Kaiser’s 22.5% raises avert nurse strike

Members of the California Nurses Association have reached a tentative agreement with Kaiser Permanente, averting a planned two-day strike by more than 21,000 registered nurses and nurse practitioners in Northern California.

Both sides announced the tentative agreement Nov. 17.

Union members at Kaiser Northern California facilities have been in negotiations since June, according to a CNA news release. Registered nurses and nurse practitioners in Northern California were set to strike Nov. 21 and Nov. 22.

The four-year tentative deal boosts wages for Northern California nurses by 22.5 percent over the life of the contract, according to a statement Oakland, Calif.-based Kaiser shared with Becker’s. Kaiser had previously proposed 21.25 percent in wage increases over four years.

“The tentative agreement is driven by the changing economy, including inflation, significant changes in the marketplace and our commitment to providing our employees with excellent pay and benefits to attract and retain the best nurses,” Kaiser’s statement says.

According to both sides, the tentative agreement also includes:       

  • An agreement to add more than 2,000 new registered nurse and nurse practitioner positions.   
  • Increased tuition reimbursement for nurses’ education.       
  • The creation of a new regional equity, diversity and inclusion committee.       
  • Language including agreement that healthcare is a human right.

We are very pleased with this new contract, which will help us recruit new nurses and retain experienced RNs and nurse practitioners,” CNA President Cathy Kennedy, RN, said in a news release. “We not only won the biggest annual raises in 20 years, but we have also added more than 2,000 positions across our Northern California facilities. This will ensure safe staffing and better patient care.”

Ms. Kennedy also praised Kaiser’s commitment “to a workplace that is free from racism and discrimination” and the health system’s agreement “that we must fight racial and ethnic disparities in healthcare outcomes.”

“The tentative agreement honors our Northern California nurses with a market-based economic package that accounts for inflation, accelerates our investments in staffing, and addresses workplace safety, diversity and equity, remote work, and other key matters in a way that is sustainable and benefits our members and patients as well,” Kaiser’s statement reads.

Union members in Northern California will vote on approving the new four-year contract over the next few weeks. Registered nurses at Kaiser Permanente Los Angeles Medical Center also reached a tentative agreement and will vote on the deal Nov. 22.

Largest private-sector nurses strike in U.S. history begins in Minnesota

https://www.washingtonpost.com/business/2022/09/12/minnesota-nurses-strike/

An ICU nurse helps to prepare medicine for a covid patient in St. Cloud, Minn. Nurses in the state are planning to go on a three-day strike starting Sept. 12. 

About 15,000 nurses in Minnesota walked off the job Monday to protest understaffing and overwork — marking the largest strike of private-sector nurses in U.S. history.

Slated to last three days, the strike spotlights nationwide nursing shortages exacerbated by the coronavirus pandemic that often result in patients not receiving adequate care. Tensions remain high between nurses and health-care administrators across the country, and there are signs that work stoppages could spread to other states.

Minnesota nurses charge that some units go without a lead nurse on duty and that nurses fresh out of school are delegated assignments typically held by more experienced nurses, across some 16 hospitals where strikes are expected.

The nurses are demanding a role in staffing plans, changes to shift scheduling practices and higher wages.

“I can’t give my patients the care they deserve,” said Chris Rubesch, the vice president of the Minnesota Nurses Association and a nurse at Essentia Health in Duluth. “Call lights go unanswered. Patients should only be waiting for a few seconds or minutes if they’ve soiled themselves or their oxygen came unplugged or they need to go to the bathroom, but that can take 10 minutes or more. Those are things that can’t wait.”

Paul Omodt, a spokesman for the Twin Cities Hospital Group, which represents four hospital systems where nurses are striking in the Minneapolis-St. Paul area, said that the nurses union did not do everything it could to avoid a strike.

“Nurses have steadfastly refused to go to mediation,” Omodt said. “Their choice is to strike. This strike is on the nurses.”

Conny Bergerson, a spokeswoman for Allina Health, another hospital system in the Twin Cities where nurses are on strike, said “rushing to a strike before exhausting all options such as engaging a neutral federal mediator does not benefit our employees, patients or the communities we serve.”

