Tufts Medical Center nurses and Tufts management are no better off now than they were a week ago, just before the 24-hour strike and four-day lockout of 1,200 nurses.
In the first such strike in Boston in 31 years, the workers, who are represented by the Massachusetts Nurses Association (MNA) union, decided to strike after failing to reach an agreement with management in 34 bargaining sessions that started in April 2016. When the nurses attempted to return to work last Thursday, they were locked out by human resources. The hospital hired agency replacement nurses who had agreed to five-day contracts when the union gave their 10-day strike notice.
There has been some progress. In addition to largely sympathetic media attention on the striking workers, Boston Mayor Marty Walsh is in contact with President and CEO of Tufts Medical Center Dr. Michael Wagner and the Tufts administration. Walsh, the former head of the Boston Building Trades, is offering to facilitate a negotiation.
But despite coming to some agreements on wages and safe staffing levels, the two sides remain far apart when it comes to pensions. At stake, and at issue:
- Tufts wants to slowly transition 341 nurses from defined benefit retirement plans (in which an employee’s pension payments are calculated according to length of service and the salary they earned at the time of retirement and paid by the employer) to 403(b) defined contribution retirement plans (basically 401(k) plans for nonprofit employees in which their pension payments are based on how much they and their employer contribute while they’re working) as a cost-saving measure. Both nurses and Tufts would be contributing to the new plan. Tufts says the price of maintaining what currently exists for those 341 nurses is $11 million. But the union says the 403(b) plan would increase the amount nurses would have to contribute for their own retirement. Several of those 341 nurses are over 30 years into their careers at Tufts, are close to retirement, and are furious over this not being what they bargained for. As a concession, on the eve of the strike, Tufts made a final offer to the union to extend the current pension plan for 18 months but claims the union left the table without considering the proposal.
- The MNA is proposing a Taft-Hartley plan, a multiemployer pension plan that would involve freezing the existing defined benefit plan that a quarter of the nurses are on. The bargaining team claims that this would have generated “substantial hospital savings that could be used to fund staffing improvements to protect patient care, and ensure market competitive wages.” They told DigBoston that Tufts management rejected the proposal despite knowing it would save the hospital $96 million overall. In response, Tufts management said that the MNA retirement proposal “would cost the hospital more money yet provide nurses a smaller retirement benefit” than their own and that the MNA’s proposed plan isn’t insured to the same level as a private pension plan. It has been widely reported that many multiemployer plans are in financial trouble, and that some—including the massive Teamsters Central States and the United Mineworkers of America plans—will go completely bankrupt within a decade. But advocates say that a government infusion to the federal Pension Benefit Guaranty Corporation (PBGC) that oversees such plans would allow them to get back on their feet.
This isn’t sitting well with nurses.
Clare Dalton is a full-time oncology unit nurse who has worked at Tufts Medical Center for 14 years and whose patients often remain in her care for several months. She was picketing with her husband and three teenagers last Friday evening and showed the Dig a picture of a cake that a patient made in support of Tufts nurses.
“Our patients are our family,” Dalton said. “I cried when I got the cake … We’ve given up so much. It’s the hospital’s turn to give up a little bit.”
Dalton’s biggest concerns: safe staffing, available resources, and her pension. Giving one example of a grievance, she said that there are often no IV nurses during the night shift on her unit, even though it takes a special skill to locate veins.
“We need specialized nurses for that, and we don’t have them around the clock,” Dalton added. As for her retirement plan…
Tufts management put together an individualized sheet explaining what changes would occur to pensions under the new model. “Our [sheet] says they’re matching 99 percent of what you would have had [under the former arrangement],” Dalton said. “But it’s deceitful.”
Another point of contention has been safe staffing. In its most recent annual survey of registered nurses selected at random, the MNA reports that 87 percent of respondents said they didn’t have enough time to properly “comfort and care for patients and families due to unsafe patient assignments”; 63 percent reported seeing injury and harm to patients due to understaffing.
According to a contract proposal that is currently in limbo, the MNA wants to focus on increasing the amount of IV and “charge nurses,” who can manage responsibilities during any shift.
According to MNA spokeswoman Jennifer Johnson, the union proposed compliance with an intensive care unit nurse safety law, An Act Relative to Patient Limits in All Hospital Intensive Care Units, from 2014 with 1:1 and 1:2 patient assignment ratios.
“It became apparent it’s hard to achieve because it’s expensive,” Johnson said. “They [Tufts management] withdrew that proposal, which was a massive concession for the union. What we asked for instead was additional resources and improvements for charge nurses.”
