Hospice nurses, doctors take on Allina Health over pay, staffing in dueling strikes

More than 60 hospice nurses picketed outside Abbott Northwestern Hospital on Wednesday, Sept. 16, demanding overtime pay and holiday and weekend pay from Allina Health as bargaining talks stretched past the one-year mark. The hospice nurses’ seven-day strike overlapped with 150 unionized doctors’ historic four-day walkout.

Following the walkout, the Doctors Council agreed to a tentative deal with Allina on Sept. 22. The Doctors Council will vote on ratifying the contract before it takes effect.

SEIU Healthcare Minnesota & Iowa, representing the hospice nurses, says its members have been stretched thin providing end-of-life care while being asked to do more work with fewer resources. Phillip Cryan, executive vice president of SEIU Healthcare Minnesota and Iowa, said pay is the remaining item under negotiation.

“These nurses are asked, really they’re required, to work lots and lots of extra hours, and they’re not given additional compensation like they would be if they were treated as hourly workers,” Cryan said. “We’re asking for holiday pay. We’re asking for time and a half or some kind of bonus and incentive for when they’re required to work extra hours.”

Lila Chryst and Susie Smerz described Allina as once a “dream job” for hospice nurses.

Chryst, an in-home hospice case manager, has worked for Allina for 26 years. She can’t recall the last time she worked under 40 hours.

“I don’t mind the salary for the eight hours, but I need to be compensated for the time that we are working beyond that,” Chryst said. “Or they need to find enough nurses to make sure that we only have needs that we can fill in the eight hours and other nurses are meeting those other needs.”

Smerz said hospice workers are required to work overtime due to a staffing shortage.

“Allina wants to blame it on the new Paid Family Medical Leave Act. It’s kind of interesting,” Smerz said. “They want to say we are understaffed because all these people have taken leaves for different injuries or medical needs or family support. That is categorically not true.”

Chryst said Allina hasn’t replaced hospice workers she says left after feeling overworked. Allina did not respond to a detailed list of questions as of this writing.

“A few years ago, we had four case managers, LPNs that worked with us, and now we’re down to two case managers, no LPNs to help us out directly with our teams because we’re sharing LPNs throughout the whole system,” Chryst said. “So our staffing has gone down immensely. They just are not replacing the nurses that are retiring or moving on to other positions because they are burnt out.”

Hospice nurses provide direct patient care in homes, assisting with pain, nausea, anxiety and depression management, according to Chryst and Smerz. But the job’s demands now extend beyond managing medical symptoms. Chryst said the company’s productivity standards are nearly impossible to meet as home visits are spread across the Twin Cities metro area.

“To get a productivity point for the hours that we’re in the car, we have to drive 85 or 88 miles before we are given a productivity point for our travel time with our mileage,” Chryst said. “It can’t be that, say I drove 40 miles to my first visit, that doesn’t count.”

Proposed pay raises have been contentious. Fourteen months before the strike, Allina attempted a market increase but excluded licensed practical nurses, Smerz recalled.

“The LPNs will come up on three years now that they’ve had any wage increase at all,” Smerz said. When the company refused to extend the raise to LPNs, the nurses voted 75% against accepting their own increase in solidarity. “We ended up voting against taking that market increase in solidarity with our two LPNs at a 75% rate,” Smerz said.

Smerz, who worked at Allina for 11 years, said Allina’s proposed disciplinary system isn’t practical for patients relying on hospice nurses on the road.

“I can’t count how many times we walk into a visit thinking we’ll be there for 45 minutes, and three or four hours later we’re still there because we’re managing acute delirium,” Smerz said. “They’re trying to implement a policy that we get disciplinary consequences if we don’t meet our productivity. Which, I kid you not, is so demoralizing, because we don’t care for patients based on how many we see.”

Dr. Saul Singh is a bargaining team member for the SEIU Doctors Council, representing workers at Allina Health’s Mercy Hospital in Coon Rapids and its Unity campus in Fridley. Those doctors unionized in 2023, but negotiations stalled until the tentative agreement was reached last week. During the standoff, Singh said, staffing pressure sometimes meant working through illness.

“I had influenza and almost passed out, and my wife goes to me, ‘You’re going to work?’ I said, ‘Yep, I’m putting on a mask.’ And the reason is we’re staffed tightly. There’s not much wiggle room,” Singh said.

Allina said the company was “disappointed that two SEIU-represented groups have chosen to strike,” adding that normal operations continued despite the walkout.

“Doctors Council SEIU represents about 10% of the physicians credentialed to provide care at Mercy Hospital’s two campuses, and not all SEIU-represented physicians will be on strike,” Allina wrote. “SEIU Healthcare hospice nurses bargaining unit includes approximately 60 nurses who provide care in homes, skilled nursing facilities and assisted living facilities across the greater Twin Cities metro area. The strike does not involve nurses at Allina Health hospitals, primary care clinics, urgent care clinics or specialty clinics.”

The Minnesota Attorney General’s Office is currently reviewing a proposed $26 billion merger between Allina and California-based Sutter Health. Union members fear the merger will compound understaffing and burnout, and they are pressing executives to sign a legally binding Community Benefits Agreement as a condition of the deal moving forward.

For more information on , visit https://www.seiuhealthcaremn.org/.

Clint Combs is a freelance journalist and contributing writer to the Minnesota Spokesman-Recorder. He welcomes reader responses at combs0284@gmail.com.