The Minnesota Nurses Association, the nurses union, said hospital administrators have continued to “refuse solutions” on understaffing and safety in contract negotiations. It said nurses have increasingly been asked to take on more patients for bedside care to make up for labor shortages, exacerbating burnout and high turnover.

Some hospitals have offered increased safety protocols for reporting security incidents in negotiations, but have not budged on other safety- and staffing-related demands.

The union has proposed new mechanisms for nurses to have a stronger say in how wards are staffed, including a committee made up of nurses and management at each hospital that would determine appropriate staffing levels. It has also proposed protections against retaliation for nurses who report understaffing. Striking nurses at some hospitals said their shifts are often short five to 10 nurses, forcing nurses to take on more patients than they can handle.

Omodt said that while there was a rise in understaffing reports during the height of covid, conditions have improved, and nurses have made contradictory claims when it comes to staffing at their hospitals since then.

In the lead-up to the strike, Minnesota hospital groups filed unfair labor practices charges against the union for refusing to go to mediation, and asked the National Labor Relations Board to block the strike for a failure to provide enough notice. The NLRB has thrown out at least some of those charges.

Hospitals facing strikes have been recruiting traveling nurses from across the region and plan to maintain staffing levels during the strike, though they are preparing for reduced operations, according to some of the hospital groups facing strike activity.

For years, hospitals in the United States have faced understaffing problems. A surge in demand and increased safety risks for nurses during the pandemic accelerated those trends. The number of health-care workers in the United States has still not recovered to its pre-pandemic levels, down 37,000 workers compared with February 2020.

At the same time, demand for health-care services has steadily increased during the pandemic, with a backlog of people who delayed care now seeking medical attention. During the covid wave that swept across the United States this summer, states such as New York and Florida reported the worst nursing shortages in decades. Research shows that patients are more likely to die because of preventable reasons when health-care providers are overworked.

Nurses, who risked their lives during the pandemic, are quitting and retiring early in droves, because of increased workloads caused by short staffing and demanding schedules that make finding child care and having a life outside of work exceedingly difficult. The understaffing crisis is pronounced in Minnesota in part because of its aging population and its record low unemployment rate.

There are some signs that nurse- and other health-care-worker strikes could spill over to other states in the coming weeks. Four thousand nurses with the Michigan Nurses Association voted earlier this month to authorize a strike related to understaffing concerns, and 7,000 health-care workers in Oregon have also authorized a work stoppage. University of Wisconsin nurses narrowly averted a strike this week. Therapists and clinicians in Hawaii and California are currently in the fourth week of what has become the longest-running mental health care strike, over inadequate staffing levels.

In Minnesota, the Minnesota Nurses Association recorded a 300 percent increase in nurses’ reports of unsafe staffing levels on their shifts since 2014, up to 7,857 reports in 2021.

Kelley Anaas, 37, a nurse who works in the ICU at Abbott Northwestern in Minneapolis said nurses in her unit have been forced to double up on patient assignments and work with lead nurses who have less than a year of experience.

It eats away at you. If that was my family member in that bed, I wouldn’t want to leave their side,” said Anaas, adding that her workload has increased steadily over her 14 years at Abbott Northwestern.

While the nurses say their main impetus for striking is staffing levels and not pay, they are also at odds with hospitals over wages. The Minnesota Nurses Association has proposed a 30 percent pay increase over the next three years, noting inflation is at a 40-year high, while health-care groups have proposed a pay increase of 10 to 12 percent.

“The union’s wage demands remain at 29 and 30 percent increases over three years, which we’ve told them is unrealistic and unaffordable,” Omodt said, noting that the average Minnesota nurse makes $80,960 a year.

Contracts expired in May and June, and the union has been in negotiations since March.

Nurses said they are frustrated the strike is happening, but the stakes are high for them and their patients.

“We’re really sad and disappointed that it has come to a strike,” said Brianna Hnath, a nurse at North Memorial in Robbinsdale. “But we feel like this is the only thing we can do to show administration how incredibly important a strong nursing core is to a hospital. Hospitals tell us it’s our fault, but we’ve been actively involved and getting nowhere.”

