“As touted on the OHSU website, OHSU is the #1 hospital in Oregon and they state “OHSU, we never settle for how things have been done before.” Several of our peer hospitals in Oregon are also at the bargaining table, they are asking for wage proposals that are equal to or greater than what we are asking for today. OHSU needs to be a leader in all areas, not just the ones that are convenient and comfortable. Focus on the staff that you have, recruit the best of the best, and make it desirable for them to want to stay.”  Bill Erickson, RN  - 6A PACU

As many as 200 nurses from across OHSU virtually packed the bargaining room for our ninth bargaining session on March 8. This was an important day as we presented our major economic package regarding wages, differentials, CNI, health benefits, education, and other financial items. Nurses from nearly every major area of the hospital spoke out powerfully, stating that it was time to take a stand and change things at OHSU. We thank each person so much for standing together on this long-awaited and empowering day! Taking action like this is paramount to winning a strong contract.

Our bargaining team members took turns presenting, focusing on the areas where they have valuable and detailed knowledge. For weeks, our team has been hard at work preparing the economic proposals and spent the day prior to our presentation caucusing. We will be sharing our economic power point at our All-Member Bargaining Update on Wednesday, March 22 (see more below). Our team knew it was time to take proactive steps to address the complex crisis facing nurses, our hospital, and our patients.  We made it clear–the status quo will not get us through this. We must see very real and serious change in our collective bargaining agreement to retain and recruit enough nurses to keep our hospital functioning. Our proposals demonstrate the clear and detailed needs of our 3050 AURN nurses. And we emphasized how much we support our ASFCME colleagues and demand that their service be recognized when they become nurses and join the AURN. Standing together, standing strong, our nurses left the bargaining session with a sense of optimism. We know what it will take, and we sent a clear message that we are standing together to finally see real change at OHSU.

Remember that we show power in numbers, so please help us by making sure you and your colleagues have signed the Bargaining Platform Petition, and by packing the room at our next bargaining session on Wednesday, April 5 at the ONA Office in Tualatin.

SAVE THE DATES for future Bargaining Sessions

4/5 @ONA
4/12 @OHSU
4/19 @ONA
4/26 @OHSU
5/3 @ONA
5/10 virtual (You will need to register)
5/24 @OHSU
5/31 @ONA
6/7 @OHSU
6/14 @ONA
6/21 @OHSU

The Economic Situation: Key Statistics

• Portland inflation grew almost 33% in the past ten years.
• We remain in a 6% inflationary environment for 2023.
• Portland’s median home value is nearly 200k higher than the national average.
• Over the the past ten years, OHSU's net position grew to $3.9 billion and now has unrestricted cast reserves of $1.3 billion. Meanwhile, AURN wages fell by 3.45% during that same timeframe.
• OHSU executive compensation totaled $30 million in 2018.
• Traveler costs were $89 million between July 2021 and April 2022.
• OHSU received $20 million to support education from our state and requested $41,680,000 more in the 2023 Oregon legislative session.
• OHSU is a nationally recognized hospital, a premier level 1 trauma center and an ANCC magnet hospital. Our nurses and patients deserve better.
• We used UC Davis in Sacramento, CA as a comparator. Like OHSU, it is a level 1 trauma center, a research hospital in the top 40 best hospitals in the country, and magnet certified. The cost of living is 6% higher in Portland than in Sacramento.
• Despite Sacramento having a lower cost of living, UC Davis wages are significantly higher. First year RNs at UC Davis make $66.23/hour whereas OHSU RNs make $44.78/hour.

Since 2019, 36% of our bargaining unit nurses have left OHSU. That is a lot of institutional knowledge lost.  Some of our departments, like emergency, have lost nearly 60% of their nurses. Many other large departments have lost 40-50% of their nurses.

We made it clear; OHSU can clearly afford to do better for its workers. We expect management to make responsible choices to utilize resources that retain and recruit nurses, so we can properly care for our patients!

