On the heels of a five-day strike by Providence nurses in June, 3,500 nurses at Oregon Health & Science University (OHSU) hospitals in Portland and Hillsboro could become the second group of nurses to strike this year.

OHSU nurses, who are unionized with the Oregon Nurses Association (ONA), are working on an expired contract and have locked in negotiations with the hospital for more than six months over the terms of a new deal. So far the two sides have yet to reach an agreement—with OHSU nurses sharing many of the same concerns that drove Providence nurses to strike. 

Foremost among those concerns is staffing. Nurses at OHSU say their departments are chronically understaffed, leaving nurses who remain with the organization overworked, and patients underserved. 

“I was never a union person,” Alejandra Rotolo, a staff nurse in the mother-baby unit who has been with OHSU for nearly 12 years, said. “I’m not in the negotiation team or anything like that. I decided to become more involved because I realized that our voices were not being heard.”

Rotolo said that her nursing unit is frequently short two to four nurses, forcing the unit to bring in nurses from other units to help try to make up the difference.

The staffing concern is not unique to OHSU. A survey conducted earlier this year found that some 100,000 nurses across the country have left the profession since the onset of the COVID-19 pandemic, with the effects visible in hospitals across the region. 

Just outside of Oregon, other health care organizations are also seeing labor disputes. Roughly 350 technical workers at PeaceHealth Southwest in Vancouver, Wash. are planning to picket next week, urging improved staffing numbers and increased wages.

OHSU, like a number of other hospitals, has increasingly turned to travel nurses to fill the gaps. Diana Bijon, a staff nurse in the emergency department and a member of the union’s bargaining team, said that continues to be an issue. 

“OHSU has really continued to rely heavily on travel nurses, who are really temporary workers,” Bijon said. “And so while some of them are wonderful, many of them are mediocre, and none of them engage in any department improvement projects or anything that is future-focused for the institution.”

Nurses want to see OHSU begin to address one of the roots of its staffing issues over the life of their next contract by focusing on retaining veteran nurses in addition to recruiting new ones. Nurses floated retention bonuses and cost-of-living wage increases as potential avenues for OHSU to boost its retention rate. 

Access to paid time off can also be an issue. Bijon, a mother of three, said that for years she couldn’t get vacation time approved for the weeks and months when her children were on school breaks. It was only after she changed roles in the emergency department to a position without health insurance that she was able to set her own vacations. 

A spokesperson for OHSU wrote in a statement provided to the Mercury that the hospital system “deeply appreciates” its nursing staff and remains committed to the bargaining process.

“We are dedicated to bargaining toward our shared goals of a safe, healthy and respectful working environment,” the statement read. “As the process proceeds, the OHSU bargaining team looks forward to continuing thoughtful, productive negotiations.”

The stakes of the negotiation at OHSU are particularly high given the hospital’s role in the state’s health care landscape. 

“We’re one of only two level one trauma centers in the state,” Bijon said. “It’s us and Emanuel. We provide the highest level of care to the most complex cases in Oregon and a four state radius and beyond. We take care of the patients no other hospital in the state can take care of. They’re all flown to us.” 

Bijon said in the emergency department, that often means patients need more intensive care from nurses than is typical at other hospitals. 

“Patients lie on the ground in my waiting room every day, because there’s nothing better and that's the most comfortable place for them to be,” Bijon said. “And that’s all we have. We’re still in this crisis mode, two years after COVID. We have not done better.”

Bijon said that level of stress is taking its toll on staff nurses, who in some cases feel unable to provide their patients with an ideal level of care. 

“You do your best every day, and your patients are still suffering and you feel like you’re failing,” Bijon said. 

According to Rotolo, the staffing crisis goes well beyond nurses. She said a general lack of hospital staff has left nurses needing to take on additional roles to keep the hospital running. 

“For the last two years, we have been taking care of our patients, we have been delivering food, we have been helping clean the rooms so the housekeepers can do it faster when they finally make it to our unit—we have been doing a lot of the work that should be taken care of by other people, so we can actually have more time to take care of our patients,” Rotolo said. 

Meanwhile, despite the negative financial outlook for a number of hospitals in the state, OHSU posted a profit of $56 million in the second half of 2022. OHSU’s net worth is nearly $4 billion. 

OHSU and its nurses began bargaining over a new contract in December, and have since brought in a state-appointed mediator to help facilitate negotiations. The two sides have already met four times with the mediator, with two more meetings set for this month. 

For now, OHSU nurses continue to work on an expired contract—while similar labor fights play out across town and in cities across the country. The fact that the Portland area may experience two nurses strikes in one year, after not experiencing such a strike for more than two decades is perhaps a sign of the extent of the industry’s woes. 

OHSU nurses have not struck since 2001, but Rotolo said this contract negotiation feels different. When OHSU nurses held an informational picket after their contract expired in late June, more than 1,600 people attended. 

“We want to avoid [a strike] at all costs, but if we cannot get to a fair agreement that will protect the nurses and protect the community, if that’s what we have to do, we’ll do it,” Rotolo said. “And let me tell you… I’ve been through several contracts already, and I've never seen the nurses so much in agreement.”