Some striking Providence nurses appeared unwilling to accept the tentative labor agreement reached with the health system this week, raising the possibility that the largest health care strike in Oregon history could continue into a fifth week.

Several nurses told The Oregonian/OregonLive they plan to vote against the contract proposal, arguing it falls short in addressing systemic understaffing, patient safety and wage and benefit demands.

“It’s insulting and for me, it’s a no,” said Heidi Foster, a labor and delivery nurse who’s worked at Providence St. Vincent Medical Center for nearly 30 years. “I understand it’s necessary to make compromises, and we’d think Providence would try to meet the nurses down the middle, but it’s not even close.”

The deal reached between Providence Health & Services and the nurses who work at its eight Oregon hospitals is said to include wage increases, penalty pay for missed meals and breaks, and provisions intended to codify a state hospital staffing law.

Providence and the Oregon Nurses Association labor union have publicly described the agreement only in broad terms. Both declined to comment while the ratification vote was underway.

Each hospital’s agreement with Providence must be separately ratified by a majority of nurses who work there. Votes began Thursday and are set to end at 4 p.m. Friday, by which time nurses will have been on the picket lines for more than 28 days. (The vote for Providence’s Medford hospital will continue into Saturday because of foul weather in southern Oregon.)

Tammi Foster, a neonatal intensive care unit nurse at Providence Portland Medical Center, said she voted against the proposal, thinking that settling now could set an unfavorable precedent for future negotiations.

“Providence has been taking things away from their employees since the pandemic, like supplies and in-house administrative support services,” she said. “Meanwhile, we’ve been expected to do more and more in our jobs with less and less.”

One of the most contentious issues is that pay raises won’t apply retroactively to the date their last contract expired, which some nurses say rewards Providence for prolonging the bargaining process.

Instead, the deal offers a one-time bonus based on hours worked since previous labor contracts expired, a concession that some said is inadequate.

Andrea Nielson, a resource nurse who has worked at St. Vincent for 27 years, said nurses at the hospital are frustrated over the lack of retroactive pay because they have been working under an expired contract for over a year.

“My jaw literally dropped as I was reading through the tentative agreement because it was just so unbelievably terrible,” she said. “I feel like we’ve given so much, and Providence is still getting away with withholding our pay raise for the last 13 months.”

For Nielson, the tentative deal would mean that she’d get a $1,500 bonus, which she said amounts to only a fraction of what she’d get if the contract included a retroactive pay raise.

Staffing remains a concern

Beyond wages, some nurses object to the contract’s approach to staffing levels and employee’s health insurance plans.

Foster said that the tentative agreement lacks concrete measures to ensure adequate staffing and doesn’t include language about staffing based on the acuity of patient needs.

“We’ve been pushing Providence to take into account how sick our patients are in our staffing plans,” she said. She said the staffing conditions have led to burnout and high turnover, and that experienced nurses are weary of having to train new nurses only to watch them leave.

Meanwhile, several nurses expressed frustrations over their health benefits, saying that their regular providers are increasingly out of network and that they have run into trouble refilling prescriptions. They said the issues started this year, after Providence hired Aetna to administer its employees’ health plans.

Julia Graves, a surgical nurse at Providence Portland, said her treatment to address a liver tumor was interrupted because of insurance mishaps.

But while Graves said she’s upset over the deal, she worries about the financial toll from potentially going without a month’s worth of wages and the possibility of losing her health coverage if the strike continues.

“I’m exhausted physically, emotionally and financially,” she said. “I was thinking of just voting yes to get this over with because I’m tired, but I’m not happy with the deal. … I’m angry that Providence is putting us in this position and trying to break us.”’

Another point of contention is the failure to consolidate contract expiration dates across hospitals.

Adaora Nkwonta, a registered nurse at Providence Portland, said nurses across the health system had pushed to synchronize their contract expiration dates to increase their bargaining power in future negotiations — under threat of a strike like the one underway. The proposed contract keeps the staggered contract end dates, she said.

St. Vincent physicians’ return to work tied to nurses’

The organized group of 70 St. Vincent hospitalists and palliative care physicians who also joined the strike last month reached their own tentative deal late Wednesday. The hospitalists and doctors have been negotiating for their first labor contract with the health system since unionizing in 2023.

Dr. Jennifer Lincoln, an OB-GYN hospitalist at St. Vincent, said the hospitalists were happy with the tentative agreement reached with the health system. She said the proposed deal included night differential pay for OB hospitalists, sick time and provisions that would give hospitalists more voice when adjustments need to be made on staffing conditions.

But Lincoln said that even if they vote to ratify their own contract, the hospitalists and physicians at St. Vincent will remain on the picket line until the nurses at the hospital approve their own contract.

She said that was a provision of their contract introduced by Providence negotiators.

“I don’t know if Providence added that thinking we would try to pressure our nurses to accept their agreement, but we’re sticking up for our nurses and will hold the line with them until they get a fair contract,” Lincoln said.

Nielson said the physicians’ commitment to stay on the line with the nurses was encouraging and could increase their bargaining leverage if the strike continues.

“We’ve always known that it’s harder to replace the physicians than the nurses, so I was glad to hear they’re sticking with us,” she said.

— Kristine de Leon covers consumer health, retail, small business and data enterprise stories.

Reach her at kdeleon@oregonian.com.

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