Retention and Recruitment Proposal

“A significant increase to our shift differentials is overdue. It will help curb our turnover rates. It will help to retain experienced nurses on nights. It will allow for the nurses who cannot tolerate the health impacts of night shift to move to days quicker instead of quitting or transferring – and it will more fairly compensate nurses who stay on nights for the compounding impacts to our health. It will better balance our skill mix – and will improve our ability to provide complex patient care to the full 24 hours that our patients require it. It’s time for our shift differentials to move to a percentage. No longer should they become increasingly insignificant over time, and no longer should they be increasingly insignificant the longer the nurse is exposed to these health impacts. We are dying on night shift. This is long overdue.” Evan Lafky, RN - 12K

Differentials & Call:

• Night Shift – 22%, with new hours from 1900-0700
• Evening Shift – 15% with new hours from 1500-1900
• Charge and Service Lead Coordinator – 15%

“Our charges are integral in keeping floor morale high, in answering complex questions and coordinating complex care for our most fragile patients. They act as role models and teachers for our new nurses and help set the high standard of care OHSU is known for. Their expertise helps a new generation of nurses work at the top of their license and help keep our nurses at the bedside by advocating for our units and patients…OHSU needs to demonstrate that they value that experience and expertise by not just increasing their differential, but tying it to base wages as a percentage so that our more experienced nurses are incentivized and rewarded for keeping the ship afloat.” Duncan Zevetski, RN - 13K

• Preceptor – 10% for precepting any type of student
• Specialty Float Pool – 20%; plus a guarantee to receive the differential from beginning of employment.
• Floating – 10% for every float
• Bilingual – 10%, and applying to all languages where the nurse passes the certified test.
• Call Pay – $14.74 for mandatory call (set by Portland minimum wage rate); $7.37 for voluntary call

We proposed a new mandatory call pay structure, which would recognize the sacrifice of excess call, by compensating nurses at a higher rate the more call hours they take.

“Our on-call pay should reflect not only the benefit to the hospital but also the burden on our lives to be available to our patients at a moment’s notice. We are passionate about what we provide in our specialty areas and only we can provide the care we are being called in for…We are making a sacrifice for our community and our patients. It is a huge offering these dedicated nurses are providing for the hospital.” Corinn Joseph, RN - South OR

Critical Need Incentive (CNI) & CNI Plus:

A new two-tiered shift incentive structure to replace CNI/MOV/vMOT/etc. was proposed on Wednesday.

CNI – $60/hour

CNI Plus – $85/hour, NEW incentive for severe short staffing.

• Exact criteria for meeting CNI and CNI Plus are in the proposal.
• Resource nurses would be eligible for CNI if they provide availability for 40 hours in a 2-week period.
• Regarding overtime, we proposed clearer language to reduce mandatory, or unwanted, overtime.
• If mandatory overtime needs to occur, we proposed a $100 per hour differential. CNI Plus would need to be offered first to find volunteers before forcing someone to stay.
• For nurses that work on call, we proposed double time for all On Call Hours Worked on a holiday.   

“We know that our infrastructure is strained. Our patient volumes have already burst our seams. The ONLY answer to this failed infrastructure is staff, and the only way to get an already overworked staff to work even more, is with incentive pay.” Diana Bijon, RN - Adult ED

Wages

Given the lack of assurance we have that OHSU wage increases will be adjusted if inflation changes dramatically again, we proposed a two-year contract. 

• We proposed a 10% market adjustment across the board for the first pay period following 7/1/2023.
• In addition, we proposed a 15% cost of living adjustment to catch up with 2022 and 2023 inflation for the first pay period following 7/1/2023.
• For the first pay period following 7/1/2024, we proposed a 12% cost of living adjustment.

Additionally, we proposed retention differentials ranging from 5-10%, based upon years of service for any type of employment at OHSU. We emphasized how much we support our ASFCME colleagues and demand that their service be recognized when they become nurses and join the AURN.

Holidays and Vacation

• We proposed that nurses who must work on the recognized holidays would be paid double time.
• Added Juneteenth (June 19) and Indigenous People’s Day as recognized holidays.
• Added two new Floating Holidays, which would give 2 additional paid days to be added to accruals. This would help nurses who recognize Eid Al-Adha, Rosh Hashana, Lunar New Year, and so many other important holidays to have additional paid time off without having to use their vacation.
• A proposed 10% increase in our holiday and vacation accrual section, to recognize additional holidays and to provide nurses with much needed respite and work life balance after the intense workloads throughout the pandemic.
• We proposed that the vacation ceiling be lifted to 480 hours and for the hold bank to be extended to one year.

