The good fight at Good Sam

Historically, contract negotiations at Good Samaritan Hospital in Puyallup weren’t contentious.

But by 2023, things had shifted.

The nurses at Good Sam were angry. They were exhausted from their excessive patient loads, many of these patients heavier and sicker than in years past.

In the last two years, reported incidents where unsafe staffing posed a serious threat to the health and safety of a patient went up 600%. Nurses regularly went entire 12-hour shifts without being able to break and use the bathroom, eat, or rest.

The 750 nurses represented by WSNA at Good Sam were after nurse-to-patient ratios, which Tacoma General, another MultiCare hospital represented by WSNA, won in 2016. And they wanted break nurses, which Tacoma General won as a result of an arbitration that enforced a settlement to a lawsuit a few years later.

The Good Sam nurses had tried to create safer working conditions. They created staffing plans with the chief nursing officer and other nursing managers that had unanimous labor and management approval. However, these carefully crafted plans were often vetoed by MultiCare leadership. Until passage of the 2023 staffing law, state law allowed CEOs ultimate veto authority.

Unless a staffing plan was baked into a contract, the hospital didn’t have to follow it because enforcement was lax.

Meanwhile, management was telling nurses of looming changes in patient care delivery, such as team nursing and virtual nursing (in which an off-site nurse is present through distance technology), which could lead to even worse staffing if used to substitute for bedside registered nurses.

And now MultiCare Good Samaritan was seeking permission from the Washington Department of Health to build a new tower with 160 patient beds without a plan to staff it.

Coming together

When negotiations for a new contract started in January, nurses were fired up. But it would take 20 bargaining sessions, six months, many tears, endless pizza, and persistence to reach a new contract.

The frustration that started with working conditions in the pandemic burst out in the hospital as soon as negotiations started. Hundreds of nurses ordered WSNA T-shirts.

In February, MultiCare sent a note to staff saying they could not wear third-party shirts or shirts with logos, which meant that nurses could not wear shirts displaying the WSNA logo. Nurses were angry at this arbitrarily enforced “rule.” Some put union stickers over the WSNA logo. Others, such as Jared Richardson, co-chair of the bargaining team and a registered nurse in the med-surg unit, wore theirs inside out and wrote with a Sharpie, “Ask me why my shirt is inside out.”

The bargaining team was mobilizing.

The 10-member bargaining team, a combination of unit reps and union officers, was a good mix of different personalities. A few people had done negotiations in the past, so they knew how things went. Many, however, were new to bargaining and nursing, such as Ashley Eubank, a unit rep and nurse in the cardiovascular and interventional radiology unit.

Eubank graduated from nursing school at Tacoma Community College in the fall of 2020. She had missed a whole quarter of in-person clinical because of the pandemic. After just three months on the job, Eubank said she was asked to train other nurses, and she said she was getting complicated patients. It was hard to keep up, and she was being asked to work back-to-back shifts.

“I started speaking up, saying this is not safe over and over,” she said. “I couldn’t handle working three shifts in a row.”

She learned about assignment despite objection (ADO) in 2021, when single rooms became double rooms, and she became an activist after filing her first ADO. She said a manager told her it was inappropriate for her to file an ADO because she had a certified nurse assistant working with her.

“I was 4:1. Everyone else was 2:1,” she explained.

Eubank had become a nurse because it was a nurse who helped her through her personal experience having a stillbirth.

“I remember her telling me how strong I was. Then she gave me a hug,” Eubank said. “I wanted to make people feel the way that nurse made me feel.”

But, as a nurse, Eubank was feeling overwhelmed.

“I don’t like conflict. I don’t like to rock the boat,” she said. “But if you want change, you need to do something.”

Then there were veteran bargaining team members like Dawn Morrell, who worked in the Cardiac Cath Lab.

Morrell had been at Good Sam since 1984. As a five-term state legislator for the 25th District, she authored a safe staffing bill in 2014 that created staffing committees at hospitals. She said nurses had been through hell during the pandemic.

“The staffing committee not being listened to was the breaking point,” she said.

But even she wasn’t expecting huge movement by management.

“I was very proud that these young nurses stood up,” she said.

The tough haul

The bargaining team provided several proposals, including putting the hospital’s own safe staffing plan, filed with the Washington State Department of Health, into their contract.

MultiCare rejected any proposal with language on safe staffing.

