Seattle Children's nurses and their union, the Washington State Nurses Association, say they don't want to strike, but the hospital, and it's anti-union law firm, aren't giving them a choice. by Nathalie Graham For the first time in Seattle Children’s Hospital’s 118-year history, its unionized nurses are on the verge of a strike.  After going back and forth over contract negotiations since May, 2,200 nurses are holding a strike vote on December 21 and December 22. If the nurses strike, much of Seattle Children’s Hospital will grind to a halt. Children receiving specialized care—like those undergoing cancer treatment, or relying on an artificial heart and lungs to survive—would likely have to relocate to Stanford in California.  The nurses and their union, the Washington State Nurses Association (WSNA), say they don’t want to do this, but the hospital has given them no choice. Nurses at Seattle Children's are asking for an average 10.4 percent wage increase in the first year of the contract as well as workplace improvements like three paid sick days for nurses injured during workplace violence.  Contract negotiations between Seattle Children’s and WSNA used to be collaborative. This year they’ve been aggressive. The hospital hasn’t moved forward on any of the nurses’ proposals and have held tight to a few anti-union measures.  “It’s not something any of us have any desire to do when it comes to taking care of our patients,” an acute care nurse and WSNA co-chair Kara Yates says, “The only reason that it is even on the table is because people feel like we're in a bad enough place that our patient care will be more at risk if we move forward in the direction that they would like to move as a hospital than if an acute action try to make a stand.” What the Nurses Want The job is difficult and nonstop, nurses say. Seattle Children’s nurses are supposed to receive two legally mandated meal breaks during their 12-hour shifts. But, because of the realities of nursing—you’ve seen a medical drama—matters of life or death can derail lunchtime.  Annika Hoogestraat, a nurse with two decades of experience at Seattle Children’s who also cochairs the WSNA, works in the Intensive Care Unit. She has to be available to her patients at all times, she says, and ends up waiving her second meal break. Often, other nurses aren’t able to cover for her. “We have this situation multiplied by 20 nurses,” Hoogestraat says, referring to the nurses on shift at one time. “It's very challenging in order to get everybody what they legally are required to have.” The nurses want Seattle Children’s to institute a breaking system for nurses to fix this… broken system. The hospital hasn’t agreed to the proposal yet, but it’s already paid for violating the law. When nurses sued the hospital over frequently skipped breaks, it agreed to settle for $16 million. Nurses are struggling. Retention rates aren’t nearly as bad as they were during the thick of the COVID-19 pandemic, but they have not recovered to pre-2020 levels. They’re hovering at about 12 percent turnover among nurses hospital-wide, according to nurse and WSNA co-chair Yates.  Nurse turnover is even higher in the hospital’s Psychiatry and Behavioral Medicine Unit (PBMU), the union says.. The nurses who remain have less experience; 28 percent have one year of experience, 42 percent have less than two years, and 65 percent have less than four years of experience in the BMU. Patients in the PBMU stay in rooms together and participate in group therapy, which is a lot to manage, Yates explained. “It’s an incredibly hard job that takes nurses years to learn how to do,” Yates says.  The inexperience combined with the increase in PBMU patients due to mental health facilities closing around the region leads to more dangerous conditions for nurses. WSNA reports that 437 violent incidents occurred in the PBMU last year, out of a total of 574 incidents at the hospital. Nurses have been bitten, beaten, concussed, and sexually assaulted. In response, the nurses are asking Seattle Children’s to provide an additional three paid sick days for nurses hurt on the job.  “What we're asking for is not an unreasonable thing,” Hoogestraat says. “These people are putting their lives on the line… and they deserve to be cared for as well.” Hoogestraat says Seattle Children’s has denied the request because the hospital is concerned “other people will want it” and “it sets a precedent that they're not willing to accept.”  Seattle Children’s did not respond to a specific question about this, but instead said in a statement, “Nurses at Seattle Children’s are vital members of the team and play an important role in providing the highest level of care to patient families.”  Strike a (Anti-Union) Pose For the first time in Yates’s 16-year tenure at Seattle Children’s, the hospital has been hostile in negotiations. Yates, who has negotiated four contracts with Seattle Children’s, says the hospital is usually a partner in negotiations. Three years ago, nurses won a landmark contract with “historic” wage increases and measures to retain nurses. But this year, Seattle Children’s is fighting against contract improvements and attempting to whittle away at the union.  