Cape Cod Healthcare Nurses Vote Yes On Strike Authorization

CAPE COD, MA — There is unanimous approval among the Visiting Nurse Association of Cape Cod Healthcare to authorize a strike as union leaders continue negotiating a contract with hospital management.

Union representatives from the Massachusetts Nurses Association, who are representing the VNAs on Cape Cod, said negotiations have been ongoing since Feb. 28 with nurses "trying to win important contract language that will improve nurses’ ability to work safely, effectively, and efficiently while providing the best and safest care possible to Cape Cod residents."

Little progress has been made in the process, union officials said, which has led to the decision to approve strike authorization, though that doesn't mean a strike is certain to happen.

The nurses’ key concerns include CCHC’s "inability to retain and recruit nurses" because of low wages, improved patient assignments and adjustments to contract language specific to nurses delivering at-home care on the Cape.

“We know what our patients need, and we know how to get there,” said Mike Berry, RN and co-chairperson of the VNA’s MNA bargaining unit. “We are 100 percent committed to being the strong advocates our patients deserve, but CCHC is fighting us at every turn.”

Wages And Departures

Only 61 permanent, unionized, registered nurses currently work for the VNA. That number has dwindled by 30 in a little more than two years, enough for union leadership to begin referring to the situation as a nurse "exodus."

Nine nurses have left from January to now, with 15 having departed since this time last year.

Union leadership said most of the staff is currently made of travel nurses rather than new hires. There are more than 25 open positions at the VNA, officials said, but no union nurses have been hired since September 2023, according to the organization.

A part of the problem? Non-competitive wages, union leaders said.

“Our wages are not competitive, and they haven’t been competitive in a very long time,” said Berry. “With such uncompetitive wages in place, recruiting new permanent nurses to the VNA is almost impossible, and keeping our highly-skilled permanent nurses is no easier. Meanwhile, CCHC spends hundreds of thousands of dollars each month desperately trying to hold the VNA system together with temporary RNs.”

Other nurses at CCHC's Hyannis and Falmouth hospitals have received pay adjustments since the start of the year, but union officials said those haven't been spread to the VNA nurses.

At-Home Care On Cape Cod

The CCHC VNA nurses care for patients across 1,000 square miles, and those patients have varying needs.

The agency stated that the average home visit is 42 minutes, but this does not account for travel, patient acuity and documentation completion. Nor does it account for all the ancillary things nurses do around each visit.

“We do prep work and documentation. And we draw labs and deliver these labs to various locations for assessment,” said Diane Munsell, RN and MNA union co-chair. “All of this happens outside patients’ homes, but it is still part of the patient assignment. Add to this the differences in patients’ acuity, the everyday snafus that occur, and traffic and it becomes clear the patient assignments need to be reduced.”

Unions reps said nurses have offered adjustments to make the schedule for fitting for the realities of the job, including reducing patient visits by two per week per nurse, and taking one patient less per day for every 30 miles a nurse travels from one assignment to the next.

The nurses are set to return to the negotiating table on Wednesday.