Ascension Union Initiates Largest Nurses’ Strike in Texas History

Nurses in the Ascension Seton cafeteria taking strike votes in the hours leading up to the count. From left to right: Monica Gonzalez, Taylor Critendon, and Jessica Gripentrog (Photo by Lina Fisher)

After eight months of bargaining with Ascension management – in which a measly three of the roughly 40 demands were agreed upon – the Ascension Seton nurses’ union has voted overwhelmingly (98%) to authorize a strike.

In September, nurses at Texas’ largest private hospital network unionized with National Nurses United, which represents 3,300 nurses in Texas. Since, they have failed to convince their executives that understaffing and poor working conditions lead to worse outcomes for not only nurses but their patients as well. Today, June 1, the union approved a one-day strike. They haven’t set the date, but will give 10 days notice to Ascension to ensure care is not disturbed.

Taylor Critendon, a nurse for five years in the ICU, describes the current situation as a “nightmare.” She says, “Our biggest concern is patient safety.” Nurses are taking on five to eight cases at a time – for comparison, California has legally required minimum nurse- to-patient ratios of 1:5 for general medical-surgical wards, 1:4 in ERs, and 1:2 or fewer for critical care units. Understaffing deteriorates the quality of care that each individual receives. Critendon says the current ratios are “profit-motivated – the more patients that one nurse can take, the more money that a hospital is saving on having to pay more nurses.” Nurses are spending more time away from patients, “because they have to run around through the maze that this hospital has created to find what they need.” Monica Gonzalez, who works in Neurology and has been with the hospital for 19 years, describes a lack of readily available chucks (pads that absorb urine and excrement), so that nurses are wasting time running to get supplies, and patients are left “sitting in their excrement,” says Gonzalez. “Their skin can deteriorate very quickly because they’re already fragile and ill.”

Protocols like disease testing requirements have been changed without input from nurses and put them at greater risk of becoming sick themselves, says Critendon. She describes patients with COVID symptoms being transferred to new units, sharing rooms with other patients, and being cared for by several nurses, all without having been flagged or tested for COVID: “It’s like, what are doctors and nurses even here for if we can’t use our own clinical judgment to decide when it is appropriate to test for things and when it isn’t?”

Critendon says “the most infuriating part of it, is that the people that are making these decisions don’t live here, make millions or hundreds of thousands, have never worked in health care, have never been at the bedside, are not currently at the bedside, and they’re telling us how to do our job.” Ascension’s staffing crisis and dubious profit motives were detailed at the beginning of this year in a New York Times investigation, which found that the nonprofit has $18 billion in cash reserves and its CEO earned more than $13 million in FY 2021. Today in Wichita, Kan., nurses at Ascension Via Christi St. Francis hospital also authorized a strike, citing the same issues: staffing issues, retention, and deteriorating conditions for patients.

A memo by NNU notes that though the registered nurse workforce is growing, nurses are moving out of hospital settings and into outpatient clinics and doctors’ offices. Data from 2019 to 2022 shows the entirety of growth in RN employment during that period occurred outside of hospitals. NNU says that goes to show the need to improve retention in hospitals.

“Nurses are tired of waiting for them to make these changes that are never coming,” said Gonzalez. “That’s why we’re here doing this. It’s of the utmost importance. It doesn’t just affect me, doesn’t just affect our patients, it affects the community at large. Because at some point, you’re going to be a patient. And you don’t want the nurse taking care of you to have six patients, and you’re at the bottom of the totem pole.”

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