Richardson said there were at least four to five sessions where members of the bargaining team were in tears telling the management team intensely emotional stories of taking care of critically ill people.

The informational picket on April 26 was their outlet. The speakers channeled the anger of the nurses. Atalia Lapkin, a member of the bargaining team and an ICU nurse, yelled to the crowd:

“We have tried negotiating, it didn’t work. We tried a petition, but it didn’t work. We are out here picketing. We hope it works. But if it doesn’t, we have to keep moving … We don’t want to strike. We want to do our jobs. But we want to do it safely.”

Two days later, more than 70 nurses took part in a public hearing over a proposed patient tower at Good Sam with 160 beds. The nurses were all in favor of expanding much needed patient care, but repeatedly challenged MultiCare considering the current state of staffing, how did they plan to staff 160 more beds?

On May 16, a vote of no confidence in MultiCare CEO Bill Robertson was passed unanimously with 400 nurses voting. A day later, two billboards went up on I-5, saying, “Hey Bill!! Safe nurse staffing saves lives. Support WSNA nurses at MultiCare Good Sam.”

WSNA lawyer Pamela Chandran said every action by the bargaining team was exceeding expectations due to the engagement of the nurses.

“This was running a marathon in three months for these folks. It was extraordinary the challenges the unit took on,” she said.

And still no movement.

Chandran said the primary negotiator was from MultiCare, the rest from Good Sam. She said Good Sam’s chief nursing officer stopped coming, and the team felt they were being gaslit.

MultiCare made it clear that they would not put anything about break nurses, ratios, or a specific staffing plan in the contract. But management did send a divisive letter to the bargaining unit, saying, “this is what you are making now, and here is what you could be making.”

At one session in May, MultiCare reps told the team, “You will be happy with our proposal,” but it was nothing that they wanted. It was after 2 a.m., and the bargaining team just walked away drained and frustrated.

“It felt like pushing a boulder up a hill,” Richardson said.

The team took a two-week break in June.

Strike assessment

No one wanted to strike, but the nurses felt backed into a corner.

“We are already spread so thin,” said Erin Butler, a bargaining team member on the Progressive Care Unit. “And when you put more and more responsibility on nurses — it puts our licenses and livelihoods at risk.”

Before the strike vote, MultiCare sent employees inaccurate FAQs about strikes and said that management would try to protect people from picketers damaging cars, causing violence, rioting, and bullying and insulting people across the picket line, said Chandran. However, the union had pre-empted management’s misinformation by holding multiple meetings to inform nurses of their legal rights and to provide factual information about strikes. By the time the FAQs came out, Good Sam nurses were fully inoculated and educated.

The strike vote on June 20 and 21 engaged the media. Camera crews were filming nurses filling out their ballots outside the hospital, some who had driven hours on their day off to vote. On the second day of the strike vote, the union bargaining team was back at the table with management.

Nurses were taking photos, and social media was going wild. Nurses in the field and nurses at the table were communicating furiously, exchanging information and updating each other.

The tally came in shortly after 9:30 p.m., June 21. More than two-thirds of the bargaining unit had voted, and 95 percent said yes to a strike. The vote was making headlines.

During bargaining that day, management showed up with a proposal a little bit better than their last one. The WSNA nurses responded with a comprehensive proposal that held on to better staffing and break nurses.

Immediately after the strike vote was made public and the news outlets interrupted broadcasts with “breaking news” of a potential strike, the team started seeing a change in management’s proposals. Both sides were going back and forth.

Just after 4 a.m., WSNA lawyer Chandran asked, “So, do we have an agreement?”

The answer was yes.

Management agreed that nurses would have dedicated break nurses and staffing plans written into the contract. Nurses would also be given 12-24% raises in the first year of the contract, ratification bonuses of $3,500, and a charge nurse and flex nurse for each unit.

The nurses were cheering and crying.

“The contract we got had just about everything we wanted,” Richardson said. “This came from nurses wanting to strike. I was blown away by that power. I knew it was possible. But to see it in action was something else entirely.”

The Good Sam bargaining was one of the longest and hardest Chandran said she has experienced of more than 100 negotiations. She credits all Good Sam nurses for fighting for what they wanted.

“For nurses to conquer the fear of the unknown and the heartache of walking away from patients is a hard choice,” she said. “The bargaining team provided such effective leadership. It was incredible to watch.”