Utilization of Benefit Time

• We added language to the scheduled time off section, clarifying that vacation/holiday or compensatory time would count towards fulfilling FTE or minimum required shifts (MRS).
• For resource nurses, we added that nurses who move from a regular position to a resource position would be paid an additional 15% if unused vacation and compensatory time isn’t paid out in a timely manner. We added that resource nurses could choose to retain up to 120 vacation hours to use if they return to FTE.
• We increased the maximum vacation cash out to 200 hours (currently 100 hours).
• On donation process, we added that a representative appointed by the association shall be included in the decision-making process for the donation pool. We also added that eligible employees may apply for funds in anticipation of other accruals/benefits ending and do not need to wait to apply.

Vacation Leave Administration

• We proposed a guide be created to help all nurses understand processes related to vacation to help make sure everyone has a better chance to use vacation time.
• For In-Block Vacation Requests, we added that requests shall be kept up to date and located where they can be accessible for all to view.
• In annual allotment, we added that employees must be given the correct number of weeks to take their annual allotment. We also added that baseline FTE allocated for each unit should be at least a 20% increase to provide coverage for nurses using paid and unpaid time.
• We increased the annual allotments based upon years of service.

Other Leave

• Bereavement Leave:
  We proposed 5 days of paid bereavement leave for each loss of a family/household member. (currently it’s only 12 hours)
• Wellness Days:
  Nurses will be able to request two wellness days per year. If the schedule is already posted, the manager and employee will work together to find coverage for the shifts.
• Oregon Family Medical Leave Insurance:
  We proposed that the employer (OHSU) should pay the 0.6% that is now coming out of nurse paychecks.

Insurance Benefits

• We increased coverage to 95% for the employee and dependents (currently 88%) for medical, dental and vision plans. Nearly all state employees in Oregon receive 95%.
• We proposed that OHSU provide an equivalent third-party health insurance coverage option due to the severe lack of in network providers with MODA and the conflict of interest in OHSU providing our healthcare through MODA.

• Support for mental health of nurses:
  • Adding mental health providers to the network so that nurses do not experience any longer    than a two month wait time for an appointment.
  • Requiring OHSU provide social workers and other trained professionals to guide nurses through mental health resources when needed, and pause disciplinary processes to assist nurses in crisis.

Staff Development

• Required Education & Certifications:
  nurses shall be reimbursed for ACLS, PALS, NRP, or any other required certification for any patient population they are trained to accept a patient assignment for in their unit or elsewhere.
• Increasing the staff development fund to $500 per FTE (currently $275 and hasn’t increased in 10 years). Adding that unused funds will rollover as authorized by the Professional Nurse Care Committee (PNCC).
• Educational leave hours increased to 36 hours for each benefitted nurse (currently it is 16 hours).
• Certification differential:
  5% on all hours worked (instead of a lump sum)
• Graduate benefit:
  increasing the tuition that can be reimbursed based upon years of service.

SAVE THE DATE: All-Member Bargaining Update
When: Wednesday, March 22 at 1200-1300, 1430-1530, 1630-1730, and 1930-2030
Where: Zoom
Who: All AURN Members

We met for our eighth bargaining session on Wednesday, February 15. This session was incredibly powerful - it was finally time to address our number one priority: safe staffing. This was a virtual session where observers came to watch. We had guest speakers and nurses present on our nurse staffing law, who told powerful staffing stories about how OHSU is willfully violating our contract and state law.

Erica Swartz bravely spoke on behalf of AURN and our nurses across the entire hospital when she said the following to management: “The message being delivered to direct care nurses by administration has been made clear- no matter the data you bring, no matter the proper process you follow and no matter the analysis you’ve done, we will not support your plan if it doesn’t meet our budgetary goals… Imagine how those nurses feel when they hear the OHSU Board of Directors celebrate their financial success, knowing that it is based on saving money, while compromising patient care and the work environment.”

