Deal comes after 20 months of negotiations and a fierce anti-union campaign

Even as negotiations between nurses and Providence Milwaukie (Ore.) Hospital dragged on, registered nurse Barbara Cole let it be known that if the hospital bet on the nurses giving up, it was a bad bet.

"If there's one thing nurses know, it's endurance," says Cole, who has worked in labor and delivery for 21 years.

In November, that endurance paid off. The nurses voted overwhelmingly, 75 to 1, to ratify their first contract Nov. 14, bringing closure for nurses who have negotiated with the hospital for nearly two years.

Many of the nurses have known each other for years, working and living together in their rural bedroom community of Milwaukie just outside of Portland. That connection "allowed us to weather the stresses and stay strong," says Cole.

The nurses voted for representation by the Oregon Federation of Nurses and Health Professionals (OFNHP) in December 2001 and had been at the bargaining table since March 2002. From the start, the nurses' focus has been on strengthening their ability to provide care.

Their contract victory comes after months of federal mediation. Last July, the nurses staged a one-day strike to protest unsafe staffing levels.

"This contract will help us to provide the best possible patient care at our hospital," says Sue Pettit, RN, a member of the OFNHP bargaining team and a critical care nurse. "We reached agreements on several proposals that involve our ability to advocate successfully for our patients and for our profession."

A highlight of the new agreement involves caps on "canceling," the widespread practice of revoking shifts that nurses are scheduled to work if managers determine that there are too few patients for the nurses scheduled. Many nurses are canceled one or more shifts weekly, making it difficult for them to meet their families' income needs and causing greater stress on nurses left at the bedside.

"We've lost several nurses" because of the practice, says Laura Beaulaurier, a member of the negotiating team and a medical-surgical nurse. "It's frustrating. They cut our hours to fit their needs."

Under the new contract, the nurses at the hospital may only be canceled a maximum of 144 hours per year. Most other hospitals in the region have no limits on how much RNs are canceled.

Once the hospital reaches its limit for canceling, the scheduled nurses will float to areas where they are needed. This will benefit them in a number of ways: They will be cross-trained and the hospital will not need to use agency nurses as much.

The nurses agree to float as long as they are properly trained and they believe the solution is much better for everyone involved, especially the patients, says Beaulaurier.

And says Cole, it changes the way the hospital does business. "Instead of balancing their budget on nurse's backs, they will have to be responsible to the people they hire."

The nurses also gained a voice in patient care decisions through the creation of a nurse practice committee, which will address issues such as staffing levels, workload, equipment selection, health and safety. A RN also will participate on a panel for product review and analysis, which selects medical devices.

The union won across-the-board raises of 6.5 percent and 4.5 percent over the life of the two-year contract, but total pay increases for the RNs will range from 15 percent to 38 percent because of a conversion from merit-based to tenure-based pay that will
alleviate many longtime inequities.
Retirement and health benefits contributions also will be guaranteed until the contract expires in December 2005.

"It's not about money, though. It's about our patients," says Dale Smith, RN, president of PMH Nurses United/OFNHP. "Fixing these pay discrepancies and guaranteeing benefits will help us keep the best nurses here at our hospital and will make our hospital an increasingly attractive employer."

The fierce anti-union campaign prompted the nurses to join a coalition of healthcare workers in the Providence Health System. The coalition will begin working soon on widespread issues such as staffing, healthcare benefits and pensions.