Workload expectations at core of nurses’ lawsuit against University of Michigan

Members of the Michigan Nurses Association are accusing the University of Michigan of unlawfully refusing to negotiate over nurses’ workloads in its bargaining with the University of Michigan Professional Nurse Council.

The union, an affiliate of National Nurses United and AFL-CIO, represents about 13,000 registered nurses and healthcare professionals in Michigan, including workers employed by the University of Michigan. The University of Michigan regents hold the contract with the University of Michigan Professional Nurse Council, the largest bargaining unit of the Michigan Nurses Association.

A total of 6,200 University of Michigan Health nurses have been working without a new contract since July 1, and they are working under the terms of the expired agreement, according to hospital and union statements. The University of Michigan Health, the clinical division of Ann Arbor-based Michigan Medicine, told Becker’s in a statement that during negotiations, it has offered a 21 percent base pay increase for nurses over the life of the contract, as well as a new salary step program for nurse practitioners and the safe elimination of mandatory overtime.

The union contends the University of Michigan has refused to bargain over safe workloads regarding the number of patients assigned per nurse, which it says is tied directly to nurses’ patient safety concerns. As a result, it filed a lawsuit Aug. 15 in the Michigan Court of Claims. 

“When nurses are forced to take care of too many people at once, patient care gets compromised and nurses are put in danger of injury or burnout, and that’s happening far too often at our hospital,” said Renee Curtis, RN, president of the University of Michigan Professional Nurse Council, said in a news release. 

“University of Michigan Health makes staffing determinations with patient safety at the forefront of its decisions, and this has produced outstanding safety results,” the health system said in its statement. “The health system continuously receives recognition as Michigan’s safest hospital with recent recognitions by top agencies.”

University of Michigan Health also said it “plans to vigorously defend itself” against the union lawsuit.

Stanford, nurses reach tentative labor deal

Stanford and Lucile Packard Children’s hospitals in Palo Alto, Calif., and the Committee for Recognition of Nursing Achievement reached a tentative agreement on a three-year contract for about 5,000 nurses represented by the union, according to hospital and union statements.

The sides reached the agreement April 29, the fifth day of a strike, and union members approved it May 1. 

“After extensive discussions, we were able to reach consensus on a contract that reflects our shared priorities and enhances existing benefits supporting our nurses’ health, well-being and ongoing professional development,” Stanford said in its latest negotiations update.

With the new agreement, striking nurses will return to work May 3. 

Meanwhile, in a news release shared with Becker’s, the union highlighted parts of the agreement, including improvements it said “ensure high patient acuity is reflected in staffing.”  

The agreement also includes a combined 7 percent base wage increase in 2022 (a 5 percent increase followed by a 2 percent increase) for nurses, 5 percent in 2023 and 5 percent in 2024, as well as funds specifically for mental healthcare of workers, according to the union.

As part of the labor deal, the hospitals also agreed to continue medical benefits for striking nurses without disruption, the union said.

“From day one of our contract negotiations, CRONA nurses have been unified in our goals of improving staffing and making our profession more sustainable,” Colleen Borges, president of CRONA and pediatric oncology nurse at Packard hospital, said in the release. “We stood strong behind our demands for fair contracts that give us the resources and support we need to take care of ourselves, our families and our patients. We are proud to provide world-class patient care — and are glad the hospitals have finally listened to us.”

Dale Beatty, DNP, RN, chief nurse executive and vice president of patient care services for Stanford Health Care, and Jesus Cepero, PhD, RN, senior vice president of patient care and chief nursing officer for Stanford Children’s Health, acknowledged on the Stanford negotiations page that reaching an agreement has been challenging.

Now “we can all take pride in this agreement. And we are proud of our team for maintaining continuity of care for our patients,” they said.

More information on negotiations is available here and here.   

Stanford Health Care to nurses: No pay for those who strike

Stanford Health Care and Lucile Packard Children’s Hospital administrators have notified union leaders that its nurse members who strike later in April risk losing pay and health benefits, according to Palo Alto Weekly.

The Committee for Recognition of Nursing Achievement, a union at Stanford Health Care and Stanford Children’s Health that represents about 5,000 nurses, has scheduled a strike to begin April 25. The nurses’ contract expired March 31.

