Thousands of Minnesota nurses hit the picket lines in historic 3-day strike

The largest private-sector nurses strike in U.S. history began on Monday with some 15,000 nurses launching a three-day strike at 15 hospitals across the Twin Cities and Duluth area.

The hospitals say the strike will bring minimal disruptions to patient care as they lean on thousands of traveling nurses to replace striking nurses.

The strike comes after months of failed negotiations as nurses seek higher staffing levels and 30% wage increases over the next three years. Hospitals have countered with 10% to 12% increases over three years and say they can’t afford to go any higher.

Here’s what to know about the strike:

How long is the strike? 

Three days, from 7 a.m. on Monday, Sept. 12 to 7 a.m. on Thursday, Sept. 14.

Which hospitals are affected? 

• North Memorial Health Care — Robbinsdale
• Abbott Northwestern Hospital (Allina) — Minneapolis
• Mercy Hospital (Allina) — Coon Rapids
• Unity Hospital (Allina) — Fridley
• United Hospital (Allina) — St. Paul
• Children’s Hospital — Minneapolis
• Children’s Hospital — St. Paul
• Methodist Hospital (HealthPartners) — St. Louis Park
• University of Minnesota Medical Center Riverside (M Health Fairview) — Minneapolis
• Southdale Hospital (M Health Fairview) — Edina
• St. John’s Hospital (M Health Fairview) — Maplewood
• Community Health and Wellness Hub at St. Joseph’s (M Health Fairview) — St. Paul
• St. Luke’s Hospital — Duluth
• St. Mary’s Hospital (Essentia Health) — Duluth
• St. Mary’s Hospital (Essentia Health) — Superior

Nurses at Essentia Health’s Moose Lake Clinic, who have been negotiating a first contract for two years, were also set to strike but decided on Sunday night to hold an informational picket instead.

Nurses are not striking at the Twin Cities’ two largest adult trauma centers: Hennepin Healthcare and Regions Hospital. Nurses are not unionized at Regions and are not allowed to strike at Hennepin Healthcare since it is a public, county hospital. Nurses did picket there for the first time last month.

How are hospitals planning to care for patients during the strike? 

Hospital representatives say there will be minimal disruption, and emergency rooms will remain open. However, some elective procedures have already been rescheduled, and hospital managers are also prepared to triage services to the sickest patients based on their staffing levels.

Hospitals are filling shifts with non-union management nurses and traveling nurses, who are licensed by the state. Some union nurses will also cross the picket line, which they’re allowed to do, but the number who do so will likely be small.

Some 2,000 traveling nurses have been hired for five days to fill in at the four health systems associated with the Twin Cities Hospitals Group, which includes Children’s Minnesota, M Health Fairview, Methodist Hospital and North Memorial Health.

Paul Omodt, a spokesman for the Twin Cities Hospitals Group, said the traveling nurses began arriving on Wednesday to get oriented to the hospitals.

Allina, Essentia and St. Luke’s have also hired traveling nurses, though they have not said how many.

“Our replacement agency has done a phenomenal job filling our RN needs,” St. Luke’s spokeswoman Melissa Burlaga wrote in a statement. “Every position we requested has been filled with qualified, licensed nurses who will join our other highly skilled inpatient care team members to continue providing safe, top-quality care.”

Why are so many nurses striking at once? 

The nurses’ union called for a strike for all Minnesota nurses with expired contracts at the same time so they could muster the greatest impact.

The three-year labor contracts at the seven health care systems expired around the same time. The contracts for Twin Cities nurses expired on May 31, and the contracts for Duluth-area nurses expired June 30.

While nurses at each health system negotiate and approve separate contracts, the nurses’ union has historically tried to move in lock-step across hospitals to achieve similar wages and benefits. The health systems also coordinate with each other to some extent.

Both sides remain far apart on wages, benefits and staffing levels despites months of negotiations. Nurses hope a strike will bring hospital leaders closer to their position.

What are nurses asking for in terms of wages?

The nurses’ wage proposals are among the most ambitious ever. While specific economic proposals vary across health systems, union nurses are generally seeking about 30% raises over the next three years. Earlier in the negotiations, they were asking for as much as 37% over three years.

A spokesperson for the Twin Cities Hospitals Group called that request “unreasonable, unrealistic and unaffordable.”

Minnesota nurses are among the highest paid in the country, with the average registered nurse in Minnesota earning $39.40 an hour, or about $82,000 a year, according to the state’s Department of Employment and Economic Development.

Hospital leaders have countered with about 10% wage increases over three years, which would be the largest pay bump in 15 years.

Union nurses have justified their proposal by pointing to soaring inflation, the exodus of nurses from the field and the inability of hospitals to find replacements. They’ve also pointed to the seven-figure salaries of hospital executives as evidence that the health systems can afford the pay increases even as some have posted multimillion dollar losses from the pandemic.

What are nurses seeking beyond pay raises?  

The Minnesota Nurses Association has made patient safety a central issue of their campaign and blasted hospital leaders for chronic understaffing, which they say is leading to more patient injuries and nurse burnout.

A recent report from the Minnesota Department of Health shows that adverse health events were up 33% in 2021 from 2020, while a recent survey from the Illinois Economic Policy Institute found a little more than half of nurses are considering leaving the profession in the next year, mainly because of what they say are unsafe staffing levels.

“Staffing has been the real roadblock for the nurses,” said Sam Fettig, the union spokesman. “Hospitals have not offered a substantive counter proposal at all.”

The nurses want a greater say in staffing levels, something they tried to win at the state Legislature earlier this year with the “Keeping Nurses at the Bedside Act.” That bill, which failed to make it out of committee in a Republican-controlled Senate, would have required hospitals to implement a staffing plan approved by a committee made up of nurses and managers.

The bill would also have created a loan forgiveness program for hospital nurses and paid for the Minnesota Department of Health to develop violence prevention strategies to protect nurses. Health care workers are among the most vulnerable to being attacked on the job, with nearly three-quarters of all workplace assaults happening in the health care and social service sectors.

Nurses are also seeking more paid sick leave and parental leave.

Several hospitals have reached tentative agreements related to workplace safety and efforts at diversity and inclusion, according to the Twin Cities Hospitals Group.

Did the nurses fail to give proper notice of the strike? 

Hours after the nurses announced they were giving the required 10-days notice of a strike, all the hospital systems except for Allina cried foul and filed complaints with the National Labor Relations Board.

Hospital representatives said the Minnesota Nurses Association had failed to file an additional 30-day notice with the state’s Bureau of Mediation Services, as required by federal law. Therefore, they argued, the strikes would be illegal. (Allina had already filed notice on behalf of them and the nurses.)

The nurses’ union filed the requested notice that day with the Bureau of Mediation Services but said they intended to go forward with the strike and believe they gave proper notice.

The NLRB, which oversees private sector unions, has not ruled on whether the strike would be illegal or not. The NLRB has not returned multiple requests for comment.

Hospital leaders have also repeatedly requested the two sides enter mediation, which the nurses’ union has so far declined. Mary Turner, president of the Minnesota Nurses Association, said mediation is only helpful when the two sides are close to an agreement.

What happens next? 

No new negotiation times have been agreed to yet between the nurses and most hospital systems.

Given how far apart the hospitals and nurses are on wages and staffing levels, a three-day strike may just be prologue to a longer, protracted strike.

In the summer of 2016, thousands of Allina nurses went on strike for one week,, which was then followed by an open-ended strike that lasted 37 days, one day shy of the longest nurses’ strike in state history.

*This story has been updated to reflect that nurses at Essentia Health’s Moose Lake Clinic decided to hold an informational picket instead of striking.