This story has been updated.

Marlena Pellegrino didn’t expect to spend her 35th anniversary as a nurse on the picket line, but she also never thought that she’d fear for her patients’ safety if she continued to work.

Pellegrino and nearly 700 nurses at Saint Vincent Hospital in Worcester, Mass., have been on strike for 207 days now, making it the longest nurses’ strike in the state’s history and the longest in the country in 15 years, according to the Massachusetts Nurses Association, the union representing the striking nurses. They’re protesting what they say are unsafe staffing levels, a concern brewing for years that boiled over during the pandemic.

“We hold patients’ lives in our hands every single day, and if we say we’re being forced to practice unsafely then it’s the truth,” said Pellegrino, who is co-chair of the bargaining committee. “They’ve left us no choice: It’s this or give up on your principles and give up on putting your patients first and watch those patients be harmed.”

As coronavirus cases skyrocketed, the Massachusetts Nurses Association said that Saint Vincent announced furloughs and staffing cuts, heightening the pressure on an already overburdened workforce and pushing them to strike.

“They think that women will take it on the chin no matter what,” said Marie Ritacco, another nurse at Saint Vincent on strike. “We are committed to our profession and to our patients, but the pandemic has proven to us that if we do not stand up for ourselves and our patients, no one is going to do that for us.”

Carolyn Jackson, chief executive of Saint Vincent who spoke on behalf of the hospital and Tenet Healthcare, the company that owns the hospital, said that while the hospital did have mandatory furloughs, none were of nursing staff. She denies that there were any staffing concerns in the lead up to the strike and said the strike itself was based on false pretenses.

“There are challenges with staffing across the country, because there is a nursing shortage,” she said. “However, in Massachusetts and at Saint Vincent, it is much less of an issue than in many other places.”

With an ongoing global pandemic marked by shortages of personal protective equipment, thousands of health-care worker deaths and a suspected rise in trauma disorders in front-line medical staff, Saint Vincent nurses aren’t the only ones who say they’re at a breaking point. According to a Washington Post-Kaiser Family Foundation poll, roughly 3 in 10 health-care workers have weighed leaving their profession. More than half are burned out. And about 6 in 10 say stress from the pandemic has harmed their mental health. A survey from the American Association of Critical-Care Nurses shows that two-thirds of critical care nurses say the pandemic has pushed them to consider leaving the profession.

Experts say the pandemic has been uniquely difficult for female workers, given their outsized burden of household tasks like child care, their poorer compensation and the fact that their work tends to be concentrated in the fields hardest hit by the crisis.

Given that almost 90 percent of registered nurses are women (at 76 percent, women make up the majority of all full-time health-care workers), the profession sits at the intersection of these crises.

“There’s a connection between womanly duties and the assumption that nurses are substitute mothers that leads them to be taken for granted and to an obfuscation of their skill,” said Eileen Boris, who studies women and labor at the University of California at Santa Barbara. “In survey after survey, nurses are rated the highest for their caring, for their skill, what they do for individuals and yet there’s been a squeeze on nurses, on both their pay and on their control over their labor.”

For many nurses, it wasn’t until the pandemic that this reality became untenable.

“We literally turned ourselves and our families inside out to make this work,” Ritacco said. “It was something we took on with great pride for our patients because we know our community relies on us.”

Nurses on strike pose as Rosie the Riveter outside Saint Vincent Hospital in Worcester, Mass.
Nurses on strike pose as Rosie the Riveter outside Saint Vincent Hospital in Worcester, Mass.

Dominique Muldoon, another striking nurse, said she noticed that each additional day she reused her N95 mask, its seal loosened allowing more air to leak in. At one point, she went to a hardware store and bought construction goggles for better protection, she said.

Muldoon said that when she rushed into a coronavirus patient’s room without a mask on because she was so panicked he was going to fall for the second time that day, she knew she couldn’t continue.

Jackson said that all allegations that patient safety was compromised during the pandemic are untrue and that there was no increase in patient harm in the lead up to the strike. Jackson also said that Saint Vincent was able to provide sufficient personal protective equipment to nursing staff during the pandemic and that any reuse was in line with Centers for Disease Control and Prevention guidance.

“They have no facts, they have anecdotes, and they have hung their hat on those anecdotes,” said Jackson of the striking nurses’ claims.

For Ritacco, what she and her colleagues experienced is “traumatic,” she said: “To say that they have PTSD is not an overstatement.”

Still, Saint Vincent nurses say that the pandemic didn’t create a problem as much as it exposed one.

When Pellegrino and Ritacco started working at Saint Vincent more than three decades ago, it was a community hospital run by the Catholic diocese. Today, the hospital is owned by Tenet Healthcare, a Dallas-based for-profit conglomerate that operates 65 hospitals and over 450 other health-care facilities.

Both nurses said that when the hospital came under for-profit management in the 1990s, their workload increased and their concerns about patient safety began. When Tenet acquired Vanguard Health Systems in 2013, which owned Saint Vincent at the time, they say these problems got worse.

Pellegrino said she and her colleagues felt pressured to get patients in and out of the hospital, squeezing as many patients into as few beds with as few nurses as possible. They said that new digital systems for tracking care kept them tied to computers, decreasing their time with patients.

“To some of these companies we are disposable: We’re a number, just as the patients are a number,” Pellegrino said.

Tenet Healthcare furloughed workers and delayed benefits during the pandemic, according to local news, citing the financial pressures of the pandemic, despite disclosing more than $2 billion in pandemic relief loans and grants from the federal government, according to Reuters. In fiscal year 2020, Tenet posted an annual profit of more than $3.1 billion.

The company’s practices have drawn condemnation from Sens. Elizabeth Warren (D-Mass.) and Edward J. Markey (D-Mass.), who wrote in a June letter: “The apparent greed of Tenet Healthcare during an unprecedented public health emergency and economic crisis is astounding, particularly in light of the billions in taxpayer assistance received by your company, and the ongoing failure to address the concerns of its frontline health care workers.”

On Wednesday, Worcester Mayor Joseph Petty (D) called on the head of Tenet Healthcare to visit the city to resolve the strike. Tenet spent $5.4 million on replacement nurses in the first week of March alone, when the strikes started, and hundreds of thousands more on police details, according to local newspaper the Telegram & Gazette.

While the two sides were close to ending the standoff in mid-August, they reached an impasse when Saint Vincent said the nurses wouldn’t be guaranteed their old jobs back. The Massachusetts Nurses Association said this is retaliatory and punitive, but Saint Vincent said they were “clear and transparent” that they were hiring permanent replacement nurses early on in the strike.

Pellegrino, speaking yesterday after picketing until midnight in the pouring rain, said the nurses have no plans to end the strike unless their staffing concerns are addressed and they are guaranteed their jobs back.

“When you find that you are being stifled and you are being diminished and you are being disrespected and dishonored by different owners and corporations, you can either lay down and take it or you can stand up for your patients,” she said.

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