Behind the scenes at Seattle Children’s bargaining

The first bargaining meeting for Seattle Children’s nurses was held in April at a law firm on the 30th floor of a downtown high rise, with a panoramic view of Elliott Bay.

Seattle Children’s Chief Nursing Officer Bonnie Fryzlewicz made the group salted caramel cupcakes with buttercream frosting.

Edna Cortez, co-chair of the union at Seattle Children’s, brought chocolate, because she said chocolate provides happiness and Seattle Children’s makes her happy. She said she told all those gathered, “We all are a team with the same goal.”

The hospital team of about 10 included legal counsel, nursing directors over patients and clinics, human resources, and managers.

The union team included legal counsel, the nurse representative, nurse organizers, and 11 nurses from the hospital.

Both sides talked about their common desire to uplift the 1,800 nurses at the state’s premiere children’s hospital.

Like at many hospitals, the pandemic had taken its toll. Seattle Children’s was down 400 nurses and was relying on travel nurses to fill the gaps.

The nurses on the Washington State Nurses Association bargaining team at Seattle Children’s were a mix of first timers and veterans to contract negotiations. The nurses came from all corners of the hospital, and while they were united in their desire for better wages and benefits for their colleagues, they had their own perspectives.

The hospital set the tone for common ground by starting off negotiations with a proposal to include Juneteenth as a paid holiday, effective 2022, even though the contract was not expiring until August. Juneteenth was offered in 2021 to other non-union and unionized non-nurse employees, but not WSNA nurses because of a disagreement over annual leave.

It was an unexpected and welcomed move by the hospital.

But these nurses had a much more ambitious list. They wanted wage increases, increased pay for relief charge nurses, equal holidays for the night shift, and student loan repayment. They also wanted a recalibration of how nurses climbed the steps of the wage scale. Seattle Children’s counted by hours worked, which had a prejudicial impact against part-time nurses or nurses who’d taken multiple leaves. WSNA nurses proposed years with the hospital instead, which would result in many nurses advancing steps on the wage scale, among other proposals.

The nurses were a powder keg coming out of the pandemic.

Seattle Children’s didn’t get hit like adult hospitals, but there had been some deaths, and there was a lot of fear. Like all nurses, they also had to wear a lot of PPE — mask, shield, CAPR (hood with ventilation). Nurses were getting sick, which exacerbated staffing challenges. An extra staff person was needed outside COVID-19 rooms to be a runner, so nurses didn’t have to change garb. Meanwhile, people were afraid of getting their families sick with COVID-19. The stress was burning them out.

The nurses had seen double digit pay increases for nurses at other hospitals — 11% at St. Joseph in Tacoma, 13% at MultiCare in Auburn, 13% at Mary Bridge Children’s Hospital in Tacoma, and were aware of the strike at Lucile Packard Children’s Hospital Stanford in Palo Alto, California, where the base wage was double that of Children’s.

“People were far more engaged because of the conditions all over,” said Diane Gates, a nurse with Children’s for 37 years. “There was a lot more expectation going into bargaining.”

Both sides wanted a solution to crisis staffing. Paying travel nurses two to three times the salary of staff nurses was not sustainable. Nor was seeing nurses leaving.

The union proposed a bold wage plan in the second or third session, said Pamela Chandran, legal counsel for WSNA.

“There were no apologies. We had big numbers. Initially, we proposed 18% the first year, 15% the second, and 12% the third,” she said.

Ian Mikusko, strategic researcher, delivered a financial presentation showing how much money the hospital had and why the hospital needed to do more and better. The presentation seemed a shock to many members of the teams — the union’s and the hospital’s. They didn’t realize the extensive assets of the hospital.

The hospital responded that it wasn’t California and that its wages were market rate. The hospital also said that it did not disagree with the union’s financial presentation, but that they would have phrased it differently.

Children’s initially proposed increases in the low-to-mid single digits. They also proposed taking away rights and benefits that were in the previous contract, like limiting access to union reps and eliminating reimbursement when nurses had been exposed to communicable diseases while at work. This last proposal was particularly contentious. Nurses had negotiated that very language in the preceding contract in 2019, prior to COVID. The hospital breached the contract by refusing to pay nurses when they were exposed at work, and the union had been grieving this issue for years.

The hospital team presented themselves as not a whole lot of change was going to happen, according to the six people interviewed for this story. The hospital counter proposed minor increases to a few pay differentials. It was a wide gap between what the nurses were asking for and where the hospital was at.

The union argued that the hospital was not at market rate if they could not attract or retain nurses ­— they were merely paying a little more than other Seattle hospitals that also couldn’t attract or retain nurses. A true market rate meant that Children’s would pay a rate that would actually compel nurses to work at the hospital.

And the negotiations continued.

“Bargaining has a rhythm,” said Chandran. “Both sides agree to a bunch of stuff in the beginning. Then there are the doldrums in the middle where proposals and counterproposals go back and forth. At the end, it’s Jenga, and everything falls together.”

She said the two things that are needed for a successful contract campaign are anger and hope. The team had both. But hope was tested in the last two sessions.

Chandran said she has probably worked on 100 labor contracts, none as intense as Seattle Children’s.

The last session lasted 19 hours.

Every member of the bargaining team had to be on board with the final decision to accept a tentative agreement and agree to recommend it — a hard task with 11 nurses with different backgrounds, experiences, and opinions. But the bargaining team needed to be a united front.

“Where is our window that says you got everything you’re going to get,” said Gates, “that if you push it more, you might push it over the edge? We were trying to figure out where the edge of that window was.”

The nurses all had great respect for each other and wanted the best outcomes, but they didn’t all agree. Some bargaining team nurses wanted to harness their strength and momentum and push harder; others were concerned that the hospital’s proposals were good enough that they would lose more timid nurses.

