- Interview by
- Andrej Markovčič
Tuesday through Thursday this week, eight thousand members of SEIU Healthcare 1199NW went on strike in Seattle and at several locations throughout Washington to demand improved staffing and working conditions from their employer Swedish-Providence. Since Providence’s 2012 acquisition of Swedish, health care workers have raised concerns about the increasing deterioration of care at their hospital campuses. After nearly ten months of negotiations, workers walked off the job.
While the strike ended Friday morning, management has retaliated by locking out hospital staff as they attempted to return to their jobs. It’s unclear exactly how long the lockout will last, but hospital management has said their strikebreakers are contracted for five days. In the meantime, hospital staff are continuing to rally outside their campuses.
Seattle Democratic Socialists of America member Andrej Markovčič spoke with a few of the striking workers — vice president of SEIU Healthcare 1199NW Betsy Scott, nursing assistant Sheron Ray, and social worker Laura Wood — about conditions in the hospital, why they decided to strike, and how management has been affecting their ability to care for patients.
Can you give me a little background on the lead-up to the strike?
We’ve been negotiating for our contract for the last nine or ten months and talking and talking and talking with management about what it’s like to work in the hospital now and the kind of care that we’ve not been able to provide that we feel like we should provide. In the past, we’ve always felt like eventually they listened. After many hours of promises unkept, we finally decided we had to strike.
They kept us at the bargaining table one whole week, and the CEO of Providence came to the table and said, “I had no idea, I’m so sorry, come back next week. Come back next week, and we’ll work with you and get a good contract going.” It was all a lie. We sat around for two days with nothing, and they gave us a one-page letter of understanding that more or less said they have the power to do whatever they want. At that point, we said we’re done.
Providence bought Swedish not too long ago. What has your relationship been with Providence management?
We negotiated our first contract when Providence bought Swedish, and there have been many instances when they have not followed the contract. It became clear they had no intention of following it. We’ve had many people who we knew shouldn’t have been laid off but were for cost savings.
The CFO would be the decision-maker, not anyone in the hospital actually doing the work. When a CFO you’ve never met before is saying we’re not going to pay for IV nurses, we’re not going to pay for ICU nurses, we knew where it was going. They’re trying to break the union. They hate having us here.
That’s been new for Swedish employees because we’ve always had a union here. We had disagreements in the past, but this time it was obvious they’re not going to work with us.
How have they been trying to break the union?
It starts with not following the contract, even where there is very clear language, by just saying, “No, we’re not going to do that.” Then they said they would lock us out, hiring these goons to keep us away from the doors as if we’re dangerous.
What have the effects of short staffing been in your hospital?
Providence says that there’s a shortage of nurses everywhere, and that’s what we’re dealing with here. The fact is that they laid off a bunch of nurses last year, which made the nursing so short-staffed that people couldn’t work here anymore. They worked so hard for so long that they said, “I’m going elsewhere.”
So Providence created their own mess. Nurses can go elsewhere where they feel supported, where they feel like management appreciates them, and where they make more money than they will make here at Swedish. Here, we feel like we’re the enemy, like we’re preventing them from making their bottom line.
What was their rationale for those cuts?
They said it was financial. They cut the IV team, which is very important for patients coming into the hospital. Nurses were given a two-hour class to start an IV. It’s about being able to do it with no stress and having lots of practice, so that doesn’t work. They said, “Oh, we have too many labor and delivery nurses,” so they cut fifty-four full-time nurses. Two months later they said, “Gee, we’re sorry we cut too far, we’ll hire nurses back.” Well, no one wants to come back after that.
We’re in a bit of a unique moment where for the first time in decades we’re seeing an increase in strike actions. Do you feel like you are part of a larger wave beyond this fight?
We feel like we’re part of a wave of working people standing up for what we know is right, instead of all the money going to the executives and us getting nothing but doing all the hard work. We know we’re in the right here. We know that we know how to take care of our patients. No CFO or Providence executive is going to tell us how to do that by cutting us at the bedside. We know we’re in the right. The way our country is with the top getting richer and the bottom getting poorer, it’s a wave that needs to happen.
How does it feel being out on the line?
It’s very powerful. It’s bringing all of Providence’s dirty laundry from behind closed doors and out into the streets. Because the message that they give the public is not what’s going on inside. We’re chronically short-staffed, patients are waiting and waiting for care. And that’s not the way we do things. It’s been a steady decline since Providence took over.
You mentioned short staffing. How does that affect your job as caregivers and your patients needing care?
We’re so short-staffed that patients are languishing in the emergency department for way too long. They need ICU-level care, and they’re staying in the ER where we can’t take care of them. It’s a dangerous thing. They can’t move to the ICU because there are beds that are open, but there’s no staff to take care of them.
It’s really a crisis, and every year is getting worse and worse. At least in my social work department, we’ve had over 70 percent turnover. So it’s all new social workers, because they’re going elsewhere for better conditions.