Our staffing presentation took about 90 minutes—so much needed to be said. Some had a hard time sharing their devastating stories and many tears were shed. Afterward, we presented our comprehensive proposal on safe staffing and demanded that OHSU finally turn a corner and make things right. Our proposal encompassed all the elements we need to do our jobs safely and to properly care for our patients. This includes, but is not limited to: safe staffing minimums, staffing plan requirements, acuity tool language, Break Relief Nurses, Proper FTE allocations for ambulatory and remote employees that include coverage for vacations and leave, UBNPC hours needed per unit, better support for our Nurse Staffing Committee members, and much more.

Our ONA Professional Services Director, Matt Calzia presented the history of Oregon’s hospital nurse staffing law, which started in 2001 and was largely improved in 2015. He then went over the required elements. He read reports on OHA violations at OHSU, the six different plans of correction that occurred to attempt to get OHSU in compliance with the law, that started back in 2017, and pointed out how those violations still have not been corrected. He set the record straight and demanded real accountability from the OHSU administration.

Matt Calzia concluded by stating: “The unfortunate reality is the record demonstrates a willful disregard for the law and practices that cannot be denied as anything less than obstruction. OHSU nurses are left with no other options than to present strong contract language to hold accountable a nursing administration who not only disregards the letter and spirit of the law, but far worse, the voices of the frontline nurses who have for years been begging for action.” (Matt's full testimony is available here.)

Next, our Staffing Committee Nurse Co-Chair, Erica Swartz gave a powerful overview of how OHSU is grossly non-compliant with the staffing law. She emphasized how the managers have stated that they can only present a plan that is within their budget, which is a gross violation of the law that does not allow external benchmarks such as budget goals to dictate safe staffing. This led to the committee not approving the unsafe plans because they are not in compliance with the law. Here is the history of where we are at hospital wide with staffing plans:
● 2020 (45 plans due, 44 plans received, 1 approved)
● 2021 (47 plans due, 0 full plans received)
● 2022-3 (48 plans due, 37 plans received, 18 fully approved). That’s only slightly more than 1/3 of OHSU working with an approved plan.

She discussed how some units, like the adult critical care cluster and labor and delivery were able to run successful meal and break relief pilots, yet other units were not afforded this same right. All of this takes a toll regularly on our work lives, along with why we are here - to take care of our patients. In 2022 alone, there were 1,268 staffing variances filed! And we know that those 1,268 variances are only the tip of the iceberg, as we found in our bargaining survey that most nurses are pressured not to file variances or have given up filing them when nothing is done. (You can read Erica's full speech here.)

Thirdly, nurses from every major cluster and area of the hospital took turns sharing about how we are all impacted by unsafe staffing across our entire institution. Nurses told the administration how unsafe staffing impacts everything: throughput, patient outcomes, revenue lost from procedures and surgeries that cannot happen, the ability to eat or use the restroom, our licenses, our mental health, and so much more. Several stories went over patient suffering and untimely death, which we believe was exacerbated by extreme short staffing.

After sharing the background, and our members’ powerful stories, it was time to present our full staffing proposal. We made sure that nothing was left out when it comes to fully addressing the needs we have in order to fully provide safe patient care. You can see a full summary of the proposal below.

Management’s Counter Proposals on Restructures and Resource Nurses

At the end of the day, they responded to our layoff proposal and our resource nurse proposal. Regarding layoffs, they made some changes to the restructure section to say that if management chooses to move nurses to other units beyond floating or temporary/special assignments, that it would require a restructure. They countered our language regarding opportunities to change FTE equitably across shifts would be with employer discretion. We expressed concern about how the COVID Connected Care Center may be impacted by these changes.

They proposed that Resource Nurses would need to provide a minimum of 520 hours each fiscal year and at least two shifts in a two-week period. The AURN bargaining team was disappointed to hear management’s continual demand of nurses to work more. This proposal would remove the flexibility that many of our nurses need. They added holiday language saying that as long as they comply with the UNBPC plan for holidays worked, that will count towards the hours requirement. They do not want resource nurses to be eligible for CNI, however they proposed that nurses would receive a higher percentage differential for those working more hours per pay period. We want to hear directly from Resource Nurses before responding and have already heard some serious concerns from those observing bargaining. Management continues to miss the mark; this is not the era for tradeoffs. Conditions need to be improved, not compromised.

