Visiting Nurses Union Calls for Strike Vote

Cape Cod Visiting Nurses Association called for a one-day strike authorization on August 19, after six months of contract negotiations. Since negotiations started, Cape Cod VNA has lost nine nurses and hired none.

What’s happening at the Visiting Nurses Association?

09 August 2024 — CAPE COD, MA — Cape Cod Visiting Nurses Association’s branch of the Massachusetts Nurses Association, a union organization, called for a strike authorization vote Tuesday after six months of contract negotiations with management.

The union, which represents all VNA registered nurses working in the field, rejected management’s most recent counter-proposal on the grounds that the wage scale was not sufficient to recruit and retain new nurses in Cape Cod’s economy. The conflict impacts hospice and home services delivered through the VNA.

Mike Barry, Co-Chair of the union’s bargaining committee, said the strike vote comes as a last resort after six months and fifteen negotiating sessions.

“We don’t want to leave our patients stranded, but at the same time, since management is pretty much deaf to our concerns, we have to do something,” he said.

How much do visiting nurses make?

Under their current contract, RNs in the VNA make between $31.94 and $49.77 an hour, moving up a peg in the wage scale for each year of their tenure up to 13 years. The union has been arguing for a 15-17% increase in the wage scale to adjust for the high costs of living on Cape Cod. Management’s last counterproposal moved the wage scale up to a range of $33.70 to $55.01, which is a 5.5 to 10.5% increase. 

Also in the negotiation is longevity bonuses, vacation time and holidays, and degree differentials, though the bargaining committee said wages were their top priority. 

The committee pointed to a recent cost of living adjustment for nurses at Cape Cod and Falmouth Hospitals, which made the wage scale for RNs $35.64 to $71.20, outside of contract negotiations. Both hospitals and the VNA are under the umbrella of Cape Cod Healthcare. Under these contracts, RNs at the VNA with tenures of 13 years or more make nearly 30% less than their counterparts at the hospitals, and 10% less than licensed practical nurses, who have completed less training than RNs and can provide more limited care. 

According to the union, 90% of their RNs in the field are at that 13th step already.

Hospital nurses generally have a higher wage scale due to the high-pressure environment and demands, and in a statement to LCTV, VNA management said their wage offers were “among the highest in the state for Home Health and Hospice organizations.” 

What does the union want?

“VNA remains dedicated to negotiating in good faith to reach a fair agreement that acknowledges the exceptional care our nurses provide every day, while considering the best long-term interests of the Agency in providing quality patient care in our communities,” management continued in their statement.

The VNA union argues that due to the high cost of living, their economic situation is most comparable to that of Boston’s VNA, whose wage scale is around 30% higher across the board.

“We all live on the Cape, we all have to buy the same food, we all go to the same gas stations, we all have to try to look for a home if we don’t already have a home,” Barry said. “When I go to the gas station, they’re not gonna say, ‘Oh, you work for the VNA? I’m gonna give you gas for 70% of what it costs.’ So we get nurses that like this home care model but just can’t stay here.”

What impact do low wages have on nurses and patients?

That was the case for Aria Robbins, an RN at the VNA in hospice care who had to move in with her parents to afford living and working on Cape Cod. Robbins said the low wages and shortage of nurses takes a toll on her and her patients. 

A recommended, “safe” hospice caseload, she said, is 12-14 patients. Hers is often close to 20.

“I’m always having to put in for extra time, I’m not getting to see my kids, and I’m not getting to see my patients, which is what my job is all about.”

Robbins gave her notice this week and took a job at a smaller hospice agency on the Cape with a 47% pay raise. She’ll be the ninth nurse to leave the VNA this year. No new RNs have come on since last September, so the count of practicing RNs is down from 70 to 61.

What impact does the lack of VNA nurses have?

Float nurses and traveling nurses often have to pick up the slack, Barry said. These nurses often don’t have the relationships or context the patients need. Sometimes, patients are skipped entirely. 

“Patients are getting bumped, and when somebody comes home from the hospital, or they’re trying to manage a chronic condition that they’re having difficulty with, one day, two days, three days can mean a lot, and it can send them back into the hospital,” Barry said.

When is the strike authorization vote?

The union’s strike authorization vote is scheduled for August 19. Based on informal polling, the bargaining committee said they’re expecting a very strong majority to authorize the strike. Management declined to comment following the announcement of the strike vote.

“We really do need to get wages and a manageable workday to attract new nurses, or else I think the VNA won’t be here anymore,” Barry said.