Asheville – Unionized nurses at Mission Hospital have threatened to strike if the hospital does not agree to acceptable concessions during the next round of contract negotiations. Mark Klein has been making a lot of public appearances on behalf of the nurses. A vascular access nurse who has been with Mission for half a century, Klein says the hospital has yet to guarantee better protections against patient violence, nurse breaks, adequate staffing levels, and sufficient employee compensation.
Mission Hospital’s spokesperson, Nancy Lindell, said the hospital “made a significant proposal that will address RNs’ concerns regarding workplace safety by enhancing our existing security measures.” These included outfitting employees with duress badges with alarm buttons, providing de-escalation training for employees in high-acuity departments, employing a Behavioral Emergency Response Team (BERT), offering a Crisis Prevention Institute (CPI) course led by a master-certified CPI instructor with 30 years of experience, conducting hospital-wide BERT drills, and employing sworn law enforcement officers in the emergency department.
The breaks seemed to be deprioritized by both sides. North Carolina, a right-to-work state, does not require employers to provide them, even though Mission nurses typically work 12-hour shifts. The long shifts are deemed better for patients because they improve continuity of care with reduced errors and omissions made in shift transitions, and they strengthen patient-nurse bonds.
Much ink has been spilled over staff cuts implemented after HCA purchased Mission in 2019. That was followed by COVID and the Great Resignation. A recent WLOS report stated the hospital remained 448 nurses short in May. Ads offering signing bonuses continue to be posted.
One concession from Mission was that the hospital would use AI to better empower nurses in the service of their patients but would not deploy it to replace them. Klein argued that nothing can replace the personal touch of human bedside manner.
Most attention seemed to focus on nurse pay. According to a July update from Glassdoor, RN salaries, including overtime, at Mission range from $68,000–$89,000, with median pay squarely in the middle. Indeed claims the average salary is $98,055, but recent recruiting ads factor largely into the calculations. Also, traveling nurses typically make more.
In a video on the Mission Nurses United Facebook page, Klein said Mission had offered the nurses a 3.5% raise over three years. “With the increase in housing costs and the increase in food costs, the increase in vehicle costs, total inflation costs, we can’t afford not to miss a day and go on strike. We’re literally talking about a financial gain to make life sustainable in Western North Carolina or taking a financial loss. If we don’t sign strike pledges or at least threaten to go on strike, the hospital doesn’t have to give us anything. The staffing will stay the same, which is ridiculous staffing. The wages will be stagnant.”
Lindell disagreed. “Salaries vary under the hospital’s current wage proposal; many RNs would receive total increases between 11.5% and 12.5% over the life of the contract. We have repeatedly explained our proposal to the union, and it is disappointing, but not surprising, that they are intentionally misrepresenting our proposal to serve their own interests. In addition to our current wage increase offer, Mission also gave a $20 million increase to annual wages in 2022 outside and above the current contract.”
Klein advised nurses for whom the strike might pose a hardship to start working extra shifts. He did not expect the strike to last for more than a day, though. He said the hospital could retaliate with a lockout, but it would be very expensive, and elective surgeries would have to be postponed. Klein said the nurses would go on strike not because they want more money, but to address the conditions that put the hospital in Immediate Jeopardy of losing Medicare funding.
Lindell, however, said, “If the National Nurses Union leadership does choose to strike, Mission Hospital will remain open. We are thankful to be part of HCA Healthcare, which has resources to support our patients’ needs. We have taken proactive measures, including contracting with fully qualified, licensed, and certified nursing staff who can provide high-quality care to the communities we serve.”
Mission employs about 1,600 registered nurses, about half of whom are unionized. The union has asked nurses to sign a strike pledge to put the hospital on notice. Should the July 16 negotiations fail, the nurses can authorize a strike. Due to the nature of the business, they are required to alert the hospital 10 days prior to any walkout. According to Klein, strikes are threatened at 17 HCA hospitals.