After 46 days of striking, labor and delivery nurse Heather Medema has been adjusting back into her nightly routine at Providence Seaside Hospital and reflecting on what she and other nurses gained — and lost — in their time on the picket line.

The strike ended after nurses on strike at all eight Providence hospitals in Oregon voted to approve new contracts with Providence on Feb. 24. The new labor contracts include wage increases of 20% to 42% percent — applied retroactively in some cases — and account for patient acuity, so workloads take into account the complexity of patient needs and aren’t based solely on the number of patients.

“Providence Oregon is pleased that union-represented RNs at all eight Oregon hospitals voted to approve new contracts and end their strikes,” Providence management said in a statement. “We recognize the challenges faced over the past weeks and are proud of these agreements that address issues the union bargaining teams identified as priorities during negotiations.”

Nurses at the Providence Seaside Hospital and at the Providence Portland Medical Center did not receive retroactive wages because their contracts expired in December 2024, though the timing of the expirations earned nurses at both hospitals contract ratification bonuses of $1,750.

“It was all the other hospitals in the system except for us” and Providence Portland Medical Center, Medema said. “But we’re happy that we were able to get them what we did.”

She said that Providence management’s agreement to retroactive pay for nurses whose hospitals had expired contracts was one of the biggest changes between the recently ratified contracts and the initial contracts that were largely rejected by nurses in January. The issue was among the top priorities for the nurses’ union, the Oregon Nurses Association.

Another of ONA’s most pressing concerns, and another change from the rejected contracts, was patient acuity. Patient acuity is the practice of determining staffing levels in part on the severity of patient conditions and the complexity of care required.

“Because we’re a smaller department with a much smaller census, it doesn’t affect us as much,” Medema said about acuity. “But it does affect nurses in the bigger inpatient departments — taking into consideration, how sick is this person? Are all four of my patients ready to be discharged tomorrow, and yours are fresh admits? Is their lab work concerning? Has it taken a turn?

“Just taking into account where the patient currently stands. And that can always change in a shift, but just trying to balance things out so that patients can get the best care possible.”

But although nearly 5,000 nurses returned to work following the ratification of the new contracts, not every demand was met — health care and contract alignment remain points of contention among many.

Although the contracts include a dedicated health insurance navigator to aid nurses in resolving coverage issues, Medema said the Aetna coverage nurses receive is still too limited and too expensive.

“A lot of people think that if you work in health care, that you just go to that facility and get care, and that’s not how it works,” she said. “We have to have primaries, a lot of people have specialists, especially for their children, and just trying to get some of that worked out has been frustrating and exhausting.”

As for contract alignment, some progress has been made. Previously, Providence nurses had contracts with varying expiration dates, and advocated for aligned contract end dates to increase collective bargaining leverage in future negotiations.

In response, Providence aligned a December 2026 contract expiration date for nurses at St. Vincent, Willamette Falls, Milwaukee and Newberg. But Hood River and Medford contracts are set to expire March 2027, while Providence Portland and Providence Seaside will have contracts expire December 2027.

“We’re happy we made a couple steps there … It gives us more bargaining leverage, I would say, when we’re all standing together,” Medema said. “Also, we’d like to see more parity among wages and benefits across Providence, and we feel like we’d get a better chance at getting that if we were all bargaining at the same time.”

Statewide unity

For Medema, the strike highlighted the unity and network among nurses across the state.

“Across the region were different Providence nurses getting to know each other better,” she said. “Sometimes we would visit each other’s lines to help picket. Sometimes it was through bargaining meetings. And it’s always nice to network as a nurse, because you’re learning what other people are doing and how to improve your own practice.”

Medema also saw a bright spot in the way the community of Seaside showed up for striking health care workers. People passing the picket line dropped off lunches, issued words of encouragement and reminisced about positive experiences with the nurses, or simply honked their horns in support.

But Medema and other nurses suffered financial and emotional hardships throughout the strike. A lack of steady income meant uncertainty, especially for those who were the primary earners in their households.

“The union offers a strike hardship fund, and we could apply for that,” she said. “But not everyone applied for it, because they were like ‘well, I think I can get by,’ and it’s not like wage replacement. It’s just a small amount that kind of helps, I guess, patch the holes in the dam until we’re back to work.

“It’s incredibly difficult for people, but, you know, the choice to strike is one that we don’t take lightly. Not just because of money, but because of patient care. Both those things are on our minds.”

Health care workers also felt undervalued by Providence management and frustrated by the fact that negotiations had initially stalled.

“A lot of us were really hurt and offended, not necessarily by Seaside, but by the way Providence, as a region, was refusing to bargain with us for so long,” she said. “We feel like they wasted a lot of time when we could have been back in the hospital working.”

Medema and her fellow nurses are happy to be reunited with their patients, something she said they wanted from the strike’s first day. And for all the difficulty they faced throughout their experiences on the picket line, they’ve cherished the solidarity that has been fostered by health care workers across the state.

“In an experience like this, you really learn a lot more about solidarity and that we’re all in this together,” she said.