The discussions tested friendships and professional relationships. They got angry at each other. Emotions ran high. People took walks. Things got snippy. Cortez said she probably cried after each meeting. She wasn’t feeling well, and she was frustrated.

But many said they felt a bond like a family.

“There was a lot of camaraderie,” said Gates. “We came from all walks of life and experience. That’s why it was so successful. … Our whole was greater than our parts.”

“I think it was just a really incredible group of people,” said Annika Hoogestraat, a member of the team. “We did a good job of listening to nurses’ concerns.”

Gates said those who felt the team was overreaching were pushed past their comfort zone to look further. And those that wanted more realized they would have to lower their expectations.

“It took all those personalities to get where we are,” she said.

For many on the team, the talks didn’t get serious until it was close to the picket on Aug. 9 and their contract was expiring.

“The picket was really powerful,” said Hoogestraat.

More than 900 nurses and 400 supporters — community members, neighbors, family members, members of other unions, kids, dogs — took part. And they got lots of support from cars driving by. Every local media outlet covered the story.

The nurses realized they were standing up for change that needed to happen not only at Seattle Children’s but also for other nurses.

“We knew other institutions were opening contracts based on our outcome. We needed to fight for what we are asking for,” said Hoogestraat. “We were not being ridiculous.”

After the picket, the bargaining team met with a federal mediator for three sessions.

The first meeting, the hospital wasn’t budging on wages.

The divide with management was getting wider. Nurses said the hospital’s negotiating team felt hostile. They understood the hospital was a business. But nurses said the leadership wasn’t getting what it would take to fix the problem.

“It’s like we were speaking two different languages,” said Gates.

And while the nurses went to every bargaining session, some members of the negotiating team for the hospital didn’t show up because of vacations. It gave nurses the impression that they didn’t take the talks seriously.

One of the most emotional days was late in negotiations when, unscripted, each nurse stood up and told management what they had been through and why they were fighting hard for the issues still on the table, compensation being first and foremost.

The nurses were ready to vote no confidence in the hospital leadership and start strike preparations.

The nurses felt defeated and exhausted.

Then, they took a hard look at the open issues and decided which were critical to walking away from the table with a great contract, and which were important but showed no traction on the hospital’s side. Much emotion was centered on the issue of student loan repayment. For a moment, it seemed as if some language about student loan repayment could be possible, but the gap between what the union wanted and what the hospital was willing to agree to was too wide. For Erin Doyle, a nurse who graduated in 2018 with $90,000 in student loans, she was passionate about repayment.

Others argued that it was more important to put their effort in wages to help people pay back their student loans.

Doyle was conflicted.

“I wasn’t ready to stop fighting,” she said. “In hindsight, I’m not sure really anything would have been good enough.”

She said she knew members of her team wanted to strangle her. But she wanted to be sure they weren’t giving up the fight because they were tired. She felt strongly the hospital could agree to a very limited student loan program. But this was a sticking point.

After midnight, Chandran asked their opinion. “Would the bargaining unit strike over what management had on the table?”

Cortez said she took pride in reminding everyone: “It’s not all about individuals. It’s about the greater good.” She told the group, “What we got now is really good.”

The hospital had come up on wages and, at the very end of the night, agreed to a contentious provision that impacted compensation that had been a holding point. That was a breakthrough moment.

But not everyone was on board. And the stress was skyrocketing. All were suffering from physical stress, said Gates.

Nurses view striking as a last resort. The uncertainty and disruption is something no one wants.

One of the team members, Katie Pobdonik, used to work in human resources, and she came up with an idea midway through negotiations that the nurses started to really get behind. She said the raises should be done as a dollar increase to hourly wages, not as a percentage. This would give newer nurses a disproportionately higher bump to their base wage than senior nurses without appearing divisive. She calculated how much extra money the nurses would get over three years, and that changed the game.

By increasing wages by $10 an hour the first year, this will keep a lot of nurses and bring in new nurses because the base rate will be quite high. The nurses called it “The Katie Plan.”

With the help from Travis Elmore Nelson, the WSNA nurse representative, and Chandran, the team worked through the cost-benefit analysis in detail: Where was the balance between a great contract and possibly starting over if they walked away? And no one wanted to start over.

Doyle said she came around to supporting the plan around 1:30-2 a.m.

At 3:45 a.m., Chandran walked into the room subdued, slowly took off her mask, and quietly said, “We got a deal.”

Gates and Lindsey Kirsch, a long-time nurse who had been on three or four other contract negotiating teams, leapt from their chair and started hugging everyone. Gates said there was a range of emotions. Some were stunned. Most were relieved.

The team had been running on fumes.

Doyle said she had to go home and sleep on it. Then she realized, “This was an amazing deal.”

By all accounts, this was a brutal bargaining session.

It was also historic.

The bargaining team achieved unprecedented wage increases — $6 an hour for each nurse in the first year, an additional $4 in less than a year (a $10 increase within the course of 12 months), and 3% in the third — a recognition of years (not just hours) of experience, and other improvements. The student loan repayment proposal was no longer on the table, along with a differential for in-patient nurses.

“This was emotionally challenging, physically challenging with long hours, and professionally challenging,” said Kirsch. “But in the end, we got what was fair and what was right.”

The team had paved the way for other nurses in other hospitals. They received messages from nurses and other unions across the country thanking them for opening the doors.

It helped set the ground for record wage increases at Swedish and UW Medicine campuses at Montlake and Northwest.

“It was a paradigm shift for the nursing industry and the healthcare industry for the region,” said Kirsch. “I have been proud but never so proud.”

The contract was overwhelmingly ratified by the SCH nurses, who turned out to vote in record numbers.