Last year’s longest-running strike came to an end in early January when nurses at St. Vincent Hospital in Worcester, Massachusetts, overwhelmingly voted to ratify their new contract and return to work.

Seven hundred nurses had walked out over dangerous staffing conditions last March—ten months ago. (See previous Labor Notes coverage from last April and August.)

In a year of health care workers organizing amid Covid surges and staffing shortages, St. Vincent nurses stood out for their willingness to strike indefinitely and for the discipline the strikers showed.

Open-ended strikes are still a rarity in health care, and Tenet was a formidable opponent: a massive for-profit health care corporation that owns 60 hospitals across the country and is valued at $8 billion.

The strikers won improved requirements on staffing, a critical issue for health care workers everywhere, and stood up to Tenet’s creative attempts to break the union.

[St. Vincent] spent hundreds of millions of dollars on this strike,” said Marie Ritacco, a longtime nurse at “St. V’s” and the vice president of the Massachusetts Nurses (MNA). “It would have taken a small portion of that to rectify the conditions in the building and make sure we could give patients the care they deserve.”


After years of public outcry about poor staffing at the hospital, the new contract includes a four- or five-patient cap for nurses on cardiac post-surgical units and other floors where patients are preparing for or recovering from surgery or require cardiac monitoring.

The behavioral health unit will also see a cap of five patients per nurse, down from six.

MNA also won the use of a resource nurse—a floating nurse in high-acuity units who will not be assigned patients, but will be available to support other RNs and to help with arriving and departing patients.

The nurses reined in the administration’s practice of “flex time.” Previously, staff could be flexed off—that is, sent home mid-shift when there were not enough patients. But then an uptick in patient arrivals later in the shift could mean dangerously high numbers of patients per nurse. New contract language will limit this practice by allowing each nurse two refusals to be flexed off (up from one) in every four-week cycle.

The strike also yielded much better health insurance premium coverage for part-time nurses, and modest raises, lump-sum bonuses, and step advancements across the board.

Health care workers across the country are facing a worrisome surge in workplace violence. The strikers won workplace safety demands, including more security staff and metal detectors in the emergency department. Nurses have been concerned that growing numbers of patients and visitors are carrying concealed weapons. The new contract also provides “assault pay” for nurses who take workers’ compensation after a workplace attack, to restore any sick or vacation time used for the injury.


This was the longest nurse strike in state history. One advantage for the union was that the strikers were able to pick up shifts at facilities across the area—easy to do given the shortage of health care workers during the pandemic. The union was still able to maintain a picket line throughout the strike.

Nearly all the components of the tentative agreement, including the improved staffing, were settled over a few days in mid-August with a federal mediator. However, in an effort to cow the union, the hospital had earlier hired permanent replacements—and Tenet refused to guarantee striking nurses their positions, shifts, or hours back. So the strike continued.

MNA argued in a press release at the time that accepting a deal without these guarantees would be “unprecedented and punitive.” For Ritacco, St. Vincent’s aim was “to pressure and demean us. Embarrass us.”

We won’t budge,” she said in response to Tenet’s hard line, “unless all strikers who want to go back are able to get their positions back.”

Because St. Vincent was already short on staff, the more than 100 nurses hired as permanent replacements all have the option of remaining on staff, though returning strikers will have seniority to return to their jobs and shifts.


When St. Vincent’s nurses went on strike in 2001 for 49 days, the tentative agreement was mediated by Senator Ted Kennedy. He brought both sides to negotiate at his Washington, D.C., office, and they reached a favorable deal for the nurses.

Ritacco and endoscopy nurse Bill Lahey, a member of the bargaining team, say they don’t know exactly what the tipping point was for St. Vincent this time, but they credit an accumulation of pressure heightened by the pandemic.

BC Guest Commentator Sarah Hughes is a staff writer and organizer at Labor Notes.

Bookmark and Share

Bookmark and Share