Mission Hospital Nurses Vote to Authorize Strike

Cal Dooley | September 18, 2024


Nurses at Mission Hospital Asheville, which hosts the only trauma center within an hour of Warren Wilson College (WWC), voted in favor of authorizing a strike following major safety concerns. This past Labor Day, Sept. 2, 2024, National Nurses United (NNU) announced that the nurses voted 97% in favor of authorizing a strike. This vote was initiated in the wake of severe criticism raised by former nurses and physicians, regulators and academics. No strike has been scheduled at this point, but this vote authorizes the bargaining team of their union to call a strike if the nurses and the hospital cannot come to an agreement.

The NNU came to represent nurses at Mission Hospital in 2020 when 70% voted in favor. The election marked the biggest hospital union victory in the South in 45 years, and the first-ever union victory at a private-sector hospital in North Carolina. NNU is the largest Nurses union in the US, representing around 225,000 nurses across the country.
The union’s contract expired this past July, and negotiations have been ongoing since April. The strike authorization provides the union with significant leverage in negotiations. Their statement cited nurse retention, staffing, financial support and adequate breaks for rest and meals as key issues which have endangered patients and led to the possibility of a strike.

Nancy Lindell, spokesperson for Mission Hospital told the Asheville Watchdog that a strike was “unnecessary,” and that the union “has seemed intent on striking long before bargaining began.” If a strike is called, the union has stated that they will provide 10 days advance notice to allow for patient care to be arranged, and Lindell has stated that steps would be taken to keep the hospital operational.

The hospital was operated by the nonprofit Mission Health until it was purchased in 2019 by HCA Healthcare. HCA is the largest hospital company in the U.S., operating nearly 200 hospitals and 2,400 other care centers. Since its purchase by HCA, the hospital’s standards of care have faced scrutiny including a working draft of a report by Wake Forest University (WFU) which states that “HCA has slashed staffing among nurses and other patient-care functions, leading to a host of complaints, from both patients and medical professionals, about patient care and safety.” Nurses at the hospital began their unionization campaign shortly after HCA’s purchase.

The report includes testimony from a number of hospital staff members describing exhaustion and rage as they struggle to provide adequate care while overburdened and without proper equipment, threatening patient safety and leading to a “flood of near misses.” One physician is cited in the report stating that “HCA’s staffing practices result in ‘throwing more at you all the time,’ forcing you to ‘have to catch them just before they hit the floor.’”

The Hospital was put under the status of “Immediate Jeopardy” by the Centers for Medicare and Medicaid Services (CMS) in February of this year following an investigation by the North Carolina Department of Health and Human Services. The status was lifted later that month after the hospital put forward a plan to fix the policy violations, although this plan has not been made public. HCA also faces an ongoing lawsuit by NC Attorney General Josh Stein alleging that it violated a condition of its purchase of Mission Hospital by effectively cutting back on Oncology and emergency services through inadequate staffing and equipment. Stein’s Complaint alleges that:

“Doctors and nurses are forced to treat patients in the waiting room, without even the bare minimum equipment or patient privacy protections, let alone adequate staff. Surgeons lack sterile equipment because HCA refuses to pay staff to clean surgical instruments. Local emergency management services are frustrated and, in one county, have stopped sending ambulances to Mission because of how long it takes for their patients to be transferred into the emergency department.”

While the hospital's “Immediate Jeopardy” status has been lifted, the nurses union maintains in their statement that the hospital is failing their responsibility to patients and staff, “it is clear that HCA is more invested in maximizing profits than ensuring we have the staff and the resources to protect our patients’ safety.” For strike announcements or more information from the union visit the their instagram page @missionnursesunited or the NNU website www.nationalnursesunited.org

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