AURN Staffing Proposal Summary:
• Acknowledges that nurses must not be assigned nursing activities that are inconsistent with the Oregon Nurse Practice Act that governs our Nursing Licenses.
• Full agreement that the Hospital Based Nurse Staffing Committee oversees all staffing plans and any modifications to those plans.
• Staffing plans must include a mechanism to measure patient acuity and nursing work intensity and we need nurses on the units to be able to hold majority votes to approve proposals that go to the HBNSC.
• Nurse staffing levels must account for non-nursing ancillary and support staff
• We laid out the exact safe staffing minimums for every major area in the hospital covered by the staffing law.
• For those not covered by the staffing law, some ambulatory and remote employees, we laid out a process that UBNPCs can carry out a data driven, evidence-based process to assess baseline FTE and allocate additional FTE where the professional standards show that is necessary. Our proposal also requires that FTE be allocated to properly provide coverage for vacations and leaves. We emphasized this as a top priority for these negotiations.
• We proposed that management stop violating the law and provide proper meals and breaks coverage for all nurses.
• Creation of Break Relief Nurses like our peers at OHSU Hillsboro and Sacred Heart Medical Center have. Empowering UBNPCs to determine the number and type of break relief positions or assignments needed for their unit, cluster, or groupings of units.
• Proper support and relief from work duties for UBNPC members to make sure staffing plans are in compliance with the law.
• Proper support for our Hospital Based Nurse Staffing Committee members to make sure staffing plans comply with the law, including a 0.5 relief time position for the Nurse Staffing Co-Chair for the extensive amount of their duties.

AURN fighting for workplace safety, management asserts that not everyone should have CNI

We met for our sixth bargaining session Wednesday, Feb. 1 at our ONA office in Tualatin. Members from departments across OHSU came to observe and support our bargaining team. They heard our opening statements about the importance of having new and improved workplace violence prevention language in our contract. Our AURN President Elisa Youngman shared with management, “When events occur that impact a patient’s safety, such as a fall, pressure ulcers, or nosocomial infection, we call it a “never event”. It is time we start treating events that impact a nurse’s safety, such as death threats, physical assault, and hate crimes as “never events”.”

Initially, the bargaining day felt productive. We felt supported and energized by our members’ presence however by the end, we felt unappreciated due to management’s Shift Incentives Proposal. We have proved our dedication to OHSU during the ongoing pandemic, dire staffing crises and much more, working endless overtime and extra shifts to keep the hospital afloat. In response they presented a regressive proposal that felt disrespectful to our contributions. At the core of their proposal, management wants more power to determine if and when they offer increased CNI, and to offer increased rates differently for one department or shift over another. For example, under their proposal management could decide to give one unit or cluster $50 CNI for months on end, while another could be kept at $25 CNI even if both were equally short staffed. This is a real risk, as we’ve already seen management give MOV and other incentives to some units and clusters over others, while all units are unsafely staffed. Additionally, if units throughout the hospital are not prioritized to fill shifts, that impacts everyone else as patients are boarded and throughput is impacted. When asked why management wants more discretion regarding CNI, they responded that “currently some are getting CNI who shouldn’t”. If this is an issue you feel strongly about, please let your Contract Action Team (CAT) members know and find out how to get more involved! We are launching a petition to make sure management knows we stand together and will not be divided, be sure you and all AURN members sign it as soon as possible. Or sign up now to get trained to become a CAT member. It’s time to stand together to show management how important these negotiations are to everyone.

Summary of Proposals:

AURN’s Workplace Health & Safety
We opened Article 26, Health and Safety, by adding a significant amount of new language to address the massive amount of safety issues that so many of us experience. We proposed the formation of a new Nursing Health and Safety Committee, that would give nurses a voice in safety measures at OHSU. This committee would include frontline nurses and members of management and would develop directives and recommendations related to workplace violence, infectious diseases, chemical hazards, security and physical safety, education and the development of signage addressing workplace violence. Additionally, we added language to support in-person workplace violence prevention training, access to copies of OSHA/Worker and Student Injury Reporting System reports, assessment of unit geography and patient population, and much more.