If the strike moves forward, Stanford Health Care and the Lucile Packard Children’s Hospital, both based in Palo Alto, Calif., are prepared to continue to provide safe, quality healthcare, according to a statement from Dale Beatty, DNP, RN, chief nurse executive and vice president of patient care services for Stanford Health Care, and Jesus Cepero, PhD, RN, senior vice president of patient care and chief nursing officer for Stanford Children’s Health.

But the statement, which was shared with Becker’s, said nurses who choose to strike will not be paid for shifts they miss.

“In addition, employer-paid health benefits will cease on May 1 for nurses who go out on strike and remain out through the end of the month in which the strike begins,” Drs. Beatty and Cepero said.

The leaders quoted from Committee for Recognition of Nursing Achievement’s “contingency manual” that the union provided to nurses: “If a strike lasts beyond the end of the month in which it begins and the hospitals discontinue medical coverage, you will have the option to pay for continued coverage.”

Drs. Beatty and Cepero said nurses who strike may pay to continue their health coverage through the Consolidated Omnibus Budget Reconciliation Act.

In a separate statement shared with Becker’s, Committee for Recognition of Nursing Achievement President Colleen Borges called Stanford and Packard management’s move regarding nurses’ health benefits “cruel” and “immoral.”

“Health benefits should not be used against workers, especially against the very healthcare professionals who have made Stanford a world-class health system,” said Ms. Borges, who is also a pediatric oncology nurse at Lucile Packard Children’s Hospital. “We have spent our careers caring for others and putting others first — now more than ever we need solutions that will ensure sustainability, safe staffing and strong benefits to retain nurses. But instead of taking our proposals seriously, hospitals are spending their time and energy weaponizing our medical benefits. We refuse to be intimidated from standing up for the fair contracts that we need in order to continue delivering world-class patient care.”

The union has organized a petition to tell Stanford not to cut off medical benefits for nurses and their families during the strike. As of April 19, the petition had more than 25,150 signatures.

Sutter Health: Nurses who staged 1-day strike must wait 5 days to return to work

Sacramento-based Sutter Health said nurses who went on strike April 18 will not be allowed to return to work until the morning of April 23, the San Francisco Chronicle reported.

The strike affected nurses and healthcare workers at Sutter Health facilities in Northern California. The nurses are members of the California Nurses Association, and the other workers are members of the Caregivers and Healthcare Employees Union, an affiliate of the California Nurses Association.

More than 8,000 registered nurses and healthcare workers were expected to participate in the strike, according to an April 18 news release from the unions.

In a statement shared with Becker’s, Sutter Health said the organization conducted strike contingency planning, which included “securing staff to replace nurses who have chosen to strike, and those replacement contracts provide the assurance of five days of guaranteed staffing amid the uncertainty of a widespread work stoppage.” 

“As always, our top priority remains safe, high-quality patient care and nurses may be reinstated sooner based on operational and patient care needs,” the statement said.

The California Nurses Association described Sutter Health’s decision as retaliatory, as well as “completely unnecessary and vindictive.”

“Nurses who are regularly scheduled to work during this lockout period will lose those days of pay,” the union said in a statement shared with Becker’s. “We urge Sutter to respect the nurses’ strike and let all nurses return to work.”

Sutter Health workers authorized a strike in March, and union officials announced an official strike notice April 8. Union members cited lack of transparency about the stockpile of personal protective equipment supplies and contact tracing as a reason for the strike. They also said they seek a contract that will help retain experienced nurses and provide sufficient staffing and training.

Nurses have been in contract negotiations since June. 

More than 4K Stanford nurses vote to strike in California

UPDATE: April 14, 2022: Nurses will begin striking April 25 if they are unable to reach a deal with the system by then, according to a Wednesday statement from the union. The two sides have met with a federal mediator three times, and the strike would be open-ended.

Dive Brief:

  • Unionized nurses at Stanford hospitals in California voted in favor of authorizing a strike Thursday, meaning more than 4,500 nurses could walk off the job in a bid for better staffing, wages and mental health measures in new contracts.
  • Some 93% of nurses represented by the Committee for Recognition of Nursing Achievement voted in favor of the work stoppage, though the union did not set a date, according to a union release. It must give the hospitals 10 days notice before going on strike.
  • Nurses’ contracts expired March 31 and the union and hospital have engaged in more than 30 bargaining sessions over the past three months, including with a federal mediator, according to the union.