REPLACING 1,200 WITH 320
Tufts Medical Center hired 320 agency nurses, most of whom were from out of state, to replace union nurses during the strike. As a result of the required 10-day strike notice, Tufts says agency nurses were recruited to fulfill five-day contracts at a minimum. According to details provided to DigBoston by a Tufts media representative, on the day of the strike, 230 of the 320 hired agency nurses were working, with 312 patients in beds and 60 scheduled surgeries.
In a statement to DigBoston, President and CEO of Tufts Medical Center Michael Wagner, MD, wrote of the replacement nurses, “More than 320 highly skilled nurses are joining an outstanding care team comprised of physicians, physician assistants, clinical care techs, respiratory therapists, social workers, residents, fellows and many, many others. Together they will deliver the same high quality care that our patients know and expect from us.”
Mary Cornacchia, an OR nurse and co-chairwoman of the union’s bargaining unit, dismissed the experience of agency nurses as “minimal,” while other nurses noted concerns over the temporary workers learning the Tufts computer system and being up to date on the needs of long-term patients.
In a move that the union calls unprecedented, Tufts Medical Center senior staff sent 1,200 MNA nurses letters encouraging them to voluntarily leave the union. The sample letter, which was dated July 5, 2017, and sent from Chief Nursing Officer and Senior Vice President of Tufts Therese Hudson-Jinks, said:
I, ______ am an employee of Tufts Medical Center, and a member of the bargaining unit there. I hereby resign with the MNA and all of its affiliated labor organizations effective immediately. This decision was mine alone and voluntarily made. As a nonmember, I invoke all my rights under applicable law and I am no longer subject to the MNA’s constitution or by-laws.
The letter, which also noted that “the Medical Center is not asking its employees to resign from the union or suggesting they do so” but rather was attempting “to provide [nurses] with factual information,” was sent to the bargaining unit and to the rest of the 1,200 union nurses at Tufts. Four members opted out. The rest went on strike.
Commenting on the management letter, MNA spokesperson Johnson told DigBoston, “This was nothing short of a classic union busting effort. It encouraged nurses to change their status as full-time members to the equivalent of non-voting, reduced-dues-paying members. It did nothing to help the nurse to change her status, and quite frankly it did nothing to help the hospital … Management’s goal was clearly to carve off a bigger segment of nurses, but they failed to do so. In the end, it really only made the union stronger. But the nurses will never forget what management attempted to do.”
Asked why Tufts management resorted to the letter, spokesperson Rhonda Mann told DigBoston, “Because the union was not sharing that information … and we were being asked by dozens of nurses.”
NOT A DAY OF REST
Politicians have publicly supported the MNA during the ongoing picket. US Sen. Elizabeth Warren sent muffins and gallons of coffee to nurses, while Mass officials like state Rep. Mike Connolly spoke at a noon rally on Thursday. Connolly, a recently elected rep from Cambridge, told DigBoston there’s a bigger issue at hand.
“Consolidation we’re seeing among hospitals in the Boston area is creating a negative impact around your ability to negotiate,” said Connolly, referring to the many area hospital and health company mergers in the past decade. The latest such move being considered by the Commonwealth’s Health Policy Commission is between Beth Israel Deaconess Medical Center and Lahey Health.
Other unions, including SEIU locals, Massachusetts Teachers Association, and Boston Building Trades, as well as community groups, have backed the union’s proposals and been out to the picket line.
Meanwhile, barbs are still being exchanged. On Sunday morning, the Tufts administration released a statement saying that MNA supporters “attacked buses trying to bring [replacement] nurses to work,” while management claimed that striking workers “threw coffee on bus drivers, pounded on windows, and stood in front of buses as they tried to leave.” The statement, sent to DigBoston via email, dug at the union: “The MNA says it stands for safety yet it physically threatened the safety of nursing professionals with these reprehensible actions. They also threatened safe patient care by attempting to delay nurses reaching their patients.”
But did it really happen? Records show that Sheraton Boston Hotel management did call State Police to report a group of protesters picketing outside the hotel without a permit. State Police spokesman David Procopio told the Dig that there were indeed protesters there without a permit, but that “they were cooperative and dispersed without incident.” Procopio also said that there was “no violence or throwing of any objects or items, as some media have suggested.”
The protesters were activists from local community groups, not nurses.
As for when the next bargaining dates will be… A spokesperson for MNA said, “In terms of the mediator bringing the parties back together, she will absolutely do this at some point, but not immediately. She will allow for a cooling-off period.”