• We added a section related to suicide prevention resources and awareness, which includes 24/7 immediate crisis intervention through the Employee Assistance Program (EAP).

• To further imprint the importance of nurse safety, we added a section for the emergency department addressing the need for consistent DPS presence and that every patient/visitor should be scanned by the metal detector every time they enter, including patients that arrive by ambulance (via wand as soon as is feasible).

• For other parts of the hospital, we added a section that requires proper staffing for code greens 24/7, which includes specially trained social workers, cognitive behavioral nurses, and case management nurses. We added a definition for code green that will expand it to mean any behavioral incidents involving violence or immediate precursors to violence, regardless of their form.

• To appropriately help nurses who experienced workplace violence, we added that a root cause analysis would occur where all involved parties would be invited to participate. For those who need time off after being assaulted, we added that the nurse could receive the rest of their shift off and an additional 3 days of paid time to explore workers' compensation and other needs.

Management’s Shift Incentive Proposal
Management finally gave us a response on CNI & shift incentives.
• They are proposing $25 for CNI, and $35 for a special advanced CNI, however, they proposed that they should get full discretion on which shifts, units, and clusters would qualify for higher rates of CNI for any length of time. This would allow them to give $50 or even $100 CNI to one unit or cluster while only giving $25 to another unit for any length of time.

• OHSU management was clear they don’t want resource nurses to qualify for CNI, but they offered that those nurses could pick up additional shifts above their minimum required shifts (MRS) without a financial incentive.

• They only want to define a shift as 8 hours rather than 4 hours for increased CNI.

• Nurses must work 4 extra shifts in a schedule to get the increased CNI.

• When asked about fairness about which departments would receive CNI, management said “currently some departments are getting CNI that shouldn’t”.

Our nurses in the bargaining room were disappointed to see a proposal like this being presented. As more members talk about it, we are hearing widespread frustration around this issue of how to fairly compensate nurses for their significant contributions to work extra shifts to properly staff our units.

Kirk Constantine from the Critical Care Float Pool stated: “Fairness is very important to me. When acute care and ambulatory were not receiving CNI, but our EDs and ICUs were, many of our members were angry and frustrated. The ED nurses need the borders to be placed in the hospital. This proposal does not help with throughput and isn’t a realistic approach to supporting our patients throughout their care. How is this going to help better staff our units? We will not let OHSU divide our nurses.”

Article 15 & 18 Management Counter Proposals
Management also presented us responses to proposals that we made on Article 15- Leaves of Absence and Article 18- Seniority. They partially accepted our changes to jury service, confirming that jury duty absences will not count as an occurrence. They accepted our changes to the Peace Corps section, accepting a 27-month absence without pay, which is in compliance with the Peace Corps. They also largely accepted language we proposed regarding domestic violence and expanded the section by calling it “Leave and Protections for Victims of Certain Crimes”. They added that bereavement leave cannot rollover to the next calendar year nor be cashed out. While we are appreciative of the movement made here, these are mostly smaller changes.

Our AURN bargaining team met with OHSU administration for our fifth bargaining session on Jan. 25 at the OHSU waterfront. We were excited to have observers present from 9K, NICU, Labor and Delivery, and other departments. Having observers attend encourages management to treat us better at the bargaining table and applies pressure to take our proposals seriously. We encourage you to help pack the room at the next bargaining session on February 1 at the ONA office in Tualatin (18765 SW Boones Ferry Road, 3rd floor) at 9:30 a.m. We will be making one of our most important proposals—addressing workplace violence prevention. You are welcome to stay as long as you are able. We would love your support to show management how incredibly important preventing workplace violence is to our entire community. If you have a story you might be willing to share please email aurnlaborreps@oregonrn.org.

At bargaining, the biggest win of the day was management responding that they are open to a guarantee for nurses to transfer within 90 days after a new position is awarded. No more waiting six months to transfer to the position that you were offered once we reach an agreement! We are hopeful further negotiation can reach an agreement on this. The administration did add language saying that the nurse and the manager could mutually agree to a longer extension.

Nico Parkes-Perret shared his relief to hear this news. He stated, “When I was held far too long in my old position, it risked my entire career as a nurse; it didn’t serve me as a nurse, and it didn’t serve OHSU as an institution.” Read more about Nico’s story on our blog.