Dive Insight:

As the COVID-19 pandemic has worsened working conditions for nurses, some unions have made negotiating contracts a priority. Better staffing is key, along with higher wages and other benefits to help attract and retain employees amid ongoing shortages.

The California nurses’ demands in new contracts focus heavily on recruitment and retention of nursing staff “amid an industry-wide shortage and nurses being exhausted after working through the pandemic, many in short-staffed units,” the union said in the release.

They’re also asking for improved access to time off and more mental health support.

Nurses say their working conditions are becoming untenable and relying on travel staff and overtime shifts is not sustainable, according to the release.

The hospitals are taking precautionary steps to prepare for a potential strike and will resume negotiations with the union and a federal mediator Tuesday, according to a statement from Stanford.

But according to CRONA, nurses have filed significantly more assignment despite objections documents from 2020 to 2021 — forms that notify hospital supervisors of assignments nurses take despite personal objections around lacking resources, training or staff.

And a survey of CRONA nurses conducted in November 2021 founds that as many as 45% were considering quitting their jobs, according to the union.

That’s in line with other national surveys, including one from staffing firm Incredible Health released in March that found more than a third of nurses said they plan to leave their current jobs by the end of this year.

The CRONA nurses “readiness to strike demonstrates the urgency of the great professional and personal crisis they are facing and the solutions they are demanding from hospital executives,” the union said in the release.

No major strikes among healthcare workers have occurred so far this year, though several happened in 2021 and in 2020, the first year of the pandemic.

Stanford, Packard nurses greenlight strike

Thousands of nurses at Stanford and Lucile Packard Children’s hospitals in Palo Alto, Calif., have authorized the union representing them to call a strike. 

In an April 8 news release, the Committee for Recognition of Nursing Achievement said more than 4,500 nurses at Stanford and Packard, or 93 percent of all nurses eligible, voted in favor of strike authorization. They are calling on hospital management to adequately address staffing, citing consistent overtime and nurses’ complaints of inadequate resources, training or staff. They also seek improved access to mental health counseling, as well as competitive wages and benefits.

“The decision by members to overwhelmingly authorize a strike shows that we are fed up with the status quo of working conditions at the hospitals,” Colleen Borges, union president and a nurse in the pediatric oncology department, said in the release. “We need contracts that allow us to care for ourselves and our families so we can continue providing world-class care.”

Nurses authorized the strike after bargaining for the last 13 weeks and are working without contracts. The vote does not mean a strike will occur, but it gives the union the ability to issue an official strike notice. 

In a statement shared with Becker’s, Stanford expressed its support for negotiations rather than a strike.

“We are committed, through good faith bargaining, to reach agreement on new contracts that provide nurses a highly competitive compensation package, along with proposals that further our commitment to enhancing staffing and wellness benefits for nurses,” the statement said.

The hospital also said it is taking the steps to prepare for the possibility of a strike, while hoping a strike is averted.

“Given the progress we have made by working constructively with the union, we should be able to reach agreements that will allow us to continue to attract and retain the high caliber of nurses who so meaningfully contribute to our hospitals’ reputation for excellence,” the statement read. 

How much nurse pay is rising—and why

Travel Nurse Guaranteed Pay: The Truth - The Gypsy Nurse

Amid a nationwide staffing shortage, rising demand for nurses has led hospitals to increase salaries and other benefits to attract and retain workers, Melanie Evans reports for the Wall Street Journal.

Hospitals increase salaries, benefits to keep up with nursing demand

Hospitals across the country have been struggling amid staffing shortages, particularly of nurses, Evans reports. According to health care consultancy Premier, nurse turnover rates have increased to around 22% this year, up from the annual rate of about 18% in 2019.

“We are employing more nurses now than we ever have, and we also have more vacancies than we ever had,” said Greg Till, chief people officer at Providence Health & Services.

To retain their current nurses and attract new staff, many hospitals have increased their nurses’ salaries to remain competitive in the job market, Evans reports.

