Unions
During the negotiating process, union leadership may encourage–or even require–its members go on strike.1
If a union calls a strike, there are several implications to understand:
- Union members are expected to follow the rules outlined in the union’s governing documents, which may include disciplinary measures for not participating in strike-related activities, meaning you may be unable to see your patients during the strike.2
- During a strike, employees may lose wages and may also experience interruptions in employer-provided benefits, depending on plan terms and strike status.3
The Realities of a Strike
The Oregon strike in 2025 demonstrated that workforce concerns can have significant impacts on patients, clinicians, operations and communities. Staying informed, understanding the issues affecting your practice, participating in feedback mechanisms and ensuring clinician voices are heard before concerns escalate are important components of maintaining a strong clinical environment.
The 2025 Oregon Strike Was Unprecedented
On January 10, 2025, acute care RNs began an indefinite strike across Providence Oregon facilities. It was the largest healthcare worker strike in Oregon’s history, and it included Oregon’s first physicians’ strike. Approximately 5,000 nurses, physicians and APPs participated across 14 Providence facilities (8 hospitals and 6 clinics). Three PMG bargaining units joined the acute care RN strike: St. Vincent Medicine and OB Hospitalists, Providence Women’s Clinic (PWC) clinicians including OB/GYNs, GYNs, NPs, and Nurse Midwives, and Providence Women’s Clinic RNs.
Strikes Affect More Than Bargaining
The strike affected hospitals, clinics, patients, caregivers, clinicians, leaders, and communities throughout Oregon. Providence ministries activated contingency plans to maintain patient care and operations during the strike. There is no staffing agency for striking clinicians. As a result, Providence Women’s Clinic closed several clinics and cancelled and adjusted appointments. Because of their due dates, some patients were referred to other practices to seek care while others simply elected to establish care with other practices.
Strikes Can Be Lengthy and Unpredictable
The strike lasted 46 days. PWC clinicians and RNs ratified and returned to work before the hospital RN strikes ended. St. Vincent Hospitalists ratified but some remained on the picket line in solidarity with the St. Vincent RNs. All striking St. Vincent Hospitalists returned to work when the St. Vincent RN strike ended.
Intent vs. Impact: A Look at the ONA Strike Outcomes
When evaluating any strike, it’s important to compare the goals that were communicated during the campaign with the results ultimately reflected in the ratified agreements. While the Oregon Nurses Association (ONA) described the strike as a tool to achieve significant changes across multiple areas, the final contract outcomes were more limited than many of the stated objectives.
What Was the Intended Outcome?
Throughout the strike campaign, ONA indicated that its efforts were focused on achieving several major objectives, including:
- Higher wage increases for later years of the contracts
- Increased PTO accruals or one-time PTO “dumps”
- Changes to healthcare benefits
- Alignment of contract expiration dates across all ministries
- Broader improvements to compensation and contract language
These objectives were presented as key priorities and, in some communications, were described as achievable through what ONA called “historic leverage.”
What Was the Actual Impact?
After ratification, the contracts reflected a more limited set of changes:
Compensation
The impact of the strike itself created an estimated $52,000 to nearly $55,000 compensation gap for Hospitalists due to wages lost during the strike. The St. Vincent Hospitalists continue to experience a loss in wages in comparison to Providence Portland Medical Center Hospitalists because of union dues and their uncompensated status during the 46-day strike.
PTA and PTO
For those clinicians with PTA, no additional PTA accruals or PTA dumps were secured. PTA remained unchanged. Hospitalists do not have to work fewer shifts. Nurses did not receive any additional PTO despite ONA’s stated goals for the strike.
healthcare benefits
No changes to healthcare benefits were included in the ratified contracts. Represented nurses and clinicians paid the same for benefits as non-represented caregivers before the strike, and they pay the same for benefits as non-represented caregivers do after the strike.
Contract alignment
Complete alignment of contract expiration dates was not achieved.
contract language
The final agreements for the RN units included only limited adjustments in certain areas compared to before the strike, with a few minor changes to differentials depending on the contract. There were no significant modifications to many key contract provisions, including the across the board wage increases that had been proposed by the hospitals before the strike. For the PMG clinicians, because these were first contracts and the negotiations were not as far advanced as negotiations for the acute RN bargaining units, there were changes to PMG’s proposals on compensation, but, importantly, PMG continued to adhere to its compensation philosophy and St. Vincent Hospitalists were not offered anything more than what other non-represented Hospitalists in other Providence Portland-area Hospitals were being paid.
Union Promise
What was actually delivered?
Union Promise
Higher wage increase
What was actually delivered?
PSVMC Hospitalists ultimately aligned with PPMC compensation, but those who participated in the strike experienced an estimated $52,000 to $55,000 compensation loss.
Union Promise
Increased PTO or PTA
What was actually delivered?
No additional PTA accruals or PTA dumps were secured for clinicians with PTA. Nurses did not receive additional PTO despite ONA’s stated goals.
Union Promise
Healthcare benefit improvements
What was actually delivered?
No changes to healthcare benefits were included in the ratified contracts.
Union Promise
Contract alignment
What was actually delivered?
Complete alignment of contract expiration dates was not achieved.
Union Promise
Broader contract improvements
What was actually delivered?
Final agreements included limited adjustments, with many key terms remaining unchanged.
Union Promise
Use of strike leverage
What was actually delivered?
PSVMC Hospitalists spent 29 days in bargaining and 46 days on strike, totaling nearly one-quarter of the year, not including bargaining preparation time.
129 U.S.C. § 163.
2NLRB v. AllisChalmers Manufacturing Co., 388 U.S. 175 (1967) (the U.S. Supreme Court upheld a union’s authority to fine members who crossed a picket line during a strike).
3Texaco, 285 NLRB 241, 245-246 (1987) (““an employer is not required to finance a strike against itself by paying wages”); General Elec. Co., 80 NLRB 510 (1948).