Overall, negotiations today involved helpful discussion that was productive and respectful. Today’s progress was made possible because of every AURN member who has gotten involved so far!

SUMMARY OF PROPOSALS:
We started the day by opening Article 6-Employment Practices. We made several proposed improvements for a discrimination-free workplace, by expanding what discrimination is and improving the remediation processes across the board for being mistreated and/or discriminated against. We also proposed stronger language related to what the pay codes mean on your paycheck, the consequences for underpayments, proper notice for position description changes, and improvements to the discipline process.

We also opened articles 15-Leaves of Absence and 19-Seniority. We proposed clarifying language for jury duty so one isn’t required to work another day to make up a missed shift nor would the absence count as an occurrence. Updates were made to the military leave and Peace Corps section for clarity.

We also proposed a new section for domestic violence leave, mirroring state law in hopes to raise awareness to this important issue. We are hopeful this might reach more nurses who are unaware of the strong workplace protections under our state law given to those experiencing domestic violence.

Management responded to our out of state licensure proposal by only including Washington licenses initially and not in future years. They also gave counter proposals to our transition to practice (TTP) proposal, and they gave us proposals on Article 19-Posting and Filling of Positions and Article 14-Sick Leave. Later in the day, they gave us another interim proposal about L&D call requirements that would help support these nurses to get something in place while we negotiate a more long-term plan.

At the end of the bargaining session, there was discussion about the amount of curtailment that the Connected Care Center nurses have received, despite these nurses not noticing a decline in the total call volume they receive. We are concerned about these nurses being told to work in person to make up those hours without management bargaining over that significant change in working conditions. We will need further discussion about this important issue and reiterated to management the need for proper notice, collaboration, and discussion over major changes in our workplace.

Over 120 nurses gathered to show their support for our first in-person Bargaining Kick-Off event Wednesday, Jan. 11. It was a sea of purple in the standing-room-only crowd that met with management at the table. Our new AURN shirts really stand out! Without a doubt, the large member turnout was responsible for the speechlessness of OHSU Management when we presented our bargaining platform based on the survey results. More nurses than ever completed the bargaining survey this year and your responses and support created this powerful session.

Our biggest win of the day was that management largely agreed to our enhanced CNI proposal, and after further discussion and counter-proposals, we reached an agreement! The expanded $46 CNI MOU will be extended until April 9 with clarifications made to the scheduling and curtailment process to increase fairness. Additionally, the current pediatric incentive to fill shifts during vacations is extended to the entire hospital. Read the full new MOU.

The working during vacation incentive, allows nurses to receive a bonus for picking up any shift during the week of vacation where accruals were also used to fill FTE. We also added two more Wellness Days for 2023. Those who haven’t been able to use their wellness days (from your current vacation/sick leave banks) would still be able to use them before April 9, 2023.

Having so many nurses show up to support us inspired our team! Management clearly treats us better when you are present. Due to this, we encourage you to observe a bargaining session! Our next in-person session at OHSU is on January 25. View our full schedule.

As Ryan McIntosh, RN from ED Observation stated:

“It’s harder for management to disrespect a room full of 100 people versus a group of 12, so please show up!”

These are our top priorities that we presented to management:

1. Staffing
2. Workplace Safety
3. Retention and Recruitment
4. Justice, Equity, Diversity and Inclusion
5. Moral Injury

Bargaining team members shared their stories and the experiences of their colleagues to impress upon OHSU Management that our members stand united in our bargaining priorities.

One of the most inspiring moments of the day, was when we presented a proposal with our Labor and Delivery nurses, stating that the mandatory call be changed to voluntary call and should not be used to support baseline staffing. A united group of L&D nurses shared their experiences to explain that mandatory call is not a solution, that no other hospitals in the region have mandatory call, and this requirement is preventing recruitment of experienced nurses. Guest speakers from L&D conveyed to management the dire situation they are in with mandatory call being used to fill baseline staffing in direct violation of our current agreement. When baseline staffing is not funded by the hospital administration, our nurses are left to care for the most acute laboring mothers and their babies in the state without safe levels of staffing.

