Picket signs and strike chants raised precisely at 7 a.m. outside 15 Twin Cities and Duluth area hospitals on Monday, where as many as 15,000 nurses walked off their jobs for three days in protest over pay and staffing levels.
Early risers at the M Health Fairview Southdale Hospital in Edina were quickly joined by tired nurses in scrubs rotating off overnight shifts and joining picket lines. Transition plans to separate the striking nurses fell apart in some cases, leaving them uncomfortably doing face-to-face handoffs of patients with their temporary replacements.
Veteran intensive care nurse Deb Shirley said it was unnerving, because her replacement seemed nice but didn't do a neurological assessment of a patient properly.
"I don't have a clue about what they do or don't know," she said.
The time-limited protest is scheduled to last until 7 a.m. Thursday and involves nurses from Allina, Children's and Fairview hospitals in the Twin Cities along with HealthPartners' Methodist Hospital in St. Louis Park and North Memorial Health in Robbinsdale. Nurses are also on strike at St. Luke's Hospital in Duluth and Essentia Health hospitals in Duluth, Minnesota, and Superior, Wisconsin.
The hospitals hired thousands of temporary nurses from around the country, often at double the usual wages or more, to maintain patient care during the strike. Twin Cities hospitals in a statement Monday asked for "patience" during the strike, because it could take them longer to triage patients. However, they urged patients with emergency needs to call 911 or go to their nearest emergency rooms as usual.
One of the largest nursing strikes in the nation's history occurred following months of failed negotiations — with nurses asking for around 30% pay increases over three years to improve retention and prevent colleagues from quitting and leaving hospitals chronically understaffed.
Hospitals responded with increases of around 10% over three years, noting that many of their parent health systems are experiences financial losses right now and that larger increases would ultimately be passed to patients through their health insurance.
"The union rejected all requests for mediation and held fast to wage demands that were unrealistic, unreasonable and unaffordable," said a statement from all of the affected hospital systems in the Twin Cities other than Allina, which handles its strike communications separately.
Nurses on the picket line said wage hikes to improve retention are important, but that better and more consistent staffing levels are a priority. Second-year nurse Madi Gay said she had already reduced her nursing hours at Southdale over the stress, and the threat to her livelihood of being asked to care for too many severely ill patients at once.
"How long can you keep this up?" said Gay, who was picketing Monday morning after completing her overnight shift. "My license is on the line."
Negotiators for the Minnesota Nurses Association, the union representing the nurses, acknowledged that high wage demands could end up as a bargaining chip to gain more staffing guarantees.
Reports to the union of unsafe staffing levels have risen substantially at Children's over the past three years while 500 nurses have left the pediatric hospital, said Melisa Koll, a nurse at Children's in St. Paul who is part of the negotiating team.
"We have very little interest in decreasing our offer any more until our hospital talks to us about staffing. That's what's important," she said. "The care of children in our community is the most important thing to us."
The hospital nurses for now are working under the terms of old contracts that expired May 31 in the Twin Cities and June 30 in Duluth. First-year nurses with baccalaureate degrees are making about $36 per hour right now at Twin Cities hospitals while those with 10 years of experience are making around $51, according to hospital contract data.
No negotiation sessions are planned this week while the strike is underway.
The strike is occurring at a time of relative stability in hospital activity in Minnesota. Federal data on Monday showed 9,337 staffed hospital beds in Minnesota that were filled by 7,955 patients, about average for the past month. The admissions included 437 adults with confirmed COVID-19, well below the pandemic peak of 1,893 in October 2020.
The major adult trauma center at North Memorial is the only one of three in the Twin Cities involved in the strike. Hennepin County Medical Center in Minneapolis and Regions Hospital in St. Paul had more on-call staff available this week if patient demand increased.
Several suburban Twin Cities hospitals do not employ union nurses and are not involved. Allina's Abbott Northwestern, Mercy and United hospitals are under strike buts its Buffalo and Cambridge hospitals are not. Fairview's Riverside campus of the University of Minnesota Medical Center is under strike, along with Southdale and St. John's, but Ridges in Burnsville and Lakes in Wyoming are not.
MNA leaders hoped the collective strike by so many nurses at once would motivate change.
Larissa Hubbartt, an intensive care nurse at St. Luke's in Duluth, said she has seen an acceleration in her 17 years on the job of colleagues leaving the profession over working conditions.
"The trauma of working short, what we see on a daily basis, it adds up over time," she said. "There is no relief. We used to have a bad day now and then. Now on a day when we have the appropriate staff, you feel guilty almost. Because you can take a lunch break."
Key issues can vary, as contracts are reached between nurses and their individual hospital systems, rather than the strike group as a whole. On the picket line at North Memorial on Monday afternoon, nurses expressed frustration with a just-in-time staffing approach that left many shifts unfilled and increased their case loads. Unbalanced schedules also leave nurses working night shifts only a few hours after getting off day shifts.
Negotiations took place Saturday even as hospitals started the training and orientation of thousands of temporary nurses who traveled from across the country to take over inpatient care this week. Hospitals reported strong response to their calls via staffing agencies for temporary nurses, who will be making double what many staff nurses make.
The strain of the COVID-19 pandemic has taught hospitals how to maintain patient care amid changing staffing levels, said a statement from chief nursing officers with the Children's and Fairview systems along with North Memorial and Methodist Hospital in St. Louis Park. "Our hospitals learned how to effectively train new nursing staff to ensure we remain focused on care."
Nurses on the picket line said the pandemic was emotionally and physically exhausting, and that they want their next contract to reward their sacrifice. Kate Zach, a Southdale intensive care nurse, recalled having to race many times to first don protective gear before going into rooms to try to save patients in cardiac arrest.
"I want to get paid for the hell of the last two years during COVID," she said.
