File this one under: absolutely not okay.

Nurses and caregivers have announced that they are moving closer toward an imminent strike at Swedish Medical Center, the largest healthcare provider in the Seattle area, saying that Providence needs to put patient safety before CEO pay.

Nurses and caregivers are raising alarms that patient care problems and severe understaffing have worsened since Swedish was taken over by the corporate giant Providence, Washington’s largest healthcare corporation which now controls over 1,000 facilities in seven states. Meanwhile, compensation for Providence’s CEO skyrocketed 157 percent to over $10.5 million in 2017. Providence raked in $24 billion in revenue in 2018, and $970 million in profits in just the first three quarters of 2019.

Supermajorities of caregivers have authorized strikes at each of the seven Swedish locations – First Hill, Cherry Hill, Ballard, Edmonds, Issaquah and ambulatory care centers in Redmond and Mill Creek – but management refused to make meaningful progress at the last contract negotiations on December 9.

If the strike occurs, members of SEIU Healthcare 1199NW at Swedish would be part of more than 13,000 total strikers at 13 Providence locations throughout the state, including members of UFCW 21 and the Washington State Nurses Association. This would be the largest healthcare strike in recent history.

Since April, Swedish-Providence nurses, nursing assistants, techs, lab workers, dietary workers, environmental service workers, clerks, social workers, and others have been proposing urgent solutions to Swedish-Providence executives. Contract proposals include: safe nurse-to-patient staffing ratios, affordable health benefits, expanded training opportunities, safeguards against racial discrimination on the job, and fair wages that recruit and retain qualified staff.

Executives have rejected almost all proposals, instead threatening steep cuts to caregivers’ sick time and repeatedly breaking federal labor law by violating caregivers’ rights.

“Being an emergency room nurse is very stressful, but I do this work because I love my patients and feel like I make a real difference in their lives,” said Whittney Powers, who works the 1 p.m. to 1 a.m. shift at Swedish Edmonds. “I’ve been alarmed to see a steep decline is staffing levels throughout our hospital and nurses are overextended. The safe staffing standard in emergency rooms is one nurse for every four patients, which should be followed at all times. But we are often required to care for five or six patients at a time, many of whom can be in severe distress.”

Powers added, “We often hear complaints from patients that they have to wait a long time for care or can’t get their pain medication in a timely manner. Because they’re also understaffed on the hospital floors, some patients have to stay for days in the emergency room hallways. One of the reasons we’re understaffed is that there’s been a mass exodus of employees because our wages aren’t keeping up with the cost of living. I pay $1,750 for a studio apartment in Seattle and struggle to make the rent. It’s frustrating that Swedish-Providence has the funds to improve patient safety and staffing, but instead they’re being misappropriated to huge executive pay packages. That makes us feel like patients and staff aren’t valued at Swedish.”

Multiple studies have proven that unsafe staffing levels in hospitals can lead to lower quality care and patient harm, including falls, medication errors and increased deaths. Recently, the Washington State Office of Administrative Hearings found that, in the Swedish First Hill Organ Transplant department, “The employer’s failure to respond to the severe staffing shortages and manager hostility and retaliation, all of which jeopardized patient health and staff health, shows a complete disregard for patient care and safety as well as a complete lack of regard for their own employees.”

In one example of worsening understaffing, 11,416 babies were born at Swedish in 2018, 2,000 more than in 2015. Yet, there are only three additional registered nurses in the labor and delivery department. In another example, Swedish had 1,571 patient beds in 2018, 145 more than in 2015. Despite this, Swedish only has one additional environmental service worker to clean and disinfect patient rooms.

“Sometimes environmental service techs can have 26 rooms to clean in an eight-hour shift, and this kind of pressure can lead to dirty rooms and the danger of infection being spread to patients,” said Angel Sherbourne, a certified healthcare environmental service technician who has worked at Swedish First Hill for over five years. “If we don’t have enough staffing, patient rooms can’t be cleaned and sanitized correctly, and workers get burned out, sick and injured. On top of that, we can’t afford to live in the communities where we work. My husband and I have been renting a small room for $850 a month, and struggling to buy a decent house that isn’t falling apart.”

In 2017, the neurosurgery department at Swedish Cherry Hill had a patient safety scandal severe enough to warrant concurrent FBI, U.S. Attorney General, Centers for Medicare and Medicaid Services and Washington state Department of Health investigations. Despite Swedish-Providence’s public declaration to solve the crisis, management has since cut staff, including the system-wide elimination of the IV nurse team. It appears that the fundamental cause of the scandal, a focus on increasing profits instead of patient safety, is still infecting the corporate culture at Swedish-Providence.

Approximately 1,000 healthcare workers a year leave Swedish-Providence and there are currently about 900 vacant staff positions. 600 of those positions are registered nurses, and 50 percent of open positions have gone unfilled for 60 days or longer. One of the reasons that Swedish-Providence has difficulty with recruitment and retention is that wages for frontline workers are not keeping up with the soaring cost of living.

Swedish-Providence pays almost 40 percent of its employees below the salary necessary to afford the average one-bedroom apartment in the Seattle area.

Providence management has also broken federal labor law multiple times with unfair labor practices including: retaliating against and terminating employees for union activity; unlawfully surveilling employees; intimidating workers to stop them from speaking out; refusing to provide information necessary to bargain a fair contract; and refusing to bargain in good faith.

The next contract bargaining session with Swedish-Providence management is scheduled for December 30, and if executives do not make significant progress toward improving patient safety and staffing, caregivers say they will set the exact date of their strike shortly thereafter.

“I’ve been a Swedish nurse for 31 years, and I’ve stayed here this long because I’m deeply committed to fulfilling our stated mission of providing excellent patient care,” said Terry Thompson, who works in Swedish Ballard’s perioperative department. “But it’s close to impossible to offer the care our vulnerable patients need because we’re always rushing. Many new nurses go home crying because they feel they could have done better if they had a more manageable patient load. Decisions are being made by executives in corporate offices miles away, who rarely step foot in our hospital. Nurses and healthcare workers are here at the bedside and we must have a voice in setting safe staffing levels. These millionaire Providence executives need to look within and ask themselves if they’re going to do what’s right to protect patient care.”