After a full day of negotiations, nurse and caregiver members of SEIU Healthcare 1199NW believe that Swedish-Providence’s proposals thus far do not address workers’ serious patient care concerns or fix ongoing unfair labor practices. Workers are still planning to strike unless a new agreement is reached soon.

“After 9 months of negotiations Providence has failed to offer any real commitment to safe patient care and appropriate staffing levels,” said Whittney Powers, a registered nurse in the emergency department at Swedish Edmonds. “On top of refusing to make a meaningful commitment, Providence has proposed to tie our wages to patient metrics that we can’t achieve without appropriate staffing. We feel set up to fail financially and professionally, and we won’t tolerate it.”

Union members say management’s staffing proposal, which centers on a series of committee meetings, does not match the severity or urgency of their patient care concerns. Swedish-Providence has over 900 open positions across all campuses. Multiple studies show that unsafe staffing levels in hospitals can lead to lower-quality care and patient harm, including falls, infections, medication errors and increased deaths. Nurses and other healthcare workers say they are understaffed throughout the hospital, from registered nurses to environmental service technicians who clean and disinfect patients’ rooms.

“In the cancer treatment center we have twelve nurse openings. Patients can wait one to two and a half hours before seeing anyone,” said Betsy Scott, a registered nurse in the Swedish First Hill Cancer Institute. “Then they go to the treatment chair for another hour or hour and a half before the nurse is free and has the medications to administer. My patients have breast cancer. The staffing issues have gone unaddressed. It is pathetic that we have to accept two to four hour waits for our patients. This has become normal. Something has to be done and it starts with paying staff more.”

Caregivers are concerned about the lack of response from Swedish to their proposals for on-call pay and scheduling. Standby pay for on-call workers has not increased significantly in over 15 years, with on-call workers paid just $4.25 per hour. Once assigned, on-call work schedules can be erratic, and many caregivers are unable to return home between shifts to sleep. They say that instead of being given sleeping rooms, they often sleep in their cars or on unused x-ray tables.

SEIU Healthcare 1199NW members have also proposed important measures to recruit and retain top-quality staff. A key factor in Swedish’s difficulty in recruiting new caregivers is that its wages for frontline workers have not kept up with the soaring cost of living in the Seattle area. Swedish-Providence pays almost 40 percent of its employees below the salary necessary to afford the average one-bedroom apartment in the Seattle area; Swedish-Providence workers commute an average of 84 minutes per day, with over 58 percent of caregivers unable to afford to live near where they work, and over 47 percent struggling to pay their rent or mortgage.

Environmental service technicians, who are responsible for hospital infection control, have repeatedly shared grave workload concerns with management. SEIU Healthcare 1199NW members have sought to improve hospital infection control and reduce the risk of worker injury with a series of proposals to set workload limits to ensure enough time and staff to provide quality infection control, and create a plan for escalating workload and staffing concerns. Swedish management has thus far refused caregivers’ infection control proposals.

Meanwhile, caregivers say they have experienced concerning treatment from management that suggests an unwillingness to bargain in good faith. Swedish has targeted unionized caregivers for discipline when they speak out about problems in the workplace, up to and including terminations, and has withheld information related to core subjects of bargaining, such as health care costs. Fair bargaining requires the exchange of information and unfair labor practices such as these are prohibited by law.

Nurses and caregivers at Swedish-Providence voted to authorize a strike in November. They are joined in strike readiness by nurses and other healthcare workers from the Washington State Nurses Association and UFCW 21 at other Providence-owned hospitals across the state. If a strike is called, 13,000 healthcare workers statewide will deliver 10-day notices to Providence management of their intent to strike. Caregivers say their goal is to achieve a fair union contract, and they are willing to return to the bargaining table at any time.