DULUTH — Nurses at St. Luke's and Essentia hospitals in Duluth and Superior began picketing at 7 a.m. Monday, beginning a three-day strike over contract negotiations. Approximately 2,500 Minnesota Nurses Association members in the Twin Ports could be walking off the job this week.

Several hundred nurses, family members and community members picketed outside downtown Duluth hospitals, while another picket stood outside Superior's Essentia hospital. The picketers, wearing red and holding both "Patients Before Profits" and homemade signs, garnered honks from passersby throughout the day.

St. Luke's and Essentia have released statements ensuring patients they are still open for care during the strike. Some elective surgeries and other appointments were rescheduled, in which case patients were contacted directly about the change. MNA members from St. Luke's downtown Duluth hospital, Essentia St. Mary's medical centers in downtown Duluth and in Superior, and Essentia Health-Duluth Miller-Dwan building in downtown Duluth are participating in the strike.

"We are fully prepared for the work stoppage," St. Luke's said in a written statement. "Our replacement agency has done a phenomenal job filling our RN needs. Every position we requested has been filled with qualified, licensed nurses who will join our other highly skilled in-patient care team members to continue providing safe, top-quality care."

Chris Rubesch, MNA first vice president and a nurse at Essentia, said one of the top priorities of nurses is to have written protections in their contracts that will allow them to use their professional judgment to refuse an unsafe assignment without fear of discipline, including protecting nursing licenses.

"What we'd like is an employer who's willing to have our backs and to say, 'We understand that you are highly trained, skilled professionals with licenses and we respect your professional judgment,'" Rubesch said. "And we'd like them to codify that in the contract."

Nurses are also asking hospitals to ensure safe staffing levels. Becky Bixby, a nurse at St. Luke's, said hospital conditions are dangerous for both nurses and patients.

"Our staffing levels were poor prior to the pandemic and we raised our concerns to management, where it fell on deaf ears," Bixby said. "Imagine yourself in a hospital bed, waiting too long for pain medication to the point that you are now in tears. Imagine waiting too long for help to go to the bathroom where you end up soiling yourself. Imagine waiting, for days even, to get cleaned up appropriately and have your linens changed. This is not OK."

Essentia said in a statement that they have hired more than 460 new nurses in the last year, but the national nursing shortage means recruiting nurses is a competitive process. There aren't enough human resources to meet the demand.

Another point of the contract negotiations involves wages. MNA nurses are asking for 27% and 24.5% in wage increases over three years at Essentia and St. Luke's, respectively. St. Luke's has countered with a proposal of 10.5% increase over three years, plus increased preceptor pay and student loan repayment. Essentia has countered with a 10% raise over three years, plus an immediate 1% bonus.

According to the health care system's website, St. Luke's average hourly nurse pay exceeds $53, which translates to an average full-time annual nursing salary of just over $110,000. Essentia said base wages for full-time nurses are $74,000 a year. According to Essentia, most MNA nurses work about 30 hours a week and earn an average of $70,000 with full benefits, and senior nurses are making more than $100,000 a year.

When asked about the cost of the temporary nursing contracts to cover for the striking MNA members, St. Luke's did not provide an answer. Essentia did not provide specifics, only saying the health care system is prepared to absorb the short-term cost.

Essentia Health–Moose Lake, which was originally included in plans for the strike, withdrew its strike notice, Essentia Health media relations specialist Tony Matt said.

According to Essentia's bargaining update website, a Sept. 6 meeting saw "important progress" made between MNA and Essentia representatives, although a tentative agreement has not been reached. Moose Lake nurses have been in contract negotiations since 2020, when Essentia bought Mercy Hospital.

Rubesch said the strike at Moose Lake was called off "out of an abundance of caution" because those nurses are still bargaining for their first contract, unlike the rest of the hospitals, which are renewing contracts.

The strike, which also includes MNA nurses from Children's, M Health Fairview, Allina, HealthPartners Methodist and North Memorial hospitals in the Twin Cities, is scheduled to last until 6:59 a.m. Thursday, impacting three days of day, evening and night shifts. Some 15,000 MNA nurses could be walking off the job, making for the largest private-sector nursing strike in U.S. history. Pickets at Twin Ports hospitals will be underway from 7 a.m. to 7 p.m. Monday, Tuesday and Wednesday of this week.

Impacted hospitals have filed unfair labor practice charges with the National Labor Relations Board, claiming the MNA did not take necessary steps in announcing their strike notice. Due to this, the hospitals believe the strike is illegal.

Rubesch said negotiation meetings at Essentia over the weekend lasted for about 10 hours Saturday. He said progress was happening at the meeting, but management walked away while discussing staffing proposals. Essentia said in a statement that they did not believe there was sufficient movement that would lead to an agreement before Monday.

At St. Luke's, Bixby said the negotiation meeting lasted more than 12 hours Saturday, following more than two dozen hours of meetings earlier in the week. She said discussions were productive and moving in the right direction, but management ended the meeting. St. Luke's said MNA had presented an 85-page proposal with several economic demands the health care system did not find sustainable.

"It became clear that further negotiation would not bring parties closer together," St. Luke's said. "We will now focus our efforts on continuing to care for our patients and community."

Both hospitals have repeatedly requested a mediator at the bargaining table, which MNA teams have not agreed to.

Rubesch said the nurses plan to return to work Thursday morning, but are prepared for a lockout if hospitals take that action. Essentia said in a Monday statement they will welcome the nurses back and return to the bargaining table. Future bargaining sessions for Essentia and St. Luke's have not yet been scheduled.

"They don't want to be out here," said Mike Mayou, Duluth City Council representative for District 2, who spent several hours at the picket lines in Duluth. "This is a hard decision, to walk away from a profession that you feel passionately about."

This story was updated at 4 p.m. Sept. 12 with coverage of the news conference and updates about negotiations. It was originally posted at 10:43 a.m. Sept. 12.