This go-around, Seattle Children’s hired the law firm Morgan Lewis to represent their interests. Morgan Lewis is an anti-labor, union-busting juggernaut. For perspective, Amazon hired the firm back in 2020 to fight unionizing efforts at its Bessemer, Alabama, warehouse. SpaceX, Apple, and Tesla have also hired Morgan Lewis.  “It very much feels like they came out with the idea that they were going to put us in our place,” Yates says. The Washington State Labor Council (WSLC) has noticed this change in tactic from the hospital. April Sims, the president of the WSLC, described Seattle Children’s and WSNA as having a “collaborative relationship” for decades. “We've seen a real shift with them bringing in an outfit that's known for its union-busting tactics,” Sims says. “That is very concerning… Why Children's would choose to engage with a union-busting firm at this moment in time is beyond me,” Sims says. Nationwide, union favorability is 68 percent—an all-time high. Yates says Seattle Children’s first proposal baked in mandatory arbitration, rescinding nurses’ right to hold the hospital accountable in court and requiring them to settle grievances with a hospital-appointed third party. It also proposed limiting access to the nurses’ union representative, to stop deducting union dues from their paychecks like it does for benefit payments, thus gumming up the process. The hospital also wanted to turn Seattle Children’s from a closed shop to an open shop, meaning instead of only hiring unionized nurses, Seattle Children’s could start hiring non-union nurses.  WSNA was able to fight off the bulk of those proposals. But mandatory arbitration is still on the table—specifically for claims regarding missed meal and rest breaks.  “It felt like they were coming at us to keep workers in their place and remind workers that they're just a number, that they're easily replaceable, that none of us matter individually,” Yates says. While there hasn’t been a change in leadership at Seattle Children’s that would explain this change, Hoogestraat thinks a few factors have contributed to a shift in the hospital’s tactics: First, WSNA is more active. Second, Hoogestraat believes the national political landscape has warped Seattle Children’s.  “We've been holding them accountable to a lot of things including their commitment to Diversity, Equity, and Inclusion and the care of our transgender youth,” Hoogestraat says. “[Seattle Children’s] has been influenced, it seems quite heavily, with the federal changes since the Trump administration took over.”  Earlier this year, Seattle Children’s stopped performing gender-affirming surgeries for patients under 19 years old after President Donald Trump issued an executive order banning them. A federal judge blocked that executive order, nullifying it. Seattle Children’s still put those surgeries on pause. Additionally, to comply with Trump’s orders, Seattle Children’s scrubbed diversity and inclusion references from their website. There’s also been a “real focus” on holding onto the money, Hoogestraat says. Last year, Seattle Children’s reported a gross revenue of $4.18 billion and a $1.9 billion endowment.  In an emailed statement, the hospital stated, “Seattle Children’s is committed to being a leader in total compensation (pay, benefits) in the Puget Sound region and must also prioritize financial stewardship in the face of potentially devastating economic headwinds, including significant federal and state cuts and taxes.” What Could Be Next  The Seattle Children’s nurses have never been on strike, but they’ve gotten close.  It takes a lot to make these nurses strike. During the great Seattle-area hospital strike in 1976, the nurses at Seattle Children’s didn’t participate because of how critical their specialized pediatric care was. But they’ve gotten close. In 1967, Seattle Children’s nurses signed a petition saying they would resign unless they received a fair contract. The hospital settled the contract before that happened. Then, in 1971, the nurses issued a strike notice, but a federal mediator helped find a settlement within three hours of the strike deadline.  “It's very hard to get them to even think about the possibility of striking, but they've been pissed off enough by this process and by the stance of the hospital,” Hoogestraat says.  If the vote goes through, then WSNA will go back to its Labor Executive Council to get authorization to strike. If that happens, they’ll give the hospital at least a 10-day notice of their intention to strike, plus when it would happen and for how long. In the meantime, they’ll continue negotiating.  In a statement, Seattle Children’s writes that it remains dedicated to working collaboratively with WSNA to reach a fair agreement as soon as possible. ...read more read less