In the late afternoon, management presented counterproposals on Article 2-Association Privileges and Limitations, Article 22-Grievances and Arbitration, Article 25-Transportation and Parking, and CNI Incentives.

Excerpts from our bargaining platform presentation:

Staffing

• The pandemic impacted nurses at OHSU with poor staffing and health-compromising situations.
• Meal and break requirements are not being followed despite clear contract language agreed to in the last bargaining round.
• Management is denying our staffing related grievances, forcing us to go to arbitration.
• There are many open positions. Some units are down by 60% on nights. We need to make OHSU desirable with compensation, safe staffing, and respect.
• Our patient population is becoming much more acute and intense. We need acuity and intensity to be recognized and to staff accordingly.
• Moral injury starts even before our shifts start. Co-workers frequently text us saying “please come help.”
• No beds or pillows for a 95-year-old patient who was stuck on a gurney for 48 hours.
• In the ED, we had three stymied patients waiting-very complex acuity.
• “I was forced to do a pelvic exam in an elevator, and we are amputating digits in hallways. The ED nurses did not sign up for this!”
• 12-24 hour wait times. Patients laying on the waiting room floor due to the wait and we are unsure if they are OK. The acuity is higher than ever in the waiting rooms.
• The ED cannot maintain a 3:1 ratio and the rest of the hospital is failing as well.
• The moral injury continues when we try to go to sleep. An ONA leader asks, “how many people have a hard time going to sleep?” Nearly every nurse in the packed room raises a hand.

  Workplace Safety
  

• Nurses are facing violence in the workplace without proper systems and support in place to keep them safe. In one incident, MDs walked by a nurse being attacked and DID NOT intervene. There was no time to even debrief. The charge nurse did not get notified that their nurse was assaulted until days later. This is a core indicator of how desensitized staff have become to a complete lack of safety.
• ED nurses have used their body many times to protect patients from other patients in the waiting room.
• Nurses submit 6-7 PSIs (Patient Safety Incident forms) per day and do not hear back on any of them. Too many band-aids being applied.
• There have been threats of gun violence in multiple departments, a recent arson event in the ED, and a car was almost driven into the ED. In these incidents the lack of a proper emergency response to keep staff safe was shocking.
• Safety for our nurses is safety for our patients, our community, for you (administration) and us. We had to prepare our families for the fact that we may lose our life due to caring for patients during the pandemic.
• We need a new contract. We want to stay.

  Retention and Recruitment

• OHSU has been offering MDs, NPs and PAs $500 for a 4-hour helping hands shift, which would have been better filled by ancillary staff or nurses, since we can do every aspect of the work. We complained and were told it would never happen again, yet it did again in December. Why wasn’t this offered to us?
• Travelers getting incentive shifts before us is unacceptable.
• We have bargained many side letters over COVID, but our asks for things that would truly retain nurses were refused by management. Nurses are leaving since they don’t feel supported or respected for their loyalty to OHSU.

  Justice, Equity, Diversity and Inclusion

• When sexual harassment cases went public, you (administration) spent 6 million dollars for a report that proved that all the cases were already reported to HR. You didn’t need to spend 6 million to demonstrate that, you needed to have listened to us to begin with.
• Racial epithets have been thrown at nurses by patients. There has been physical violence. At best those patients are banned for 30 days but they are still allowed to come back even though nurses repeatedly complained about the patients’ illegal behaviors.
• Violence starts with microaggressions. When we report them, we don’t get resolution. Signs are not enough.
• On Juneteenth we got 7.2 hours, yet many people of color still had to work 12 hours and the rest of us didn’t even get to take the 7.2 hours off due to short staffing.
• The accommodations requests for nurses with disabilities are backlogged by several months. This is a disservice to our members who are struggling in their current positions. 

Moral Injury

• Nurses are set up to fail before they even arrive for their shift; and they know this. Getting calls from their peers, who are desperate to have enough staff to safely care for patients impacts every nurse. It’s demoralizing knowing you either come in to be set up to fail or stay home leaving your peers to fail and patients in unsafe conditions.
• The lack of follow-through on reporting compounds the moral injury.
• When a nurse needs a meal or break to process all this, it doesn’t happen.
• Nearly every nurse raised their hand when asked “who in the room has had difficulty sleeping.”