A strike — and a care crisis — likely averted

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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There is never a good time for a strike by nurses and other front-line medical staffers. But some periods are worse than others. An ongoing pandemic and a winter respiratory-illness season off to an early start create one of them.

Minnesotans had been staring down a potential health care crisis with thousands of nurses at 16 hospitals poised to strike beginning Sunday after months of tense negotiations. Thankfully, tentative agreements have been struck at almost all of them as zero hour approaches, a welcome reality that should inspire a collective sigh of relief across the state.

"A deal with St. Luke's nurses in Duluth was announced by the hospital late Monday, followed by agreements announced early Tuesday morning in the Twin Cities by spokespeople for Allina Health, Children's Minnesota, North Memorial Health, Methodist Hospital, and M Health Fairview's Southdale Hospital and University of Minnesota Medical Center," the Star Tribune reported.

Tentative agreements were also announced Tuesday for nurses at Essentia Health hospitals in Duluth and Superior, Wis., and at M Health Fairview's St. John's Hospital in Maplewood. Talks were also continuing between St. Luke's Hospital and nurses at Lake View Hospital in Two Harbors, the newspaper reported.

Individual members of the Minnesota Nurses Association (MNA) union still need to vote on the terms, but the compromises reached appear to be sensible. A "yes" vote would also put the state in a far better position to battle the still-dangerous COVID-19 virus in addition to influenza and other viruses making the rounds.

The hospital systems where walkouts could have happened form the state's health care backbone. While there were plans to bring in replacement nurses in the event of a strike, which would have lasted until Dec. 31 at most hospitals, that labor pool is already stretched thin as the holidays approach.

It wasn't realistic to expect normal levels of staffing if a strike occurred. With the worst of the winter respiratory-illness season still ahead, the breakthroughs by the hardworking negotiators for both sides may very well have saved lives.

Also averted: having to send pediatric patients out of state. Children's Minnesota recently said its ICU capacity would be cut in half if a strike occurred, and the specialty health care system had planned to transfer some patients.

That would have been far from an ideal solution because capacity is thin at many hospitals elsewhere. This arrangement also would have created significant hardship for Minnesota parents with hospitalized children. Life is already difficult when a child is seriously ill. Adding a long drive on top of this, plus hotel expenses, would have been overwhelming.

A short strike this fall illustrated the impasse that has marked these critical negotiations for months. About 15,000 nurses went on a three-day strike in September after talks up to that point failed to yield agreement. Contracts with nurses had expired in June.

Details about deals reached this week suggest a reasonable compromise from both sides on a particularly sticky issue: wages.

Nurses sought increases of 30% or more over three years, a big ask but one reflecting their dedication throughout the pandemic and concerns about future staffing. They've been battling this virus since before the vaccine and reliable treatments were available. Many stayed away from their families for long stretches to prevent this pathogen from spreading within their homes.

But the pandemic also strained hospital finances, with the short September walkout exacerbating pressures. Health care systems countered by offering 10% increases early on.

Negotiators managed to bridge that chasm, "agreeing to 18% raises over three years for nurses in the Twin Cities at Allina Health, Children's Minnesota, M Health Fairview, Methodist Hospital and North Memorial. Raises of 17% over three years were announced for nurses at Essentia," the Star Tribune reported.

Staffing and safety on the job were also contentious issues. Details are still emerging, but MNA President Mary C. Turner summed up the improvements: "Nurses have more of an open door now to management when things need to change, when things are a mess."

Even if the agreements are finalized, however, the Legislature should continue to scrutinize staffing and on-the-job safety. There are lessons to be learned from the pandemic. In addition, these areas require continuous improvement.

The health care workforce pipeline also remains a concern. Gov. Tim Walz's administration launched a praiseworthy program to provide no-cost training to those who want to become nursing assistants.

That initiative merits continued funding. Similar programs to aid those interested in other medical careers would also be helpful, and should be given serious consideration during the next session.

A health care crisis likely has been averted in Minnesota, but workforce and workplace conditions still require policymakers' attention to ensure that health care delivered here is both world-class and sustainable for essential caregivers.