Tacoma General RNs win ratios in contract for first time in Washington

After more than a year of grueling negotiations, the WSNA nurses at MultiCare Tacoma General Hospital won a groundbreaking contract that for the first time in Washington state includes specific nurse-to-patient ratios. These ratios, and the guarantees supporting adherence to the ratios, are a big, concrete step towards safe and strong nurse staffing and patient care in Washington and across the nation.

“Getting ratios in our contract is huge,” said Renata Bowlden, a member of the contract bargaining team. “It’s all about staffing and having enough nurses to safely provide care. Ratios will certainly help get us where we need to be with staffing at Tacoma General.”

Hundreds of Tacoma General RNs turned out to the ratification vote on Jan. 4, and the contract was ratified with an overwhelming majority.

After a year of little movement in negotiations, MultiCare Tacoma General Hospital management stepped forward in the end and worked with WSNA to hammer out firm, detailed nurse-to-patient ratios. The ratios cover 10 units in the hospital: Medical/Surgical, Progressive Care, Critical Care, ED, OR, PACU, NICU, Birth Center, Women and Infant and Antepartum. There is a financial penalty of $5 per hour for nurses forced to “surge” up one or two additional patients, and the contract includes a hard cap on how many patients a nurse can take in a “surge” situation.

“Ratios are something we have argued for in many, many contract negotiations without success,” said Christine Himmelsbach, WSNA Assistant Executive Director for Labor. “I cannot overstate how groundbreaking it is to get nurse-to-patient ratios into our contract at Tacoma General, and I have to credit management for, in the end, hammering out this truly significant agreement. These aren’t mere recommendations that can be ignored — these ratios must be followed.”

These staffing ratios, while not perfect, are a solid foundation on which to ensure safe staffing. We are confident that better staffing will lead to safer patient care, increases nurse satisfaction and should help with the recruitment and retention of nurses.

The contract specifically allows charge nurses to take acuity into account when staffing and specifies that if charge nurses are assigned direct patient care of 50 percent of the unit’s ratio or higher, they may relinquish charge duties in agreement with a manager, or receive the $5 per hour ratio shift premium penalty.

“We really wanted to see the charge nurses used appropriately as part of this contract agreement,” said Danielle O’Toole, a bargaining team member. “Too often, charge nurses get pulled into direct patient care, which makes it impossible for them to carry out their charge nurse duties well. They needed to be empowered to have an out, which they get in this contract.”

The WSNA team at MultiCare Tacoma General began negotiating a new contract in December 2015. Reaching an agreement took 19 bargaining sessions, including four with the assistance of a federal mediator. Initial proposals from management represented a huge step backwards and were completely unacceptable to the WSNA bargaining team. Getting movement took a lot of hard work on the part of not just the officers and the negotiating team, but also the entire bargaining unit, the labor community, supportive nurses from other WSNA-represented facilities, elected officials and the entire staff at WSNA.

WSNA activities over the course of 2016 included TV commercials on Pierce County cable TV in April and May, an informational picket on June 27, a community rally and BBQ on Sept. 8, a “No Voluntary OT, No Voluntary Extra Shifts” job action in November and preparation for a Strike Advisory Vote planned for Dec. 16, which was called off when a Tentative Agreement was reached at 5:30 a.m. that morning. The WSNA bargaining team worked through the night on Wednesday and Thursday, Dec. 14 and 15, to reach a deal.

We had significant media coverage of the Tacoma General negotiations, particularly the week of the planned strike vote, with coverage from all major TV stations, radio and the Tacoma News Tribune. On Tuesday, Dec. 13, the Tacoma News Tribune ran an editorial headlined “MultiCare, heal thyself and avert a nurse walkout.”

In addition, the contract includes wage increases that closely track rates at St. Joseph Medical Center in Tacoma, including a retroactive increase covering all of 2016. Nurses also are set to get a ratification bonus of $2,000 and full back payments for the hospital’s annual “Gainsharing” bonuses withheld during negotiations.