Years of nurse shortages culminate in second strike in six months at two Ascension hospitals

We explore what triggered the crisis as nurses outline their grievances with Kansas’ largest healthcare provider.

by Sawyer Belair

After a monthslong struggle against cost-cutting measures, nurses at two Ascension Via Christi hospitals in Wichita went on strike for the second time in six months on Dec. 6 as negotiations dragged between the union and the state’s largest health care provider.

Ascension Via Christi’s St. Francis and St. Joseph hospitals are dealing with ongoing concerns regarding parent company Ascension’s staffing practices, which were the subject of a New York Times report last year.

“We are standing up and telling people you don’t have to take this anymore,” said Shelly Rader, an intensive care nurse at Ascension Via Christi St. Francis Hospital and a member of the negotiating team for the union, National Nurses United.

‘Almost as bad as I’ve ever seen’

The nurses contend the chain has cut hospital staffing too much, threatening quality of care and forcing them to care for unreasonable numbers of patients.

“We always hear that (they’re going to address it) but the real substantial changes have yet to happen,” said Katie Best, a pediatric sedation nurse on the union’s facility bargaining council, which supports Rader’s contract negotiating team. “Staffing levels right now are almost as bad as I’ve ever seen.”

The striking nurses’ complaints come in light of the reported $18 billion Ascension Health possessed in cash reserves as of last December, when The New York Times published its story. The company also controls an investment company responsible for $41 billion in assets.

Rader said Ascension’s status as a nonprofit hospital makes it imperative to meet the union’s demands.

“We have asked and asked and it goes unnoticed,” she said. “It needs to be patients over profits; Ascension has the resources to invest in better patient care.”

Support from the community, stonewalled by management

Since voting to unionize in November 2022 and March 2023, nurses at St. Francis and St. Joseph hospitals have criticized Ascension’s negotiation tactics. The company holds monthly contract calls, while union representatives are demanding weekly talks.

“They’ve continued to drag their feet, they continue to call our bluff, but we’re serious,” said Danielle Martin, a nurse at St. Francis and general member of the union. “We want to be able to take care of our patients while also being taken care of. We want this to be over.”

Marvin Ruckle, a pediatric intensive care nurse at St. Joseph, said nurses at both hospitals have found common cause with well-established unions in town, including United Teachers of Wichita, Teamsters Local 795 and unionized workers at Spirit AeroSystems. Support has ranged from helping union leadership to unify its members to joining with nurses on the picket line.

“This is all new to us, but I feel like we’re doing very well; we have a lot of support,” said Ruckle, who is also a member of his hospital’s bargaining team, which is negotiating a contract separately from St. Francis despite calls for unified talks that have allegedly gone ignored by Ascension.

The nurses struck for one day. Ascension told the union it would hire replacement workers for four days, effectively making it a four-day strike.

National Nurses United, which represents some 950 nurses across both hospitals, called the four-day mandate union-busting. Ascension said the contract it negotiated with replacement workers required at least a four-day commitment. The same dispute occurred when Ascension nurses struck last June.

In a statement, Ascension Via Christi said it had to hire replacement nurses to assure ongoing care for patients. It said the strike created “unnecessary uncertainty for our associates and their families, and concern for our patients and their loved ones.”

Cost-cutting and its consequences

Wednesday’s strike is one of the latest flashpoints in a nationwide trend triggered by a nursing shortage that accelerated under the strain of the pandemic and saw hospitals competing for labor.

After an internal study in 2013 projected a $5.2 billion loss through 2018, Ascension Health began laying off thousands of nurses.

One study found half of most hospital costs come from labor. By the end of 2018, the company had earned $2.7 billion in profits over the previous five years, but the Times reported the company continued the layoffs for years after.

Profitability has ebbed more recently, however. Ascension reported net losses In the past two fiscal years, including $1.8 billion in 2022 and $2.7 billion in 2023, reportedly due to reductions in COVID-19 public funding and rising costs. 

The union says the cuts have hurt patient care, a trend worsened by the pandemic-driven labor shortage. Nurses were assigned more patients than they are capable of handling, the union contends.

Nurses also say they are taken out of their areas of expertise and sent to other floors to help address the workforce shortage.

While hospitals typically have a designated pool of “floating” nurses trained in multiple disciplines, Rader said the hospital’s demand often exceeds that capacity. An ICU nurse, who typically cares for three patients, might be transferred to an oncology ward to care for six or seven patients.

Best, the pediatric sedation nurse who is also a frequent floater, said the practice has gone too far and threatens patient care.

“I’m not able to be as good of a nurse as I want to be for my patients,” she said. “We have to hold Ascension accountable.”

A nationwide chorus for change in healthcare

Union members said they see their strike as part of a broader struggle extending beyond Ascension, addressing an issue they say had gone unnoticed prior to the pandemic.

“It’s not just us that feels this way, it’s nurses around the country,” Martin said. “It’s health care in general. There’s a system that is broken and it needs to be fixed.”

Another NNU chapter at an Austin, Texas, hospital, which voted to unionize in September 2022, also went on a second strike. It’s protesting what it contends is a lack of adequate equipment, including IV pumps, thermometers, gowns, blankets and work phones. 

Meanwhile, nurses at a Baltimore-based Ascension hospital voted to join NNU early last month. The union had previously filed a motion against the company for actions allegedly taken to prevent the vote, although the company has maintained that it acted within the confines of the National Labor Relations Act. The complaint is under investigation by the National Labor Relations Board.

A native of Omaha, Nebraska, Sawyer Belair is a recent University of Nebraska-Lincoln graduate who found his calling in journalism after spending his first two years of college studying physics and mathematics. Since then, he’s worked as a reporter at the UNL student-run Daily Nebraskan, Norfolk (NE) Daily News and, most recently, the Lincoln Journal Star. Beyond his passion for weaving compelling data with human-centric storytelling, Sawyer is an avid enjoyer of science fiction, the outdoors and thinking way too hard about the nature of human existence.

This article was republished here with the permission of: The Beacon