For example, HCA Healthcare, one of the largest hospital chains in the country, said it increased nurse pay this year to keep up with Covid-19 surges and compete with rivals also trying to fill vacant positions.

Similarly, Jefferson Health in May raised salaries for its nearly 10,000 nurses by 10% after the system discovered that rivals had increased their compensation. “The circumstances required it,” said Kate Fitzpatrick, Jefferson’s chief nurse executive.

In addition, Citizens Memorial Hospital in Bolivar, Mo., this month raised its nurses’ salaries by up to 5% after rivals in other nearby cities increased their workers’ wages. Sarah Hanak, Citizen Memorial’s CNO, said the hospital also increased the hourly wages of nurses working overnight shifts by around 15% to ensure sufficient staffing for those shifts.

“We were forced to,” Hanak said. “We absolutely have to stay competitive.”

Overall, the average annual salary for RNs, not including bonus pay, grew to $81,376, according to Premier—a 4% increase across the first nine months of the year. This is larger than the 3.3% increase in the average annual nurse salary for 2020 and the 2.6% increase in 2019, Evans writes.

In addition to salary increases, some organizations, such as Providence, are also offering other benefits to attract and retain nurses, such as more time off, greater schedule flexibility, and new career development opportunities. Many hospitals are also hiring new graduates to work in specialized roles in ORs and other areas, allowing them to advance their careers more quickly than they would have before.

Overall, this rising demand for nurses has allowed those entering the workforce to negotiate higher salaries, more flexible working hours, and other benefits, Evans writes.

“I think you get to write your ticket,” said Tessa Johnson, president of the North Dakota Nurses Association.

Nurse compensation increases were inevitable—here’s why

It was inevitable that we would get to this point: baseline nurse compensation on a clear upward trajectory. Inevitable because this boils down to laws of supply and demand. Amid a clear nursing shortage, organizations are being forced to raise baseline compensation to compete for increasingly scarce qualified nurses. This is true in nearly every market, even for those considered to be ‘destination employers.’

If anything, what’s most surprising in the data from Premier is the moderated increase of around 4%. From a worker’s perspective, that’s not even covering cost of living increases due to inflation. However, amid this new data, it’s important to keep two things in mind:

Two considerations for health care leaders

  1. New data only captures baseline compensation.Differentials—which organizations must standardize and expand across shifts, specialties, and even settings—plus overtime put baseline compensation much higher. Not to mention lucrative sign-on bonuses, that members tell us are increasingly table stakes in their markets. In general, we don’t recommend this type of incentive that does nothing for retention. You’re better off investing those resources in baseline compensation as well as beefing up your RN bonus plan to incentivize retention.
  2. There is a new floor for wages (and it’s only going up from here).

Open questions (and important indicators) we are assessing

  • What happens to wages for entry-level clinical roles? As the shortage of RNs persists, organizations will need to make a shift to team-based models of care, and those are only possible with a stable workforce of entry-level personnel. Right now, that part of the health care workforce is anything but stable. When you consider their work and their wages in comparison to out-of-industry players that pay the same or better, that’s a clear area where investment is required. 
  • Will the share of nurses working permanently with travel agencies return to pre-pandemic levels? That’s to say, what will those RNs who experienced the traveler lifestyle and pay value more moving forward: the flexibility and premium pay or stability of permanent employment? Even if this number stabilizes a couple percentage points above pre-pandemic levels, that will aggravate provider’s sense of shortage.

RN hourly wage in 10 US metro areas

RN Salary -Registered Nurse wages and employment information

The hourly mean wage for registered nurses in the U.S. is $38.47, according to the U.S. Bureau of Labor Statistics’ latest occupational employment and wage statistics survey.

Among 10 metropolitan areas with the highest employment level in registered nurses, registered nurses have the highest hourly mean wage in the Los Angeles area and the lowest in the Miami area.

Ten hourly mean wages for RNs by metropolitan area, in descending order:

1. Los Angeles: $54.38

2. Boston: $47.79

3. New York City: $45.63

4. Houston: $40.85

5. Washington, D.C.: $40.14

6. Philadelphia: $38.45

7. Dallas: $37.50

8. Chicago: $37.48

9. Detroit: $36.64

10. Miami: $34.76