At the entrance to Providence Seaside Hospital Friday morning, dozens of nurses, many clad in green rain ponchos bearing the Oregon Nurses Association logo, gathered in the drizzle wielding picket signs.

It was the first day of an open-ended strike — reportedly the largest strike by health care workers in Oregon history.

The Seaside nurses, whose contract ended on Dec. 31, had been attempting to negotiate with Providence Health & Services management since October. The Nurses Association represents 115 registered nurses at Seaside.

Along with Seaside, health care workers at seven other Providence hospitals in Oregon walked off their jobs at 6 a.m. Friday, along with workers at six Providence clinics in Portland, advocating for safe staffing practices, fair compensation and adequate paid time off.

In all, nearly 5,000 nurses and other frontline health care workers in Oregon reportedly were on strike, the Nurses Association reported, although a Providence spokesman said 609 union-represented workers showed up for work Friday.

Providence Seaside, along with Providence’s other hospitals in Oregon, remained open. Both sides in the dispute urged people in need of medical care to get the treatment they need, despite the picket lines.

Mary Romanaggi, an emergency room nurse, has worked at Providence Seaside Hospital for 40 years. She had planned to retire this year, she said, but didn’t want to leave her coworkers and the hospital in the current state of limbo.

“We went to coordinated mediation in December, with all of the Providence facilities, but Seaside just didn’t get a voice at the table,” she said.

And then, she said, Providence stopped bargaining.

“I mean, we could go to the table and we could talk, but we’re just, like, bargaining against ourselves,” she said. “You know, giving them proposals, and they’re like ‘No, we don’t like that,’ not giving us any counterproposals.”

Providence officials said they stopped negotiating when the Nurses Association issued a required 10-day notice of the strike on Dec. 30; Providence said it needed to focus during those 10 days on arranging for about 2,000 temporary workers to replace the striking nurses.

Staffing and wages

Safe staffing is at the forefront of the issues raised by the Nurses Association. The union says it’s seeking contract language that assures having sufficient nurses to meet patient needs at all times and making sure nurses are not overworked.

A state law passed in 2023 mandating minimum nurse-to-patient ratios has been helpful, but many nurses say it is not enough. “Acuity,” which refers to the severity of patients’ cases and the complexity of their care, was not addressed in the bill, and has become a primary issue in recent negotiations.

“If you need two nurses to manage a heart attack or a stroke or a trauma or a brain bleed, you have to provide more nurses for your department, and so it’s just more money,” Romanaggi said. “But it’s a patient safety issue, to be honest with you. We’ve been fighting for that for years, and we’re finally getting somewhere with this new staffing law, but it’s just a battle. And so we want language in our contract to help strengthen that.”

Though issues surrounding fair compensation and adequate paid time off have taken somewhat of a back seat to concerns over patient acuity, labor and delivery nurse Heather Medema said those issues remain vital.

In Seaside, nurses have reported being paid less than their counterparts in other Providence facilities.

While on strike, some workers can fill out an application for the Oregon Nurses Association Hardship Fund, which can help tide nurses over for a time. But not everybody is eligible.

“Leading up to this, a lot of people have been picking up extra shifts or cutting money where they can,” Medema said. “We’re not loaded. I’ve seen posts on Facebook saying that, like, we just want to get richer. We’re not rich, we just want fair compensation like the rest of the region.”

She said out-of-pocket expenses for health care are a related issue.

“And then the other issue for us is our PTO, our paid time off; that is not just vacation time,” she said. “That is also our sick time. … You get tired, worn out. You get sick from patients and you need to take time off, and our time (off) is very, very limited.”

Providence CEO Jennifer Burrows said Friday that the Nurses Association called the strike “with the intent of disrupting patient care,” a charge that the union disputes.

Providence officials also said they had offered a 20% raise over the next three years for acute-care nurses with a double-digit pay increase after contract ratification.

“They keep throwing money at us,” said Romanaggi. “It’s not the issue. It’s the power of the contract. It’s alignment with the other Providence facilities, and it’s safe staffing. I’ve been here 40 years, and I remember working and taking care of ten patients.

“You’ve probably heard of nurses’ moral distress,” she said. “It’s because you go home at night and think … you didn’t give patients the care you were trained to do, or they deserve to have. And that’s getting better because of these nurse-driven staffing laws. We’re the ones that keep negotiating better staffing, and we want that in our contracts.”

The walkout also marks the first time in Oregon that doctors have gone on strike; about 70 doctors who work at Providence’s St. Vincent Medical Center in Portland, along with 80 doctors, clinic nurses, midwives and nurse practitioners at Providence’s six women’s health clinics in the Portland area joined the walkout.

The striking doctors are limited to St. Vincent and Providence’s women’s health clinics in Portland, where the company has consolidated care at its clinics in Gresham and Beaverton. Physicians are not striking at any other Providence location.