has announced the hiring of 100 new nurses, and plans to hire more after failed negotiations. Though Deyo says that no one has been hired to her unit, she has an optimistic attitude about the new hires, “Maybe they’re hiring them because they know we need them.”
The job listings include bonuses and incentives to cross the picket line. Muldoon doesn’t believe they have actually hired what they hired, but that Tenet is using “scare tactics.”
She said, “Instead of coming to the table and really addressing our issues they have fought us tooth and nail, and spent 100 million dollars on keeping our strike going and replacing us.”
While the end may or may not be in sight, the message from the nurses at SVH is very clear; they are on strike for the safety of their patients and community. Muldoon said, “We want to build it back to what it was. A community hospital that cared for its patients and each other.”