Bargaining for Pay Equity

Pay inequity for nurses trained outside of the United States has been an issue for a very long time,* but it can be hard to address because many nurses simply aren’t aware they’re being paid less than they should be. It only came to the forefront for the Washington State Nurses Association (WSNA) at St. Joseph Medical Center in Tacoma (St. Joe’s Tacoma) as a bargaining issue in 2024, with two Filipino nurses who were brought to the United States by an agency and were roommates. One was working at St. Joe’s Tacoma, and the other was at another hospital in the same health system. They were on the same wage scale, both represented by WSNA, but the nurse at St. Joe’s Tacoma started at a lower rate than her roommate. She came to me wanting to know why.

HR told me that it was the health system’s practice to give nurses with experience in countries other than the United States or Canada—which means primarily people of color from Asia, Africa, or the Caribbean—only 50 percent credit for that experience. It wasn’t an official policy; it was just the practice they had followed for decades, through several mergers and ownership changes. When confronted, HR’s response wasn’t Let’s take a look at this practice so we can ensure our nurses are compensated equitably; it was Tell us who the other nurse is so we can bring their pay down. I was shocked.

Our contract language had no carve-outs for nurses with international experience, so we started digging. First, we sent a survey to members asking how their international experience was credited. We got a range of responses. Some received full credit, but most people received 50 percent credit, and some received no credit. With that information in hand, we filed an association grievance on behalf of WSNA. There were 13 named nurses in that first grievance; when I got their hiring documents, I saw that there was always a note on their credit experience sheet: “Philippine nurse, half credit.” There was no further explanation.

When I asked administrators about the reasoning behind the half credit, I was basically told “They’re not doing the same work ‘over there,’ so the experience isn’t the same.” That’s ridiculous, particularly in the Philippines, where nurses are trained in English in American-style hospitals for the specific purpose of coming to work in the United States. Employers know it’s untrue, too. If they really thought nurses trained elsewhere weren’t ready to work in US hospitals, they wouldn’t send them straight to the floor after orientation—they would have to offer additional training. But this pay inequity is not about experience. It’s about profit.

When we filed the grievance, we were preparing to go into bargaining, so the employer and WSNA agreed to put the grievance in abeyance to see if we could work it out in negotiations. We were fortunate to have Kathleen Jabasa, a Filipino nurse, as one of our bargaining team members. She fought hard at the table to get the employer to understand how racist and xenophobic this practice was, and she told her story and the stories of her coworkers in a very powerful way. She was a huge help in convincing the employer to end this practice.

Our agreement included a six-month period for affected nurses who came forward to be re-stepped, but we could not get the employer to agree to full back pay. They said it would be too difficult, and they weren’t willing to put in that effort. That was disappointing, but getting people to the appropriate step and making sure this process won’t happen moving forward is still a huge win for our international nurses.

Of the 37 affected nurses at St. Joe’s Tacoma, more than 30 were from the Philippines, but nurses from Ghana, Saudi Arabia, South Korea, and India were also affected. Four of the nurses were already at the maximum wage scale because they had been at St. Joe’s Tacoma for so long, so they couldn’t be re-stepped. We were able to come to a settlement agreement with the employer for one-time payments of $5,000 each. That isn’t anywhere close to what they are owed, but it’s all the employer was willing to pay out.

Since then, we’ve gotten the same deal for a sister facility from the same company, St. Clare Hospital in Lakewood, Washington. That’s a much smaller hospital—200 nurses, compared to 1,100 at St. Joe’s—but we got 15 nurses there re-stepped. We’re also heading into negotiations at Virginia Mason Medical Center, our third hospital from that parent company, and we expect to get the same deal there. And it’s been a key part of our negotiations for units at other health systems. Tacoma General has already stopped this practice, and we’ve secured contract language prohibiting them from reinstating it. They’re also going to open an experience review period for anyone who thinks they may not be at the correct wage scale. We’re proud of the progress we’re making, but we also know we’ll continue to see the effects of this unfair practice, so we’ll keep fighting for as long as it takes.

Jared Richardson, RN, is a Washington State Nurses Association nurse representative and a former combat medic.

*See, for example, go.aft.org/pfu. (return to article)

[Photo credit: courtesy of the author]