A three-day strike at hospitals in the Twin Cities area and Duluth is anticipated to begin Monday if a contract settlement isn’t reached. (iStock/The Minnesota Star Tribune)

Opinion editor's note: This commentary was submitted on behalf of several members of the Minnesota Nurses Association union who are in the bargaining units negotiating with hospital systems. Their names are listed below.

A three-day strike at hospitals in the Twin Cities area and Duluth is anticipated to begin Monday if a contract settlement isn't reached.

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As bedside nurses in the Twin Cities and Duluth, we have experienced firsthand the growing crisis of care in our hospitals. Patients are being treated in hallways or left to sit for hours in waiting rooms. They're waiting longer with their call lights on, for medication, or for help to visit the restroom. The consequences are undeniable — last year, adverse events for patients increased by 33%, meaning more patient falls, bed sores or fatalities within Minnesota hospitals.

These problems did not begin with the COVID-19 pandemic and did not happen by themselves. They are the direct result of the choices made by hospital CEOs who have pushed corporate health care practices onto our hospitals, with disastrous results. What made Minnesota's health care system strong for so long was the spirit of community carried by hospital staff with a commitment to the people they serve. But today, this care model has been bought out and paved over by corporate health care chains run by executives focused on the bottom line.

Hospital CEOs have closed hospitals, clinics and services throughout the state. Since 2009, Mayo has closed more than 20 hospitals or clinics in southern Minnesota and neighboring states. Allina recently closed labor and delivery services at Regina Hospital in Hastings; Children's Hospital is closing its Pediatric Intensive Care Unit in St. Paul, and M Health Fairview closed two hospitals in the middle of the pandemic, including the state's only dedicated COVID-19 facility. In 2020, hospital executives closed 21 clinics and hospitals in the Twin Cities metro area alone.

Cuts have also targeted nurses and other essential workers. Hospital CEOs implemented a "lean model" of staffing, reducing staff levels and pushing nurses to try to do more with less to provide patients with the care they need and deserve. These executive decisions left fewer nurses at the bedside when the pandemic hit. Now, nurses are understaffed, overwhelmed and overworked, and many are leaving the bedside. One recent study found that more than half of nurses may leave in the next year if staffing and other working conditions do not improve.

These cuts and closures have done nothing to make health care more affordable for Minnesotans. In the last two decades, the cost of care has more than doubled nationally, as hospitals now charge patients $417 for every $100 in costs. That means hospitals are raking in excess revenue of more than three times their costs for labor, medical supplies, administration and other expenses. While most hospitals insist they are nonprofits, any other business would call this what it is: profit.

Meanwhile, hospital CEO and executive compensation continues to climb as these leaders implement the corporate policies devastating nurses and patients at the bedside. M Health Fairview CEO James Hereford took a 90% raise in 2019, bringing his total compensation to more than $3.5 million that year, while Duluth's Essentia Health CEO David Herman received a $1 million raise in 2020, bringing his total compensation to $2.7 million.

This is why 15,000 nurses are going on strike. Because every day hospital executives understaff our units, patients are forced to wait for care even as they pay more for it, and health care workers are left to ration their time, stretched to the breaking point by ever-increasing workloads. Nurses are leaving the bedside because they are overworked and understaffed under the corporate policies pushed by our CEOs.

Nurses are asking hospitals to fix the crises of understaffing, retention and care in our hospitals, including ensuring nurses are able to afford the rising cost of living after working through two years of a pandemic. Hospital CEOs with million-dollar paychecks can afford to make these changes for nurses and patients suffering at the bedside. Every day they refuse, it is patients who are paying the price. It is time to put patients before profits.

Signatories to this article, all registered nurses, are Angela Becchetti, Abbott Northwestern; Gail Olson, Unity; Sara Wahto, Mercy; Brittany Livaccari, United; Doreen McIntyre, Children's Minneapolis; Melisa Koll, Children's St. Paul; Chelsea Schafter, M Health Fairview Riverside; Ericka Helling, M Health Fairview Southdale; Bernadette Fielding, M Health Fairview St. John's; Shiori Konda-Muhammad, North Memorial; Becky Bixby, St. Luke's; Stacee Rosier, Essentia, and Andy Barber, Methodist.