It’s the same for the nursing staff. It used to be that nurses were here fifteen, twenty, thirty years. Now it’s two years, one year, six months. They’re not staying, they’re getting burned out. Because they come in today, and it’s like you’re in a war zone every single day. You know what has to get done, but there’s only so many minutes in a day. Nurses are going without breaks for the bathroom or food or anything. Or if they do take a break, they take their phone with them, and they’re constantly interrupted. You cannot give good care when you cannot catch your breath.
Every day we get text messages calling us back in on our days off. We feel guilty knowing that our coworkers are struggling and not getting the care they need, so we’re all getting burned out.
I think that’s something that a lot of people can relate to, increasing turnover, people rarely staying somewhere for more than a few years. What is the impact of that lack of experience whether it be due to turnover, or in the immediate case, the hospital bringing in strikebreakers?
I heard management say these were experienced nurses, but they don’t know where the supplies are. They don’t know what numbers to call, they don’t know who to call, because most of the people they’re supposed to call are standing outside. You’ve got managers and supervisors who don’t usually do the work in there trying to do the work, and it’s a mess. It doesn’t matter how good of a nurse you are coming in cold to a new situation, there’s no way you can give good care.
Similarly, for social workers, we have to know the local resources, because we’re the ones discharging patients into higher levels of care, family homes, or finding them psychiatric beds. I’ve heard a lot of the social workers who were flown in are from Florida. They don’t know the shelter system here in Seattle. There’s no way you can get a crash course on that in a day.
Some of our patients are 1:1, so they’ve been pulling me to sit with this patient 1:1, and that increases the patient load on my nurses and on the other nursing assistants on the floor.
In the ER, we’re not meeting the legal safety ratios. If it’s a suicidal patient, we have to have 1:1 staff. We’re doing 1:3, 1:4. Our manager just tells us to do it.
“Make it work,” that’s their favorite term.
It’s unsafe. I’ve been assaulted, chased down the hall. It’s because we don’t have enough bodies.
For people who aren’t working in a hospital, can you explain the impact of 1:1, 1:2, 1:4 ratios?
When a doctor writes an order that a patient should be 1:1, that means that there is one person watching this one patient to make sure they don’t harm themselves or anybody else. But a lot of the time [management] will have us sitting in the hall between one to three patients, and I’ve heard stories of four to five. These are patients that are impulsive, confused, not quite themselves, and you’re watching them trying to prevent falls. Well, if two of them try to get up at the same time, who am I supposed to catch first?
So on paper you have been told this is a 1:1 patient, but in reality it’s 1:3, 1:5, and you’re just hoping they don’t need help at the same time?
What was the breaking point for you, when you thought “we have to go on strike”?
When they absolutely refused to deal with the issues at hand: the unsafe staffing, the quality of the patient care, the supplies that we’re using. So we had to draw a line in the sand. Every year, we have problems, and they say we’ll fix it in a committee. Then they dissolve the committee, or they won’t meet, or they won’t let people off to meet.
When they wanted to do that again, we said, “Not this time, we’re not going to leave anyone behind. Not this time. Because you’re not going to do what you said you would do. The trust is broken.”
We could have accepted their contract if all we were after was money. They came up on the money, but you haven’t dealt with all these other issues. It’s a no-go. We told them what they needed to do for us to say yes. They didn’t address any of that.
Have there been any threats or retaliation from management?
Managers were calling us into their offices one by one to ask us if we’re going to strike. There’s been anti-union literature that’s put around the break room, particularly in the environmental services break rooms where many people are English-language learners and might not fully understand.
Some of our coworkers have been unfairly disciplined or passed up for promotions. One of the social workers who helped organize with me a couple years ago was fired for her work. But we have to keep fighting. There’s no other option.
We cannot go back to the way we were.
Have you felt a change with the strike?
Absolutely. I’ve met people from all different departments who I never knew before. We’re much more powerful. We’re more connected. That’s going to mean better care for patients. Our community sees what’s happening. Maybe Providence will listen to the community.
How are my loved ones going to be treated when they get to that hospital? Are they going to be laying in the bed unable to move, and unable to get to the bathroom? Or is there going to be someone there to help them out? And right now, it’s hit or miss.
Would you feel comfortable with your family members coming to this hospital?
My mom was in the ICU for three weeks in 2017, and she got really good care. It’s changed now, and I wouldn’t let her be here alone.
I would be here twenty-four hours a day if any loved one of mine was here in the hospital because I already know the staff is that backed up. There’s just not enough.
The nurses want to do the work, we want to care. We just don’t have the capacity.
It takes real commitment to be a care provider under even the best conditions. What are the best and worst parts of this job?
The best part for me is meeting all the different people from different walks of life and different parts of the world and listening to their experiences. The worst part is, I can’t give them what they need, it breaks my heart. I got into this field because I care. I am a caregiver. I started with my family and moved outside of my four walls to the public.
But not being able to give the patients what they deserve is the one thing that just breaks my heart and takes a little bit of my soul every day. It’s not right.
I love to care for my patients. I love to be able to educate families and let them know they’re going to have support, but that it will be hard. I love crisis work. I love being there for a family when they’ve lost a loved one. It’s hard, but I can do that, I love to do that. And it’s when I’m not able to give that care that it breaks my heart. And it’s something fixable, that’s the thing. It’s fixable.