With an estimated 8,000 Swedish Hospital health care workers poised to walk off the job Tuesday demanding a new contract with better wages and working conditions, both the workers’ union and Swedish management are scrambling to prepare for what the union plans as a three-day walkout.

However, the strike could extend two additional days while Swedish keeps its contract agreements with the thousands of replacement workers hired to keep the hospitals operating during the walkout.

Swedish says the replacement workers will not be enough to cover all the bases, and the hospital system has announced that during the strike it will close the emergency departments at both Ballard and Redmond, as well as Ballard Labor and Delivery. During the closures Swedish advises Ballard obstetrics patients to get services at Edmonds and First Hill, while patients seeking emergency services should go to First Hill or Cherry Hill in Seattle, Issaquah, Mill Creek or Edmonds.

Workers represented by SEIU Healthcare 1199NW plan to begin picketing at 7 a.m. on Tuesday, Jan. 28 at First Hill, Cherry Hill, Ballard, Issaquah, Edmonds and the Redmond and Mill Creek ambulatory care centers. Picketing will continue every day for the duration of the strike.  In addition, the union plans a march at First Hill at 3:30 p.m. Wednesday, followed by a 4:30 p.m. rally at Seattle’s Westlake Center.

The union has also issued a statement saying that while caregivers plan to return to work on Friday, Jan. 31, management has “threatened to lock workers out of their jobs for an additional two days.”

According to Swedish, these additional two days are needed to honor their contracts with the temporary replacement caregivers, which include a five-day commitment. “Striking caregivers will be called back to work, in accordance with the contract provisions, as work becomes available,” Swedish said in a news release.

While the issues keeping the two sides apart have been reported in detail in the days and weeks leading up to the strike (see our earlier coverage here), the effect on workers and the community goes beyond contract negotiations, spilling over from the bargaining table to the kitchen table.

Many say it’s become personal, as they watch the job they once loved and in which they took pride become increasingly less fulfilling as working conditions take what is — for them — a disappointingly downward turn.

Thirteen-year employee Robin Strine of Brier is planning to join the strikers this week. Strine has seen a lot in her years at Swedish Edmonds.

“When I started it was still Stevens Hospital,” she recalls. Stevens became Swedish Edmonds in 2010.

Today Strine works in the lab, processing blood samples and other specimens, but spent many years drawing blood as a phlebotomist. This work took her throughout the hospital from pediatrics to oncology to mental health, and she’s seen it all.

“In the beginning it was great,” she says. “And that’s because we had the staff and resources to do the job right. We had top-quality supplies and management supported us in our efforts to give patients the very best care.”

But that all changed when Swedish became affiliated with Providence Health Services in 2012.

“Since Swedish joined with Providence things have really gone downhill,” she explains. “We’re given cheap supplies, and they’re working people as hard as they can. To keep up we’re on high drive every minute of every day. Folks are working so hard they can’t even take a break or go to the bathroom. It’s killing our health care workers — it wears you out. And people are leaving in droves, which means even more work is falling to those who remain.”

Also planning to join the strike is Sabrina Rasch, a three-year Swedish Certified Nursing Assistant who lives in Mountlake Terrace.

“We do the grunt work,” she explains. “We spend the most time at our patients’ bedsides. We clean them, turn them, change them, feed them, walk them — pretty much everything.

“We didn’t want to strike,” she added. “But we’ve sat at the bargaining table for more than nine months, and we’re not getting anywhere for our patients or our community.”

The issue that hits closest to home for Rasch is staffing ratios.

“I’m supposed to care for eight patients at a time,” she explains. “But sometimes I’m taking care of 11, 12 or even 13 — and this doubles when someone goes on break. I love what I do, but it’s so hard when I can’t spend as much time with my patients as I know I should.”

Strine’s big issue is the plight of Environmental Services (EVS) workers, the folks who prepare, clean and disinfect rooms, ensuring that all patients are in a germ-free environment.

“EVS workers are the front line in keeping the hospital clean and germ-free, and they need to be taken care of,” Strine says. Swedish has increased the number of beds, but not hired additional EVS workers to meet the increased workload, she adds.

“That’s just plain wrong,” she says. “Our EVS workers need to have safe workloads so they can do the job right, so patients know they’re going into a clean environment and won’t contract an infection. Right now, EVS workers are being pushed so hard that they simply don’t have time to do the job right. It’s not their fault — they’re just being spread too thin.”

But it’s not just isolated to one type of worker or one function.

Rasch works on the medical/orthopedic floor, which brings her into contact with a huge cross section of patients from those with tuberculosis, ruptured colons and sepsis to IV drug users and patients with severe emotional issues — who occasionally become violent.

“The threat of patient violence is an everyday thing for us,” she says. “Numerous workers including myself have been kicked, punched or injured, and we simply don’t have enough staff or security to protect against this. The worst cases are assigned personal safety attendants to be with them all the time watching for violence, suicidal tendencies, pulling out IV lines, etc. If the attendant leaves the room even for a moment, someone gets pulled off the floor to watch the patient, leaving us even more short-staffed.”

From the workers’ perspective, the staffing issue is a major point of contention with management.

“No one is untouched by staffing levels,” Strine explains. “Safe staffing affects everybody. It’s not just the nurses or the EVS workers – if one area is short, it cascades throughout the hospital.”

Strine says she is “heartbroken” about how all this is affecting the patients.

“People shouldn’t lose their dignity just because they’re in the hospital,” she explains. “They need to go to the bathroom, get their meds on time, and just know that they’re being cared for. But despite this, so many patients remain grateful and understanding, knowing that we’re doing the best we can under the circumstances. It’s wonderful to hear this, but it also breaks our hearts that we simply can’t give them the care they deserve under our current working conditions.”

Rasch reflects this.

“I love to be there for my patients, I love to give compassionate care,” she says.  “It makes me feel good to give, but it’s no longer safe. It’s become a huge burden.”

For its part, Swedish stresses that it shares the caregivers’ concerns about staffing levels, but fundamentally disagrees on how to address this.

“The real divide comes down to a difference in approach,” said Swedish CEO Dr. Guy Hudson in a recent open letter to the community. “With a national nursing shortage, we want to work with our nurses to identify solutions to fill our open positions and build a strong talent pipeline. We have committed to recruiting additional caregivers to ensure that our employees have the support they need to continue providing safe care, but SEIU wants control over our staffing decisions. It is unprecedented for any union to take that control away from management. We refused to back down despite their threat to strike.”

This followed an earlier statement by Dr. Hudson in which he reinforced Swedish’s commitment to its caregivers. “Our caregivers are the backbone of the care our community counts on,” he said. “They provide the bedside support that makes the care at Swedish so exceptional. We support our people and we’re here for them. That’s why our proposal was comprehensive and provides what our caregivers and their families need.”

However, for many health care workers, the decision to go out on strike goes beyond addressing the significant workplace problems, and hits them right in the checkbook.

“The loss of wages will put me in a bind,” admits Strine, who works a second job in her off-hours to make ends meet. “But morally it’s something I have to do because it’s right. I can dig a little deeper and economize at home. As a single mom with three young kids, Creative Cooking 101 is part of my repertoire. If it means a little less meat in the spaghetti sauce, we’ll deal with it.”

Rasch shares a $750 per month apartment with her currently out-of-work significant other, so her salary covers everything and the lost wages from the strike will hit her particularly hard.

“We’ve had to cut a lot of things this month,” she explains. “I’ve had to ask for extensions on several bills. We try to eat healthy, but lately it’s been a lot of ramen.”

Despite her own tight financial situation, Strine makes regular contributions to the union’s hardship fund to help workers in bad straits weather the crisis. “I’ll help if I can,” she says. “Yes, it’s a bit of a hardship now, but it doesn’t compare with the hardship my co-workers would endure under the current contract proposal.”

Strine remembers when things were different and Swedish was “the head of the game,” the place where people wanted to work and go to for care.

“Forty years ago, I was living in Oregon and my mom came down with colon cancer,” she recalls. “We wanted to put her in the best place where she could get the best care possible, and at the time that was Swedish. We brought her to Seattle where she had surgery and received top-notch care. Thanks to Swedish, she was able to enjoy three more years of life.  That’s the Swedish I want to be part of.”

Strine pointed out the motto painted on the walls of Swedish: Extraordinary Care and Extraordinary Caring — a motto that in her view has become hollow.

“We want that back, but we can’t have it without safe staffing,” she concludes.  “We simply can’t be extraordinary under these conditions.”

— Story and photo by Larry Vogel